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‘That Was When People Started to Worry’- Book Review- A Breath of Fresh Air In Our Era of Empty ‘Mental Health Activism’

Nancy Tucker’s That Was When People Started to Worry is the single most raw and honest depiction of mental illness in literature I have ever read. It’s a breath of fresh air for those frustrated by the empty promises of the bi-monthly mental health awareness discussions, and a vital piece of education for those fortunate enough not to have lived with a mental illness.

The introduction to the book, titled ‘Voice to the Voiceless’ begins: ‘People say mental health isn’t discussed, and that’s why no one understands it properly. That’s bullshit though.’ – from the very start the book pulls no punches – if you’re looking for a rose-tinted view of life with a mental illness, look elsewhere (you won’t have to look very hard). It continues, ‘What’s wrong with contemporary representations of mental health? Well, for starters, they shouldn’t be called “representations of mental health”, because mental health is just the state of the inside of your head. … So what’s wrong with contemporary representations of mental illness? They’re sanitised. They’re superficial. They’re tokenistic. A lot of the time, they’re just inaccurate’.

These words are taken from one of the 70 interviews with mentally ill young women Tucker conducted prior to writing this book – and I cannot tell you how refreshing I found reading that for the first time, feeling those very same frustrations, feeling left behind by the supposed gains of ‘mental health awareness’ campaigning when I’ve been facing stigma from medical professionals, friends and classmates (including those eager to post an inspirational quote World Mental Health Day), and strangers since my mid-teens. From the very first sentence, I knew this wasn’t going to be a book that lied to me about what it’s like to live with a mental illness, I felt understood from the very first line.

Picture credit: Amazon

As previously mentioned, prior to writing That Was When People Started to Worry Tucker conducted interviews with 70 young women living with a variety of mental illnesses, from which she created characters and wrote snapshots from the perspectives of women living with depression, generalised anxiety disorder, borderline personality disorder, self-harm, disordered eating, post-traumatic stress disorder, and bipolar disorder. Each snapshot is followed by a somewhat tongue-in-cheek section highlighting damaging misconceptions about the disorder or issue in question – with biting titles like ‘Not Much Behind It!’: The Ultimate Guide to Attracting Attention for No Good Reason’ (which follows the self-harm chapter) and ‘The Borderline Myth! Everything You Need to Know Before Embarking on Life as a Master Manipulator!’ (which follows the chapter on BPD). Following this Tucker gives reflections on what she learnt from her interviewees about the disorder or issue in question in her own voice, and finally section in a list format titled ‘What I wish I could tell you about my [X]’. 

Tucker’s characters feel real and their expression of emotion and pain is raw – as in the introduction – nothing is held back in the depictions of the lives of these characters, there is no attempt to make them palatable, comforting or anything but authentic. There are characters in the book who are hospitalised and their experiences are not sugar-coated; in the chapter about BPD, our protagonist Maya tells of the ‘cattle-van ambulance’ that took her from hospital to hospital, of the air-locked exits and confiscated belongings – when she gets to her room she thinks ‘Did I commit a crime? I don’t remember committing a crime. Why am I in a cell? I don’t know why I am in a cell’. The details of another book, or a self-righteous but ultimately useless Instagram post, would omit in favour of giving its non-mentally ill readers a more comfortable reading experience and an easier time empathising with mentally ill people, are the focus of this book. Her chapter on bipolar disorder shows a character who has been hospitalised because of a manic episode and explores her mania and the delusions that come with that, and the experience of coming out of that episode. Her chapter on disordered eating chooses to depict a protagonist who suffers from binge eating disorder; it shows her struggle to access treatment, attending an unhelpful appointment with an eating disorder service which brings into sharp focus both trivialisation of BED and underfunding of NHS services. Her chapter on borderline personality disorder is one of the most rough and honest portrayals of the disorder and of what it’s like to have a mental health crisis I have ever seen or read in my life.

In short, Nancy Tucker’s That Was When People Started to Worry is the most raw and authentic depiction of living with mental illness I have ever read. Tucker’s commentary on the failure of ‘mental health awareness’ conversations and campaigns to improve the lives of sufferers is biting and pertinent. I saw myself in some of her characters, my very own private pain staring right back at me in prose in a way I had never experienced before. From the characters whose experiences were vastly different from my own I gained valuable insight into the experiences of others – insight one will not get from much of the online discussion of ‘mental health’. Whether you have experience of mental illness or not, That Was When People Started to Worry is essential reading.

Written by Elliot Mears