Turtles All the Way Down: A Painstakingly Accurate Portrayal of Mental Illness

“Writing is a socially acceptable form of getting naked in public.”


I have not written a book review since I was forced to several years ago in college. This is my forewarning and apology for any sloppiness that may follow. Also, in case you didn’t realize, there will be SPOILERS.

Firstly, it is of great importance I say this: Thank you, John Green. Thank you for this gift. Thank you for your honesty, vulnerability, and meticulous writing that reveals every aspect of life with a mental illness. Now that that is out of the way, I will write some of my more in-depth, well thought out opinions (and probably share some difficult things from my own life, too).

Turtles All the Way Down is a well-executed and all-encompassing portrayal of what life is like when you live each day with a mental illness. Green writes with precision about every detail, every corner, that mental health is present in (here’s a hint: it is in every corner possible).

Green’s writing on mental health is cathartic for those reading and, hopefully, for him, too. The intricacies of a heart, mind, and soul living with a mental illness are cut out and served to the reader on a rusty platter: it isn’t pretty, but it is handled masterfully.

The initial brilliance of the novel is found here, in the raw, emotional honesty of Green’s own experiences depicted through the protagonist, Aza Holmes. While Green has openly stated that Aza’s specific tendencies and obsessive thought patterns differ from his own, it is still clear that the accuracy and depth of his writing comes from personal knowledge. After all, Aza herself says one cannot truly know another’s pain, therefore this accuracy must come from within.

As someone who lives every day with anxiety and depression, it was a relief and a struggle to read a profoundly relatable story like Turtles All the Way Down. In fact, I found myself bawling my eyes out through a majority of the book simply because it all felt too real–I could feel Ava’s spirals in my bones, my blood boiled, and Green’s words transcended the fact that he and I have never met–I understood. I, too, felt myself being enclosed by Aza’s thought spirals. I felt her desperation beating in my chest and stomach as she swallowed the hand sanitizer. This is where Green’s strength in writing shines.

While I do not suffer from OCD, my anxiety disorder does present obsessive compulsive behaviors that I must manage when things get particularly out of control. For example, I have a scab on my forearm. It has been there for two months, because whenever I get socially anxious, my fingernails desperately dig into my swollen skin to once again remove it. In short, I understand the need to do something as a result of panic from a particular thought that leads to another and another and another and…

Here is one prominent way this novel stands out: it details all aspects of life while living with a mental illness. While other books tend to be singularly focused, we get an insight into all parts of Aza’s life. Each page details the profound existential struggle of a teenager trying to grasp at straws to manage her life and her illness.

The reader gets a beautiful yet a merciless picture of the tug-of-war between rational thought and illness influenced thought. We see her friendships (specifically with Daisy, a friendship I could write a separate blog post about), her relationship with her mother, her dating, her school life, her attempt to navigate any and all social waters, and her relationship with herself. There is not a space that is left untouched.

Green is thorough, but these in-depth depictions are captivating and transport the reader right into Ava’s shoes, or rather, her mind. Every thought spiral winds its way around the reader’s neck and suffocates them alongside Aza. His unprecedented writing capability allows for an exhaustive but interesting look into mental illness. And this, I would argue, is significant for those who are unfamiliar with mental illness as it will allow them to be engulfed by a genuinely great story.

However, just as important as Green’s authentic portrayal of mental health is his continued ability to write phenomenal female characters. He writes female characters that are complex, multi-layered, and acutely aware of themselves in all capacities. They transcend the oversimplified call for more “strong female characters” as they showcase the many polarizing dualities of a real human existence.

Aza Holmes is presented to us as weak but strong. She is fiercely loyal to her friends, but also aware of her own limits. She says no because she knows she needs to, but also caves in because she wants to make those she loves happy. She wants to get better, but is also committed to the idea she can’t.

These are just a few of the ways she represents reality, both just as a person and as a person living with a severe mental illness.

I consistently cried during the majority of the book. I cried because my social anxiety sends me down similar thought spirals, even though the subject and content are different, they are just as real. My last awful thought spiral occurred a couple weeks ago as two bad events collided at once: some friends decided I was not their friend anymore and I accidentally hurt another friend’s feelings. See, my own spirals tend to come from a shred of truth and then I extrapolate it out into the worst extreme. I remember being so panicked, body shaking, not able to sleep or eat, and lost in the spiral of not being worthy of people’s love or friendship.

I got out eventually, because Green and Daisy are right: it does get better. But sometimes it takes a long time to get better and that’s okay. And sometimes it is only better for awhile and it gets bad again: that is also okay.

But on that note, don’t be fooled, this novel is not about conquering a mental illness. Everyone wants to hear the story that the depression finally went away, but so far I have not lived a single day of my life where it wasn’t at least lingering in the distance. Aza’s story is far greater than merely defeating something, she learns to cope. I believe that coping will always be stronger than defeating. Coping, surviving, and living a fulfilling life despite this thing, this thing always there to some degree, that is the real victory.

I still have a long way to go on my own mental health journey. In fact, it will never end and I will always have more to learn. Aza’s story ripped my heart out, but also filled my heart with a feeling I haven’t found a word for. She made me feel less alone. And her story is one I need everyone to read, for the sake of myself and for the sake of the large community of those with mental illnesses.

There is no doubt in my mind that as society moves forward in educating people about mental health and mental illnesses, this novel will become required reading. This novel breaks the barriers between “young adult” fiction and the category of fiction at large. The weighty existential questions, situations, and artful handling of a topic as convoluted of mental illness (and a mind suffering from one) will bring this book into high school and college classrooms alike.

Those who live with a mental illness will see their thoughts on the page (at least to some degree). And those who do not live with a mental illness will be given a comprehensive yet enjoyable lesson. Every reader will benefit from diving into this book.

My final thought for this is a message for John, maybe one he has never heard before, but one that has saved me on multiple ocassions. My therapist once said: “You are not your thoughts, you are the awareness of your thoughts.”

I hope that helps, John.





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