How the Teen Dramas Tackled Mental Health

I’ve put off writing this analysis for more than two years.

Mental health is just so heavy.

As someone who has their own mental health issues, did I really feel up to diving deep into its depictions in our teen dramas? Not really. I still don’t.

But it feels like a necessary topic to explore, so I’m finally doing it.

Bear with me.

Perhaps needless to say, but…

TRIGGER WARNING: The content discussed below and depicted in the accompanying videos may be upsetting to some people.

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We begin, as we always do, with “Beverly Hills, 90210.” In its earliest years, the show was very episodic with a lot of one-off storylines before becoming more serialized with season 3 and beyond. Those first two seasons had many “issue of the week” plots, including episode 1.19, “April is the Cruelest Month.”

A pre-“Friends” Matthew Perry played Roger, a West Beverly athlete Brandon (Jason Priestley) is covering for the school paper. Brandon discovers Roger has a much darker private life than one would expect, even getting the impression that the teen was gearing up to kill his father. In actuality, a suicidal Roger was on the verge of killing himself. By the episode’s end, he’s hospitalized for mental health treatment — and never seen or heard from again.

A mental health hospital is also where Emily (Christine Elise) ends up in season 2 after her failed relationship with Brandon sparks a downward spiral that nearly leads to her setting a parade float on fire outside the Walsh home. And that’s also where, in season 5, David (Brian Austin Green) brings his mom Sheila (Caroline Lagerfelt, more than a decade before her role on “Gossip Girl”) after finding her living on the streets of Portland. For the first time, David’s father reveals his mom’s struggles with manic depression and his fear that David himself might be more susceptible to the disease for genetic reasons.

Referring to a season 4 storyline where David acted out while hiding a drug addiction, his father now admitted, “There was a part of me that was actually relieved to find out you were high on crystal meth and not on your own body chemistry.” It didn’t stay that way, however. Following David’s mother’s suicide attempt in season 6, David shows his first signs of depression. The following season, he exhibits manic behavior and, like characters before him, ends up in the hospital. In a season 8 plotline, a seemingly recovered David provides counsel to a suicidal co-worker whose parents reject him for being gay (a storyline I failed to discuss in my look at the evolution of LGBTQ teen drama characters).

Besides David, one of the only other main “Beverly Hills, 90210” characters with a significant mental health issue is Valerie (Tiffani Thiessen). It is Val who helps David in the wake of his mother’s suicide attempt, even though she’s struggling with PTSD triggered by Sheila’s actions. In season 7, as Valerie contemplates jumping from the same cliffside she once took David to for a “gut check,” Brandon convinces her to step back from the literal and metaphorical ledge.

Then and now, I appreciated the seriousness with which David and Valerie’s storylines were handled, and that they were threaded across multiple seasons. They stand in stark contrast to season 6’s Single White Female plot with Kelly (Jennie Garth) and Tara (Paige Moss), where the latter was primarily depicted as some sort of villain. In reality, and as the ending of the storyline made clear, she was actually just a young woman dealing with deep mental health issues and in serious need of professional help. (Ironically, Tara and Kelly — a psychology major — met in rehab, where the latter had much-needed therapy after dealing with a cult and a drug addiction.) The same was true of the Laura (Tracy Middendorf) storylines in season 4 — another character given a villain arc instead of a true mental health arc.

Meanwhile, main characters getting professional help was seen time and again on “Dawson’s Creek.” Andie (Meredith Monroe) is the first, with a season 2 storyline emotionally laying bare the inner struggles both she and her mom are dealing with in the wake of her older brother’s death. Episode 2.20, “Reunited,” doesn’t hold back in showing Andie having a mental breakdown, and she spends the summer getting in-patient treatment. Her mental health comes up again in seasons 3 and 4, though oddly not when her brother Jack (Kerr Smith) has his own struggles in season 5.

But season 5 does showcase Dawson (James Van Der Beek) seeing a therapist for help dealing with grief over his father’s death. It followed Jen (Michelle Williams) seeing a therapist in season 4, which was long overdue considering she first seemed suicidal in season 2 — around the very same time as Andie’s struggles. The show’s final season had a mental health storyline, too, with Audrey (Busy Philipps) struggling with substance abuse and other issues, leading her to rehab. As someone who started therapy as a tween, I like that “Dawson’s Creek” normalized getting counseling. And with Andie, needing medication was normalized, too.

That wasn’t the case on “The O.C.” Like with Tara on “Beverly Hills, 90210,” the Oliver (Taylor Handley) storyline was crafted in such a way that it seemed more about the show introducing some sort of villain than taking a serious look at mental health, even though he and Marissa (Mischa Barton) meet a therapist’s office. A number of episodes later, he has a breakdown while essentially holding Marissa hostage, which is basically what Tara did with Kelly.

I think we can all agree that mental health was a significant issue for Marissa throughout the series, yet never deeply explored. She drinks too much in season 1, has her infamous poolside meltdown in season 2, and deals with PTSD in season 3. While the circumstances of her death were outside of her control, I can’t help but wonder if Marissa would still be alive if she at some point received the help she so desperately needed. Marissa was a tragic character and maybe always destined to be that way. Just when it seemed she was making a healthy choice for her life, fate decided otherwise. But I wouldn’t say the show handled any of this particularly admirably.

At the same time, Ryan (Ben McKenzie) no doubt should’ve been in therapy both before and after Marissa’s death. Even so, I do admire the way the series showcased different expressions of grief between Ryan, Julie (Melinda Clarke), and Summer (Rachel Bilson). Summer is the only one we see get counseling after Marissa’s death, but as brief as the montage is, it’s powerful. And lines like Julie saying “Tell me about her” and Summer saying “I miss my friend” still break my heart.

“One Tree Hill” had one of my most favorite mental health storylines — and a few of my least favorites. When Jimmy (Colin Fickes) returned to our screens in season 3, he was different from the teen we first met in season 1. Isolated, angry, depressed, he was the linchpin of the show’s poignant school shooting episode, which I still believe should be required viewing in every high school.

This is probably going to sound weird, and I am obviously not saying I support or encourage suicide, but I was glad the show depicted Jimmy taking his own life even after Keith (Craig Sheffer) insisted to him that “it gets better.” The reality is, it doesn’t always get better. I’ve long hated that slogan because it feels like a false promise. It doesn’t get better for everyone. That doesn’t mean Jimmy was right to kill himself, but his journey, however upsetting, was one that was worthy of depicting. Not every story has a happy ending, sadly.

In season 7, however, there was a mental health story that I did not find worthy of depicting. Haley (Bethany Joy Lenz) falls into a depression after the death of her mother. That in and of itself is understandable. Grief takes people to low places. My issue then and now is that the storyline felt unearned and emotionally manipulative. We saw so little of Haley’s relationship with her mom, a relationship that was seemingly nonexistent for so many years, that it was hard to buy when the show suddenly wanted viewers to believe they were super-close all along and that’s why Lydia’s (Bess Armstrong) passing was so devastating.

The continuity issues, for me, dulled the impact of what could’ve been a really strong storyline. To this day, I frequently see comments from fans about how moved they were by Lydia’s death and Haley’s depression and I get it. I’m not made of stone. Sad things make people feel. But as I wrote extensively on the original TeenDramaWhore at the time this storyline aired, it felt like cheap storytelling tactics rather than something well-crafted.

Or, as I put it back in 2010: “It was cheap storyline that preyed on our emotions and manipulates you into thinking it’s a good storyline because it makes you cry or it makes you feel sympathy for the characters or because it deals with a real-life problem. But that’s not enough for me. That’s not enough to make this a quality storyline.” A TDW reader called it “emotional blackmail” at the time and I still see it that way.

And while I want to give “One Tree Hill” props for season 5, 6, and 7 storylines in which Haley, Nathan (James Lafferty), and Brooke (Sophia Bush) went to therapy, something else has been rubbing me the wrong way lately. After recently spending a lot of time editing this CordCutting.com article on the show’s “villains,” I felt very uncomfortable upon the realization that Psycho Derek (Matt Barr), Nanny Carrie (Torrey DeVitto), and Katie (Amanda Schull) were depicted as monsters when in reality they had serious, untreated mental health problems. At the same time, though, it felt like a cheap out that after so many episodes of Psycho Derek and Carrie’s villainous behavior, both were given tragic backgrounds, as if that explained their actions. I guess the show wanted it both ways.

Perhaps more disturbing is what happened in season 7 with Alex (Jana Kramer). The character — still relatively new to the show — is driven to commit suicide after a series of events in which she’s largely seen as an antagonist. It culminates in episode 7.11, “You Know I Love You, Don’t You,” showing her in a bathtub with slit wrists and blood spilling out of her arms and into the water. A tragic, realistic plot point? Maybe. But the graphic way in which it was shown still greatly upsets me 13 years later.

Jimmy’s suicide had shock value, too, but in an entirely different way. The scene in which he pulls the trigger felt delicately handled, not exploitative, and not irresponsible to show. This with Alex… wasn’t that. It was far too explicit and gratuitous. And while there is follow-up in the next two episodes, with Alex surviving and getting mental health treatment, it seems completely forgotten as the show goes on.

On “Gossip Girl,” mental health was a part of the series right from the start. In fact, it’s a mental health-related event that sets the pilot in motion: Serena (Blake Lively) returns to New York City from boarding school after learning her brother Eric (Connor Paolo) has attempted suicide. Eric’s struggles figure heavily into the series’ first few episodes. By the fourth season, it’s Serena who is in the Ostroff Center, the same facility where Eric received treatment in the first season, although under vastly different circumstances — indeed, it’s part of a scheme orchestrated by another character, but Serena does get some much-needed therapy.

Other mental health issues also figure into season 1, and are referenced again in season 4, with the revelation that Blair (Leighton Meester) struggles with bulimia and takes Lexapro. However, this isn’t deeply explored in the series, nor does the show spend any significant time examining Blair’s mental state after she suffers a miscarriage in season 5. These were missed opportunities. And don’t get me started on the ways in which the series should’ve tackled mental health with Chuck (Ed Westwick) and Jenny (Taylor Momsen). Or the ways in which the show shamefully normalized an abusive relationship between Chuck and Blair.

Speaking of Chuck, during one of his downward spirals throughout the series, he ends up on the roof of Victrola. Distraught following the apparent death of his father, he seems on the verge of jumping off the building. Blair essentially talks him off the ledge, literally. Is there any real follow-up to this? Nope. Another missed opportunity. Sigh.

We wrap up, as we always do, with “90210.” The “Beverly Hills, 90210” spinoff features Erin Silver (Jessica Stroup) as one of its main teen characters, years after she was born on the original series. Like her half-brother David, she, too, struggles with her mental health. In the first season, a storyline builds to the revelation that Silver has bipolar disorder. The discourse surrounding this plot really bothered me at the time, as viewers and the press drew unfavorable comparisons to Emily on “Beverly Hills, 90210” (something I touched on in my 2009 interview with Elise). It felt like a simplistic way of viewing both characters and dismissing them as “crazy.”

But unlike Emily, Silver was focal point of the show and developed a strong fan base. Understandably, those fans were horrified by a season 3 plotline in which Adrianna (Jessica Lowndes) switched out Silver’s medication, causing her to suffer an emotional breakdown. It was a shocking storyline, one of several for Silver that dealt with her mental health — others included her grief after her mother’s death from cancer and her own cancer-related health issues in seasons 4 and 5. (A scientific study even credited the show for raising awareness about genetic screenings, and for that “90210” should be applauded.)

Another significant mental health-related storyline on the show involved Naomi (AnnaLynne McCord). “90210” was one of the few teen dramas not to romanticize a student-teacher affair but instead carry out a plot in which Naomi was raped by her teacher. The ramifications of this play out in season 3, from Naomi suffering from PTSD to her later taking time to focus on restoring her mental well-being, although that latter aspect twists into a plot where she’s defrauded by a purported spiritual guru. Good start, bad ending.

As you can see, the ways in which the teen dramas dealt with mental health run the gamut. Some characters with psychological issues were portrayed as villains, others as anti-heroes. Some storylines toyed with viewers’ emotions, some rightfully earned our tears. And what I’ve examined above really only scratches the surface; there are many other plots across these shows that had mental health elements, some for better and some for worse.

In 2021, I was struck by this Buzzfeed story titled, “23 Teen Drama Storylines I Saw No Problem With When I Was 15, But Now I Find Super Irresponsible.” Among the things highlighted, some of which involved the teen dramas above, were:

• “A suicide-related storyline for shock value”

• “And along the same lines, unnecessarily graphic sexual assault, self-harm, and suicide attempts”

• “And just in general, mental health storylines only lasting briefly or for drama's sake”

The article, which delved into more than just problematic mental health storylines, concluded, “Now, this isn’t all to say that teen dramas need to always be realistic, or only depict things in healthy ways. But teenagers can be really impressionable, and I do think that teen dramas should be more mindful of some of the things they are glamorizing or normalizing.”

As someone still watching and obviously writing about these shows at age 36, I think the genre should be more mindful when it comes these topics regardless of viewers’ ages. Of course, it’s been many years since these episodes were produced and 2023 is a very different time. Maybe if these shows were made today, such storylines would be handled differently.

The irony is that even as these series dealt with mental health topics and often did so poorly, the shows themselves helped with my mental health. Yes, the teen dramas negatively affected the way I see physical appearances, but on the whole they saved me. These shows were my escape, the characters my friends. It’s scary to think where I might be without them. My mental health — my life in general — is better because these shows, warts and all, existed and still do. For that, I’ll forever be grateful.