In any given year, one in four Americans will experience a mental disorder¹. Yet, turning on their televisions, searching for relatable protagonists, what do they find? Insanity as a precursor to violence, an excuse for murderers and rapists. Depression and anxiety as signifiers of weakness rather than symptoms of a disorder. Unless, perhaps, they turn to FX’s new police drama The Bridge, featuring a main character – Detective Sonya Cross (Diane Kruger) – who suffers from Asperger’s syndrome. Or to Homeland, Hannibal or Girls – all television series from the last couple of years, all shows that herald an emergent trend to treat mental illness with maturity and accuracy. These shows feature mental illness prominently, yet they’re more Mad Men than gibbering madmen; anchoring their worlds with strong, multifaceted characters whose mental health conditions represent one aspect of their persona rather than defining them entirely.

Mentally ill characters aren’t an entirely new phenomenon in television. The idea of a detective experiencing severe social difficulties has been around for a long time; whether it’s Tony Shalhoub experiencing obsessive-compulsive disorder in Monk, Vincent D’Onofrio experiencing unexplained psychiatric troubles in Law & Order: Criminal Intent or even Sherlock Holmes himself, who regularly demonstrated autistic tendencies in Arthur Conan Doyle’s original works, even if there was no such word for it at the time. There are numerous examples of this brand of quirky, awkward investigators, a trope that’s always been a mainstay of crime fiction. These detectives combine an aptitude for their work with relatable flaws; you don’t have to be on the spectrum to relate to uncomfortable social interactions.

There is a significant difference between Monk and The Bridge in their depiction of mental health conditions, however. Monk used its titular character’s condition as an opportunity for quirky humour, a hook to differentiate itself from the countless police dramas with which it shared the airways; it was hardly a nuanced, researched presentation of mental illness, but it wasn’t intended to be! Modern television approaches the subject with more care; note how The Bridge avoids picking the low-hanging fruit of writing Sonya as a “savant,” brilliant at deduction but incompetent at conversation. This is not to say that it is entirely successful. I found Kruger’s performance overly showy and lacking the intense inward focus of Asperger’s patients, though I may be biased by my own experiences with autistic individuals. Nonetheless, it’s clear that the show is clearly making an effort to portray her as a real person struggling with a real condition, rather than yet another eccentric (“wacky”) investigator.

This take on mental illness is another lesson learned from The Sopranos, whose shadow still stretches over modern television. Tony Soprano has many imitators: white, wealthy men whose extraordinary talent at their job is only matched by their predilection for booze, women and selfish, immoral decisions. But while Mad Men’s Don Draper, House of Cards’ Frank Underwood and Ray Donovon’s Ray Donovan might share many of Tony’s traits, none of them share his struggles with mental illness: it’s easy to forget how prominent the Jersey crime boss’s struggles with depression and panic attacks were, particularly in the early seasons of the show. The Sopranos didn’t take the issue lightly, either; while later seasons largely sidelined Tony’s therapy, its early seasons demonstrate a well-researched, considered approach to his issues. Alongside mob hits and family troubles, the first season included an entire episode focused primarily on the side effects of mental health medication, as Tony struggled with a waning libido brought on by Prozac. Over a decade later, television writers are still learning from The Sopranos, moving on from the gruff anti-hero archetype to build upon its subtler elements.

It’s somewhat surprising that it’s taken this long for showrunners to follow in The Sopranos footsteps in this area, but aside from occasional outliers (In Treatment), the majority of television over the last decade has either avoided the issue altogether or handled it clumsily. Being a “psycho” has always been a scriptwriter’s crutch to avoid writing actual motivation for characters performing heinous acts (see: any mediocre cop drama), but even shows with good intentions have time and again fumbled on the execution. Dexter is a prime example: its first couple seasons were exciting in the way they placed a genuine sociopath, incapable of true empathy, front-and-centre. Before long, however, Dexter Morgan became less sociopathic and more sympathetic, developing real feelings for the people in his life in stark contrast to his more realistic psychological characterisation in season one.

Comedies seem particularly guilty of mishandling the subject; both Big Bang Theory and Community feature prominent characters with Asperger’s – the shows may be reluctant to specifically identify Sheldon and Abed, respectively, as on the spectrum, but the subtext is clear. Community has noble goals behind its characterisation of Abed, with creator Dan Harmon basing the character on his own social awkwardness, but a weekly comedy with broad humour is not above selling out the character for cheap jokes, particularly in its fourth season, which lacked Harmon’s input as showrunner. It’s not uncommon to see mental illnesses such as these used as easy excuses for uncharacteristic behaviour, the specific details of the character’s disorder fluctuating from episode to episode.

There is a growing vanguard of shows challenging the status quo with a nuanced interpretation of mental illness. Homeland, Hannibal and Girls share The Bridge’s approach to the subject, though each have very different approaches and encounter very different problems. Homeland’s Carrie Mathison’s bipolar disorder is a major component of the show’s continuing narrative; while Clare Danes performance in the role is beyond reproach, the show’s writers don’t always clear the narrative hurdles presented by her illness. Hannibal is renowned for its dark, unreal beauty, but its exaggerated dreamscape conceals a remarkably realistic, if problematic take on mental illness, while Girls is the rare comedy to tackle a significant character’s mental disorder with surprising subtlety and sophistication.

Homeland’s Carrie Mathison has lived with bipolar disorder all her life; it’s a fundamental part of her character. This character trait was a significant factor behind both the high quality of Homeland’s first season and the subsequent problems the show experienced in season two. The first season of Homeland treated Carrie’s disorder with respect. That respect doesn’t prevent the writers from using it as a plot engine of sorts, driving the action in unexpected ways thanks to her erratic decision making. It’s hard to imagine a rational character making the decisions that lead to the show’s high-water-mark, “The Weekend,” where Carrie escapes to a secluded cabin with Nicholas Brody (Damien Lewis), who she suspects of being a terrorist double agent – sleeping with the guy and starting a bar fight while she’s at it. Her condition allows these sorts of exciting leaps in storytelling, and throughout season one this potential is maximised without compromising the core of Carrie’s character.

Carrie’s bipolar disorder also provides a source of tension; throughout the season, she is forced to conceal her disorder from her CIA superiors, aware that her career and her condition are not considered compatible. It’s a careful balance – in season one, Homeland recognises the stigma and challenge that comes with bipolar disorder, while also recognising that the unpredictable, irrational behaviour demonstrated by someone with Carrie’s condition is not suited to such a delicate role. When her secret is revealed in the first season’s penultimate episode, her subsequent dismissal from the CIA does not seem entirely unjustified.

Homeland’s second season had many strengths, but its treatment of mental illness is not one of them. The real and lasting consequences of her condition are swept under the rug. The show’s producers are very aware that Emmy-winning Clare Danes needs to be front and centre, and concerns about her mental state are rarely addressed in preference of getting her involved in the Agency as quickly as possible. This is understandable, if unfortunate (they’re hardly going to confine Carrie to her house for season two), but the writing throws a realistic take on bipolar disorder sufferers under the bus in preference for “thrilling” cliffhangers. Carrie becomes increasingly erratic throughout the season, regularly reduced to bug-eyed hysteria. What was once a well-written consideration of mental illness in a high-stress career has become a narrative crutch for the writers, an opportunity to have characters make bad decisions for the sake of plot development.

One would expect this flaw of Homeland, its increasing over-reliance on mental illness to patch over any holes in characterisation, to be present in Bryan Fuller’s new gothic horror/police procedural series, Hannibal. After all, Hannibal – a tremendous, exquisite show – is adapted from Thomas Harris’s novels (Red Dragon, Silence of the Lambs, Hannibal) and strongly inspired by their film adaptations; this is fiction that can hardly be noted for an authentic take on psychology. Hannibal Lecter (played by Mads Mikkelsen here) is described by showrunner Fuller as “a complete work of fiction. He’s not a psychopath, because he experiences regret, and he’s not a sociopath, because he experiences empathy.”² Not to mention that he exists in a universe where psychology is a kind of superpower, where a few choice words can convince someone to swallow their tongue. It’s also a universe where serial killers who mount their victims in bizarre, extravagant tableaux are apparently a dime-a-dozen.

Nonetheless, the show’s gothic, hyperstylized version of reality has become fertile ground for main character Will Graham (Hugh Dancy)’s gradual descent into mental illness. Graham is fundamentally weird from the get-go, an extraordinarily empathetic individual who just happens to empathise most strongly with serial killers (this is a cliché, granted, but the show makes the most of it). It isn’t until his careful manipulation at the hands of the sinister yet ever so charming Dr Lecter that he becomes truly ill, but the manipulation is not whispered words between prison cells, but a comprehensive and calculated denial of information: Lecter becomes Will’s confidant and abuses his trust comprehensively, hiding his growing problems with perception and time, and eventually even withholding Will’s encephalitis diagnosis from him.

I found it significant that the show portrayed Will’s mental degeneration using a real illness, encephalitis, rather than a nebulous, ill-defined “insanity.” Encephalitis is not technically a “mental” illness, rather severe inflammation of the brain; however, its symptoms – hallucinations, memory problems, issues with perception – allow the show to contemplate how Will’s empathy weighs upon him with real, plausible symptoms, where a weaker show might have resorted to him simply “going mad.”

This show’s interest in mental illness and sympathy for those who suffer from it is particularly evident in “Buffet Froid;” featuring Graham’s diagnosis, the episode also includes a “killer of the week,” a ghoulish, emaciated individual who – in a memorably horrifying scene – lurks under a woman’s bed before emerging to brutally vivisecting her. The killer turns out to be not a faceless monster, but a young girl named Georgia (Ellen Muth) suffering from Cotard delusion, a real mental disorder leading people to believe they are essentially the walking dead. This could all be very silly, but “Buffet Froid” treats the real villain as mental illness, leading to a powerful, haunting reversal of the opening scene: finding Georgia concealed beneath his bed, Graham reaches out to her – “You’re alive.” Instead of a violent confrontation, her story ends with a profound connection between two people, demonstrative of the show’s sympathy for the damaged characters inhabiting its world.

That same sympathy is evident in the final episodes of the season. Without delving into spoiler territory, the symptoms of Will’s encephalitis only worsen, and when shocking accusations are directed his way, the real tragedy is Will’s inability to truly defend against them. His own perception of reality has deteriorated to the point where he is unable to distinguish between his hallucinations (which often revolve around death) and reality. Hannibal demonstrates a powerful desire to ponder the consequences of mental illness, the doubt and despair that it sows. Unfortunately, its noble intentions are seriously compromised by the subject matter; it’s hard to give the show too much credit when the primary symptom of mental illness in this universe appears to be an affinity for murder.

Girls faces no such problems; it’s set in the altogether less violent world of twenty-somethings in New York City. As a comedy, there’s the danger that its presentation of mental illness could degenerate into an opportunity for wacky humour, even though it’s a more grounded show than Big Bang Theory or Community. The show’s recent introduction of a mental illness subplot seemed ill-considered at first, before revealing itself as a simple, yet profoundly effective take on mental health. When main character Hannah (Lena Dunham)’s obsessive-compulsive disorder manifested itself in “It’s Back,” the eighth episode of season two, my initial reaction was trepidation – it felt like a cheap ploy. The development was so abrupt that I half-expected it to become a modern version of a “very special episode.”

But my fears were unfounded – the show’s presentation of Hannah’s OCD (based on Lena Dunham’s real life experiences with the disorder) was an unqualified success. Not only was her disorder subtly foreshadowed³ in season one, its return made perfect sense in hindsight, reflecting Hannah’s anxieties regarding her book contract. What was more impressive, though, was the way the show committed to the reality of an anxiety disorder; there’s a very good reason people with crippling depression or anxiety don’t make good television: they’re withdrawn, isolated, avoiding social situations wherever possible. Television thrives on interaction, conversation and conflict. It’s a bold move to spend an episode with your main character alone, doing little more than jamming a Q-tip in her ear.

Hannah’s isolation ends up being successful as a storytelling tool. Stranding her from the major plotlines lends a powerful resonance to that final scene where her ex-boyfriend, Adam literally breaks through her boundaries, “rescuing” her in a scene that’s either a repudiation of romantic comedy tropes or a sincere embrace of them, depending on who you talk to (I think it falls somewhere in the middle). There’s a recurring thread throughout the last episodes of the season of Hannah looking for help but not really knowing how to do so, meeting rejection or indifference again and again.

It’s easy to read this as an indictment of Hannah’s selfishness, a demonstration of how she’s burned her bridges in so many of her relationships. Her inability to connect with her father over the phone is a great scene because it’s so easy to understand each character’s perspective, and why her father has so little compassion. It’s also a potent portrait of the difficulties people face when they’re mired in mental illness, desperately in need of help but unable to make rational decisions to receive it. Notice how Hannah rejects every effort of her parents to assist in “It’s Back” before her desperate search for support shortly afterwards; whether it’s the doctor treating her Q-tip mishap or her one-time fling. Anyone who has been in the throes of depression/anxiety or knows someone who has can relate to this dichotomy, a powerful desire for help paired with self-destructive impulses.

It’s a little unfair to compare Girls to Hannibal and Homeland, admittedly; Girls may be a comedy, but its primary mode is as character study, giving it plenty of scope to explore Hannah’s condition without having to throw terrorists or serial killers into the mix. While the narrative challenges presented by the medium (and exacerbated by the unforgiving schedule that most television shows operate on) means that these are hardly flawless portrayals of mental illness, the effort to approach the subject with accuracy and insight is an exciting development, one that makes for great entertainment – with the added benefit of breaking down some of the social taboos surrounding mental health. That doesn’t sound crazy to me.