Trying to convey such an intimate and interior experience such as mental illness, which is dependent on the mind yet simultaneously blocked and impeded by it when it must be described, has been made even harder throughout history because of an overwhelming stigma.

Intimate portraits of the mind are dependent upon a kind of self-awareness and insight that is difficult to cultivate when life’s basic tasks become impossible and reality itself becomes distorted. Out of this uniquely human need for narratives of madness—even in an era of increasing medical understanding of mental illness—a market has developed in the publishing industry for memoirs of madness that excludes the same people that many corrosive institutions do.

While the well-researched atlas—a personal narrative coupled with extensive inquiry into the historical and scientific context of certain mental illnesses, including notable authors like Andrew Solomon, Kay Redfield Jamison, and David J. Morris—has established itself as the new gold standard in the genre of the psychiatric memoir, less privileged, non-white authors remain at the margins of the publishing and social circles of the canonical memoirists.

Just as it does in comparative literature more broadly, the establishment of a canon, while it is ever-evolving, also enforces pre-existing hierarchies in the world, such as race, class, and gender. The psychiatric memoir is no different. An overwhelming majority of writers are white males who came from backgrounds of thorough economic privilege. These are often the breaks necessary to cut through the crowd in publishing, making the psychiatric memoir no different than many other genres in the barriers many writers face.

There have been, however, non-white memoirists who have made an impact with their work, but not on the same national scale that the canonical white authors have been privy to. Meri Nana-Ama Danquah and Monica A. Coleman have written well-received memoirs on depression and bipolar disorder, respectively. As black women, they have not made the same kind of circuit in book promotion that authors like Solomon have been able to, from TED Talks to Charlie Rose appearances. Coleman’s account was published only in 2016, so it remains to be seen if she can break through the glass ceiling, as it were.

One female of color author that stands out in her status as a public figure is Terrie Williams, who built a public relations empire from the ground up. Representing clients such as Prince, Miles Davis, Janet Jackson, and Eddie Murphy, she had to completely step away from her business after suffering from a severe bout of depression that nearly took her life. Her memoir, Black Pain: It Just Looks Like We’re Not Hurting (2003), became a crucial addition to the genre that addresses issues and stigma facing people of color that white patients do not necessarily have to deal with. However, while she has appeared on networks like NPR and given commencement speeches that involve her memoir, they are more often than not at historically Black colleges and programming geared towards narrower non-white demographics. While Solomon has appeared on Charlie Rose multiple times after publishing Noonday Demon around the same time as Williams’ Black Pain, she has never appeared on the program. While there is nothing remotely wrong with appearing at Howard University and on YouTube channels instead, there is no reason why Williams’ voice on mental illness should not be on the same playing field for promotion as someone as privileged and well-connected as Solomon. Having experienced Black culture in America, Williams is in a more authoritative role to talk about many of the issues Solomon was credited for in Noonday Demon, particularly barriers to treatment in what he calls “indigent communities.”

Williams cites the “normalization” of pain in Black communities as being used as a reason to not get treated for depression, coupled with internalized pain or externalized pain in the form of substance abuse and other forms of lashing out. In interviews across platforms, Williams often says the first reason she decided to write her memoir after a breakdown she experienced at the hand of depression was to combat the stigma surrounding mental illness, particularly in communities of color. Differing from Solomon slightly, Williams posits that having a name for depression is already a way to alleviate some of the pain of the illness because the word itself is so often unspoken.

In an interview with the Connecticut Health Foundation in January of 2013, Williams spoke to the pre-existing literature of psychiatric memoirs and how they addressed communities of color.

“I know there are lots of books out there about mental health, but there are very, very few—if any—that really spoke uniquely to the Black American experience. You know? So that’s why I had to do it,” she said.

On the other end of the spectrum, there are privileged white authors who have not established themselves in the canon, not necessarily because of a lack of quality or even a failure to pay homage to the pioneers, but instead because the genre has moved on and the critical reception didn’t come in the way it was supposed to. The most salient example in this realm is Andy Behrman, who published his controversial memoir Electroboy in 2002. In many ways, Behrman is the heir apparent to Wurtzel, only with electroshock therapy and bipolar disorder instead of Prozac and depression. Like Wurtzel, he is unapologetic in his inclusion of raw details. Like Wurtzel, Behrman seeks to reclaim a form of treatment from an abstracted and misguided public perception in his title, in which he gives himself a nickname that identifies with electroshock therapy. And, finally, like Wurtzel, Behrman is unabashedly self-absorbed and provides hyperbolic and grandiose self-assessments and action scenes, which he admits are enhanced by mania. Yet there is no movie version of Electroboy as there is for Prozac Nation—though, supposedly, it has been optioned for one and there is indeed an Electroboy movie about a Swiss party organizer who suffers from anxiety.

Many reviewers, such as Rick Marin at The New York Times, mocked Behrman for what seemed like the sheer absurdity of his tale, which involves living high on innocent, wild, and later dangerous manic episodes that land him in prison for forging art. Marin mocked Behrman after the lede by saying, “The noonday demon made him do it,” adding that the book’s preface follows the genre as “the required bit of sociopsychology that precedes any memoir of dysfunction.”

While Behrman’s identification as the disease and its treatment may seem like the full Kraepelin manifestation of the chemical approach to mental health, he incorporates a pseudo-Freudian narrative tracing his illness back to his time in college, where an inferiority complex, a mediocre (in his opinion) campus therapist, and a vibrant arts scene that included scores of drugs propelled his mania to unknown heights.

“At the end of August, complete with an updated nose, I left the tranquil suburbs for the frantic pace of college life in placid Middletown, Connecticut. I ended up at Wesleyan because I didn’t get into Harvard, Yale, or Princeton,” Behrman writes. “I was exposed to all types of new stimulants, and I quickly came to crave more and more of them: alcohol, drugs, sex, staying up all night. After a two-month binge in which I had met hundreds of people, went to parties, drank, and experimented with drugs, I lapsed into my first real depression.”

He then becomes enthralled with the campus therapist, Dr. Andrea Logan, who surprisingly has enough time to see him several times a week for four years in a row, now unheard of at campuses with “short-term care” models. Despite the immense privilege of his college experience and the mental health care available to him—while not cutting edge—Behrman argues that “she didn’t have any understanding of what I later learned was my illness.”

For once, it appears that privilege may have worked against a memoirist from entering the forbidden genre. Nonetheless, Behrman’s identification as the disease and as radical treatment has caught fire in the blogosphere, as well as in a strand of celebrity memoirists, like Emma Stone and Kendall Jenner who speak out on having acute anxiety as a debilitating mental illness, though not always consistently. Much of our pop culture today is closer to the Behrman-Wurtzel evolution of the psychiatric memoir than the heirs to Styron or the well-researched atlas cohort.

Jake Lahut can be reached at jlahut@wesleyan.edu and on Twitter @JakeLahut.