The Perks of Being a Wallflower is a coming-of-age epistolary novel written by American novelist Stephen Chbosky set in the suburbs of Pittsburgh in the 1990’s (Wikipedia, 2012). It follows the life of a teenage boy named Charlie. Charlie is a 15 year old boy who is on the verge of beginning his freshman year in high school. He lives with both his parents and his sister in the suburbs of Pittsburgh, Pennsylvania.
One look at Charlie may render him a normal, introverted, and shy boy, but his mind is dancing with intelligence beyond his years and overflowing with creativity in the form of his own unique writing. Contrastingly, mental illness does not discriminate. Although a normal boy on the surface, his brilliance is often met with despair, regression, and pervasive thoughts of hopelessness. Charlie’s past struggles most likely made him more susceptible and prone to developing a mental illness. Since he was a child, Charlie’s “favourite person in the world” would be his aunt.
She was killed in a car accident on his 7th birthday. Charlie witnesses his sister being physically and emotionally abused by her boyfriend, and although he wants to do something about it, she says that she still loves her boyfriend and that it is okay. His best friend committed suicide several months before they were supposed to start high school together, which caused his emotional and physical deterioration. When he begins high school, he becomes friends with Patrick. Patrick was in a secret relationship with a closeted gay student, Brad.
Brad was beaten by his father when he found out. To try to overcompensate, Brad begins tormenting Patrick at school, and that is when Charlie snaps. He fights with Brad and threatens to “blind” him if he hurts Patrick again. Feeling accepted by his new group, he develops feelings for Sam, Patrick’s sister. When the two start to become sexually active, Charlie feels uneasy and has to stop. Repressed memories of his late aunt were beginning to surface in his consciousness. He then remembers that he was molested and sexually abused by his aunt since he was a small child.
After his memories came back to him and “visions” were reported, he was hospitalized. Illustrated Disorder Although the book and film did not directly say what Charlie was diagnosed with, he seems to fit the criteria for Major Depressive Disorder. He experiences being in a depressive mood most of the time, feeling fatigue, feels worthlessness and harbours inappropriate guilt, diminished general interest, seclusion, insomnia, and social anxiety. These feelings have persisted for more than two weeks and impairs his everyday life functions.
His posture and movements are usually slow and slumped, and he has experienced traumatic life events that may trigger the onset factors of depression. Referring to the DSM Multiaxial system for assessment, Major Depressive Disorder falls under Axis I. M. D. D. falls under episodic mental disorders. It represents acute symptoms that need treatment. Axis IV describes relevant life events like stress situations, current/recent/past trauma, death/ loss of a significant other etc. For this particular axis, Charlie has a plethora of past and recent events that may have caused severe stress and trauma in his life.
For example, his sexual abuse by his aunt since he was a child, his aunt’s death when he turned 7 years old, the witnessing of his sister’s abusive relationship, the suicide of his best friend right before high school, and the overall pressure that he is under to act “normal” on an everyday basis. Current Research on Major Depressive Disorder A recent study explored the predictors of first lifetime onset of M. D. D. in young adulthood. Daniel N. Klein and Catherine R. Glenn worked with the participants of the Oregon Adolescent Depression Project, who were between the ages of 17-31.
In a self- report, eight distinct factors were measured in relation to the contributors to Major Depressive Disorder. The questionnaires included measures of subthreshold depressive symptoms (1- rarely to 4- most of the time), suicidal ideation (1- rarely to 4- most of the time) (the pervasive thought of suicide), self-related physical health (1- poor to 4- excellent), self-esteem, major life events, daily hassles, perceived social support, and childhood physical and sexual abuse. History of familial disorders and illnesses was also studied.
Results show that participants that had family members that suffered from mental disorders, substance abuse, and so on were more likely to experience Major Depressive Disorder than those participants who were not subject to these illnesses. Daniel N. Klein and Catherine R. Glenn (2013) concluded that, “in bivariate analyses, we identified six predictors of first onset of MDD in young adulthood: female gender, familial loading of mood disorders, history of childhood sexual abuse, anxiety disorder in childhood/adolescence, poor self-reported physical health, and subthreshold depressive symptoms. ” (p. )
Charlie’s aunt sexually abused him, which may mean that she was once sexually abused by a family member. The fact that Charlie still loved her may be Learned Helplessness, which occurs when a person is repeatedly subjected to aversive stimulus. Eventually, the person will “get used” to the aversive stimulus and behave submissively because they do not think that they have the power to stop it (Cherry, 2011) . Charlie was very young and his aunt was an authority figure that he was supposed to feel safe with. Growing up with the sexual abuse, Charlie did not know any better and must have thought that the molestation was a normal occurrence.
As he grew older, he repressed the memories and it only submerged from his subconscious when he was affected by a traumatic event in his life. Treatment for Charlie’s Major Depressive Disorder Hollon and Sexton (2012) stated that: “Depression is an inherently interpersonal process, yet it is most often treated with medications alone or individual psychotherapy. Although these interventions are often ef?cacious, they are far from a cure, and their effects might well be enhanced by incorporating a more relational perspective” (p. 199).
Individual Psychotherapy, Family Counselling, and Cognitive Therapy (Multi-Systemic) Recent studies show that although medication and introspective therapy work, family therapy may also be a useful adjunct to the above treatments. If Charlie had his family supporting him through his individual/ introspective psychotherapy, instead of just being 1-on-1 with the therapist, maybe he can learn more about himself and how important he is to his family. His treatment may consist of 1-on-1 therapy when he wants it, and when he wants family support, the therapist may ask them to come in, too.
Both of these therapies may result in him learning and growing better as an individual and as a family unit. It will open him up to his depression and make it easier for him to integrate it into his personal schema the more he talks about it. Hollon and Sexton (2012) says that, “therapists bring theoretical models to life for clients through an interpersonal relationship in which they implement the treatment principles and interventions” (p. 207). Being able to discuss his issues and feelings may lead him to be less self-conscious about his disorder.
Removing Charlie from the “Major Depressive Disorder” stigma may make it easier for him to feel “normal” in everyday society. Another form of therapy that may be effective is Cognitive Therapy. “Cognitive therapy is predicated on the notion that it is not just what happens to someone that determines how they feel and what they do about it, but rather the way they interpret that event”(Beck, 2005). This form of therapy may give Charlie a useful set of tools, whether it be physically or emotionally, that he can use when he feels the onset of the episodes of depression.
The combination of these three approaches will give him well-round his therapies and will give him options on which ones he may like to progress with and which ones he did not deem effective. Providing Charlie with options and variety may be effective in him choosing the course of his own road to personal growth and recovery. Medicinal Treatment “There are four major classes of antidepressants. All are generally ef?cacious in the treatment of depression, and choice of medication usually is made on the basis of symptom pro?le and ease of management” (Hollon et al. 2002). At the end of the film, Charlie seems to be doing well after being emitted to the hospital.
He is interacting with his family on a regular basis and still writes to his friends. Medication may not be necessary because the power of the multi-systemic therapies may be enough to better himself, but “The SSRI’s are relatively safe and free from major side effects (other than indigestion and impaired sexual interest/performance) and have largely fuelled the surge in prescriptions in primary practice over the last two decades” (Olfson et al. , 2002).
If he feels, and if the therapists feel that therapy isn’t enough, introducing him to SSRI’s would not be a bad idea. Treatment Conclusion Etiology implies treatment, but treatments do not imply etiology. Since everyone’s case is different, treatments should start of with a framework (standard treatment approaches), but then it should mold and fit with the specific person. Feedback from Charlie would help him help himself and give a better flavour of what treatments he could continue and focus on that would help him achieve a better quality of life.
The multi-systemic approach of Individual Psychotherapy, Family Counselling, and Cognitive Therapy (paired with SSRI’s if need be) would be effective in helping Charlie. Prognosis of Depression While each episode usually responds well to treatment, depression tends to be a constant and continual disorder, and patients do have a tendency to relapse. Recurrences of M. D. D. are common in patients who have been hospitalized for an initial episode, like Charlie, there is a 30- 50% chance that it may happen again within the first 2 years and a 50- 70% chance of recurrence within 5 years (Epstein, 2011).
Although the chances of the reappearance of depressive episodes are high, the likelihood of relapse for those who are going through treatment are much lower than those who are not receiving any help. As more depressive episodes are experienced, and followed by treatment, they tend to become less astringent and frequent (Epstein, 2011). Conclusion Charlie is a regular adolescent boy beginning his first years of high school,which inevitably are the toughest ones.
Teenagers are at a stage in their lives where they do not know who they are yet. They have yet to figure out what they want to be and who they want to surround themselves, but they must also conform within the social norms of society. High school may be an extremely stressful environment to be submerged in everyday. Just by looking at Charlie, you would not know that he suffers from a mental illness. Mental illnesses affect everyone, whether they are poor, rich, white, asian, young, and old. Being able to talk about his
