Throughout the Heartstopper graphic novel series, the main character, Charlie, suffers from a multitude of mental illnesses. Through the first few books, although it’s not yet explored, he’s seen avoiding food, wearing long sleeves and having low self-esteem levels. He suffered from bullying, an abusive relationship and a strict mother who avoids talking about emotions. It is not, however, until their Paris trip during the third book that Nick, Charlie's boyfriend, notices the signs of Charlie’s eating disorder. Charlie is seen avoiding food more than ever before to the point of fainting. By the end of the third volume Charlie admits to his avoidant eating behaviors and previous self-harming tendencies to Nick. This topic continues to be a major theme throughout the fourth book.
The “Paris Squad” all visit the beach upon their return to England. During this trip, Charlie is hesitant to join his friends in the water because he is afraid to take off his shirt and reveal his scars, although later Nick convinces him to go in the water with the shirt on. He rejects the food although he is later shown eating in Nick’s house, a safe space for him. Nick has now been researching more about eating disorders and once again confronts Charlie, convincing him to tell his parents about his issues with food, which he is unfortunately unable to do. Nick appears increasingly overwhelmed by what he feels is his responsibility to help Charlie. In a conversation with his mom, Nick admits to this burden he has placed on himself, and she tells him that Charlie needs more help than he can give him alone, that Nick will not be able to “fix” Charlie, but he can be there and hold his hand throughout the process. Following directions and advice he found online, Nick approaches Charlie again. Charlie admits that he does not know if he’ll get better or how to ask for help. Together, they agree to write down everything he wants to say to his parents, so he can read it out to them. A time lapse happens while both Nick and Charlie write diary entries of over 6 months' worth of progress. Things get worse before getting better after Charlie goes to a psychiatric hospital. He was diagnosed with anorexia and OCD. After leaving the Hospital he started seeing a therapist at home. He continues to have relapses and bad days but is overall improving.
Alice Oseman is able to portray emotional turmoil through the face expressions and body language of the characters as well as changing the format of the comic frames. For example, breaking frames when a character feels broken and adding a radiating darkness off of a character when they are stuck in their own mind. The visual representation of these emotions creates a realistic depiction what if feels like to experience mental illnesses. It both creates a third person look to the character, while allowing the internal struggles of the characters show without the need of words. The fragmented and distorted frames as well as the darkness are able to portray feelings in a way dialogue and narration could never accomplish; the best example of this being when Nick and Charlie confront Charlie's parents about his issues, as that scene is incredibly emotional while containing no dialogue.
The representation of mental health issues in Volume 4 is messy, just like those issues are in real life. Through Nick, it is shown how mental illnesses affect those around the person who is struggling. He becomes an example of how to help those who need it while understanding that one person can’t single-handedly "fix” another. Charlie is able to get help, despite a myriad of challenges. Charlie is able to improve, despite some moments being much worse than others. His recovery is realistic, it is not linear. Professional help is favored in this storyline, although it is acknowledged that not everyone would benefit from the same type of help. A prevailing message throughout the Volume is the importance of other people, not just romantic partners, for the sake of an individual’s, specifically a teenager’s mental health. This book keeps its intended teen audience in mind and models a healthy non-codependent high school relationship. Even through its objective portrayal of mental illnesses, it has an optimistic perspective that things will become easier and improve with time.
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