December 13, 2017

By Luna Greenstein


“True terror isn’t being scared; it’s having no choice in the matter.” This quote from John Green’s new book, Turtles All the Way Down, is a simple but powerful insight into the book’s major theme: Obsessive Compulsive Disorder (OCD).

In this book, Green takes readers down the spiral of OCD-based fear with his main character, Aza Holmes. Aza lives her life in constant terror that she will contract a bacterial disease. She is aware that her thoughts are irrational and wages a constant interior battle with herself, trying to quiet what she refers to as “intrusives” (intrusive thoughts).

Green is able to depict fear, anxiety and OCD in an accurate way because he, too, experiences OCD: “I couldn’t have written this story if I hadn’t lived with this since I was a little kid,” he stated during his book tour.

It’s his own lived experience that makes the book so palpable and real. As Green brings readers deep into Aza’s mind, the book can be uncomfortable to read. But that’s almost a good thing—because the powerful writing can teach young adults what living with OCD is really like.

OCD is Not a Gift

Turtles All the Way Down is a detective story that shows how true “obsession” can impede detective work. “There’s so many detective stories about obsessive people who are brilliant detectives because of their obsessiveness and my experience with obsessiveness has been more or less the complete opposite,” Green explains in an interview with Time. “I wanted to write a detective story where the plot keeps getting interrupted by this person’s inability to live in the world in the way that she wants to.”

While Aza tries to uncover the mystery of a missing fugitive billionaire, her symptoms keep her inside herself and make her less observant. The book also shows how Aza’s uncontrollable thoughts impact her daily life—from being accused of being selfish by her best friend to not being able to have a “normal” relationship. While many young adult book heroines experience butterflies in their stomachs during a first kiss, Aza experiences panic at the thought of receiving someone else’s bacteria.

Every time she gets too close to her love interest, her intrusives take control: “Billions of people kiss and don’t die just make sure his microbes aren’t going to permanently colonize you come on please stop this he could have campylobacter he could be a non-symptomatic E. coli carrier.”

OCD is Not a Phase

Green also masterfully showcases the power Aza’s obsessive thoughts have over her actions. Towards the end of the book, Aza’s intrusives convince her to eat hand sanitizer. “It’s the only way that’s stupid if it worked alcoholics would be the healthiest people in the world you’re just going to sanitize your hands and your mouth please think about something else stand up.” Moments like this highlight the seriousness of OCD—how it’s not something a person can simply stop or control.

Aza struggles throughout the book and in the end, she isn’t cured—a boy doesn’t save her, a magical quest doesn’t heal her, getting what she wants doesn’t make her symptoms dissolve. That’s not how mental illness works and the point of a book about mental illness shouldn’t be about a person’s ability to rid themselves of it, but their journey to learn how to live with it. And Green captured that reality for Aza.

“We really like stories that involve conquering obstacles and involve victory over adversity. And I love those stories too. It’s just that hasn’t been my story with mental illness, and I didn’t really want it to be Aza’s,” Green explains to Time. “For me, it’s not something I expect to defeat in my life. It’s not like a battle I expect to win. It’s something I expect to live with and still have a fulfilling life.”

Turtles All the Way Down isn’t a light-hearted, fun, young adult novel. It’s a reflection of an author’s life lived with mental illness. Aza clearly doesn’t have it all figured out yet, but like John Green, she will learn to live with her condition. And this book has the potential to inspire others to do the same.


Laura Greenstein is communications coordinator at NAMI.

Submit To The NAMI Blog

We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices.


NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264,
text “helpline” to 62640, or chat online. In a crisis, call or text 988 (24/7).