The medical advances depicted in Star Trek are nothing less than extraordinary, but solutions have not been found to maladies that millions in our world are struggling with: mental illness. This article examines the few instances where characters are depicted as struggling with mental illnesses, and sadly concludes that Star Trek’s writers completely failed to present us with a future where such illnesses have been eliminated, nor one where mental illness does not carry the stigma it carries today. This is a two-part article, with the second describing my own struggle with mental illness and how I use Star Trek to help.
Star Trek Solves Many Maladies, But Not Mental Illness
By the 24th century, Star Trek depicts a universe where most medical maladies have been solved. Everything from bacterial infections to major viruses have been controlled or eliminated. As Dr. McCoy humorously demonstrated in Star Trek IV, even renal failure can be reversed with a simple pill that will heal even the most damaged of kidneys.
Skin wounds, from the smallest of scrapes to the worst burns, can be healed within a few moments by a dermal regenerator. Even paralyzed individuals, such as Worf in “Ethics,” can receive a new spine and escape a potential life-long disability. Blind individuals can even regain some of their eyesight, Geordi La Forge serving as a fine example. Individuals with less-than-perfect eyesight can have it remedied through the use of Retinax V (assuming one is not allergic).
However, Star Trek depicts a future where not all of our illnesses can be remedied. They are not all as readily apparent as a separated shoulder or chronic disease. Some are impossible for others to see, yet many suffer with them on a daily basis. When David Gerrold and David Goodman conceived of a character who served as an “emotional healer” aboard the Enterprise in Star Trek: The Next Generation, Commander Deanna Troi was born. However, the show’s writers focused more on her empathic abilities and her role as Captain Picard’s emotional consciousness, rather than her duties on the ship as a therapist.
Star Trek: Deep Space Nine’s final season showed us another, Ensign Ezri Dax. The dilemma for the writers with Ezri, who entered the show in its final season after Terry Farrell left the show, was that they had to deal with her joining with a symbiont and the crew, which left little time to flesh out her function aboard DS9: that of a counselor.
Star Trek Continues introduced a ship’s counselor onboard the Enterprise in the 23rd century in the character of Lieutenant Elise McKennah. While not canon, the writers of Continues have introduced the first character in Starfleet who, in “The White Iris,” provides therapy that is instrumental to Kirk overcoming his guilt over his past loves who have died.
The presence of these characters in Star Trek demonstrates that mental illnesses have yet to be conquered in the future we all wish would come sooner. Starfleet doctors do not even seem have medication to prescribe to patients suffering from mental illnesses. Indeed, one character struggling with social anxiety, Lieutenant Reginald Barclay, was ridiculed by fellow crewmates, no matter how talented he was. Mental illness currently has a stigma attached to it, and it is unfortunate that stigma still exists in the 24th century.
Mental Illness in the 21st Century
Depression, anxiety, attention deficit disorder, post-traumatic stress disorder, and other forms of mental illness are said to affect at least 20% of populations in the developed world. In the United States alone, an estimated 44 million of the country’s population of roughly 325 million suffered from some form of mental illness, according to The Economist.
Yet, despite the advancements that have been made in medicinal and therapeutic treatment of mental illness, there remains a stigma attached to the diseases that so many of us, including this author, suffer from. Many of our peers, whether they be family, friends, or co-workers, do not understand what those with mental illness battle on a daily basis. While they would fully understand if we suffered from a physical illness or disease, such as cancer, mental illness is something that many still do not recognize.
As a result of the stigma and general lack of understanding inherent to mental illness, many people who suffer with it end up hiding it from others for fear of being unfairly judged. As I have battled anxiety and depression for more than 15 years, I have often attempted to hide my symptoms from friends and co-workers. If one comes down with the flu or a stomach virus and has to miss a social activity or day of work, everyone seems to understand.
However, because of the stigma associated with mental illness, canceling plans or calling in sick because of a flare-up of one’s symptoms does not feel like a viable reason for staying home. Sufferers can often worry whether our peers are judging us, and perhaps thinking that our reason for missing out on plans or work is somehow less valid. Personally, I have had friends and co-workers question my ability to battle my depression and anxiety if I have to cancel on plans or take a day off. My father even questioned why I needed to see a therapist on a weekly basis, as he had no understanding of mental illness.
Breaking the Stigma
Just as Star Trek raised awareness of the role of women and minorities in the workplace and society in general, we need to raise society’s understanding of mental illness. Much of the stigma about mental illness is a result of ignorance.
While TNG and DS9 put counselors aboard starships and space stations, they seemingly did little to destigmatize mental illness or help their patients. Star Trek provides us with two cases of mental illness: Barclay’s social anxiety and Nog’s post-traumatic stress after losing his leg at the Siege of AR-558.
TNG Supervising/Consulting Producer Bob Justman once said “you can’t turn out a Picasso every week,” and season three’s “Hollow Pursuits” is an example of exactly that.
In the episode, Barclay is depicted as an engineer wrought with nervousness and a lack of confidence. According to Gene Roddenberry, the character of Barclay was created to “[take] a character who is just like the rest of the human race and put him on the bridge.” Due to the fact that he was constantly nervous and on-edge, his work suffered and he drew the ire of his crew mates. Many members of the crew referred to him as “Lieutenant Broccoli,” and Commanders Riker and La Forge sought to have him transferred off the ship after he was the first member of the Enterprise crew to receive an unsatisfactory performance rating.
It was immensely disappointing to see two members of our crew, one of whom was disabled, ridicule and seek to pass an individual suffering from mental illness off to another ship. Thankfully, Captain Picard refused to simply transfer him away and La Forge, who did so at Picard’s behest and with Guinan’s wisdom, encouraged Barclay, which led to an increase in Reg’s confidence and performance and a burgeoning friendship.
Unfortunately, the individual best-suited to assist Barclay with his troubles, Counselor Troi, played a minimal role in destigmatizing Reg’s mental illness to the crew or helping him. Barclay’s means for dealing with his mental illness is the holodeck. This is partly due to Reg’s inability to deal with the real Counselor Troi, whom he was attracted to.
Part of the problem was that the writers did not know how to use Troi properly. Roddenberry had initially envisioned her as the brain of the show. Someone with the intelligence of Spock. The writers, such as Brannon Braga and Naren Shankar, could not understand why a therapist was aboard the Enterprise, especially, according to Braga, when “[the characters] had gone beyond human foibles and no longer succumbed to jealousy or anger.”
After Reg’s use of the holodeck, and in particular the images of Enterprise crew members, was discovered, his illness became holo-addiction. Rather than address the underlying reasons as to why Barclay felt more comfortable in the holodeck than in the real world, he was forced to delete his programs after helping Geordi discover that the Enterprise’s malfunctioning systems were a result of a harmful substance being released onboard.
After he appeared in additional episodes of TNG and made a brief cameo in First Contact, Barclay would also become known for his role on Voyager as part of the Pathfinder Project working to get the lost ship home. In “Pathfinder,” Reg, who was then able to function in the real world much more easily, created a holo-program of Voyager and its crew to build a rapport and refine his ideas for getting them home. When his simulation was discovered, Admiral Paris suspended Reg pending a psychological evaluation and suggested that he had suffered a relapse of his holo-addiction. Despite this, Reg violated orders, and his idea ended up establishing contact with Voyager, where he was praised and viewed as an honorary member of the crew.
While not shown on-screen, it is apparent that Barclay visited Counselor Troi for therapy aboard the Enterprise D. Reg even turned to Troi to discuss his feelings about his new assignment to Starfleet’s Communications Research Center in a VOY episode.
While Reg’s own work with Troi can likely be credited for his anxiety subsiding, the fact that his behavior and symptoms were chalked up to holo-addiction is deeply troubling. Although the concept of holo-addiction is an interesting subject to explore in a future where we can escape from life’s problems thanks to technology, the holodeck was a coping mechanism for Reg, rather than the cause of his symptoms.
Nog underwent an extraordinary character arc over the course of DS9, going from mischievous teenager to the first Ferengi in Starfleet. The character’s finest moment came following “The Siege of AR-558” when Nog lost his leg in the fighting, and struggled emotionally with post-traumatic stress as well as physically trying to adapt to his biosynthetic leg. Like many individuals who suffer from mental illness, Nog refused help from anyone. The culmination of this arc came in the season seven episode “It’s Only a Paper Moon,” which was an episode devoted to Nog’s struggles.
After returning to the station following months of rehabilitation at a starbase, Nog refused to attend a welcome home party the crew was putting on for him. Nog was on medical leave from Starfleet, but he was suffering from phantom limb syndrome. While tricorder scans showed that the nerves in his brain were not trying to communicate with his amputated leg, Nog refused to believe it, using a cane to walk around and complaining about the pain. Further, while the doctors believed that Nog’s pain was psychological, he refused to see Ezri Dax, the counselor on the station. Like Dr. Crusher and Barclay, Dr. Bashir unfortunately goes missing, adding more weight to the idea that medicines to treat mental illness do not exist in the 24th century.
Nog’s only solace came by listening to Vic Fontaine’s rendition of “I’ll Be Seeing You,” which annoys Jake Sisko and forced Nog to sequester himself in a holosuite running Vic’s program. Beyond Nog’s phantom limb syndrome, he experienced flashbacks to the death of friends on AR-558 and losing his leg, both hallmark symptoms of PTSD. When the crew met to discuss Nog living in a holosuite, Ezri gave it her blessing, pointing out that it could be a good thing as Nog’s therapy was not progressing. When Ezri visited Vic in the holosuite to evaluate the situation, the hologram assured her that he had a few tricks up his sleeve to help Nog. The writers deserve credit in this instance. Even today, individuals suffering from mental illness can be reluctant to seek treatment. It sometimes takes those closest to us, like Vic in this episode, to give us the nudge we need.
Trouble shortly ensued when Jake visited his friend with a girl he was seeing and played up Nog’s heroism, which irritated Nog and caused him to lash out by punching Jake. When Ezri paid him another visit, Nog threatened to resign from Starfleet if he was forced to leave the holosuite. Vic took the drastic step of shutting down his program and refusing to reinitialize it, despite Nog’s attempts. This was effective in getting Nog to realize what he was missing in the real world, and Nog confided in Vic that he was holding back from talking in his therapy sessions.
Nog told Vic that when the war began, although he was not happy about it, he was eager for the chance to prove himself to be a good officer and solider. Although he saw a lot of combat and witnessed many people being wounded or killed, Nog thought he was going to be okay. Then he got injured at AR-558 and was suffering from an overwhelming fear of his own mortality caused by the loss of his leg. It was this, apparently, that he could not tell the counselors. After realizing this, Nog ditched his cane, left the holosuite, and returned to limited duty.
Star Trek Failed in Its Depiction of Mental Illness
In these two examples, it is troubling how ineffective Starfleet counselors are. Despite the fact that therapy and psychiatric medication were prolific during the writing of both TNG and DS9, a future was depicted where both appeared to be either unused or ineffective in helping our characters. It is also shocking that, in the instance of Barclay, his use of the holodeck is labeled as holo-addiction, whereas with Nog it is viewed as a therapeutic tool. In a universe that broke down barriers for so many, it is staggering to find that Star Trek does not paint a hopeful future for those suffering from mental illness. TOS inspired millions of minorities into believing they were equal and should not be held back from education and positions of responsibility for the facts of their birth they could not change, but there is no equivalent for those of us suffering from mental illnesses, a fact of birth we also can not change, and no future where our problems have been cured and are simply a thing of the past. Star Trek inspires us to dream and ponder possibilities, and it is unfortunate that viewers coping with mental illness do not have a future free of such maladies to look forward to and strive for.
Should Star Trek: Discovery happen to portray a character with mental illness, I hope the new series will treat it with the compassion and understanding that previous Star Treks lacked.
Read Part Two Here