HBO’s Six Feet Under was, hands down, one of the greatest television series of all time, and if you want to argue, I will fight you to the death in a cage match and win. Sorry, that’s just the way it is. The show furnishes a lot of material for discussion and thought, to the point that I feel quite comfortable discussing it five years after the finale aired, because we are not done talking about this show. Please be advised that this post contains spoilers, and if you haven’t seen Six Feet Under, you may want to skip this until you have.

Billy Chenowith is introduced to us when Nate is at his girlfriend Brenda’s house and a mostly naked man strolls out, teasing him, allowing the tension to build, and finally confessing that he’s Brenda’s brother. In the scene, viewers are clearly supposed to see something off about Billy; the character has, for example, the stereotypical ‘manic laugh’ designed to suggest that someone is unhinged and about to break out with a case of The Crazy.

Billy has bipolar disorder. Billy, and his mental illness, become a running theme throughout the show. His relationships with other characters are dynamic and complex and we can’t accuse the show of making him one dimensional, but it is worth exploring the kinds of stereotypes presented through Billy’s characterisation.

Here’s what you’d know about bipolar disorder if you’d only learned from Six Feet Under:

It makes you capital C Crazy. It’s not just the ‘manic laugh.’ Most scenes we see with Billy show him with poor self control. He twitches. He blurts things. He fidgets. At the same time, he can be oddly childlike and clingy. The show documents self harm as well as abusive behaviour directed at other people. Now, many people are not aware that bipolar disorder comes in a number of flavours, that people can experience it in a variety of ways, and that everyone is different. If you watch Six Feet Under, you come away with the idea that bipolar disorder is inherently scary and dangerous and that most people are fairly rapid cycling; when Billy is having manic episodes, he is frightening, really frightening, and in depressive episodes, he is a figure of pity. At least the show doesn’t sugarcoat mania by presenting it as bubbly and fun, a trope I see in some settings, I guess.

It makes you an asshole. Billy Chenowith is a lot of things, an asshole is one of them. He’s competitive, he can be downright nasty, he’s good at reading people so he knows exactly how and where to strike. Now, these traits are not caused by mental illness, they are simply other facets of his personality, but the show seems to imply that Billy is this way because of the bipolar disorder; it’s evidently not possible to be mentally ill and an asshole, if you’re an asshole and you’re mentally ill, it must be because of your mental illness.

It makes you ferociously territorial and jealous, to the point that you become dangerous. In the first season, we are reminded again and again that Billy has effectively prevented Brenda from pursuing romantic relationships. During a period of extreme emotional distress, he threatens Nate with a creepily staged death scene and a knife, proceeds to cut off a tattoo with said knife, and then shows up at Brenda’s house to take off her matching tattoo the same way. He stalks Brenda and Nate to Las Vegas, takes pictures of them while having sex, follows Nate around. Violence is an undercurrent with Billy and this is also attributed to his mental illness, not any other aspects of his character.

But, you’re perfectly safe if you take your meds, and people with bipolar disorder should all take their medications. Indeed, I think Brenda says that in the episode where we meet him; ‘he’s ok, as long as he takes his meds,’ a statement I also hear in the real world that infuriates me every time I encounter it. I know a fair number of people with bipolar disorder. Some of them choose to manage it with medications, some do not. This is based on their personal experiences, their preferences, and other things that aren’t my business. This idea that mental illness needs to be controlled and that medications are the best/only way to do that is pervasive, and it’s harmful. (As is the opposite, that mental illness is a result of weak personal will and medications are dangerous and people just need to try harder to control themselves.)

We are reminded at various points during the show that Billy is safe and lovable when he’s on his meds, and mean and scary when he’s not. The show also explores, though, some of the reasons why people choose not to use medication. Billy talks about feeling dead inside, dulled, and useless while he’s on his medications. He struggles to produce art and feels like his creativity is sapped. He’s tired. These are all costs that come with medication and I like that they were discussed pretty honestly, not in the ‘being mentally ill makes you creative!’ way that some shows do (a harmful trope in and of itself), but in a ‘medications do not come without costs and those costs aren’t always things like physical side effects.’

Of course, when it comes to institutionalising Billy, the story is told primarily from the point of view of the people around him, not Billy himself. We should pity Billy and feel sorry for Brenda for having to commit him, and the story doesn’t dig that much further.

I’d argue that Billy is not a very positive depiction for people with bipolar disorder, because there are some serious problems with the way he is presented and with how the show characterises mental illness. But the show did chip away at a few corners to get people to think about how they view mental illness; Billy is not the only mentally ill character on Six Feet Under, and while his is a very troped and dubious presentation, there are also some things about him that ring true and feel real to me, some things that spoke to me as a mentally ill viewer even as I found myself irritated by his characterisation sometimes. In the overall balance, the show gets it right more than it gets it wrong.