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It's Dark and Hell Is Hot: Mental Illness in Hip-Hop

Several of Camille's loved ones suffer from mental illnesses, and her own struggle with ADHD has informed her perspective on mental health.

Mental Illness is Often Reflected in Writing

Mental Illness is Often Reflected in Writing

Notes from the Author

  • I am not a therapist, psychologist, psychiatrist, or other mental health professional.
  • The albums listed for each artist are not comprehensive, but are those that - in my opinion - contain the songs that best illustrate the artist's struggle with mental illness.
  • The elephant in the room - Kanye West's 2017 hospitalization for an alleged mental breakdown - will not be covered in this article. While his "rants" may have served as a warning sign, I could not find direct evidence in his music that foretold this outcome.
  • My main source: DSM-5 TM guidebook the essential companion to the Diagnostic and statistical manual of mental disorders, fifth edition. Washington, DC: American Psychiatric Publishing, 2014. Print.

As a child, I was frightened by my cousin who vividly described the monsters he saw. "Don't look or you'll always see them," he warned. His words haunt me still.

Years later, he was institutionalized in a state mental hospital. He was diagnosed with schizophrenia, the same illness that plagued his mother for most of her life. If someone - anyone - had recognized this early cry for help, he may have had a successful mental health intervention prior to the breakdown that necessitated his hospitalization.

He remains hospitalized to this day.

Below are a few cries for help from successful rap artists who have experienced severe mental illness firsthand...

Schizophrenia Diagnosis

Schizophrenia may be diagnosed if two or more of the following symptoms are present for longer than a month:

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Grossly disorganized or catatonic behavior
  • Negative symptoms (i.e. diminished emotional expression)

Source: DSM-5 TM guidebook the essential companion to the Diagnostic and statistical manual of mental disorders, fifth edition. Washington, DC: American Psychiatric Publishing, 2014. Print.

Substance Use Disorder

The DSM-5 includes substance use disorder:

  • "The diagnosis of a substance use disorder is based on a...pattern of behaviors related to use of the substance."
  • A characteristic of these disorders is "an underlying change in brain circuits that...persist beyond detoxification."
  • Substance abuse disorders include Alcohol-Related Disorders, Caffeine-Related Disorders, Cannabis-Related Disorders, Opioid-Related Disorders, and Tobacco-Related Disorders.

Source: DSM-5 TM guidebook the essential companion to the Diagnostic and statisti

The One Who Did Drugs: DMX

Relevant Album: It's Dark and Hell is Hot

What comes to mind when you see the word "Hell"? If you're a Christian, you likely envision fire, brimstone, and endless torment. As an atheist or agnostic, you probably use the word to describe something tough or painful. In short, hell is no walk in the park.

Rapper DMX's 1998 debut album, It's Dark and Hell is Hot, was both a visual and auditory representation of his pain. The album's cover reveals only part of his face. He and his surroundings are tinged in deep red. You cannot see the whites of his eyes.

Aside from the album's title and cover art, songs like "Let Me Fly" hint at his sorrow:

Wit' this Y and you don't know you slow like Baltimore
If you ain't trying to go ya blow
I soak up all the pain and accept it in silence
When I let go it's violence cause the wildest
Leaves the dog barking up the tree for the cat
In the fog but ya'll n*ggas see is the bat
Flapping away but I'm blind like Stevie
N*ggas don't hear me, still trying to see me
Stop being greedy, you heard what I said
Let me flow, let me go or I'm dead

"F*ckin' Wit' D" is even more revelatory:

Is you on a level of a madman whose mind's twisted?
Mad n*ggas dreams caught the last train, mine's missed it
Listed as a manic-depressive with extreme paranoia
Hey dog, I got something for ya
Hear my name, feel my pain
N*ggas wanna steal my fame, but first, feel my reign
Know what it's like to suffer, never have enough of
Shit, starting off hard then only getting rougher!
Tougher, but then came the grease

While DMX hasn't publicly acknowledged his struggles (short of saying he felt himself “moving to a dark place” in 2017), his run-ins with the law and stints in rehab show that maybe he's not OK. His first charges - for animal cruelty and weapons possession - came in the late 90s. He entered rehab for drug addiction in 2002, and again in April 2017. Most recently, he was "charged in a 14-count indictment" for "...concealing millions of dollars in income from the IRS".

Major Depressive Disorder

Major Depressive Disorder may be diagnosed if five or more of the following symptoms are present during the same two-week period:

  • Depressed mood most of the day
  • Diminished interest or pleasure in all or most activities
  • Insomnia or hypersomnia (excessive sleeping)
  • Psychomotor agitation or retardation
  • Fatigue or loss of energy
  • Recurrent thoughts of death
  • Problems concentrating
  • Feelings of worthlessness

Source: DSM-5 TM guidebook the essential companion to the Diagnostic and statistical manual of mental disorders, fifth edition. Washington, DC: American Psychiatric Publishing, 2014. Print.

The One Who Was Depressed: Kid Cudi

Relevant Albums: A Kid Named Cudi; Man on the Moon: The End of Day

Facebook and Twitter are apparently news sources - about 60% of Americans get their news from social media. If you're in this majority, you've probably seen the Twitter "beef" between Kid Cudi and Drake, with Drake coming under fire for criticizing Cudi's struggle with mental illness:

You were the man on the moon/ Now you just go through your phases/ Life of the angry and famous/ Rap like I know I’m the greatest

No one is less surprised than I am that Cudi checked into rehab for help with depression and suicidal urges. Cudi's work has always hinted at his struggles. Take one of my favorite songs, "Pursuit of Happiness," from his 2009 album, Man on the Moon: The End of Day.

Tell me what you know about the night terrors every night
5 A-M cold sweats, waking up to the sky
Tell me what you know about dreams (dreams)
Tell me what you know about night terrors nothin'
You don't really care about the trials of tomorrow
Rather lay awake in the bed full of sorrow

Even the title of the album suggests isolation; who is the man on the moon but a completely lonely being, eternally doomed to watch us from afar? Further, if one is on the "pursuit of happiness," they are presently unhappy. Cudi paints an image of a tortured and misunderstood soul: "Tell me what you know about night terrors nothin'". No one knows how he suffers, even when at rest.

"The Prayer" spells it out even more clearly:

God please help me
I am feeling so alone, wait
I don't need to worry
Cause I know the world'll feel this, n*gga
Blessing in disguise, but
I am not hiding who I am, open your eyes, bro

I'm ready for the funeral, hey-hey
I'm ready for the funeral, hey
I'm ready for the funeral
Hey, I'm ready for it
I'm ready for it
I'm ready for the funeral

"Soundtrack 2 My Life" is another tragic ballad set to a digestible beat:

My heart's an open sore that I hope heals soon
I live in a cocoon opposite of Cancun
Where it is never sunny, the dark side of the moon
So it's more than right, I try to shed some light on a man
Not many people of this planet understand... fam

I've got some issues that nobody can see
And all of these emotions are pouring out of me
I bring them to the light for you
It's only right
This is the soundtrack to my life, the soundtrack to my life

I am happy, that's just the saddest lie


The One Who Almost Died: Lil Wayne

Relevant Albums: Tha Carter After Tha Carter; Free Weezy; The Drought Is Over 2 (The Carter 3 Sessions)

Despite overdosing in 2013, rapper Lil Wayne allegedly continues to abuse lean. One of the primary characteristics of a substance use disorder is that the "individual continues using the substance" despite negative consequences. Lil Wayne's love affair with lean is clear - he even wrote a song called "Me and My Drank" about it. What are the underlying reasons Wayne seeks euphoria in a cup? He hints at them in the song:

I love it when she's near me
I hate when she's away
And Satan'll see the day
That Hell freeze over
Before I let her go
And let one of you bitch n*ggas get her
No, no, no

You don't know how to treat her
You don't know that I need her

Hey, do you know that I need ya?
'Cause baby, right now
It feel like the whole world is against me
Ever since the death of Pimp C

Lil Wayne's "He's Dead" continues to discuss his struggles (note the reference to hell):

We not one and the same;
Casper the Friendly, Tunechi Cobain
Ask how I'm livin'? I can't complain
Like, it's hot in hell, but it never rain
Shit never sweet, him never changed
I'll always be the MF'er Wayne
I been lost conscious, I never regain

Possibly the most explicit song in his repertoire (and on this list), "I Feel Like Dying" makes it clear that Wayne uses drugs to ease his suffering:

Only once the drugs are done
Do I feel like dying, I feel like dying
Only once the drugs are done
Do I feel like dying, I feel like dying

Black Masculinity

While reading an article on Chris Cornell's suicide, it occurred to me that many musical genres are outlets for emotional pain. Listeners of the Blues, Country, Grunge, and Alternative expect they'll hear their favorite musicians spilling their guts. However, Hip-Hop - much like the Black people who perform it - is not known for its emotional openness. This is precisely what makes the vulnerability in these lyrics so striking. Men, especially Black men, are often taught to suppress their emotions. Showing vulnerability is "soft," so they hide. It's no wonder suicide rates among young Black men are rising.


How Can You Help?

While you probably won't be able to reach celebrities with mental health issues, you can support friends and family who may be suffering:

  • Acknowledge their struggles. So often people with mental illnesses are ignored or told to "get over it".
  • Encourage them to seek the assistance of a mental health professional.
  • Offer your ear and your time. Going for a walk together, sharing a meal, or joining them for an activity of their choice can be incredibly helpful.

If your friend or family member begins to talk about suicide OR is depressed and suddenly becomes upbeat and excited, please alert someone close to them (e.g. a romantic partner, parent, etc). If your loved one poses an immediate risk for suicide or threatens to harm someone else, call 911 (or the emergency service in your area).

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2017 Camille Harris