The Yellow Wallpaper, Hysteria, and the Long Misogyny of Calling Women Crazy

I was sixteen years old, in an AP English class taught by a woman named Mrs. Hammond who had a haircut like an exclamation point and absolutely no patience for the boys in the back row, when I read “The Yellow Wallpaper” for the first time. The story is short, twenty-something pages depending on the edition, and it ends with the narrator on the floor of a locked attic room, having torn the wallpaper down with her bare hands, having seen (or hallucinated) a woman trapped behind it, crawling, while her husband faints in the doorway. I read it in approximately forty minutes. I did not move for another twenty after I finished. Mrs. Hammond noticed, because Mrs. Hammond noticed everything, and she walked over to my desk and said, in the specific quiet voice she used when she did not want to embarrass somebody who was clearly having a moment, “Yeah. The first time hits.”

I think about that classroom moment a lot, especially recently, because the story has been doing the same thing to teenage girls in slightly different versions for a hundred and thirty-three years now and the reason it keeps doing it is, I think, the central uncomfortable fact about being a woman who makes things in a culture that has had a long, complicated, sometimes-medical, sometimes-marital, mostly-just-bored relationship with women who make things. The story is not, as I read it at sixteen, a horror story about a woman going crazy in a yellow room. The story is, as I read it now at thirty-something, an operating manual for women whose intelligence is being managed by people who would rather they be quieter, and an attack document aimed at one specific doctor who managed Charlotte Perkins Gilman’s intelligence so badly that she nearly died of it. Both readings are correct. The second one is the one nobody ever taught me in school.

I want to walk you through what actually happened to Gilman, what she did about it, and what the same cultural mechanism is doing to working creative women in 2026 in slightly more polite but recognizably similar form. The mechanism has not retired. It has updated its vocabulary. It is, statistically, still operational.

What happened to Charlotte

In 1887, Gilman was twenty-six, married, had just had her first baby, and was in the middle of what we would now diagnose as severe postpartum depression. Her husband, who was probably acting out of genuine concern and definitely acting out of the gender norms of his cultural moment, sent her to the office of Dr. Silas Weir Mitchell, the most famous American physician of the era. Mitchell was the inventor of something called “the rest cure,” which was the standard treatment for what was then called “neurasthenia” or “hysteria” in middle-class women.

The rest cure was approximately what it sounds like. Total bed rest. Isolation from family. No reading. No writing. No intellectual stimulation of any kind. A diet heavy in fatty foods and milk, the theory being that you needed to “build up” your nervous system. Daily massages. Absolute submission to the male physician’s authority for a period of weeks or months. The patient was supposed to emerge calmed, gentled, and prepared to return to compliant womanhood. Mitchell published the protocol in multiple books that went through many editions; he was, in 1880s America, a national figure on the order of a contemporary Oprah-with-a-medical-degree. People believed him.

Gilman underwent the cure for approximately one month. By her own later account, the experience nearly broke her mind. She left, against medical advice, with what she called “the dim borderland of utter mental ruin.” Within a few years she had also left her husband (extremely unusual for a middle-class woman in that era), started writing professionally, and started building the career that would eventually produce two hundred-plus books and articles, Herland (the proto-feminist utopian novel), the founding of a major women’s magazine, and the body of work that has kept her name in print for a century.

She wrote “The Yellow Wallpaper” in 1892, five years after the rest cure, and published it in the New England Magazine. She sent a copy to Mitchell. He never publicly responded. Multiple sources (Cynthia Davis’s 2010 biography is the canonical one) document that Mitchell did, in fact, modify some of his treatment protocols in subsequent decades, partly in response to growing critical attention to cases like Gilman’s. He never apologized to her, that I know of. The story did some of the work an apology would have done.

Now: I want you to notice the structural shape of what just happened. A talented young woman experiences a real medical problem. The available medical framework converts the real medical problem into a prescription for compliance. The prescription nearly breaks her. She refuses the prescription. She produces, instead, a body of work that includes a literary attack on the doctor who prescribed it. The work is enduring. The doctor’s reputation, in retrospect, is not.

This is, in microcosm, the playbook for being a creative woman in any era when the available cultural frameworks are pathologizing your ambition. The story is the playbook. Gilman wrote the playbook. The playbook is still load-bearing.

What hysteria actually was (the surprisingly long version)

The diagnostic category “hysteria” has a 2,500-year history, give or take. The Greek word hystera means “uterus.” Hippocratic medicine held that the uterus could physically wander through the female body, producing symptoms wherever it went. The treatment was to encourage the uterus to return to its proper place, often through marriage, pregnancy, or sex. By the late nineteenth century the wandering-uterus theory had been (mostly) abandoned but the diagnostic category had grown into something that could absorb almost any constellation of symptoms in a middle-class woman that did not fit elsewhere.

If you read late-Victorian medical journals carefully, the symptoms that could get a woman diagnosed as hysterical included: anxiety, depression, anger, sexual frustration, intellectual restlessness, having strong political opinions, opposing one’s husband, refusing to have more children, fatigue, headaches, insomnia, “inappropriate” emotional responses, the desire to write, the desire to study, and the desire to leave one’s marriage. Carroll Smith-Rosenberg’s foundational 1985 essay “The Hysterical Woman” made the case clearly: hysteria, in operational terms, was the medicalization of women’s resistance to nineteenth-century gender norms. Women whose symptoms got the hysteria label were almost always women whose lives were straining against the era’s expectations. The diagnosis converted the strain into a private medical problem the woman should fix by becoming more compliant, rather than into a public political problem the society should fix by becoming less constraining.

The diagnostic category “hysteria” was officially retired from the American Psychiatric Association’s diagnostic manual in 1980. The cultural pattern that hysteria was one expression of has, however, not been retired. It has just been distributed across a broader set of diagnostic and cultural mechanisms.

Why I keep returning to this

I keep returning to this because I am, professionally, a working creative woman in 2026 and the pattern Gilman wrote about is recognizable in the working life of every other working creative woman I know. The diagnostic version of it shows up in the substantially higher rates at which female creatives get referred to mental-health interventions for the same constellation of symptoms our male peers are not referred for. Women in creative professions get more anxiety prescriptions, more antidepressant prescriptions, more “have you considered taking a break” comments from editors and clients, more therapeutic referrals than our male peers with comparable symptom profiles. The data on this is unambiguous. The asymmetry is real.

The cultural version of it shows up in the casual vocabulary the industry uses about female creatives versus male ones. The female writer who is intensely focused is “obsessive”; the male writer who is intensely focused is “dedicated to his craft.” The female artist who is angry about her conditions is “difficult”; the male artist who is angry about his conditions is “uncompromising.” The female designer who refuses to compromise on aesthetic standards is “perfectionist”; the male designer who refuses to compromise is “principled.” The asymmetric vocabulary is real, it has been studied (Joan Williams’s 2014 What Works for Women at Work is one of the better data-driven sources), and it has not been substantively corrected. The pattern is operational, in 2026, in roughly every creative industry I have worked in.

This is the part of the working creative life that, when I name it to peers, almost every working woman around me nods at and almost every working man around me looks slightly puzzled by. The puzzlement is itself diagnostic. The pattern is invisible to the people who do not have to navigate it; the pattern is brutally legible to the people who do.

Sylvia, Virginia, Zelda, Anne

Gilman is the most famous case of a creative woman pathologized by the medical-cultural framework of her era, but she is far from the only one. The literary record is depressing on this exact point, and the depression is part of why nobody likes to look at it carefully.

Virginia Woolf was diagnosed at various points across her life with what would now likely be called bipolar disorder. The treatments she received included extensive bed-rest periods comparable to Mitchell’s protocol, prohibitions on writing during depressive episodes, and the threat of institutionalization. Hermione Lee’s biography is the canonical source. Woolf’s own On Being Ill (1925) is a quiet rebellion against the medicalization. She drowned herself in 1941 at fifty-nine. The depression was real; the medical treatment was, by modern standards, almost entirely useless and probably contributed to the deterioration.

Sylvia Plath was hospitalized at McLean for shock therapy in 1953 (the basis for The Bell Jar) and again in the early 1960s. The treatments were the contemporary version of the Gilman framework: physical interventions plus a strong cultural pressure to return to functional womanhood as the success criterion. Her response (writing the Ariel poems in the months before her 1963 suicide, in a sustained creative burst that produced some of the most important poetry in twentieth-century English) is the same response Gilman had: the work was the rebellion. Plath did not survive long enough to make the rebellion sustainable. She was thirty.

Zelda Fitzgerald was diagnosed with schizophrenia in 1930 at thirty (modern clinicians have variously revised the diagnosis) and spent the last 18 years of her life moving between mental hospitals. Her writing was actively suppressed by her husband F. Scott Fitzgerald, who used her diagnosis to justify limiting her access to writing materials. She died in a hospital fire in 1948.

Anne Sexton was diagnosed with what we would now call BPD plus major depression. Her treatment included extensive ECT, which she described in her published correspondence as “the worst thing that has happened to me.” She killed herself in 1974 at forty-five.

The pattern across all four cases is consistent and is the pattern Gilman wrote about. A woman with substantial creative gifts produces work, and produces friction with the cultural arrangements her gifts make her unsuited for. The friction gets medicalized. The medicalization treats the woman as the problem. The treatment fails. The work survives the treatment, often at terrible cost. The cultural memory frames the woman’s late work as the product of her madness rather than as the product of her resistance to the medicalization of her madness. The framing has been intact for a hundred and thirty years.

What the story is actually telling us to do

If you read “The Yellow Wallpaper” carefully (and I would suggest rereading it once a year, the way people reread certain religious texts), the story contains operational instructions. They are not subtle. I am going to list them, because the list is the part most curricula skip in favor of “this story is about Victorian gender roles and isn’t that interesting in a museum-display kind of way.”

Write anyway. The narrator writes the story we are reading in defiance of her husband’s explicit prohibition. The act of writing is the rebellion. The story exists because the prohibition was disobeyed. When the people in your life tell you to stop creating because creating is making you sick, the creating is in fact what is keeping you alive, and the not-creating would be more dangerous.

Name the doctor. Gilman doesn’t say “a doctor”; she says “John, my husband, who is a physician.” The specific naming converts what could be a vague allegory into an indictment of a specific power dynamic. Gilman’s published essays explicitly named Mitchell. If you are being pathologized, name the specific person doing it. The specificity is the protection.

Trust your perception over the diagnosis. The narrator perceives, increasingly, that there is a woman trapped in the wallpaper. By conventional standards she is hallucinating. By the story’s framing she is seeing the truth of her own confinement, projected outward. When the medical framework tells you your perception is unreliable, the medical framework may be the unreliable narrator. Cross-check.

The destruction is the freedom. The story ends with the narrator on the floor, having torn the wallpaper down. The “madness” is the moment she stops complying with the cure. Gilman’s biography mirrors this; she left the rest cure, left the marriage, and the leaving was framed as her “breakdown” by the contemporary culture and as her recovery by everyone who came after. When people around you describe your breaking-out as breaking-down, they are telling you something about themselves, not about you.

These are the instructions. Mrs. Hammond, in 1998 in an Ohio public-school classroom, did not give us the instructions explicitly. She did not need to. The story does the work. The story has been doing the work for a hundred and thirty-three years. The work is not finished.

The closing thing

I am writing this on a Tuesday afternoon in April with my cat Margaux on my desk and my coffee gone cold and my partner texting me about dinner and the specific contemporary version of the medical-cultural framework that produced the rest cure operating, currently, in approximately every workplace and editorial board and family Thanksgiving I have ever sat at. The framework has updated its vocabulary. The framework is using more polite words. The framework is, at the operational level, recognizable to every working creative woman I know.

The piece I am writing is not, in any literal sense, going to dismantle the framework. The piece is, however, the same kind of thing Gilman did. Name the pattern. Name the people inside the pattern. Trust your perception. Refuse the prescription. Write the next thing.

Gilman lived to seventy-five and chose her own death by chloroform in 1935 after a terminal cancer diagnosis. Her suicide note: “When all usefulness is over… it is the simplest of human rights to choose a quick and easy death in place of a slow and horrible one.” The autonomy was the project. The autonomy is, still, the project. The rest of us are continuing it on her behalf.

If you have not read “The Yellow Wallpaper” recently, the full text is at the Library of America and approximately a hundred other places online for free. The story is twenty-something pages. Read it tonight. Mrs. Hammond is, somewhere, still nodding.