Simply by nature of Aza's mental illness, she's extremely interested in making order out of the chaotic situations in which she finds herself. Often, the novel examines the idea of "order" through circular or spiral patterns: not only is Aza's name a circle of sorts (her name goes from the beginning of the alphabet to the end, then back again), but she often describes her intrusive thoughts as "thought spirals" that leave her with little control over her thoughts or actions. In this way, Aza's word choice illustrates her attempt to make meaning and order out of what feels like chaos. Aza's mental illness in particular complicates her quest for creating order our of chaos, as she often becomes a prisoner of her own spiraling need—and failure—to find a sense of control over her thoughts and her body.
When readers meet Aza, she's reasonably functional: she's able to eat, drive, go to school, and respond to Daisy's questions. However, as she begins seeing Davis romantically and refuses to take her medication regularly, Aza slowly begins to spiral in on herself until she has spiraled so tightly, she nearly fractures into two people. In that fractured state, she's not in control of herself anymore—rather, her "inner demon" is in control, and she's at the mercy of its whims. It's important to note that Aza's relationship to medication is one that's grounded in her fear of something else controlling her. In this case she's afraid of the medicine controlling her, just as she fears that bacteria are controlling her. Aza is so intent on figuring out if she's actually the one in control, she refuses to do the one thing that could offer her some degree of relief and a degree of control over her destructive thought spirals: taking her medication. After her mental breakdown in the hospital, Aza is able to “loosen” her spiral, becoming less anxious, controlling her intrusive thoughts, and involving more people in her life than just herself and her paranoid brain. When Aza isn't so caught up in her own spirals of thought, she's able to connect more with Mom and Daisy, and in doing so she becomes a better and more engaged friend. By changing her medication and making an effort to take it every day, she's also able to obtain a degree of control over her own thought spirals and experience fewer of them.
The idea of circling also encompasses the cyclical nature of mental illness like the OCD that Aza experiences. OCD isn't something that Aza will ever fully recover from, and the novel makes this very clear: she'll never fully get "better." Aza can only slow down the spirals by taking her medication, staying in therapy, and using breathing exercises. However, intense bouts of OCD return to Aza in adulthood: in the final chapter, readers learn that the novel is written by Aza sharing the story of how she got to the point where she is in the present. At that point in her life, she has been hospitalized for her mental illness two more times. This serves as a final reminder that, for Aza, life is made up of circles, spirals, and the time in between. Although the chaotic spirals themselves are inescapable and at times terrifying, the very act of naming them and describing her experience allows her to create order out of chaos, giving her a sense of safety and control in her life.
Chaos vs. Order and Control ThemeTracker
Chaos vs. Order and Control Quotes in Turtles All the Way Down
I have these thoughts that Dr. Karen Singh calls "intrusives," but the first time she said it, I heard "invasives," which I like better, because, like invasive weeds, these thoughts seem to arrive at my biosphere from some faraway land, and then they spread out of control.
... now I was talking about parasite-infected bird feces, which was more or less the opposite of romance, but I couldn't stop myself, because I wanted him to understand that I felt like the fish, like my whole story was written by someone else.
When my thoughts spiraled, I was in the spiral, and of it. And I wanted to tell him that the idea of being in a feeling gave language to something I couldn't describe before, created a form for it, but I couldn't figure out how to say any of that out loud.
Him: When you're on a Ferris wheel all anyone ever talks about is being on the Ferris wheel and the view from the Ferris wheel and whether the Ferris wheel is scary and how many more times it will go around. Dating is like that. Nobody who's doing it ever talks about anything else.
As I looked at his face looking at mine, I realized the light that made him visible to me came mostly from a cycle: Our screens were lighting each of us with light from the other's bedroom. I could only see him because he could see me.
It was saying that my bacteria were affecting my thinking--maybe not directly, but through the information they told my gut to send to my brain. Maybe you're not even thinking this thought. Maybe your thinking's infected.
I would always be like this, always have this within me. There was no beating it. I would never slay the dragon, because the dragon was also me. My self and the disease were knotted together for life.
... I realized something Davis must have already known: Spirals grow infinitely small the farther you follow them inward, but they also grow infinitely large the farther you follow them out.
I know that girl would go on, that she would grow up, have children and love them, that despite loving them she would get too sick to care for them, be hospitalized, get better, and then get sick again. I know a shrink would say, Write it down, how you got here.
So you would, and in writing it down you realize, love is not a tragedy or a failure, but a gift.