The conversation around mental health and illness has never been stronger, and this is more than likely due to the pandemic. Many people suffered mental health issues during that time, and those with existing mental health illnesses had an exponentially harder time with them. Hollywood, by and large, has largely been unhelpful in depicting accurate portrayals of real mental illness. Turner & Hooch, a comedy with Tom Hanks and a drooling French Mastiff dog, shows OCD as quirky little repetitive habits that can be overcome by the love of a pet. The Shining and Psycho suggest schizophrenia automatically begets extreme violence. Neither of these assessments is true, of course, but assumed stigmas about the illnesses still prevail. But when Hollywood gets it right, when people can turn to film and truly understand the intricacies of mental illness, it can be a very, very powerful tool.
As Good As It Gets (1997): Obsessive-Compulsive Disorder (OCD)
Melvin (Jack Nicholson) is a writer. A cranky, hateful, obsessive-compulsive one at that. His world gets turned around when Carol (Helen Hunt), the restaurant waitress that’s become part of his breakfast routine, isn’t at work one day, leaving him unable to order breakfast. Then, after his neighbor Simon (Greg Kinnear) is beaten and hospitalized, Melvin is asked to care for Simon’s dog. Soon, the three end up together on a road trip to Baltimore to seek out Simon’s parents and develop a deeper understanding and love for one another as a result.
What It Gets Right: Melvin’s OCD symptoms are textbook. Locking the door several times, checking to make sure it’s locked, and turning the lights on and off five times are al common traits of OCD; receiving comfort from the ritual aspect of the repeated actions. He is constantly overwashing his hands with very hot water and a new soap bar every time to evade any bacteria. His frustration at being interrupted is one example of another common trait: becoming anxious whenever a routine is interrupted. People with OCD typically have a “checklist” of how things need to happen, and in which order they need to happen. There is almost nothing worse for those with OCD than throwing a last-minute change to the events of a day since they then have to fit it into the mental list they already made of the expected day’s events.
The Skeleton Twins (2014): Depression
Twins Maggie (Kristen Wiig) and Milo (Bill Hader) are reunited after 10 years of estrangement when Milo is hospitalized after a suicide attempt. (Maggie gets the news just before she was going to try and take her own life.) Together, they confront how their lives went so wrong and are forced to come to grips with their past in order to help one another fix their future.
What It Gets Right: By using the two characters, the many faces of depression are presented unabashedly. Milo is the more “traditional” depressed individual, visibly dejected but forthcoming about his bouts of depression, while Maggie is the face of smiling depression, the one who holds down a job, is “happily” married, and presents herself as content, but reeling internally. The film depicts the seeds of depression and how they present quite accurately as well. There’s an acknowledged biological element to it, something that runs in a family line, but there are also two different triggers depicted in the characters. Milo’s depression is partly incident driven, having been molested by his teacher in high school. Maggie’s depression doesn’t really have a flashpoint, another trait in depression where it floats in and out without rhyme or reason, which results in impulsive, destructive actions. What the film also cleverly weaves in is how people with depression aren’t some sad-sack caricature, like an Eeyore, but capable of laughter, love, and aspirations. They function in society until they can’t anymore.
We Need to Talk About Kevin (2011): Antisocial Personality Disorder
In the present, Eva (Tilda Swinton) has, for some reason, become a social pariah. Flashbacks throughout the film begin to tell the story. Eva puts aside her career when she gives birth to Kevin but struggles to connect with the child. As Kevin (Jasper Newell) grows, his actions become increasingly strange, like using a squirt gun to cover Eva’s bedroom in paint, smiling satisfied in having provoked her anger. Eventually, a teenage Kevin (Ezra Miller) does the unthinkable and perpetrates a school shooting that results in the deaths of a number of students after having killed his sister and father at home.
What It Gets Right: It’s a hot-button topic with the school-shooting aspect, and the film does a great job of showing the development of the disorder, starting with addressing the “nature vs. nurture” debate on the illness. Those with the disorder are “wired differently” than others, leading to callousness, lack of empathy, grandiosity, and entitlement. But the genetic wiring is only half of the disorder – other influences make up the other half. In a nurturing, structured environment with limits, there is a better chance of the disorder not escalating, while an environment that’s too extreme in either direction – authoritative vs. permissive – is more likely to see the disorder become aggressive. Eva does not provide a nurturing environment for Kevin, which contributes, but is not the sole reason, for his horrific act. The one thing the film doesn’t show is how the large majority of those with the disorder are not going to kill and are not dangerous, and in fact tend to be thrill-seekers, perfect for challenges because they are free of the anxiety that would plague most.
Eighth Grade (2018): Anxiety
Kayla (Elsie Fisher) tries desperately to be accepted by her peers in middle school, but her struggles with anxiety and nervousness make it difficult. She obsesses over social media and makes motivational vlogs as a coping mechanism, which only serves to alienate her from her father and, ultimately, from herself. It’s only after coming to terms with who she truly is that she finds strength.
What it Gets Right: Anxiety and panic attacks are a tricky beast to portray on film without coming across as cliché, which Eighth Grade manages to avoid. It’s clear that Kayla feels foolish when her anxiety and panic attacks hit her, like she’s the only one in the world that can’t keep their s**t together. It can be crippling, and anytime you can collect yourself and move on feels like a small victory… but it doesn’t stop it from happening again.
Copycat (1995): Panic Disorder with Agoraphobia
Criminal psychologist Helen Hudson (Sigourney Weaver) is a specialist in serial killers. While testifying at a murder trial, the serial killer being tried kills a police officer in the courtroom before trying to kill her. As a result, Helen becomes agoraphobic. Sometime later, a slew of murders takes place in the city, which Helen realizes is the work of someone who is copying the modus operandi of notorious serial killers in the past. She provides anonymous tips to the police about the crimes but is soon identified, leading her to work with the police on creating a profile of the killer. She is also identified by the killer, who begins stalking her.
What It Gets Right: The need to be in a “safe” place and remain housebound is indicative of agoraphobia, which in this case is complicated by a panic disorder as a result of the attack on her. Her refusal to interact with the outside world is to prevent coming across another potential serial killer. There’s danger everywhere she looks outside, and the panic attacks she suffers almost knock her unconscious, another symptom exhibited by those with the illness.
First Blood (1982): PTSD
Vietnam War veteran John Rambo (Sylvester Stallone) is traveling across the US, looking to contact his comrades from the war, only to discover that most have moved on or have passed away. His travels bring him to Hope, Washington, where the town’s sheriff mocks his looks and labels him a drifter. But when trumped-up charges are laid against him and Rambo is taken into custody, the actions of the sheriff and the officers under him trigger flashbacks to the torture he faced in Vietnam. He escapes, and this one-man army takes on everything that comes his way. The town of Hope will never be the same.
What It Gets Right: First Blood was way ahead of its time in depicting the effects of PTSD on war veterans, which at the time had only just been identified as a formal disorder. The survivor’s guilt, the isolation, the loss of self, and the events that trigger flashbacks and nightmares are very real symptoms of the disorder. Despite focusing on its effects on war vets, the symptoms are typical of anyone stricken with the disorder after traumatic events like rape, car accidents, or, like in Copycat, violent attacks.
Silver Linings Playbook (2012): Bipolar Disorder
Pat (Bradley Cooper), a man diagnosed with bipolar disorder, is discharged from a psychiatric hospital. He was sent there after badly beating a man he found in the shower with his wife. His goal is to reconcile with his now ex-wife, who has moved away and placed a restraining order against him. But he has a new philosophy on life: always look for the good things, the “silver linings,” in every experience. While having dinner at a friend’s house, he meets Tiffany (Jennifer Lawrence), a widow who has a disorder of her own. The two connect, and she promises him she’ll help Pat reconcile with his ex if he will partner with her in an upcoming dance competition. He agrees, and the two grow closer as they practice together.
What It Gets Right: Bipolar disorder is complex, certainly much more than the notion of switching from being extremely manic to extremely depressed, and the film does a great job of expressing many of the disorder’s traits. Manic episodes, extended periods of abnormal, elevated, expansive, or irritable moods, are evidenced by Pat’s vicious attack on his wife’s lover. Without medication, those with bipolar disorder may feel like they have special powers, go without sleep, talk non-stop and act recklessly. Pat refuses to take his medication, and in one scene he stays up to read Ernest Hemingway‘s A Farewell to Arms. Other symptoms – hypomania, mania, depression, and mixed episodes – are also evidenced realistically throughout the film.
Black Swan (2010): OCD, Self Harm, Bulimia, Anorexia, Schizophrenia
Nina’s (Natalie Portman) life is consumed by dance, as are many other ballerinas in her ballet company. Opportunity comes her way when the opening production for the new season is Swan Lake, and the lead role of the Swan Queen is open. The artistic director gives her the part but is honest with Nina: she’s perfect for the White Swan half of the character, but has doubts about her ability to embrace the Black Swan, the sensual side of the character. When a talented new dancer enters the company, Lily (Mila Kunis), it’s clear that she would be perfect for the Black Swan. Driven by the rivalry and the pressure to perfect both sides of the character, Nina rapidly falls into a madness that leads to her destruction.
What It Gets Right: Black Swan, and Portman, in particular, portray the battle with severe psychological illness excellently. The driving need to be perfect feeds her bulimia and anorexia traits, a common instigator for the illnesses. Her moments of self-harm are two-fold: as a means of coping with the stress she’s placed upon herself (common), and as a means of physically transforming into the character (more related to becoming the “perfect” version of the character). And as she progresses further into madness, her grasp on reality wavers, another realistic and plausible symptom of mental illness.
If you or a loved one are struggling with depression, please reach out. There is help.
In the United States, call 988 to access the Suicide & Crisis Lifeline.
In Canada, call 1-866-585-0445 or text WELLNESS to: 686868 for youth, 741741 for adults.
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