Why Hollywood’s Depiction of Mental Illness Matters

Nearly 200 years ago, Lady Carolyn Lamb famously described her lover, the notorious seducer, Lord Byron, as “mad, bad, and dangerous to know.”



But Lady Carolyn was not the first to equate madness with a dangerous, but often erotic, “badness.” And she certainly wouldn’t be the last.

Mental Illness

In fact, for pretty much as long as Hollywood has existed, it’s used mental illness as a favorite plot device. Just as Lady Carolyn did so many years ago, for decades, filmmakers have used mental illness to signify all sorts of things, from evil and danger to seduction and loss of control.

But while these matters might make for blockbuster films and must-see TV, they often have very little to do with the reality of mental health. And that matters, because Hollywood stories shape what we think of mental illnesses, and those who live with them.

How does Hollywood depict Mental Illness?

The Broken Shell

One of the most dangerous aspects of Hollywood’s usual depictions of mental illness is that they suggest that these illnesses are simply impossible to manage.

Films like The Deer Hunter, Coming Home, and The Hurt Locker depict veterans returning from combat with Post-Traumatic Stress Disorder (PTSD) as almost entirely incapable of reintegrating into society. They rarely address the measures that veterans, their families, and the military take to help soldiers live and function with their PTSD or the effectiveness of these treatments.

Mental illness in general, and combat-related PTSD in particular, is most often shown as a state of perpetual brokenness. The sufferer becomes a prisoner of his own mind. There is no escape from the illness. There is little hope for its victims.

Addicted and Irredeemable

Hollywood’s narrative of mental illness as largely unmanageable and of those with mental illness as fundamentally irredeemable usually ties in fairly easily with the drama-packed addiction story.

As helpless sufferers struggle to accept, or at least deal with, their fate, they “naturally” turn to drugs and alcohol to numb their pain. Or they use their addiction to escape the stultifying effects of their illness, as does the clinically depressed and emotionally paralyzed Gretchen in the series, You’re the Worst.

Alcohol abuse is shown most often as an almost logical response to mental illness, a perhaps poor but entirely understandable choice made by those looking for a way to cope. Only a handful of films, such as Leaving Las Vegas, deal with alcoholism as a mental illness in its own right. Unlike most films, which gloss over or ignore the long-term effects of alcohol abuse, Leaving Las Vegas graphically depicts the physical ravages of alcohol dependency, including not only cirrhosis of the liver, but potentially fatal gastrointestinal bleeding and even debilitating seizures.

But, studies show that the darker realities of alcohol use disorder are rarely shown in films, and this can have a particularly dangerous impact on young audiences. Teens and young adults report that alcohol features heavily in many of the films and television series they watch.

Yet these films rarely show, for example, the intense discomfort and significant physical danger of detox. Excessive alcohol consumption, especially if it happens frequently or is sustained over a long period of time, impacts nearly every bodily system. Too much alcohol alters heart rhythms and circulation and literally changes how the brain’s neurotransmitters are produced and absorbed. Over time, both the kidneys and the liver lose their ability to filter the alcohol from the blood, organs, and tissues.

All this makes the detox process long, painful, and potentially very dangerous. These dangers are rarely ever the topics of films, especially those that target college students. Cult classics like Animal House have turned the idea of college students drinking to the point of vomiting, passing out, or simply making fools of themselves into a sort of running joke. Hollywood has essentially trained moviegoers to think of binge drinking as a rite of passage for any college student.

What many of these films don’t show, or at least only in a very limited way, are the mental and physical illnesses that so often begin with college binge drinking, the evolution of the substance use disorders that college binge drinkers may end up battling for the rest of their lives.

Pleasure and Pain

As we’ve already seen, Hollywood’s depictions of mental illness make it seem as though there’s no managing such conditions, and no hope for those affected unless it is to escape into drugs or booze. But that’s not all. Hollywood also often links mental illness with sex, violence, or, more often than not, with both.

Consider slasher films such as Nightmare on Elm Street or Friday the Thirteenth. The killers are more than merciless and sadistic, they’re also mad. And it’s their madness that drives their violence.

Hollywood’s habit of connecting madness with gore isn’t confined just to horror porn, though. Some of the greatest films ever made, from Psycho to Silence of the Lambs, also make this link.

And while they’re at it, they also often play up the whole erotic element as well. Hollywood is especially good at drawing on that age-old image of the seductive mad woman. Fatal Attraction is probably the greatest example of the mentally ill but sexy woman who lures the unwitting and ultimately powerless man into her bed and onward to destruction.

A Cause for Hope

While Hollywood has long been a bad actor in perpetuating stereotypes and misinformation about mental illness, there is some cause for hope. Several examples of more positive, accurate, and thoughtful representations of mental illness have emerged in recent years.

A Beautiful Mind is an Academy Award-winning account of the experience of schizophrenia from the inside. Director Ron Howard based his sensitive portrait on the true story of one of the world’s leading mathematicians who learned to manage his disease and build a happy family and an illustrious career.

The acclaimed series Empire shows an African-American lead character managing his bipolar disorder with care, and, in general, functioning well as a result. The openness about and acceptance of his diagnosis by both his family and his community provides an important model for minority communities, where mental illness is often particularly stigmatized.

And the forthcoming Netflix original All the Bright Places explores the love story of lead characters who are both learning not only to live with mental illness, but also to love, grow, and thrive in the face of it.

The Takeaway

Mental illness does not have to doom those who experience it to a life of pain and suffering. It does not consign their loved ones to endless suffering, sacrifice, worry, and fear. Millions of Americans and their families live happy and fulfilling lives with proper treatment following diagnosis. Unfortunately, if you were judging by Hollywood’s standards, you might never have known that. There is hope, though, that this is changing and that the film and television industry is finally catching on to the reality of what it means to live with mental illness or to love someone who does.

Watch this space for updates in the Entertainment category on Running Wolf’s Rant.

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Staff Writer

Running Wolf's Rant's correspondent who chooses to remain anonymous...

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