Homeland and Bipolar Disorder: How TV Characters Are Changing the Way We View Mental Illness

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Convinced that her medication for bipolar disorder clouded her judgment, Homeland’s protagonist began the show’s third season self-medicating with exercise and alternative therapies. And doctors say that decision, along with others Carrie Mathison has made concerning her condition, are influencing the way real patients are approaching the mental illness.
Once a taboo topic, mental illness is an increasingly prominent plot line on television, not just on Homeland but on Girls, where Lena Dunham’s Hannah depicts life with Obsessive Compulsive Disorder (OCD) (when stressed, she organizes everything in a series of eights). The portrayals can be a double-edged sword, however, as they raise awareness of the realities of living with mental illness while frequently focusing on some of the more extreme symptoms and therapies.

(MORE: Inside the National Suicide Hotline: Preventing the Next Tragedy)

On the plus side, say mental health experts, not only are are more characters with mental disorders in starring roles, but their symptoms and treatments are more detailed. “I think [Homeland] does a lot of things that are not only accurate but are commendable. In terms of accuracy, It shows someone with bipolar disorder who has episodes,” says Dr. Vasilis Pozios, a member of the American Psychiatric Association and a forensic psychiatrist and co-founder of the consulting group Broadcast Thought. “Instead of being someone who is [either] happy or sad, which is the lay person’s possible understanding of bipolar disorder, this shows the actual major depressive episodes, the manic episodes and also the psychosis that that can happen with bipolar disorder.”

Mathison experiences a variety of symptoms associated with bipolar disorder, including impulsivity and engaging in risky behaviors, including sexual promiscuity (her character slept with potential terrorist Nicholas Brody and a stranger from a liquor store). “These are things that can happen when someone is manic, in addition to [being] paranoid and having trouble distinguishing reality from a delusion,” says Pozios.

(MORE: Mental Health Researchers Reject Psychiatry’s New Diagnostic ‘Bible’)

What’s encouraging about the portrayals of Carrie or Hannah is that outside of their manic episodes, both characters live arguably well adjusted lives (aside, of course, from the requisite dramatic plot twists). “It’s becoming less rare to have accurate portrayals of mental illness, but one thing that is still exceedingly rare is depictions of heroes with mental illness,” says Pozios. “There are plenty of people who live and work and raise families and have mental illnesses like bipolar disorder. It’s good to show this break in stigma to show people with mental illness are not outcasts or violent, but it also breaks the tropes of portrayals of mental illness in entertainment.”

In an HBO interview discussing the episode that reveals Hannah’s OCD, Dunham has said, “it’s something that I’ve struggled with so I feel as though I am able to shed a certain kind of light on the experience and do something that doesn’t necessarily feel cookie cutter. One of my biggest pet peeves is when people go like, ‘I just love it when my room’s clean; I’m so OCD!’ It’s like, actually no, you’re just a neat person and not a slob animal.”

(MORE Most Common Psychiatric Disorders Share Genetic Roots)

Still, entertainment value can still get in the way of a completely accurate portrayal. Season one of Homeland ends with Carrie receiving electro-convulsive therapy (ECT), and forgetting important details about the case on which she is working. While memory loss can be a side effect of the treatment, Pozios says this consequence was overemphasized. “Any time a real life illness, whether it be a mental illness or otherwise, is portrayed, there are going to be some concessions for story. Sometimes there is give and take and it doesn’t always serve the accuracy of the depiction as well as it does the entertainment value of the story,” he says.

But at least the latest depictions are shifting toward more realistic portrayals and away from those that show the mentally ill as primarily psychotic. Slasher films, like Halloween, in which Michael Myers escapes from a mental hospital to murder teens in his hometown, and thrillers  like Fatal Attraction, with Glenn Close playing a violent and suicidal stalker with borderline personality disorder, perpetuated the bias. Close, who is now the founder of BringChange2Mind, says the character likely added to the stigma of mental illness and if she were to do the film again, she would do it “totally differently.”

Aside from helping those unfamiliar with mental illnesses to have a more realistic and unbiased view of psychiatric disorders, the depictions may help patients struggling with mental illness as well. “Someone with bipolar disorder may identify with a character and say to themselves, ‘if they can get through it, I can get through it.’ They can model that behavior in a positive way,” says Pozios. Normalizing mental illness can de-stigmatize having a disorder and help patients to accept the need for taking medications as well. And as Mathison’s story shows, the experiences of these characters struggling with their symptoms can also make compelling material for television shows and movies. “It’s a win-win for both patients and the entertainment industry alike,” says Pozios.

8 comments
KathleenPottleBrannon
KathleenPottleBrannon

This is a pretty badly written and sometimes factually wrong article (as pointed out in other comments), but as far as it goes, yes, it's a good thing that entertainment media are making the effort to portray serious mentally characters realistically, As for Homeland, though, Carrie Matheson is really beginning to get on my bipolar nerves. She is seemingly never in an emotionally stable or neutral state. Even when she's functioning,  she registers any and every emotion in the extreme, with lots of wild-eyed facial expressions and rushing around, jumping to conclusions. In her interactions with colleagues she reacts so vehemently that it's a wonder anyone puts up with her at all. 

I forgave all this in the first two seasons out of sheer joy to see a smart and sympathetic character with bipolar disorder portrayed sensitively. Then came the ECT. Getting the details and context wrong on a procedure so widely misunderstood and feared already is a major betrayal. (Yes, I have had ECT -- two rounds, about 30 in total.) And now, I'm just hoping Carrie will calm down and at least seem a little normal  -- but I'm losing hope. 

Oddly enough, her character is based on a lead writer's sister who is a well-respected journalist and authority on I forget what -- but the sister had one serious episode of mania, was put on lithium and has been stabilized ever since. So all this Carrieness is just as much a result of the writer's misconceptions and speculations as is every other character in the popular media. What a shame.

candy.clouston
candy.clouston

W/r/t the fourth paragraph, manic episodes are not a part of OCD.

lbarnitz
lbarnitz

First, I hope the person that wrote this story is still a student at Northwestern U. because in just a few paragraphs she contradicts herself at lease 3 times. Also, the author is clearly uninformed about mood disorders (bipolar) and the how the majority of the media portrays individual with mental health disorders.

But I also understand the commercial side of the media. First, It's about money. If you don't sell your media you’re out of business

Sorry but I very much disagree with this story “Homeland and Bipolar Disorder: How TV Characters Are Changing the Way We View Mental Illness.

I think it’s foolish to think thatmental health disorders are being more accepted through mediums such as T.V. Shows, Movies, Video Games, Internet, etc…  

EXAMPLES (

Television:

"Ghost Adventures" - one of the most highly watched Travel Channel programs frequently goes to abandon psychiatric hospitals to reach the spirits (crazy, demonic) spirits that might still haunt the psychiatric hospitals. Not a helpful image.

*”Criminal Minds Episode: S04:” The team investigates a serial killer who is shooting owners of luxury cars on Southern California freeways. Serial killer almost always conjures up the idea of a person with a mental health disorder.

But one of the characters on the show has a mother that has been institutionalized due to her mental health disorder. The show tries to portray the mother in a positive light but often fails. The mother of the son on the show is incredibly fearful that through genetics he will become mentally ill too.

*”CSI: Miami Episode:  S10”: The team pursues a killer who takes the eyes from victims; a new adversary challenges Horatio.

*”FBI: Criminal Pursuit: Episode: Sex, Murder, & Videotape: S 04”: The FBI and police work to find a serial killer when a dozen women are found dead in St. Louis. Serial killer almost always conjures up the image of a person (with a mental health disorder.

* Law & Order: Special Victims Unit”: Just about every episode includes a person with a mood disorder/mental health issue.

One difference in this show is one of the main characters has a mother that is in a long term/mental health facility. Unfortunately, this about the only show that has a story line that includes a compassionate relationship with a person with a mental disorder and a person considered “normal”.

Video Game:

*Batman: Arkham Asylum video game is based on the long-running comic book mythos. In the game's main storyline, Batman's archenemy, the Joker, instigates an elaborate plot to seize control of Arkham Asylum or for the p.c. crowd "Behavioral Health Unit".

Movie:

*"Shutter Island: Leonardo DiCaprio" a drama set in 1954, U.S. Marshal Teddy Daniels is investigating the disappearance of a murderess who escaped from a hospital for the criminally insane and is presumed to be hiding nearby.

News:

*When there is a mass shooting people often assume the person(s) that committed the act had some type mental illness. Unfortunately, in many a cases this is true but not for all cases. 

Internet:

Youtube is filled with short videos of individuals actually having psychotic episodes and other mood disorder episodes right on camera.

This is just a very small listing of different types of medium using mood disorders or mental illness in a very poor and misguided way to sell their product(s).

I say all of this from direct experience. I'm have been diagnosed with Dysthymia (Depression for the rest of my life) General Anxiety Disorder (GAD). I've been hospitalized 3 times in my life. It’s always interesting to see the faces of the hospital maintenance crew that is not familiar with the Behavioral Health Unit come to the unit to fix something. They’re very cautious to stay away from the patients and you can tell their uncomfortable. Maybe they’re looking for our horns and tails.

Visitors mean well but I've also had fellow patients tell me that their family(s) won't visit them because they're in the Behavioral Health Unit.

 In Egypt, all of their mental health facilities are outside of city limits.

Sorry for my rant.

P.S.

When you're off work due to a mental health issue you don't receives: Cards, flowers, etc

ColdAir
ColdAir

Please don't turn Manic-Depression, now BiPolar into something trendy.  Don't let pop culture turn a mental illness into gay marriage.  Trying to make being manic acceptable , or overly common, removes the reality for those who know.  Unless one has experienced a manic break, they have no clue what it's really like.  This topic is not fodder for TV writers, because they will certainly get it wrong.  I'm not writing any bios here, but I've been there since 21 and I'm much older now.  I prefer not to have this world, this generation, interpret what they don't understand, like so much else..  No movie or TV show has ever got it right.  There is no "bipolar moment," it's life long.  Patty Duke called her book "A Brilliant Madness" and that is a part of it.  Don't look to "Silver Linings Playbook" for much reality.

LaurenL
LaurenL

I am 57 years old and have lived most of it in SHAME. Both of my parent's side of the family have mental illness; my own father being one who has lived his whole life as a "rage-aholic." Screaming, yelling, and some sort of physical violence filled my life well into adulthood. A dysfunctional family of 5 girls followed by my brother was created. Two of my sisters actually had themselves sterilized in their twenties due to their fear of having inadequate parenting skills. I showed sign of major depression by the time I reached elementary school but my parents did not believe in psychiatry (they were Catholic so religion did not factor here.)

I managed to attend and graduate from college (not without depressive episodes happening)  then I married the most wonderful man on this planet (the total opposite of my father) and had two wonderful kids. But by the time they reached elementary school when the untimely death of my dear brother occurred, I not only fell into a deep depressive state but was psychotic and paranoid as well. I was in and out of the mental hospital and was drug resistant. I spent 5 days a week on my psychiatrist's couch speechless and trembling in fear. Within 18 grueling months and thousands of dollars later, I had 27 ECT treatments until my poor husband said enough. I lost my job, lost my friends who thought I was unfit to have my children be with theirs, lost my short-term and part of my long term memory, and as well as my dignity and self esteem. Of course my family was nowhere to be seen and actually criticized my poor husband's handling of my care.

But, years later, I am doing great but the cost has been high. I had difficulty maintaining my career, am estranged from my family except from my mother a two of my sisters, and continue with self-doubt even though I have found medication that keeps my depression at bay. But my children are fine, successful young adults who have benefited from being raised in a peaceful, loving, stable and happy household. 

I continue living with my SHAME. Even when I was diagnosed with Stage IIIc breast cancer and was given 18 months to live 5 years ago, I just couldn't bring myself to disclose this information to my medical team who achieved the miracle that I am still alive.  But now I am formally disabled from all the side effects from my cancer treatment. I now have to once again find a new normal for my life but the SHAME, like my shadow, never leaves and give me a break.

DJS
DJS

I think it's great that T.V. shows are depicting mental illness within the light of people with mental illness otherwise

able to lead functional lives, as well as not being violent individuals which unfortunately is  a negative stereotype

which is is not reflective of the actual facts, which is that mentally ill individuals are FAR LESS LIKELY to commit

violent crimes than their non-mentally ill peers. On the other hand, while this is a positive development, the New York

Times recently ran an article regarding Bar Associations in numerous states refusing admission to the Bar if someone

has ever experienced treatment for a mental illness, including states which will not admit someone to the bar

who has been treated for depression or anxiety.Most of the commenters were extremely biased against the mentally ill

and stated that they would not want a mentally ill person representing them.Ironically ,several lawyers responded that they

have diagnosed mental illnesses, I know someone who suffered an episode of depression which forced him to take a leave of absence form Law school. He was treated, graduated, admitted to the bar and is now a senior attorney at Google! His illness

has obviously  not interfered with his ability to practice law.Unfortunately, prejudice and stigma against the mentally ill

remain rampant. The portrayal of mental illness as described in this article might help to chip away at the stigma

of mental illness, which would be great. Many people I know who are being treated for mental illness. are highly functional

individuals who are often professionals.