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.
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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.
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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.”
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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.