Movies and TV series can help us understand our emotions and help explain complex, sometimes polarizing, topics.

When we see on-screen characters deal with depression, or hear scripted interactions between clinicians and patients, we may think that’s the right way to approach those situations in real life.

But is the entertainment industry doing more harm than good when depicting depression?

What Hollywood is Getting Right: Fighting Depression and Psychiatric Stigma Through the Years

Portrayals of depression have long been a part of popular entertainment. One of the earliest examples is It’s a Wonderful Life (1946).

The popular holiday classic was selected by Depression Alliance as one of the 13 best movies about depression. Depression Alliance explains:

“Depicted in a series of flashbacks, It’s a Wonderful Life opens at the beginning of the third act. The lead character stands on a bridge, in an incredibly depressive state, suggesting he is about to commit suicide.

Then, his life flashes before him with the help of an angel sent from Heaven. The audience sees just how different everyone’s lives in the film would be if our protagonist never existed.

The film emphasizes the darkness that those suffering feel and how their truths can greatly differ from the actual realities of the situations at hand.”

At the time of the movie’s release, lead actor Jimmy Stewart was only about a year removed from fighting in the Second World War. As he and the country dealt with complex emotions following the war, the depression of Stewart’s character, George Bailey, was depicted as extreme anger and despair.

According to Independent, Stewart was still struggling from the effects of the war during his performance. “As I said those words, I felt the loneliness, the hopelessness of people who had nowhere to turn, and my eyes filled with tears,” said Stewart in 1977. “I broke down sobbing. That was not planned at all.”

Other films and media have addressed depression and the practice of psychiatry as central to their plots.  The 1975 film One Flew over the Cuckoo’s Nest, adaptedfrom Ken Kesey’s 1962 book, comments on overcrowded state institutions when there were few other options for treatment.

“Whether President Kennedy was familiar with either the book or play is unclear, but he pushed through the landmark Community Mental Health Act in 1963, paving the way for the deinstitutionalization of the state hospitals like the one portrayed by Kesey,” according to an article in Psychiatric Times.

Contemporary films have found new and sometimes humorous ways to address depression stigma and normalize conversations on the topic.

The Skeleton Twins (2014) shows how a brother and sister – Milo (Bill Hader) and Maggie (Kristen Whig) – come together and discuss depression openly after each attempts suicide.

It’s Kind of a Funny Story (2010), based on a novel by Ned Vizzini, portrays Craig (Kier Gilchrist) as a depressed teen seeking help at a psychiatric hospital and finding a mentor in another patient, Bobby (Zach Galifianakis). According to The National Alliance on Mental Health (NAMI), the hospital is depicted as “a safe place where people struggling are getting help, and using humor as a relief from the serious conditions that brought them there.”

What Hollywood Gets Wrong: Harmful Depression Stereotypes

We still have a long way to go.

A recent study by the USC Annenberg Inclusion Initiative and the American Foundation for Suicide Prevention found that only 1.7% of film characters “experience a mental health condition.” Characters with depression accounted for only 0.4% of all characters. The lack of characters with depression underrepresents those with this illness; the Inclusion Initiative reports that 21.4% of American adults will have a mood disorder in their lifetime.

Also damaging is that many of the characters who suffered from mental illness were disparaged or portrayed as violent. Almost half the characters (47%) suffering from mental illness in the movies were subject to “name calling, dehumanizing phrases, and stigmatizing behavior.” Almost half (46%) of the characters with mental illness demonstrated signs of violence.

“The erroneous belief that individuals with mental health conditions are largely ‘dangerous’ to society is one that is being reinforced in media depictions,” wrote the authors of the study.

Depression trivialization is also a concern, giving viewers a false impression of the day-to-day impacts of depression.

“TV depression looks fabulous. I’d love to have that kind of depression. And it’s not just TV depression; any mental illness on-screen looks rather thrilling. Either it’s dark and dramatic — unlike day-to-day depression, which is at best super dull — or it’s quirky and fleeting, like a flash sale of Zooey Deschanel’s wardrobe,” writes Amanda Rosenberg in Salon.

What Hollywood Gets Wrong: Inaccurate Depictions of Mental Health Professionals</strong

Concerning stereotypes are not just limited to people suffering from depression. Incorrect and misleading stereotypes of healthcare providers can further harmful myths about mental illness.

Ilan Shrira described three negative depictions of psychiatrists in the movies in Psychology Today:

• “‘Dr. Evil’is refined and cultivated on the outside, but sinister, deranged, and manipulative at heart…
• ‘Dr. Dippy’is the incompetent, ineffective buffoon who can’t shake his own insecurities…
• ‘Dr. Wonderful’is the caring, insightful, dedicated super-therapist, but gets overinvolved with patients and has a chaotic personal life”

These portrayals could misinform viewers on a clinician’s role and lower their confidence when seeking help and treatment. In the case of “Dr. Wonderful” characters like Jennifer Melfi in The Sopranos, or Susan Lowenstein in The Prince of Tides, patients may have unrealistically high expectations of what their doctors can do for them or be given inappropriate depictions of the clinician-patient relationship.

How Hollywood Can Improve Depression Representation

 When presented accurately, depression as part of a character’s story can be both enlightening and entertaining for audiences.

USC Annenberg’s Inclusion Initiative suggests that directors and producers should work with people who either suffer from or treat mental illness to ensure they are accurately portraying the illnesses. This collaboration would help “portray mental health conditions and related experience in a way that represents the illness experience and prevalence, but can serve the viewing public by presenting stories that destigmatize those experiences.”

Further, the Inclusion Initiative recommends that all content creators and storytellers ask themselves the following questions when evaluating use of mental illness in their content:

1. “Is a mental health condition presented as a plot device?”
2. “Is a mental health condition used for humor?”
3. “Is there unnecessary stigma depicted?”
4. “Do portrayals include help-seeking?”
5. “Why am I telling this story and what do I want audiences to take away?”

If answers to these questions further stigmatize mental illness or do not include the benefits of seeking care, creators should restructure their content in ways that better shows the realistic aspects of mental illness.

You can make a difference too. If you see a movie or show with characters that accurately portray depression or other mental illness, encourage people you know to see it.

To learn more about misrepresentations of mental illness in the media, visit: https://genesight.com/blog/patient/fighting-stigma-misrepresentations-of-mental-illness-in-the-media/