10 Things Movies And TV Get Wrong About Mental Health

Hollywood loves mental disorders, which provide plenty of material for intriguing or outlandish character traits. Unfortunately, Hollywood doesn’t love depicting mental disorders accurately, since that seldom makes for an interesting or uplifting movie. Instead, Hollywood disorders usually draw from a loose collection of stereotypes, creating an inaccurate popular perception of many harrowing mental problems.

10The Difference Between OCD And OCPD

Obsessive compulsive disorder (OCD) has firmly cemented its place in popular culture thanks to the hit TV show Monk. The lead character, Adrian Monk, is a brilliant detective whose OCD spirals out of control following the tragic loss of his wife. As a result, Monk goes to extreme lengths to make everything in his life perfect. Not a single button out of place or hair where it shouldn’t be escapes his attention, usually resulting in some sort of humorous escapade. It’s exactly the sort of behavior that people associate with the disorder, leading to the usual casual jokes about how “OCD” people are because they keep their house tidy or don’t like the peas and carrots to touch on their plate.

But in reality, people are usually confusing two very distinct disorders. Obsessive compulsive personality disorder (OCPD) is characterized by an extreme need for neatness, along with an anal attitude about almost everything. People with OCPD are often extremely neurotic, which fits Monk to a tee. However, just because you don’t like your vegetables touching doesn’t mean you have OCPD. You are only diagnosed with the disorder if it severely affects the functioning of your daily life.

Obsessive compulsive disorder, on the other hand, is usually characterized by obsessive thought patterns, usually in the form of unpleasant thoughts that repeatedly enter the mind for no apparent reason. Another symptom is repeated strange behaviors or ticks, sometimes performed to block out the unwanted thoughts. Interestingly, people with OCD are usually aware that their thoughts are bizarre and unreasonable, while people with OCPD often refuse to acknowledge that they have a disorder at all.

9How To Treat A Seizure

When someone has a seizure in popular culture, the response usually involves holding the person down and putting something in their mouth so that they don’t bite or swallow their tongue. This common trope is more than just a silly myth—it’s bad advice that could actually get someone injured or killed. First of all, it is completely impossible to “swallow your tongue.” Biting your tongue is a real worry, but it’s very unlikely to do irreparable damage. Meanwhile, trying to force something into the mouth of a seizure sufferer can result in choking or damaged teeth. In fact, it’s not impossible that forcing a hard object into a seizing person’s mouth will result in them chipping or dislodging a tooth and then choking on that tooth when it falls into their throat. Finally, messing around with a seizing person’s mouth is a great way to get your fingers bitten.

Additionally, trying to hold a seizing person down to “keep them from hurting themselves” is more likely to end up hurting them or you. The correct response is actually to remove any sharp or hard objects and see if there’s anything you can use as cushioning to prevent them from injuring their head. If possible, you should also try and get them on their side. What you shouldn’t do is shove an object into their mouth and then hold them down as hard as you can—that’s just Hollywood artistic license to increase the intensity of emotional scenes.

8Bipolar People Are Powder Kegs About To Go Off

This myth has become so widespread that it permeates almost all popular culture and frequently bleeds into real life, ensuring that many people simply have no understanding of what bipolar disorder actually is. The term is often used to describe someone who seems to fly into a rage at the drop of a hat, but this is completely inaccurate. That person may not be getting enough sleep, they may be stressed, have drunk too much or too little coffee, or maybe they genuinely have some sort of behavioral disorder, but having a short fuse has nothing to do with being bipolar.

Bipolar disorder, also known as manic depression, is characterized by extreme highs and lows. But even with the rarer version of the disorder that causes you to move quickly between the two extremes, it’s unheard of for them to change back and forth in the same day. In fact, the current definition of rapid-cycling bipolar disorder suggests the patient might experience four or more episodes of depression or mania over an entire year. Furthermore, neither of those states are likely to put someone into a towering rage. Instead, the depressive state is basically depression (and is often confused as such, making diagnosis difficult), while the manic state consists of periods of elevated mood, increased risk-taking behavior, and increased energy. Someone suffering from bipolar disorder can actually sometimes be going through both at the same time, which is known as a “mixed episode.” So if your boss tends to shout at you for no reason, they might be a jerk, but they probably aren’t bipolar.

7Violating Doctor-Patient Confidentiality

Hollywood loves to play fast and loose with the rules around doctor-patient confidentiality. In order to provide a hint of drama, a movie therapist will often refuse to share client information, at least initially, even if it’s the crucial clue required for the cops/band of plucky kids/wisecracking cat detective to save the day from their out-of-control patient.

In reality, the rules around doctor-patient confidentiality are clear and not particularly complex. Like any medical records, mental health information is extremely sensitive and therapists are not at liberty to share it, even with well-meaning friends or relations. The exception is if the mental health practitioner believes their patient might cause serious harm to themselves or others. In that case, they have a legal right and obligation to relay the information to someone who has the ability to do something about it. In some cases, this might involve a therapist telling a parent their child’s suicidal tendencies. In others, it might mean providing information to the law about a patient likely to harm others.

Where TV and movies gets it wrong is in depicting therapists as reluctant to disclose such crucial information, forcing the cops to lean on them to get access to their files. In fact, breaching confidentiality in a situation where there’s the slightest chance someone may be harmed is the farthest thing from a risky career move. Instead, current laws provide thorough protection for mental health professionals who wish to invoke that exception. As such, it is unlikely that the trope of the brave psychiatrist risking their career to share information is anything like reality. In truth, doctors know that the law will always back them up if they do have a moral need to violate confidentiality.

6The Character Who Ends Up Cured

In fiction, this myth stems from an understandable desire on the part of the writer and the director to provide some positive resolution and leave audiences satisfied. This leads to movies constantly going for the easy way out, where the character has some final revelation that makes them realize how they can live a normal life. Then they have some romantic reconciliation and everyone lives happily ever after.

Sadly, this is pretty much the opposite of how things work in real life. Most serious mental disorders can’t be fully cured, and even those that can require a lot of time and patience to deal with. Someone may indeed have a helpful revelation, but the movies don’t show the years of hard work after that in order to cope with the disorder: the trips to multiple different doctors, the trial and error of different medications, and the painful struggle to repair relationships and rebuild a normal life. Of course, a movie doesn’t have to end on a depressing note to be realistic. Showing that someone is on the way to recovery and has a strong support structure would be a grounded and positive way to bring a story to a conclusion.

5Autistic People Are Either Savants Or Totally Helpless

Movies like Rain Man and Mercury Rising have popularized the idea of an autistic person with advanced math skills or other abilities beyond normal human functioning. Hollywood also frequently features autistic people who are completely incapable of caring for themselves, but very little in between. Apart from Asperger’s syndrome, which is becoming better known, autism has many widely different forms stretching across a scale known as the autism spectrum. As a result, researchers who have studied common stereotypes of autism have found they usually don’t fit well with the reality of the issue.

In fact, savant-like skills are extremely rare among autistic people and their portrayal in Hollywood movies can create unrealistic expectations. One father of an autistic child observed that he often found himself having to tell people that his son was “just” autistic, causing people to respond as if his kid “is doubly challenged.” Yet, as far as Hollywood is concerned, people with autism can either have “diminished capacity or superhuman capacity, but nothing in between.”

4The Cool And Collected Therapist

Many of Hollywood’s stereotypically mentally ill characters have a counterpart in a calm, efficient therapist who listens to them and puts their weird actions in perspective. The therapist may ask the character about their dreams, encourage them to follow their goals, or dispense advice leading to a life-changing epiphany. These characters are almost never shown as anything but the perfect, patient professional. However, it would likely be more accurate if they showed the therapist as a neurotic, anxious, depressed individual who struggles with mental health issues of their own.

While it may disturb some people who get therapy (which is still extremely useful and important), a large number of therapists entered the field because their own mental health problems made them interested in it. Additionally, there is generally no screening for serious psychological issues in the people who are dispensing counseling. The issue is made worse because many therapists end up physically attacked by their patients or discover that a patient has committed suicide. This means that even those therapists who entered the field with relatively good mental health still find themselves dealing with a level of emotional stress much higher than the average medical professional. Therapists also often struggle to get proper help from other therapists, even though they should know better than anyone what help they really need. Even Sigmund Freud, who could arguably have used some counseling himself, believed that therapists should have themselves evaluated every few years for the sake of their patients and themselves.

3People Know What Mental Illnesses They Have

In the movie Fight Club [Warning: 15-year-old spoilers ahead], the main character eventually figures out that he is Tyler Durden and that he has been forgetting his double-life as the Tyler persona. In other words, he has a second personality that’s a total psycho, making him two different parts of one extremely insane person. The problem is that the big reveal also happens to be extremely unrealistic: our anti-hero just kind of suddenly figures out what’s going on. In real life, people with mental disorders don’t simply trip a switch and work out what their disorder is and how to deal with it. Instead, it’s a long, painful process requiring lots of trial, error, and often multiple different attempts at medication.

In fact, many people go without treatment for years because they don’t realize their problems are actually a mental illness. Even if someone does believe they have a problem and is actively searching for the solution, it can still take years to find the right diagnosis or medication. Many people initially go to their primary care doctor, who often doesn’t have the time or knowledge to address the symptoms correctly. And once someone starts treatment, they may not take their medication as often they should. Even if they do, there’s no guarantee the medication will work for their particular issue. This, along with misdiagnosis, makes treating mental health problems a lengthy process.

2Treating An Overdose With A Needle To The Heart

In Pulp Fiction, John Travolta has to help Uma Thurman’s character after she accidentally overdoses on heroin. He drives like a lunatic to his dealer’s house, who immediately produces a massive adrenaline needle, which Travolta stabs into Uma Thurman’s heart, instantly reviving her. Surprisingly, there is a grain of truth to this, since an actual procedure called intracardiac injection has been used to treat cardiac arrest in the past. Unsurprisingly, the procedure depicted in the movie bears no relation to the real one and Travolta’s actions would simply have ensured that Thurman’s character definitely died.

For starters, intracardiac injections are almost never used anymore, since there are obvious complications from stabbing someone in the heart in an attempt to save them. Assuming Travolta didn’t hit a lung or the pulmonary artery, which he almost certainly would have, the procedure still wouldn’t have gotten the drugs to Thurman’s heart any faster than injecting them normally. Even if an injection to the heart was somehow necessary, there’s never any reason to ram a needle through someone’s chest, since the heart can be easily reached from the side through the ribcage. And finally, heroin overdoses actually cause respiratory problems, not the cardiac arrest an intracardiac injection of adrenaline could theoretically be used to treat.

1Depressed People Look Depressed

While depression may be one of the most widespread mental disorders, it’s also among the least likely to be realistically depicted. In movies, a depressed person will probably wear dark clothes, constantly appear sad or somber, and act withdrawn from their friends and family. Hollywood depression apparently involves indifference or contempt for everything outside a small bubble of overly indulgent self-pity. However, these depictions are often the farthest thing from the truth.

In reality, many depressed people put on a public face that fools even their closest friends and family. In fact, depressed people are the most likely to act out in public and draw attention to themselves, putting on a show to hide their problems from others and even themselves. The outgoing popular kid in the movies is always either a one-dimensional caricature or an extremely put-together and well-adjusted person. In real life, the class clown who makes the most noise and keeps everybody laughing could very well be severely depressed on the inside. As a result, many people with depression suffer in silence, putting on a happy face to ensure no one knows what they are really dealing with.