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If “life imitates art”, what examples should we look at to better understand mental illness?

Image of Vincent Van Gogh exhibition
Image credit: Redd (Unsplash)

Opinion / by Andra Nesim

Throughout history, art has provided a medium through which people have examined and presented depictions of mental illness. Andra Nesim provides her analysis of some of the most accurate representations of mental health issues in art, as well those that do more harm than good.

As a film graduate, I often approached these subjects in my own creations. In this piece I will look at examples of modern storytelling where mental health is concerned, be it film or television, and a few examples of how these depictions were inspired, visually by paintings and, in terms of storytelling, by classical literature.

Experiences with mental illness are not a monolith, and as I’m looking at mostly fictional works, I won’t look for indisputable accuracy in these depictions. For my positive examples, I’ll be looking either at media that demystifies these concepts for non-mentally ill audiences or media that visually depicts the internal struggles with mental illness in a helpful way. For my negative examples, I’ll be discussing media which showcases negative stereotypes or misconceptions regarding mental illness, which contribute to the systemic oppression against mentally ill people.

Positive portrayals

Two of my favourite films of mental illness in women and how society’s gender inequality is connected to this are Black Swan (dir. Darren Aronofsky) which depicts Nina’s psychosis as a symptom rather than an illness, and Last Night in Soho (dir. Edgar Wright) which also deals with a potential episode of psychosis, albeit unconfirmed, in Eloise’s character, as well as PTSD in Sandie’s character.

In Black Swan, Nina’s psychosis is caused by the pressure and abuse from her mother, who wants her to become the best ballerina, as well as the inappropriate sexual advances of her ballet instructor and her developing bulimia. In contrast, Last Night in Soho’s Eloise has a mental illness predisposition seemingly inherited from her mother who had schizophrenia and took her own life, while Sandie has PTSD due to being forced into prostitution and abused by many men.

Image of Natalie Portman in Black Swan
Image credit:

Black Swan provides a stunning and unsettling depiction of psychosis experienced by Natalie Portman's Nina in response to pressures from her mother and her pursuit of excellence

Although psychiatrists say the depiction of psychosis is somewhat realistic in the first film, with the second one being newer and not having received as much analysis yet, it’s worth noting that hallucinations in most cases are auditory, not visual. However, it makes sense that they’re depicted as visual due to the medium of film being, well, visual. Both films make use of bold visuals, Black Swan with the body horror of the swan itself, with feathered wings growing out of Nina’s body, and Last Night in Soho with its bold neon colours and the ghostly figures of the men who hurt Sandie in her past.

As a woman who suffered sexual trauma and abuse, I found myself relating to these characters’ loss of personhood and the feeling of disconnect from their bodies while the pressures typical of a coming-of-age story mount. It’s worth noting that both these films are made by men however and, although I enjoyed them, some women might find them inaccurate descriptions of womanhood. I have no doubt there are people who disliked the vengeful wrath with which Sandie ended the lives of the men who abused her, and although from a moral perspective I agree with their point, I couldn’t help but feel some sort of catharsis as a survivor of a similar abuse while watching her take ownership of herself again.

I also enjoyed The Virgin Suicides (dir. Sofia Coppola) because it showed depression and suicide from a male perspective, making the viewer question the morality of the male gaze. The girls’ struggle is intertwined with many other struggles they experience living in a patriarchal society, and although this depiction may not be the most accurate one from a psychiatric perspective, it opens a conversation about men romanticising women’s depression and seeing mental illnesses as something that adds to our allure (something that came back as the problematic internet trend dubbed “The Sad Girl”), as opposed to how ugly they can really be to the sufferer. There are nuances that might be unrelatable to some, as this is after all a film about a white middle class suburb, so there is always room for better exploration of the mentally ill teenage girl’s experience in a man’s world in terms of intersectionality.

On a more realistic note, the TV show This Is Us (Dan Fogelman) showcases an array of mental health topics such as addiction, anxiety, depression, eating disorders and PTSD, as well as things that can trigger mental illnesses, such as coming to terms with your life direction whilst developing Alzheimer’s and grieving the loss of a loved one. All these stories are contained in an extended family’s story (and their close friends), and they help us see how people with these diagnoses interact with and support one another, as well as how they can overcome the clashes that inevitably stem from misunderstanding each other’s symptoms.


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Mixed bags

I will put 13 Reasons Why (Jay Asher, Brian Yorkey) and Euphoria (Sam Levinson) in its own category, the mixed bag category, because I think they do some things wrong and some things right. 13 Reasons Why romanticises suicide in a way that made me uncomfortable, as someone who survived a suicide attempt, but it showcases trauma from sexual assault and rape in a realistic way. Euphoria shows addiction in its true frightening light, but romanticises teenagers’ sexual trauma, sometimes from intercourse with much older adults.

Image of Joaquin Phoenix in Joker
Image credit:

Arthur Fleck's evolution into Batman's most familiar foe in the double-Oscar winning Joker highlights the often overlooked influence of poverty in the development of mental health issues  but it also platforms the harmful stereotype of mental illness being associated with violence

Similarly, Joker (dir. Todd Phillips) explores poverty as a cause for developing mental illness, which is very realistic, but I can’t help but feel dissatisfied with how the ending felt unearned. Arthur’s mental health deteriorating was something we knew would come from the start, but his enjoyment for violence would have been a plot twist, if we hadn’t known the character from other media. This perpetuates the harmful stereotype that mentally ill people can just snap at any second and become dangerous without warning.

Negative portrayals

Both Split (dir. M. Night Shyamalan) and Psycho (dir. Alfred Hitchcock) are great movies at face value, with the latter being used as a lesson on creating suspense for every film student. I have greatly enjoyed both, but I perfectly understand why they are critiqued in terms of mental health. They portray people with dissociative identity disorder (DID) as unstable, violent and dangerous to others. Enjoy the movies for what they are, great works with good acting, but don’t look at them for accuracy on DID or as a tool to understand people with it.

The same can be said for Fight Club (dir. David Fincher). DID is caused by trauma, which is not presented as an inciting incident in Fight Club. While I’m not someone with DID, it’s easy to see that there are rarely, if at all, positive representations of this disorder in media.

Image of Edward Norton in Fight Club
Image credit:

Fight Club is quite rightly revered as a groundbreaking piece of film-making, but it's portrayal of dissociative identity disorder does little to improve understanding of it

For TV, most teenage girls from my generation (the 90s) would have seen Pretty Little Liars (I. Marlene King). It discusses themes such as addiction and eating disorders, but it does so on an extremely shallow level. The character of Spencer who deals with addiction is mocked by her friends, which is never addressed afterwards, whereas Hannah, who was bulimic, completely recovers from it and is never shown to have triggers afterwards. Mental illness does not work that way; once you heal, you’re still predisposed to relapses. Triggers don’t just disappear. It also portrays mental institutions in a horror-esque manner and creates an imaginary mental illness for the character of Mona for shock value.

Other forms of art

Lastly, I want to discuss other works of art that I find enjoyable and accurate in describing mental illness. “The Bell Jar” by Sylvia Plath has been very dear to me when I was struggling with depression and suicidal thoughts. It describes Sylvia’s own journey through her psyche and her own struggles with the very same illness. It keeps both the gritty realism of writing about such a dark subject and the beauty of a classical work of art.

Perhaps Edvard Munch's most well-known piece, The Scream provides a haunting and effective representation of Munch scrutinising his own struggles with depression and addiction

Vincent Van Gogh has always been one of my favourite painters, because I thought I could relate to him. His life was an endless trial of finding happiness and curing himself. He admitted many times that he would have been lost without art, but that art is ultimately the thing that’s awakening his emotions and thus deepening his depression. Similarly, Edvard Munch, best known for his painting “The Scream”, was predisposed to mental illness from the start. Both his father and one of his sisters had depression and schizophrenia respectively. He struggled with depression and addiction and let these illnesses guide his art. The tormented artist myth seems to have some truth to it, but perhaps it’s a harmful myth which motivates artists to plunge deeper into the darkness.


Ultimately, the enjoyment you get from a piece of media or a work of art which depicts something incorrectly is not morally wrong. I think to some degree, you can separate the art from the problematic portrayals of certain things, as long as you don’t let these portrayals dictate how you act in real life and provided you always do your own research on topics that seem exaggerated for entertainment purposes.

Curate your hobbies in a way that positively influences your life, whilst working to disassemble the stigmas around mental illness and be an ally to mentally ill people everywhere!


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