The Way Bipolar Disorder is Represented in Popular Culture

Introduction

Most people are aware of the ways the media influences and reflects what the public believes, we’ve seen this as the bias of specific authors or of news outlets. Unfortunately, oftentimes, larger more longstanding stereotypes in American culture can be reflected in nearly all media. This leads to discrimination and prejudices that affect nearly all marginalized groups. The research in the paper will focus in on the way that mental illness is typically negatively represented in media, specifically bipolar disorder. Many sources of media will be considered, and the damaging effects of their depictions discussed. The goal is to show the specific stereotypes that exist, how they affect those with bipolar disorder, and how these stereotypes present themselves across different forms of media.

Mentally ill individuals are in general, a marginalized population that people often forget about. They are often dismissed or lost in conversations about prejudice, disability, and discrimination. Obviously, the stigma surrounding mental illness exists on a spectrum with all disorders having their own stereotypes, with different levels of public understanding and acceptance. Illnesses like major depressive disorder and generalized anxiety disorder having more public support and understanding than schizophrenia and bipolar disorder.

TV & Film Representation

Most people are aware of the common tropes and stereotypes that exist in mainstream media, the damsel in distress, the bitchy boss, the lovable bad guy, and many more that we’ve become accustomed to seeing in nearly all TV shows and movies. The focus is going to be on the way bipolar disorder is characterized and how it intersects with creativity to create the “bipolar artist”. This trope has been around for a long time and has been typically seen in relation to visual artists and writers, but not limited to it, don’t forget about the “mad” scientist. But first all the different ways the media imitates bipolar needs to be addressed. The most mild and well recognized form is the “manic pixie dream girl” (MPDG) character, which the term’s creator, film critic Nathan Rabin, described as “that bubbly, shallow cinematic creature that exists solely in the fevered imaginations of sensitive writer-directors to teach broodingly soulful young men to embrace life and its infinite mysteries and adventures” (Rabin, 2007). The manic pixie trope is essentially just the intersection of sexism with a poor rendering of what could be considered mental illness. But these women are never truly psychotic or delusional, only manic enough to be quirky and fun. Despite these women being hysterical and crazed with energy they still uphold the expectation that women are to take care of men. All of the women serve as half-baked characters only present to entertain and babysit the male protagonist. The MPDG stereotype is just an introduction into the way mania and bipolar disorder are handled in media.

In recent years there has been a push to be more inclusive in media, to include more female protagonists, more people of color, and more honest portrayals of mental illness. This has resulted in some authentic characters being conceived. As O’Hern mentions in his paper, in contemporary shows like Shameless, Empire, and Degrassi there are fuller characterizations of bipolar disorder. He found however, that despite the absence of stereotypes like instantaneous recovery and professional incompetence there are a large amount of characters being shown as violent (O’Hern, 2017). This inaccurate illustration of violence is something that has followed bipolar disorder in media and public opinion for a long time. It’s no surprise considering bipolar disorder got its start in film and literature where most mental illness does, in the horror genre. The Strange Case of Dr. Jekyll and Mr. Hyde (1886), The Cabinet of Dr. Calgery (1920), and The Roommate (2011) are all excellent examples of characters being shown with bipolar symptoms while also being violent and homicidal. And, in the case of The Roommate, because the antagonist is female she is also portrayed as highly manipulative, sexually promiscuous, and obsessive. It has been found that those with bipolar disorder do have a slightly higher risk of committing violent crime, and slightly more significant risk if they have comorbid substance abuse disorder (Fazel, et al., 2010). It’s also important to note that those with severe mental illnesses are also more at risk of being victims of violent crime (Teplin, et al., 2006).

These negative depictions of bipolar disorder can be considered extremely harmful because they make the public believe that they should be afraid of the mentally ill. There are however, portrayals in award winning, critically acclaimed films that perpetuate a far more insidious message. In the drama films mentioned shortly, and many others, they continuously disregard the depressive episodes and symptoms. They will often give the film a happy conclusive ending, or only show the character manically floating about. This creates a misperception to the public about what bipolar truly is, where they will then romanticize it. Romanticizing a mental illness is far scarier than demonizing it. It results in people not taking symptoms seriously, someone diagnosed believing they just need a lover to “fix them”, or that treatment works immediately.

A drama/romance movie that needs to be discussed is Mr. Jones (2013). This film does do a good job at showing the ups and downs and representing symptoms fairly honestly, however, that’s where the praise ends. With this film, they employed the tired scenario where a woman is introduced to heal and take care of the male main character. To make matters even worse, the woman who they assign to this role is none other than his therapist, Dr. Libbie Brown. They even went as far as to make her a psychiatrist. The notion that a woman who had spent 12 years of schooling and probably thousands of dollars on said schooling would risk her career for a patient is wildly distasteful and unrealistic. While the character is aware that her actions are unethical, and it is acknowledged throughout the film, she continues to treat him and sleep with him, eventually resigning from her position in the end.

Patient/doctor relationships do happen, there are always people that will unethically cross these lines, that wasn’t what was unrealistic. It was the impractical and problematic reasoning his therapist had for falling in love with him and breaking ethical code. It’s implied throughout the movie that her affection towards him is because of his mental illness. The tagline for film even being, “Everything that makes him dangerous makes her love him more”, yikes. For a film that tried so hard to get bipolar disorder right, which they did for the most part, it was disappointing to see it all thrown out the window with the unnecessary romanticization.

It was interesting to do research on this film as well, because when reading the reviews there is some insight into the impression it had on the public. It seems that even famed movie critic, Roger Ebert, was intoxicated by the glamorized nature of the film saying at the end of his review, “There is often a strange quality about crazy people: They are filled with a glowing conviction that everything makes sense, and sometimes we almost envy them” (Ebert, 1993). This just goes to show the impact that films can have on the perception of mental illness, that few are exempt from falling for.

Another film to discuss is Silver Linings Playbook (2012). There are moments in the film that do a wonderful job, like the manic scene featuring Pat discussing A Farewell to Arms, which is ironic because Ernest Hemingway has been speculated to have had bipolar. If a layperson were to meet someone diagnosed, they might only have Bradley Cooper’s character, Pat Solitano in Silver Linings Playbook (2012) to reference. For the most part, this character remains manic throughout the film, never really cycling into a depressive episode. Hollywood presents characters as manic because they want the action, they want the euphoric character riding an incredible high. They want a protagonist like Mr. Jones jumping up on stage during a performance, to conduct a symphony orchestra and trying to jump off a building because he believes he can fly. This can make people believe there is only an up cycle, so how could it be so bad? Pat also has multiple violent outbursts, a dangerous mischaracterization. In some manic episodes, individuals can be aggressive and irritable but not typically violent.

In a study conducted in New South Wales, researchers reviewed 272 people who were found not guilty by reason of mental illness. These individuals had committed either assault that resulted in serious injury, attempted homicide, or homicide. They found 12 of those 272 were manic at the time of the incident and only 2 of those 12 had bipolar disorder. This was their conclusion, “Mania, in particular the manic phase of bipolar disorder, is not strongly associated with severe violence” (Nielssen, et al. 2012).

Another film, Infinitely Polar Bear (2014) features a father, Cameron who is wildly manic. This is a better depiction, seeing as it is based off of the writer and director’s life, although, there is a romanticized, Hollywood air about it. The father is almost always manic but when he is it is often viewed as kooky or endearing, and once again, the film has a happy ending.

In addition, if it’s an artistic bipolar character, their ability to create during episodes of mania is always expressed at the forefront, as though it justifies the negative symptoms of the illness. This is very clearly shown in Vincente Minelli’s, Lust for Life. Vincent Van Gogh played by Kirk Douglas. Van Gogh has been presumed posthumously to have a myriad of possible ailments, the most popularly inferred being bipolar disorder, depression, and borderline personality disorder. Regardless, he is shown in the film in a way that’s true to history for the most part. They include the negative symptoms, the psychotic episodes and his inevitable suicide. Although, they wrap this all up with a celebration of his work, which largely feels like a justification and possibly a result of his suffering. They juxtapose his vibrant paintings with his unpredictable, melancholic disposition. This is an example amidst many in movies and TV shows that are able to manipulate the way bipolar disorder in perceived. Also, you can see, with the bipolar artist trope, it’s a sort of double stereotype because it is at such a higher risk of romanticization than a bipolar character being represented having any other occupation.

Treatment in general is not the element of bipolar disorder that tv show and movie writers are interested in, like they’re not typically interested in depressive episodes or symptoms. Due to this they’ll either show treatment as instantaneous or as an institution to rebel against. The former is a big issue for bipolar individuals watching, because medication adherence is already a pervasive problem already. They don’t need anyone promoting that behavior and being seemingly fine as a result. Stopping medication, especially suddenly can have detrimental side effects.

An example of this behavior can be seen in The Sopranos. The main character, Tony Soprano in an early episode is seen flushing his prescription of lithium carbonate down the toilet. He did this as a reaction to experiencing extreme hallucinations. He goes through the episode believing there is an exchange student house-sitting next door, when in reality there’s not, she doesn’t exist. He talks to her, goes out to lunch with her, and even argues with his wife about her, but none of it happened. While The Sopranos was progressive for showing the struggle of being a man and going to therapy, and the perceived stigma of that, the therapy itself and the situation misses the mark.

Not only does he flush the lithium, but after the tells his therapist about the hallucinations she immediately tells him to stop taking it. This most likely wouldn’t happen, it could be unhealthy for someone to completely discontinue use without incrementally coming off the medication. Also, hallucinations themselves aren’t a common side effect of lithium, in fact, they are a common symptom of mania, so it would be more likely for her to up the dosage. If someone were experiencing hallucinations because of lithium, it would be a rare symptom of lithium toxicity, where the levels of lithium are too high in the body. These hallucinations would be paired with much more common symptoms like sweating, shaking, drowsiness, weakness, impaired speech and if severe seizures, vomiting, diarrhea, etc. Therefore, most likely, if it were the result of lithium, Tony would have a lot of other things going on.

Additionally, the nature of his hallucinations is unrealistic. Tony is in a depressive phase when he’s experiencing them, which is less common, psychotic symptoms are typically associated with mania. He also is experiencing hallucinations which is a less common psychotic symptom in bipolar disorder compared to delusions. Finally, he has no prior history of hallucinations and he’s experiencing a full-blown visual and auditory hallucination which then reoccurs multiple times. This feels a little over the top, even for patients with schizophrenia, which is more commonly associated with hallucinations. Individuals experiencing psychosis typically experience auditory hallucinations rather than visual, and even less commonly, both in conjunction. These are technical things that are incorrect, but they still help to spread misinformation and strengthen stigma.

Music Representation

Many of the misconceptions regarding mental illness comes from the language. The words we use incorrectly slowly morph their perception and diminish the seriousness of a given disorder. Similarly, to the way that companies market products using offensive phrases about mental illness, the music industry does the same thing. The way that music is presented in a quick, catchy format that typically gets ideas across in a basic way, can be dangerous for any touchy topic, and this proves to be true for mental illness. There are many songs out there that pertain to a kind of mish-mash of symptoms that don’t define a given mental illness, but then language will be used incorrectly as well which then falsely connects the two. Similarly to the MPDG trope in films, there are insulting ways that these songs involve gender to trivialize mental illness, and be sexist at the same time.

Two great examples of this are Bebe Rexha’s pop hit, “I’m A Mess” and Ava Max’s, “Sweet but Psycho”. Both songs center around the idea that both women are “crazy” or “insane” because of their romantic relationships. This perpetuates the misogynistic idea that women are emotional and hysterical and diminishes the struggle of being a mentally ill and a woman. No woman is psychotic simply because a guy doesn’t love her. In “Sweet but Psycho” the song lyrics normalize terms like psycho and not only inaccurately portraying psychosis but equating it with being violent or dangerous. This can be seen in lyrics like, “Grab a cop gun kinda crazy, She's poison but tasty”. Ava Max has created other songs that are similar in theme and tone that she has stated are satirical, and they are a critique of the stereotype of crazy, messy, women. It feels more like the stereotypes are being reinforced, and that is definitely the message being perceived by a casual listener.

To make the problem even more multidimensional, there are also the music videos to worry about. With the song, “I’m A Mess”, the lyrics by themselves aren’t so problematic, at points they feel like they are trying to be empowering. It’s the music video that sends a terrible message. It’s set in a stereotypical stark white mental institution, with dancers rocking back and forth, staring blankly, and one man appears to be smashing his head off a table. Bebe Rexha herself is dressed up in a sexy version of a straitjacket dancing and flailing with the backup dancers also acting bizarre in their movements by doing things like jumping around and crawling on the floor.

Unfortunately, these songs are just the most recent, modern-day examples of a longstanding trend of making mental illness a theme and including asylums in music videos. The two songs discussed are no-where near the most offensive either. The following songs are just the more well-known out of many:

- Nicki Minaj – “Outta My Mind”

- Lil Wayne – “Krazy”

- NSYNC – “I Drive Myself Crazy”

- Green Day – “Basket Case"

As was mentioned earlier, part of the problem is that they aren’t addressing a specific mental illness, just insanity as a general theme, lumping all disorders together. As a result of there aren’t many songs that specifically address bipolar disorder. Instead, many songs use the word bipolar when describing being unstable, emotional, dangerous, etc. in any situation.

When discussing bipolar disorder and music, Kanye West will inevitably come up in discussion. Kayne is open about having bipolar disorder, but he is a really dangerous role model for those with the disorder. On one hand, he’s a great role model for black men and black culture in general, where mental illness is not often acknowledged or taken seriously. On the other hand, he very publicly glamorizes and praises his disorder. On his album, Ye, he refers to his bipolar as a superpower and has discussed in interviews how important it is/was to his success. He also has been a proponent against medication, crediting his most recent musical successes to going off psychiatric medication. This is harmful message to put out, as well as the idea that bipolar and creativity are connected, and success is only possible while unmedicated.

Romanticization

Kurt Cobain Suicide Note T-shirt Billboard. 2015

shopbando Instagram 2018

Romanticizing mental illness in general has been a big occurrence in Western culture, especially in the last 10 years or so. Romanticization can be found in many of the films discussed previously, but it is also much more prevalent in everyday consumer culture. There are problematic products popping up constantly to try appeal to a younger generation obsessed with poor mental health. Products like the t-shirts featuring Kurt Cobain’s suicide note (Payne, 2015). There was also the time the company, Ban.do created and sold anxiety, depression, and bipolar necklaces, oh and they’re $48 (Khoo, 2018). This act of normalizing harmful feelings and behaviors even reaches into our language. It is so commonplace to hear people using mental illnesses as adjectives in daily conversation, “That poster is so crooked, it’s making my OCD go crazy” or “He just got mad at me out of nowhere, he’s so bipolar sometimes”. This kind of glorification and normalization does just as much to contribute to stigma as negative perpetuated stereotypes.

Social Media

With the massive shift towards social media in the past decade, there have been many benefits to its use for our culture, but many disadvantages as well. There have been recent studies and articles suggesting that trends on a person’s Twitter account can be used to predict depression (Choudhury, et al. 2013).

The romanticization of mental illness can also be found flourishing on social media. Across Twitter and Instagram, young people are constantly joking about their depression in the current meme culture. An argument could be made about whether these memes are a positive, funny way of talking about a big problem that young people face or that they are making depression “relatable” and normalizing it. Regardless, these memes are the most recent addition to a bigger system of glorifying mental illness.

Public Perception of Bipolar Disorder

There is no definitive way to understand why people stigmatize others, but it is easy to see how different forms of media continue to fuel stereotypes and prevent a realistic public understanding of mental illness. So, it is known that the stigma against bipolar disorder exists and is widespread across media, but the question is how bad is the stigma that exists?

A study based out of Germany looked at public perception of mania and depression in bipolar disorder independently. This is interesting because there isn’t much research looking at what phase of the disorder is more stigmatized. The researchers found that there was a general negative attitude about both episodes presented, but more so with mania than depression (Wolkenstein & Meyer, 2008). It is known that the media portrayals of individuals with bipolar disorder need to be improved on, pertaining to several misrepresented characteristics. This research is important because identifying which phase is the more stigmatized, allows the changes to be focused on that aspect of the disorder.

A factor that need to be considered in conjunction with all of this is stigma. It is the insidious result of romanticization, poor media representation and stereotypes. Stigma makes it harder for those with bipolar to go about their daily lives because of the unconscious and conscious bias that others have. Even worse, this stigma often manifests into self-stigmatization. This internalization of the negative stereotypes leads to development of self-stigma in many bipolar individuals, more so than those with depression or psychotic illnesses. It has been seen that this self-stigma results in a lower quality of life, relapse, poor self-esteem, and a delay or resistance of treatment (Latalova et al, 2013).

It is also known that there is a link between public perception and self-stigma. A study observing 14 European countries found that countries that had better public perception of mental illness also had lower rates of self-stigma in those with mental illness. They found these rates in countries that had better rates of public education on mental illness and available resources for the mentally ill (Evans-Lacko et al, 2012). They looked at individuals diagnosed with depression, bipolar disorder, and schizophrenia.

Conclusion

The takeaway from the vast examples of poor media representations of bipolar disorder, is to demand improvement. The best way to remove stigma is to inform. The people creating this unacceptable content are just in recent years being called out for their actions and the consequences they have. As a society we need to be aware of what we’re saying and the language we use. When there is a TV show, song, movie, etc. that is troubling we shouldn’t condone it or accept it. When positive depictions of mental illness are present in the media, they deserve recognition. The best way to work on this stigma is to support works that are appropriate, refreshing takes on mental illness.

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