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Mental illness is an invisible disability. It's not tangible, it's not something you can see. How then would you portray something invisible on screen? What happens when films attempt to portray these types of identities? Mental illness tends to be underrepresented and misrepresented as well as villainized in film. There is larger cultural anxiety of not being able to identify a person with mental illness which "feeds the desire to visualize madness" reflected in art as well as in other fields.

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Historian Sander Gilman, who said, "society which defines itself as sane must be able to localize and confine the mad, if only visually, in order to create a separation between the sane and insane." makes great observations about how it is portrayed. Our awareness is based on our construction of the images of madness rather than the illnesses themselves. In the late 1950s, films from the likes of Alfred Hitchcock began to stray towards portraying psychiatry as ineffectual, mental illness as violent and incurable. Stigma results from unquestioned repetition that supports and creates stereotypes and negative representation.

There are certainly limitations to film, a visual medium, and portraying something you can't see. Getting every detail to your audience visually can be difficult, hence why some films use narration. Also, a structure like a TV series has much more time to develop a character and the timeline of their mental illness. The short format and limitations of a film can make it difficult to fully show all aspects of a character's mental health. The excerpt from book "Culture- Theory- Disability" critiques the economy of visual storytelling in an ableist culture. "If you want to make a film that is about disability, then every aspect of the story has to do with disability." In the context of mental illness, take "Girl Interrupted", a film about a girl with borderline personality disorder spending time in a psychiatric hospital after attempting suicide. I don't totally get the poor reviews for this movie but maybe you have to be a mentally ill teenage girl to like it. Anyway, films like this set in psychiatric hospitals feel the need to describe the disorder and history of every single character. We go through everyone's diagnoses and now Georgina is a pathological liar, Janet's anorexic, Lisa's the sociopath. This can be compared to how Polly has facial scars and Susanna asks how she got them, learning she set herself on fire. Later, we see a few seconds of a newspaper clipping in Polly's diagnostic files, again showing she was in a fire in sixth grade. Why would that even be in her files? How did her psychologist get that? The fire is never mentioned again and Polly is a fairly minor character. It's only shown to explain. She can't just exist as she is, she has to be explained. When there is a character with a disability, the disability must be the focus and it must be explained, or else the normalcy of the film is being tampered with. "In an ableist culture, disability can't just be."

Mental illness is not always specifically mentioned, meaning there may not be an explicit indication of diagnosis. Yet characters who are "crazy", who abuse substances- it's implied. Look at "Black Swan", which involves signs of obsessive-compulsive disorder, anxiety, paranoia, eating disorders, hallucinations- and I don't think anything is ever mentioned by name. At one point in Pixar's "Inside Out", (source) protagonist Riley is clearly depressed; among other things, she loses interest in her activities and her personified negative emotions remain in control. When mental illness is not explicitly mentioned, it can still be portrayed. Sometimes this leads to inaccurate representation, however, as there can be misinformation and a blending of disorders and symptoms. Either way, a variety of disorders are shown in film.

Depression and anxiety disorders are portrayed on screen often, and I think they're generally well done. These disorders in particular are also often shown in teenagers, which I think helps normalize it for people my age, and allows us to relate. Anxiety disorders are the most common type of mental illness in the US and often play both small and large roles in film. I think anxiety can be easier to portray on screen than other disorders because of the physicality of it that is involved, despite the disorder still being an invisible disability. Severe anxiety can cause hyperventilating, sweating, nausea, trembling, and film understands visuals. Take this scene from Bo Burnham's "Eighth Grade", where middle schooler Kayla experiences social anxiety at a birthday party and becomes overwhelmed, possibly having an anxiety attack. Staccato notes resembling a fast heartbeat play with tense rising synths before Kayla shut herself in the bathroom. The handheld camera gives her a sense of instability and close-ups make the scene intimate, almost uncomfortably close, mirroring Kayla's own discomfort. Her hyperventilating breaths echo metallically in the bathroom as she paces, the camera following, going in and out of focus to disorient like blurry vision. I find this to be an excellent representation of anxiety and the whole film does a wonderful job of providing a realistic, relatable portrayal. I think depictions of anxiety and depression are generally more realistic because it is more likely that the artist creating the film has experience with the disorders. Bo Burnham for example has dealt with anxiety and depression, as has Stephen Chbosky of "Perks of Being a Wallflower", "It's Kind of a Funny Story"'s Ned Vizzini. Actual experience with a lived identity is generally going to make art more authentic and realistic. When that doesn't happen, we get things like Sia's recent film "Music" about a girl with autism.

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Sia mentioned in an interview, "I've always- I don't know why but I've always had a thing for special- and they're called special abilities now, not special needs. As accurate a representation as, that I know." Yes, Sia. What you as a non-autistic person, knows. Which is nothing. Psychological disorders other than depression are sometimes portrayed when filmmakers have little knowledge of the disorder due to things like rarity or pre-existing stigma and misinformation- and so the cycle of stigma continues. For example, dissociative identity disorder, formerly known as multiple personality disorder. Films like "Split" where the antagonist has DID, and the writers use it specifically as a villainizing tool. Their disorder is the source of the conflict and violence. This can also be seen in films like Hitchcock's "Psycho" where the killer Norman Bates seems to have split personality. DID is a rare disorder, according to therecoveryvillage.com, DID is known to cover around 2% of the population, but could well be 7%, just undiagnosed, or even misdiagnosed.

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DID is often misrepresented, as well as disorders like sociopathy, or antisocial personality disorder- every villain is a sociopath or a psychopath or a narcissist. These words become ingrained in our minds through media allowing us to forget they are real disorders and that in real life, not everyone with these disorders are serial killers.

Not only is it these disorders that are villainized, but the association of queerness and madness in film. There's an unfortunate pattern of "insane" characters with implied mental illnesses being queer coated, from Disney to horror films. In "The SIlence of the Lambs", murderer Buffalo Bill has been denied gender reassignment surgery, killing women to wear them as a suit, a reference to Bill's own identity. Though filmmakers may deny Buffalo Bill is transgender, there are clear implications of gender dysphoria as well as a non-straight sexual orientation, and the associations between insanity and queerness remain. The Gay and Lesbian Alliance Against Defamation examined on-screen portrayals of trans people over a 10-year period and found that transgender people were depicted as serial killers or villains in 21% of roles. Depictions like these of queerness and mental illness tend to result in more stigma and harmful portrayals. In an article exploring queerness and mental illness in film, Ruby Tandoh says "not all films that depict mentally ill queer characters make an effort to illuminate the ways in which a homophobic society- not queerness itself- might be responsible for catalyzing and reinforcing these mental health problems." When there are depictions of people with marginalized identities dealing with mental health issues, there may not be an in-depth exploration of how mental health issues are different for these people. Both minimal and poor representation contribute to a stigmatizing culture.

In conclusion, quality representations can help inform audiences and reduce hurtful ideas about people with mental illnesses. Media like film is influential on societal and individual perception, so if the industry focuses more on authenticity than relying on familiar narratives, the destigmatization of mental health issues could be in the future- and in our movie theaters.