Ignore Popular Culture Portrayals of Mental Illness

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Popular culture is rampant with misportrayed mental illnesses (Fawcett, 2015)—unfortunately, entertainment influences. Further, many people's main resource is the internet, which is full of unvetted information or inaccurate information that is easily taken out of context. These matters aren't likely to clear up any time soon.

Add to this social media's influence, especially TikTok, where people share the videos they just happen to catch of themselves being "symptomatic," and misunderstanding of certain disorders is here to stay.

You see, bipolar disorder, borderline personality, dissociative identity disorder, and schizophrenia aren't usually as dramatic or caricatured as people need to post so they get likes. Like Hollywood, they're only interested in what draws attention.

This might leave one wondering what can be trusted on the internet. There are scores of websites and articles with accurate information about symptoms and what contributes to mental illnesses. The most prevalent of these are professional organizations and university medical school websites.

Despite the vetted resources and accurate information, that still doesn't necessarily portray mental illnesses, and readers are left to imagine what it looks like. This includes students studying abnormal psychology. There is a mere semester perusing only some of the conditions, largely from a criteria standpoint. It is easy, for example, to read an accurate description of bipolar disorder but still envision it as someone whose life is a mood rollercoaster they can't get off of, especially if one's imagination has been primed by Hollywood or on TikTok.

To help correct any extra-stigmatizing ideas of these mental illnesses, here are more accurate descriptions, based on 22 years of experience working with them, of how people with the conditions present in real life.

Bipolar disorder: Moodiness is not synonymous with bipolar disorder. Many conditions present moodiness, like personality disorders and posttraumatic stress disorder (PTSD), and they're not all treated the same, for the moods are generated by different factors. Bipolar disorder, or manic-depressive illness, is technically a depressive episodes that cycle with mania or hypomania. This is usually accurately informed. However, less known is that people can experience depression and mania at the same time, in what's called a "mixed episode."

To imagine this, think of being depressed but agitated, with racing negative thoughts, entirely unable to sleep, and likely hallucinating, which is common in mixed episodes. Further, rapid cycling (four or more mood episodes in a given year) isn't the norm. Many people may have only a couple of mood episodes a year, or even less, once treated. That said, when moods occur, it is not the Jekyll-and-Hyde sort of scenario implied by the adjectivized modern pop culture idea of bipolar that moods are quick to change. Sufferers can endure weeks, and even months, of any of the mood states.

Borderline personality disorder (BPD): While Glenn Close's character in Fatal Attraction might come to mind, such an extreme presentation is the exception. Many with BPD don't possess confrontational boldness but can seem meager or even possess a hermit-like component to their personality. Violent vindictiveness and intense drama-stirring relationship dynamics may be replaced by more passive aggression and avoidance.

Further, while push-pull relationship dynamics are a central component of BPD, not often portrayed is the intensely unstable sense of identity (often a complicated mix of how the person perceives themselves and chameleonizing to others to feel accepted or that they belong.). These BPD subtypes are brought to life, both scientifically and anecdotally, in Christine Anne Lawson's book, Understanding the Borderline Mother.

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Dissociative identity disorder (DID): Put on the entertainment map by the 1976 movie Sybil, DID, historically called multiple personality disorder (MPD), is perhaps the most egregiously exaggerated psychiatric illness. Often depicted as an unpredictable and dangerous revolving door of different people in one body (e.g., split), nothing could be further from the truth. First, MPD was changed to DID in recognition that it's not a whole other person or even personality that appears but an alteration in conscious identity, which is often fragmented.

It's not unusual, for instance, for a protective profile to emerge if feeling threatened. The identity is assertive, and the usually timid core personality is quick to let it be known they will not be taken advantage of. No "complete" personality is involved; rather, there are utilitarian identity fragments. Outside of this, "alters" are usually extremely subtle and noticeable only to people very familiar with the sufferer. In fact, the symptom that most often brings people to treatment isn't that anyone notices changes in "who they are." Rather, they keep experiencing blocks of missing time they can't account for. This, of course, is when there is an identity shift. Patients aren't necessarily aware of the alters emerging.

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Schizophrenia: This is not always the person with a tinfoil hat on, talking to themselves in a basement. Further, it has nothing to do with someone just being behaviorally erratic, as the comment "they're kind of schizophrenic" might imply about an unpredictable person. Some people with schizophrenia, indeed, are severely impaired, following the commands of voices and experiencing grossly disorganized behavior or even catatonia at times.

While hallucinations and delusions are usually the first symptoms listed, they are not necessarily obvious. One person I know heard voices constantly and explained, "It's like somebody with ringing in their ears; I can just usually drown it out." Others "have it together enough to know they don't have it together" can question their reality, work, and go to school. They are not invalids; they're rather resilient, but that's not entertaining and thus not normally portrayed.

Disclaimer: The material provided in this post is for informational purposes only and is not intended to diagnose, treat, or prevent any illness in readers or people they know. The information should not replace personalized care or intervention from an individual's provider or formal supervision if you're a practitioner or student.