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Depiction of Substance Dependence vs Other Mental Disorders in Motion Pictures

Navya Kapoor

In the research paper “Stigma, Discrimination, Treatment Effectiveness, and Policy: Public Views About Drug Addiction and Mental Illness” (Barry, McGinty, Pescosolido, & Goldman, 2014), differences in the public attitudes about mental disorders and drug addiction were examined. Public attitudes for four dimensions, namely stigma, discrimination, treatment effectiveness, and policy support were studied through a web-based national survey. Half the people received questions with reference to mental disorders and the other half received the same questions with ‘mental illness’ replaced by ‘drug addiction’. Results indicated that respondents’ attitudes about people with drug addiction were more negative than people with mental disorders. People’s attitudes about alcoholism have been found to be equally negative as about drug addiction (Corrigan, Kuwabara, & O'Shaughnessy, 2009).
In this blogpost, I would like to focus on the role of popular motion pictures in contributing to the negative attitudes about drug addiction in comparison to other mental disorders. In recent times, multiple mainstream movies have been made that depict different mental disorders such as anorexia nervosa and bulimia nervosa in To The Bone, paranoid schizophrenia in A Beautiful Mind, obsessive compulsive disorder in The Aviator, post traumatic stress disorder and depression in The Perks of Being a Wallflower, etc. These movies typically have the protagonist as the one with mental ill health and the theme involves portrayal of the behavioral symptoms of the disorder, the ways in which it impacts the life of the patient and their family, kinds of struggles they encounter, and the like. Even though the portrayal of the disorders may not have been completely accurate in these movies, they have successfully created awareness regarding the disorders, initiated a discourse on them, and paved a way for normalizing them.
On the other hand, movies that present drug addiction or alcoholism have failed to represent them as mental disorders. Be it Leaving Las Vegas or Half Nelson, time and again in the movies, the characters who have drug or alcohol dependence are shown using the substances for pleasure and by choice. The element of helplessness in relation to one’s substance dependence is missing from these movies, which exhibits constant use of substance as one’s choice rather than as a result of their dependence on it. These characters are almost never referred to as patients. Moreover, the importance of rehabilitation centers in most movies is not emphasized. In Leaving Las Vegas and Half Nelson, we find only mentions of a psychiatrist or medication required in the rehabilitation process. In A Star is Born, Jack (the protagonist) joins a drug rehabilitation center, yet emphasis from his substance dependence dissipates due to a focus on his childhood problems, which is shown as a cause of his substance use. While delineating the cause of initiation of substance use is clinically important, it comes across as a reason for his regular substance use in the movie. This misleads the viewers to believe that he uses substance as an escape mechanism, which might have been true for his initial use but later his use was being driven by his dependence, which is a mental disorder classified under DSM V. In most movies depicting mental disorders other than substance dependence, an emphasis on therapy, medication, and one’s struggles with their disorders significantly help in depicting the conditions as mental disorders. For example, set in an institution for people with eating disorders, To The Bone successfully portrays eating disorder as a mental disorder, even though the portrayal is not completely accurate. On the other hand, in the four Hollywood movies that I have watched on addiction, none of them present the struggles one encounters in their battle with addiction in a rehabilitation center, if they join one.
Other ways in which movies propel negative attitudes for addiction are through an enormous emphasis on maladaptive behaviors that co-occur with substance dependence such as stealing to pay bills or to purchase more substance, ill-treatment of friends or family, impulsivity, etc. Even though such behaviors are correlated with substance use or dependence and their representation is required to provide a complete view of the disorder, I have a problem with the large extent of focus on these behaviors in the movies. In contrast, feelings such as guilt, regret, and will to recover are not highlighted even though they are found in most of the recovering patients (Meehan, O'Connor, Berry, Weiss, & Acampora, 1996). Further, major parts of the movies depict the falls and failures of the characters with addiction, while their achievements are either neglected or scarcely mentioned. On the other hand, whether the movies depicting other mental disorders are fictional or inspired from true stories, they generally highlight the accomplishments of the patients. For instance, in A Beautiful Mind and The Soloist.
Moreover, movies on alcoholism and drug addiction often end with a suicide or death caused by the substance, like in Leaving Las Vegas and A Star is Born. Even though these incidents are common in addiction patients, many of them recover and lead on their lives. In contrast, movies on other mental disorders generally end with a positive regard. For example, the final scene of A Beautiful Mind shows Nash, his wife, and his son leaving the auditorium after receiving Nobel Prize in Economics and The Perks of Being a Wallflower ends with Charlie, Sam, and Patrick revisiting the tunnel where Charlie and Sam first kissed and fell in love. The negative end note in the former movies can be viewed as propelling the attitudes about treatment effectiveness dimension in the above mentioned paper, that measured the attitudes about possibility of recovery and effectiveness of treatments, which were more negative for addiction than other mental disorders.
The lack in portraying substance dependence as a mental disorder, emphasis on maladaptive behaviors and failures of addiction patients, and lack of presentation of their achievements in movies significantly contribute to the dismissive and apathetic attitudes for them as well as the stigma attached to them. These attitudes and stigmatization include unwillingness to marry into family or work closely on job with people with addiction, justification of discrimination in regards to their employment and housing, and opposition to policies that suggest equivalent insurance benefits as well as increased government expenditure on their treatment, housing, and job support (Barry, McGinty, Pescosolido, & Goldman, 2014). These attitudes are not equally widespread for mental disorders other than addiction, which might be due to their relatively positive depiction in movies. Nonetheless, it ought to be imperative for the makers of motion pictures to ensure that they adopt the much needed positive angle while producing movies and are cautious in representing substance dependence as a mental disorder.


References
Barry, C. L., McGinty, E. E., Pescosolido, B. A., & Goldman, H. H. (2014). Stigma, discrimination, treatment effectiveness, and policy: public views about drug addiction and mental illness. Psychiatric Services65(10), 1269-1272.
Corrigan, P. W., Kuwabara, S. A., & O'Shaughnessy, J. (2009). The public stigma of mental illness and drug addiction: Findings from a stratified random sample. Journal of Social Work9(2), 139-147.
Meehan, W., O'Connor, L. E., Berry, J. W., Weiss, J., & Acampora, A. (1996). Guilt, shame, and depression in clients in recovery from addiction. Journal of psychoactive drugs28(2), 125-134.   

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