Borderline personality disorder, despite entering the Diagnostic and Statistical Manual of Mental Disorders in 1980 and affecting 1.6% of the population each year, is a condition that is still not very well understood. Much of the medical community agrees that BPD isn’t even a particularly good name for the disorder. Its causes are unclear, but the symptoms include an extreme fear of abandonment, distorted self-image, intense emotional reactions, impulsive behavior, unstable relationships, and self-harm. And for some reason, I gravitated towards two dramatic portrayals of BPD this weekend — the 1999 film Girl, Interrupted, and the most recent episode of Crazy Ex-Girlfriend, “Josh is Irrelevant.” My, how things have changed in the way mental health is portrayed in the media.
I remember the buzz around Girl, Interrupted, the film adaptation of Susanna Kaysen’s memoir of her 1968 stay in a Massachusetts psychiatric hospital, when it was released. I mean, who could forget Angelina Jolie’s Morticia Addams look at the 2000 Oscars (or the fact that she kissed her brother on the mouth on the red carpet, an anecdote that deserves its own article entirely)? Of course, being 8 years old, it took me a few more years to actually see the film. Scrolling through Amazon Prime, I saw that it was available to stream and decided to give it a watch.
This was after I had caught up with my current favorite show on television, Crazy Ex-Girlfriend. In this week’s episode, Rebecca Bunch returns to West Covina after surviving a suicide attempt and finally gets what she’s always wanted — a proper mental health diagnosis. That diagnosis ends up being borderline personality disorder, and Rebecca understandably freaks out after doing some cursory Googling.
Susanna, the protagonist of Girl, Interrupted, played by the inimitable Winona Ryder, follows a similar path to Rebecca, albeit several decades in the past. After chasing a bottle of aspirin with a bottle of vodka, her parents send her to Claymoore, a fancy private psychiatric hospital where she stays for a year with several other young women struggling with their own mental illnesses. A few weeks into treatment, Susanna is diagnosed with BPD. She tries to make some sense of her diagnosis by looking up the symptoms in one of the doctor’s books, but doesn’t fully understand how her doctors could’ve arrived at that diagnosis. Her doctors don’t seem to fully understand it either.
Rebecca and Susanna do have several of the textbook characteristics of BPD. Their similar suicide attempts are just the tip of the iceberg. Both find themselves in unstable relationships with men in positions of power — for Rebecca, it’s her law professor; for Susanna, it’s the father of one of her classmates. They act out in impulsive ways, like escaping the grounds of the psych ward with a known sociopath, or moving across the country for a summer camp crush. And of course, both have a tendency to dissociate during stressful moments.
For a musical comedy that loves a good poop joke, though, Crazy Ex-Girlfriend portrays mental illness in a much more realistic and ultimately loving way than any psych ward drama I’ve ever seen, including Girl, Interrupted.
For one thing, Crazy Ex-Girlfriend shows its protagonist actively seeking treatment. Rebecca is seen going to therapy intermittently throughout the series, but after the incident on the plane, she seems much more enthusiastic about getting treatment. In fact, she sings a whole song about how excited she is to get a new diagnosis and “find her tribe” of people struggling with the same illness. Susanna, on the other hand, is more or less checked into the hospital against her will. A relatively routine appointment with a psychiatrist following her suicide attempt turns into more of an intervention when her doctor puts her in a cab to Claymoore. She denies that she tried to kill herself through much of her stay in the hospital, as well. She goes to her therapy sessions out of obligation until about the third act of the film, when she finally commits to getting well and getting out.
Of course, Girl, Interrupted is set in the late 1960s, when psychiatry was just starting to gain traction in American culture. In fact, the first real study of borderline personality disorder wasn’t published until 1968, the year in which the film takes place. Perhaps Susanna is so resistant to treatment in the film because of the stigma attached to mental illness at the time. The film, however, always leaves us wondering if Susanna was ever ill at all, or if she was just sent away because her parents didn’t know what to do with her. I fear this kind of ambivalent attitude could lead viewers with similar high-functioning mental illnesses to avoid treatment, simply because they don’t see themselves as “crazy enough” to warrant it. Even today, Susanna’s struggle with the stigma of mental illness seems all too familiar.
That stigma pops up in “Josh is Irrelevant,” as well. Nathaniel, Rebecca’s WASP-y boss and would-be love interest, struggles to reach out to Rebecca throughout the episode. It’s later revealed that he witnessed his mother’s suicide attempt when he was a child. When she went away for treatment, his father claimed that she “had the flu and needed to go sailing for a month” and refused to talk about it again. We see the same attitude with Susanna’s parents in Girl, Interrupted. During a family therapy session, they ask if she’ll be back home in time for the holidays, so they won’t have to answer any prying questions from their neighbors. While Nathaniel’s parents are probably a bit younger than Susanna’s, they likely grew up with the same attitudes and in the same environment, where any struggles are swept under the rug. Nathaniel quite bravely decides to break the cycle, confront his parents about what happened, and have an honest conversation with his mother.
One problem with psych ward narratives is that the patients that the main character meets in the hospital are often just walking diagnoses. With the exception of Lisa, the sociopathic queen bee who earned Angelina Jolie an Academy Award for her portrayal, most of the patients in Girl, Interrupted are just that. We learn about their specific mental illnesses, how those illnesses present themselves, and (in some cases) how they ended up at Claymoore, but that’s about it. We don’t really see who they are outside of the ward because they don’t exist outside the ward. This leads to a pretty narrow view of mental illness as something that lands you in a hospital for the rest of your days rather than something that affects people with real, full lives.
Rebecca, on the other hand, receives outpatient treatment and spends most of her time with her family of West Covina friends, who (as far as we know) have not been officially diagnosed with mental illnesses of their own. As CEG is quickly becoming a show about mental illness, we could see the #BunchaFriends diagnosed down the road (I, for one, am looking forward to the show tackling Paula’s co-dependency issues). But by now we know who these characters are outside of any mental health struggles. Having spent three seasons with Rebecca, who has been struggling throughout the series, we know that she is a full, three-dimensional character and not just the sum of her BPD symptoms.
If anything, the differences between Crazy Ex-Girlfriend’s and Girl, Interrupted’s approaches to mental illness show how far we’ve come in our attitudes towards mental health. Disorders like BPD are no longer something you have to fight alone, hidden away from the rest of the world. The outpouring of support Rebecca receives from her friends is truly inspiring, and the kind of response anyone should receive when they’re going through a hard time. Though her friends may not totally understand what’s going on with her, they care enough to stick around. Though Susanna was surrounded by doctors and similarly afflicted women, I don’t think she had quite the same support system. I mean, she ended up taking a cab home after being discharged. Her parents could’ve picked her up at least.
Things are changing when it comes to mental health. We still have a long way to go, but better portrayals of mental illness in the media definitely help. Thank the TV gods for Crazy Ex-Girlfriend.
Top photo: Crazy Ex-Girlfriend
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Charlotte Dow is a New York-based writer whose work has appeared in The Billfold, The Dot and Line, and The Financial Diet. You can find more of her writing on her website and her blog, A Suitcase Full of Pens. Follow her on Twitter, Instagram, and Facebook.