Besides maybe Emergency Medicine, there’s probably no other medical specialty that appears in pop culture and entertainment more than the pyschiatric diagnoses. And there’s definitely no other medical discipline with so much stigma attached to each and every diagnosis. Here now, in order that I think of them, my examples of pop culture psych:
- Psychosis/Schizophrenia: Hearing voices, seeing things, having fixed incorrect beliefs (delusions). Probably the most skewed, stigmatized diagnosis of all medical diagnoses, including the other psych diagnoses and HIV. Schizophrenics are always the “crazy people that hear voices” and mutter to themselves, and are very, very dangerous. They are unstable, they attack people for no reason. The screaming naked guy from The Sixth Sense, for example.
In the real world, these people are often managed and doing well on medications. Many of the chronically homeless are also schizophrenic. If they make strange movements with their mouths or tongues, it’s a permanent side effect from some of the older medications. They can’t help it. From the patients I’ve seen, schizophrenia is an incredibly sad, incredibly terrible disease. While there are definitely some people with the disease that scream or are violent, most of the folks I’ve seen are kind, quiet, confused, and scared. They hear voices talking to them all day long, or screaming at them, or narrating their thoughts. One patient is constantly being told she’s being arrested, or she’s bleeding internally, or that she’s done something awful. All. Day. Long. Another patient hears his friends’ voices narrating his day. If he drinks a cup of juice, they say, “He’s drinking some juice now.” If he walks down the hall, they say, “He’s walking down the hall.” I don’t think I could stand that for a day, let alone a lifetime.
- Dissociative Fugue: Usually after some traumatic event, a person forgets their entire past life, moves to another city, and starts a totally new life. Geena Davis in The Long Kiss Goodnight, and maaaybe Kermit in The Muppets Take Manhattan, when he starts working in the ad agency after being hit by a car. Probably also “amnesia,” but I’ll just include it here.
- Speaking of amnesia: it’s the perfect plot device for most crappy soap operas and movies alike. (But Memento was good.) Problem is, it’s quite rare, and usually doesn’t happen after getting hit in the head; it’s usually after a very traumatic life experience.
- Munchaussen’s By Proxy: Someone purposely gets someone else sick (often their child) in order to get medical attention. (Think the mom in The Sixth Sense that was poisoning her daughter.)
- Tourette’s disorder involves frequent vocal or motor tics. A tic is a repeated behavior that can be suppressed, but causes great distress to do so. The coprolalia form is your classic “Shit! Fuck! Shitfuck!” from classy movies like Deuce Bigalow, Male Gigolo.
- Antisocial personality disorder: the pop culture “sociopath” that doesn’t abide by societal rules and shows little remorse. Serial killers in TV docudramas will fit the bill.
- Hypochondriasis: Isn’t the guy on Monk supposed to be a hypochondriac? Oh, and Bob in What About Bob? Very significant anxiety and worry about having disease. (Also most 2nd year med students.)
- Male Erectile Disorder: better known as impotence. Charlotte’s first husband on Sex and the City, anyone?
I could go on and on, but I think you catch the drift: psych diagnoses are everywhere, and they’re often totally off-base.