Exploring the Connection: Mental Health in Horror Movies

Take a deep breath and get grounded, because we are diving into all those avoidant places your anxieties and phobias hide and pulling them up by the root to expose some of the most powerful takes on Mental Health in Horror.

I don’t write this list lightly as a fan of horror or a patient, and as with any mental health article I write, this is an analysis, and was not designed to diagnose, treat, or cure any illnesses physical or mental. I was careful with the films I chose and why. I want all readers to know that my undergraduate degree was in healthcare and law, my early law school work focused on malpractice, I have volunteered in major hospitals such as CHOP, I am a published mental health advocate, and I have been in treatment for mental health for nearly seven years with therapies including DBT, CBT, talk therapy, EMDR, prolonged exposure, and a pharmaceutical cocktail I’ve learned to pronounce and parse apart. Mental health consumed my life, and in turn, I looked to horror to find a place to bury my sorrows about my diagnoses and find some fresh dread in how they can be viewed. I have several labels to my name, and I carry them with as much grace as I can, but sometimes films or performances brush up against fresh wounds or old scars and remind me there are heartbreaking or mind-blowing portrayals of the mentally ill within the genre told with imagination and depth. From the blanket terms of dementia and trauma to the nitty gritty of personality and dissociative disorders, I’ve dug deep to understand the meaning and feeling behind some of the most moving pieces revolving around the health of the human mind, and wanted to do some light character studies and analysis of how mental health has been presented through the horror lens.

Mental Health in Horror – 10 of the Best Horror Movies

Smile (intrusive thoughts/suicide/trauma)

Exploring the Connection: Mental Health in Horror

I’ve written about this before, but I’ll happily do it again as I find this to be one of the most salient, painful, and relatable portrayals of mental illness I’ve seen in horror. Smile pulls back the mask on intrusive thoughts and trauma, laying bare scabs that have sat dormant for years, unhealed, ready to be picked at. Dr. Rose Cotter is seeing a patient, not one of her usual clients, a young woman who claims to be followed by something pretending to be people—and it’s always smiling. In a fit of terror, the girl rears back believing she sees the entity and is overcome, suddenly standing, smiling, ending her own life in front of Rose brutally. What follows was what some called the scariest film of the year and what others scolded as an exercise in jump scares, I think it was both, and both aspects were done incredibly. Painting trauma as the hungering monster it is, the scares feel real and imitate, the unwanted intrusions in the form of what should be so innocent: a smile. 

I am diagnosed PTSD and I’m currently in prolonged exposure therapy, a regular little look at the “smile” to remind yourself it’s just a memory, and it cannot hurt you anymore. Smile’s use of jump scares wasn’t just a gimmick it was a weapon designed to mimic the intrusive thoughts and images that a powerful trauma can cause you to see and hear. Flashbacks, audio visual hallucination, feelings of being lost, isolation, an inability to verbalize what exactly is happening to you because there are no words when an event so powerful, and so god awful, unfolds in the middle of your life. Even the trailer’s use of the repeating, echoing phrase “You’re going to die” sounds like an inner decree from someone who truly believes their life is coming to an end. Rose is likely (it’s inferred) already suffering from some form of PTSD after the death of her mother, and her visions and dreams of this hint that before the smiling demon took control there were already instances in Rose’s life she wasn’t confronting. Showing how a moment can shape a lifetime and that your own thoughts can be more relentless than a serial killer hot on your heels, Smile made it feel as though your own thoughts and emotions were hunting you, and there’s nowhere to go because everywhere you go… there you are. 

Malignant (BPD rage)

Exploring the Connection: Mental Health in Horror

Few people I spoke to thought this would count as a mental health selection, but few people I’ve talked to have dealt with feeling or dealt with a person that has BPD rage. BPD was most famously portrayed by Winona Ryder in Girl, Interrupted, showing a less extreme, diagnosed and treated version than Malignant of reckless behavior, outburst, and a lack of a sense of self, some of the hallmarks of this condition beyond the rage component. A trademark of the personality disorder, rage states that can last for hours or even days and are a sign of BPD and a dysregulated sense of mood and self. Gabriel, firstly, as the former being and current consciousness that he is, is now a fragment though still aware and able to communicate telepathically. Cut away at by doctors at Simion Research Hospital until he was managed into a single section of gray matter, Gabriel is suppressed and trapped at an early age. After thirty years of forced dormancy, he awakes after another incidence of violence, domestic abuse at the hands of his sister’s husband, cracking her skull and giving Gabriel his first window in decades. His immediate use of his abilities and who he targets demonstrates this powerful rage. Targeting those close to him and lashing out with immense cruelty and unruliness, Gabriel kidnaps his mother, targets his doctors, and begins an all-out assault on those trying to turn him back into a prisoner.

BPD can also cause other hallmarks we see in Gabriel; people with this condition are often seen as self-serving, reckless, with a possible compulsion for violence or self-harm in turn, and a lack of ability to control mood. Gabriel, with his rage and trauma, fits all these bills. BPD can also have a fragmentation aspect where the personality becomes split somehow due to severe trauma, creating instability of the self which Gabriel could represent as he is a literal fragment taking over the central body, personality, and mind. This is all very extreme, of course, but I can’t say as someone diagnosed that I haven’t had these intense phases of anger, felt like I might lose control, or that I haven’t felt sometimes like I’m always quite “me.” I’ve yet to see a character as ambitious, enraged, calculated yet wild as Gabriel and I’m not sure when I will again. I think he is the perfect face for BPD rage: twisted, tormented, and out of control. 

Lights Out (depression/codependency/guilt)

Lights-Out lights out Exploring the Connection- Mental Health in Horror

Some of us are people pleasers, some of us don’t care, but for those that give themselves to others very freely and have high expectations of themselves could experience something called codependent guilt. This condition causes inappropriate guilt and can keep codependents from setting life changing boundaries or detaching from negative influences. Lights Out focuses on a mentally ill woman, Sophie, already prescribed anti-depressants, struggling to take care of her children, and talking to what appears to be an imaginary friend, Diana. When it’s revealed that Diana was a fellow patient back in Sophie’s youth at the hospital, things get ugly. Diana, believed to be an evil little girl, and Sophie formed a bond in their captivity, but when Diana died due to an experimental procedure, it seems she’s unwilling to let go of life—and her only friend.

Sophie begins with some classic symptoms of depression, tethered to her house, having difficult relationships, and trapped in her head and the dark. Her devotion to Diana and perceived guilt at having gotten out while Diana passed is painful to watch as the spirit strips her of her remaining free will and oppresses her family. Sophie becomes enraged during an intervention but secretly asks for help, showing she understands the connection is detrimental, that her guilt and attachment are unnecessary and her sadness is affecting her whole family. Her codependent guilt stemming from illness and an unhealthy childhood friendship caused a link she didn’t ask for, tethering her to something otherworldly and isolating her. With a healthy support network that is quick to the medicine and the light switch, Diana and the conditions she created for Sophie were light work, showing how a support network and safety plan are essentials for those suffering from mental illness or oppressed by unhealthy connections. While this may not always be enough, it’s still a good reminder that, sometimes, it’s okay to need someone to lean on. 

The Taking of Debora Logan (dementia/alzheimers)

deborah-logan Lights-Out lights out Exploring the Connection- Mental Health in Horror

“There are no words to describe how distressing it is,” says Deborah Logan on the topic of losing her mind. One of the most horrifying diseases and blanket terms to be diagnosed with, dementia is a slow, painful killer of the mind and body that takes the whole family for a ride. The Taking of Deborah Logan was a mockumentary feature that covered the journey of an Alzheimer’s patient and the mental and health effects this has on loved ones. The crew is warned about Deborah’s behavior from her daughter (blood pressure through the roof from the stress of caretaking), and is almost excused by the patient herself due to nerves, but over the following days they begin to document some of the bizarre and unexplainable behavior that Deborah has been exhibiting. Her doctor says this is all common for someone with an aggressive form of Alzheimer’s disease (her scans read that she is in the early stages of cognitive impairment), but as the case goes on, the crew begin to become convinced that organic illness isn’t the cause of the strange occurrences or behavior. 

Dementia is rarely a diagnosis any longer. It is a blanket term to refer to a set of symptoms that affect cognitive abilities, thinking, memory and behaviors. Alzheimer’s is the most common type of dementia, a neurodegenerative disorder that affects cognition. Deborah is a diagnosed Alzheimer’s patient with regular care, a set routine, and some off the wall behavior, nothing uncommon. Alzheimer’s is usually diagnosed correctly with modern medicine’s advances, with a now 90% success rate and the ability to perform a PET scan to meet further diagnostic criteria such as abnormal levels of plaques (amyloid protein) in the brain. We see in films like The Pope’s Exorcist that most often, a priest isn’t necessary for wild or abnormal behavior, as most were recommended to doctors and psychiatrists. However, it is uncanny how much mental illness can make a person appear to be possessed or influenced by some greater, darker power. The Taking of Deborah Logan was a supernatural lens to view illness through while still delivering the painful, arduous looks into a life torn apart by an impaired mind. While Deborah may have had problems beyond this world, this is still an amazing film documenting one of the most prevalent forms of dementia that affects over six million Americans over the age of 65. A triumph and a light shined on the plights of elderly patients, this was a nasty illness to watch play out into pure evil. 

Mental Health in Horror – 10 of the Best Horror Movies

The Babadook (maternal depression/anger/grief/trauma)

bbb babadook Mental Health in Horror

You can’t get rid of The Babadook. The chants of “Don’t let it in! Don’t let it in!” still ring in my head when I watch this film or trailer. A portrait of maternal frustration, grief, and rage, The Babadook was award worthy film and horror that painted a picture of life after loss and the burdens of a mother. Having lost her husband on the day her son was born, Amelia has been living the last six years in hell raising a difficult son, working a demanding job, and trying to cope with her grief. This first becomes a study on her son, Samuel, who begins exhibiting strange behavior like insomnia, anxiety, and a fixation on monsters and weapons. After dealing with issues at school one day, Samuel brings in a strange book called “Mister Babadook” to read, and becomes obsessed with the titular monster. Soon it’s no longer Samuel that’s seeing visions and acting strangely, but Amelia is a ball of rage, snapping, violent, seeming to channel the rage of the monster that mocks her denial of its existence. 

While maternal depression usually only applies to postpartum up to three years, Amelia seems to have a rocky connection with her son and associates him with the traumatic loss of her husband. Single parents have a different health profile, as do their children, and in 2020 alone fifteen million children were being raised in single mother households. Common stressors to look out for are being “stretched too thin” much like Amelia is, no personal time, loneliness and isolation, to name a few. The Babadook and the idea of “letting it in” as well as the notion that you “can’t get rid of it” makes it sound like a chronic disease, setting into the victim permanently. Amelia has to battle her rage at her son, her losses, and her mental condition to overcome the power that this cursed entity has brought to the surface. In the end, we see there really is no getting rid of our Babadooks, tending to and feeding them, our illnesses and anxieties, like little pet monsters. The Babadook could represent a great many things but I believe it was the representation of the heavy shadow of sorrow overtaking a single parent that desperately wants to love but is too damaged and scared to try. 

Glass (DID/trauma)

Dissociative Identity Disorder (DID), also known as multiple personality disorder (but I won’t be referring to it as such here), is perhaps the most complex form of dissociative disorder. Characterized by at least two “alternates” or “personalities” it is believed the person assumes different personalities while some schools of thought believe it is a single personality malfunctioning. Childhood trauma plays a large part in this disorder, but I’ll get to that momentarily. Kevin Wendell Crumb suffers from DID in both Split and Glass, but I’ve chosen Glass as we see more of his identities and some intimate moments with key players like his alternate Patricia. After losing his father as a young child, he is left alone with his abusive mother and meant to spend the rest of his days fleeing from her neglect and hatred. As Kevin grew, presumably more identities arose to help cope with the trauma, and finally, a form much like a monster and a protector, The Beast, is created as the ultimate guardian.

Kevin experienced severe trauma and abuse as a child, this much we know and we know this is a factor in developing DID. We also see that Kevin’s father boards a train with a pamphlet about the condition, making me wonder if Kevin was already presenting several alternates already, or perhaps that his mother’s abuse was more clandestine when his father was present. DID can often go overlooked as other mental health conditions and I’ve found that in some cases people with dissociative disorders that are in active treatment fail to receive an accurate diagnosis until after five to twelve years of therapeutic work. Trauma as a factor is a widespread health concern for the population with the vast majority of adults reporting having experienced at least one traumatic incident in their life. For those for which the trauma persists though, compartmentalizing the abuse and shock into identities or fragmenting the personality is a coping mechanism. Trauma, the blanket catalyst, finds another home in this condition, ripping away at the self and causing fragments to fight for the “light” in Kevin’s case, and causing an unknown amount of patients both in and out of treatment to suffer daily from dissociative symptoms. 

Last Night in Soho (schizophrenia/PTSD)

Both of our leading ladies Sandie and Eloise are touched by trauma and illness during their last nights in Soho. Eloise is a dreamy artist, fantasizing about becoming a star designer in London and soon, her dreams come true as she’s accepted to study fashion in the heart of North London. After things don’t go well with her abusive roommate, Eloise moves to a small studio in the city over a restaurant run by an older woman, Ms. Collins. Her first night there she has vivid dreams of a young woman, Sandie, seeking fame and fortune as a singer in Soho back during the height of the swinging 60’s. Soon seeing signs the dreams are more than just illusory, Eloise rushes to discover the secrets of her time traveling dreams and the mysterious, beautiful and tortured woman at the center of them. 

It’s implied that Eloise may be schizophrenic, a condition affecting thinking and behavior that can look like a detachment from reality, causing hallucinations and delusions. A feature of her character seems to be visions, hallucinations, almost exclusively of the dead but sometimes in the living as well. Her mother committed suicide when the burdens of the condition became too much, and Eloise’s grandmother worries she may suffer from the same malady and become overwhelmed by the stress of the city much like her mother was. Meanwhile, Sandie’s story seems to be a classic case of severe PTSD, trapped in memory, literally building a life around secrets and pain. Speaking in dissociative terms like wiping out the faces of the men that assaulted her, Sandie’s time in the sex industry has scarred her to the point of violence. After dozens of unnamed, faceless clients Sandie snaps. She says she died in that room a hundred times and as revenge, put a knife into the man that put her there one hundred times. It’s hard to blame a girl that believed she would be on stage but instead ends up on her back forcibly for fighting back after the trauma became too much. That’s not to say trauma is justification for murder, but it certainly illuminates why Sandie became a killer: to save what was left of herself, and dole out her own form of justice to those that made her a victim. 

American Psycho (Psychopathy/narcissism)

Not an area of my expertise, psychopathy is a difficult to diagnose, complex condition that’s rare amongst the population. Patrick Bateman and American Psycho are two icons we immediately think of when we imagine psychopathy. An elite businessman working in finance and ladies’ man at that, Patrick is large on his outer shell hiding what he calls his cold gaze. Attempting to function as a presentably normal person, it’s important to note that Patrick understands what he is. Though he puts on the mask every day to pretend to be normal folk, when the sun goes down and Patrick’s urges and temper peak, violence and death are sure to follow. Patrick spends the entire film living a double life, fully immersed in his psychopathy and narcissism while simultaneously fooling his peers. After his ego takes a bruising from a hilarious yet tense discussion of business cards, Patrick kills a homeless man and his dog, showing he’s reactive when his self-image is attacked and seeks to assert power over a weaker individual. 

From interviews with psychopaths like Dahmer we know these individuals tend to and can understand how differently they function from normal society. Bateman has all the qualities of a narcissist as we see from the beginning of the film as he narrates his routine and shows off his physique that he’s so carefully worked to maintain. This obsession with appearance fits his character, carefully crafting a veneer to hide his tendencies towards humiliation, narcissistic injury, and cold-blooded murder. Almost 30% of the population displays some psychopathic tendencies (though only 1.2% of adult men meet the criteria for significant psychopathic traits) such as hallmark traits like reduced empathy, risk taking, or a grandiose sense of self, but these in themselves don’t make a psychopath. Bateman is emotionless, perhaps aside from rage, when it comes to his actions. He neither feels nor understands most emotion, and is frustrated by other people imposing on his desires. Patrick is a classic, mainstreamed psychopath delivered with all the self-worship and cruelty you could hope for with a scornful internal monologue that somehow comes with a reassuring smile. 

Midsommar (bipolar, suicide, trauma, mortality coping)

Covering a spectrum of issues, dilemmas and illnesses, Midsommar was a ruthless emotional uppercut when it came to the initial confrontation of mental illness and its worst-case scenarios. We begin with the struggling relationship of Christian and Dani. Worried about her family, Dani finds out she had good reason to as her bipolar sister has committed suicide and killed both her parents as well via carbon monoxide poisoning. I can speak to being bipolar, and this depiction made me itchy. Depressive episodes can be viciously demoralizing to the point life can seem to lose its value but I don’t think bipolar patients are often portrayed so extremely as both ending their own life while murdering their own family. Manic episodes are euphorically dangerous and the lows are craters but I don’t know anyone from support groups or my time in therapy that’s ever attempted such a rash, harsh, terrible gesture that would devastate or kill those closest to them. Moving past this, the incident keeps Christian from breaking up with Dani, instead inviting her on a trip to Sweden with his classmates and an escort. The festival which is all drugs, greenery, and sunshine soon shows its true colors dripping blood red like flower petals: this is not just a celebration of life, but an acknowledgment of death in the grandest, horrific way possible. More suicides by tradition follow, and Dani is left to cope after watching two elders take their lives as she grapples with this culture’s concept of the life cycle. 

Dani is certainly suffering from PTSD as we see she is having panic attacks, crying fits, hallucinations and feelings of isolation. Losing one’s entire family in an instant is frankly unfathomable. Her trauma inflicted by suicide and murder is only triggered by the ceremonial taking of life, causing her to spiral and desire to escape the village. As Dani slowly plunges into her own hazy form of insanity, she has incredible emotional breakdowns, surrounded by the women of the town that pant and sob in unison with her pain. She seems to come full circle as the May Queen, drunk on hallucinogens and dance, she appears to shed her ambivalence about life, her relationship and herself when she chooses to sacrifice Christian in an inferno instead of a local. Closing this chapter behind her, this again shows a character slipping into madness and choosing the murder of someone close to them as a means to an end. An interesting take on how illness or pure insanity can change our views on the value of life, both increasing and decreasing simultaneously, Midsommar touched on the seasons of our lives and how abruptly once green leaves on the tree of life wilt, and soon, fall away like limp bodies from a cliff top. 

Nefarious (sanity determination/compos mentis)

This was the most mysterious topic on the list, avoiding my eyes and fingers as I searched the depths of the web for a compos mentis determination hearing. I found virtually nothing to document the final days and sanity determination of prisoners sent to death. In Nefarious, Dr. James Martin is sent to a prison for a compos mentis hearing of inmate and convicted serial killer Edward Wayne Brady. Brady has supposedly driven past physicians to kill themselves and is telling stories of demonic possession. This, should, in theory with his belief system so attached to the idea, make him non compos mentis, but in our story, things are just as hazy, morally and clinically, as they are in real life.

The final days of a death row inmate are mysterious. Moved from death row to an observation cell, there are a couple of days preparation prior to execution allowing family visits and some final contact as well as opportunity for the courts to call off the sentencing. The Supreme Court has yet to find a method of execution inhumane, but some states do, and we see that in Nefarious it takes place in a state where the electric chair is still in use. Edward claims he is a demon, prompting an initial non compos mentis determination from James as Edward’s beliefs line up that he truly believes he is possessed. As the interview goes on though, we see that dissociative identity disorder, which James suspects, is off the table and a violent brawl in which Edward seems to fully understand his violent capabilities prompts James to declare Edward (and his demon) competent to be executed. I worked as an intern at the Philadelphia District Attorney’s Office and came across a couple of cases in the Post Conviction Relief Act Unit that some inmates applied saying that new facts—their mental state—applied to the case and weren’t taken into consideration at trial. This was my closest brush with compos mentis determination which means “of sound mind” or “having mastery of one’s mind” depending on the source. Nefarious attempts to peek behind a curtain that hides some of the most intense psychological and moral secrets that man keeps when we determine that one of our own is no longer fit to live amongst society. A thoughtful and engaging reimagining, I guess I won’t be able to tell you how close to the truth this hearing would be to an inmate telling their story in Philadelphia County. 



About Gabriella Foor

My name is Gabriella Foor, I am an author for Warped Perspective, a List Editor for Morbidly Beautiful, an avid horror fan, published mental health advocate and new enough writer. I attended the University of Pennsylvania and competed in varsity fencing as well as volunteering at the Children’s Hospital of Pennsylvania, graduating with a degree in healthcare and law. I began writing a year ago as a form of therapy and to express my love of horror that I had kept mostly to myself until recently. I find writing the most honest and open form of communication, and my goal is to spread the spooky spirit and, when I can, give a voice to those suffering from mental illness and ideally provide a sounding board or outlet for those that might feel unseen. I have been writing for a year now and would love to continue to spread the joy horror brings me while advocating for those in a marginalized community. 

Twitter: GabriellaVF @lavelavioleta

Instagram: gabriellavelavioleta

Warped (where you can find my most recent review on The Animal Kingdom):

https://warped-perspective.com/

Morbid (where you can find editorials and original lists): https://morbidlybeautiful.com/

Mental Health Advocacy Work (features on imposter syndrome and addiction to be published and I am covering disability in film for Access:Horror next month through Lincoln Center): 

https://mentalhealthyfit.org/thinky/horrorfilms

https://www.lincolncenter.org/series/lincoln-center-presents/reelabilities-film-festival-new-york-1

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  • Jim Mcleod

    Jim "The Don" Mcleod has been reading horror for over 35 years, and reviewing horror for over 16 years. When he is not spending his time promoting the horror genre, he is either annoying his family or mucking about with his two dogs Casper and Molly.

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