Whenever TV and movies portray a person with mental illness, it’s usually a “crazy schizophrenic,” an ax-wielding sociopath, a violent, drug-addicted mental patient or an insane asylum escapee — or a combo of all four. Either way, that person is almost always hopeless, dangerous and deranged.

When the news media tries to tackle mental illness, it’s typically after a horrific tragedy has occurred. A writer for the University of Wisconsin-Madison Daily Cardinal explains:

“The script usually goes as follows: tragic event occurs, media pounces, the feeding frenzy begins, the public is inundated with endless graphic and heart-wrenching details, pundits and analysts play the blame game until the next media firestorm occurs.”

Stigma in mainstream media is nothing new, and has a long, insidious history (see here for examples). So when a TV show aims to address mental illness, you hold your breath and hope for the best — especially if it’s a drama like “90210,” whose primary audience is teens. For many of them, this is their first look at bipolar disorder.

The Portrayal

Erin Silver (played by Jessica Stroup), one of the main characters, displays a variety of classic bipolar symptoms, including erratic, reckless behavior, racing speech, grandiose ideas, hypersexuality, lack of sleep, euphoria and confusion (see here for an excerpt on YouTube). As often happens during manic phases, Silver ends up making destructive decisions, which end with her at the train station, rambling and bewildered, running toward a speeding train. (Ultimately, she’s OK.)

In the episode that aired the week of April 13, Silver was diagnosed with bipolar disorder and received treatment. She voiced her frustration at having to maintain a strict regimen that includes a regular schedule for meals and sleep, taking her medication, seeing her therapist, journaling and avoiding anything “stimulating” — including not reading a “stimulating” book. Her sister, Kelly (played by Jennie Garth), is supportive, but stifling, as she tries to create a highly regimented environment for Erin.

Overall, “90210” does a decent job of portraying bipolar disorder. The show focuses on a severe case, known as bipolar disorder I. However, many viewers might miss the fact that there’s a spectrum with shades of severity. Some people experience mild manic episodes — known as “hypomania” — and deeper depressions. Others can cycle through depression and mania within a month, whereas some patients experience depression for a year. Simply put, everyone experiences bipolar disorder differently, so viewers shouldn’t assume that all individuals who have bipolar disorder act like Erin Silver.

It is commendable that “90210” chose to portray mental illness in the first place, because, unfortunately, shows rarely do — and I’m not sure why that is. Its portrayal provides an opportunity to talk about mental illness and reach many teens. “90210” also aired a public service announcement about bipolar disorder, prompting viewers to visit a website for more information.

Key Points

Though it’s uncertain if “90210” will go beyond a narrow portrayal of bipolar disorder, the episodes do underscore several important points:

  1. There is not just one treatment. Silver talks about taking medication and seeing her therapist, and medication and psychotherapy both are important components of bipolar disorder treatment. However, the episode doesn’t talk about her treatment any further. We also see Kelly going through a mood chart with Erin, though Erin seems less than thrilled about it.It’ll be interesting to see how much of a role her treatment will play in the show. Will “90210” show a typical therapy session? Will the writers address effective treatments for bipolar disorder? It’s doubtful they’ll go into much detail, but it’s certainly something that’s needed.
  2. Routine is important. Structure is key in successfully managing bipolar disorder. “90210” hammers in this point, with Kelly’s insistence on Erin’s maintaining a rigorous routine. It’s true that any slight changes in one’s routine, such as skipping several hours of sleep, can trigger a manic episode. But loved ones might push too hard in trying to help. Managing bipolar disorder is far from simple, but leading a fulfilling, productive life is very possible. Hopefully, “90210” will show this.
  3. It’s not a matter of “fault.” When referring to bipolar disorder, many of the characters describe it as a disease, which is a step in the right direction. For instance, when talking about his biological mom — who has bipolar disorder — Dixon, Erin’s boyfriend, explains that it wasn’t his mom’s fault that she has bipolar and that she just needed help (see here). This touches on one of the biggest misconceptions of mental illness: that somehow a person has brought it on him- or herself.I wonder if “90210” will take this further and explore the contributing causes of bipolar disorder, showing viewers the complex interplay of biological, psychological and genetic components — but it, too, seems doubtful.
  4. Individuals can lead productive lives. Dixon’s mom seemed put-together and professional in last week’s episode. She talked about doing better, having a job and her own apartment. Though it’s a short scene, viewers do get to see that although it’s a chronic disorder, bipolar individuals can lead healthy lives with continuing treatment. This is a far cry from the prevalent disparaging stereotypes of the mentally ill.

“90210” is in the business of garnering viewers and being provocative and “good TV.” But let’s hope it will spark honest dialogue about mental illness and do a responsible job in its portrayal.

Do you think “90210” is providing an accurate, realistic portrayal of bipolar disorder? Were you satisfied or offended by the portrayal?

“ER” and Bipolar Disorder

Bipolar television characters have been rare. One of the most famous is Sally Field’s character in “ER”. Marcia Purse, About.com’s guide to bipolar disorder, has several good posts that point out the accuracies and inaccuracies in those episodes (see here, here, here, and here).

Bipolar Disorder Resources

Check out these resources for accurate information on bipolar disorder:

Psych Central’s excellent blog, Bipolar Beat

Bipolar Fact Sheet

Living with Bipolar Disorder

Guide to Bipolar Disorder

NAMI StigmaBusters