Brace Fellow Zoe Sttile ’17

Women and Mental Illness.  Stigma and Stereotypes.

Screen Shot 2020-01-23 at 12.52.51 PM“What’s worse, looking jealous or looking crazy?” sings Beyoncé in one of the most popular songs of her new visual album, Lemonade.  The lyrics speak to the power the word “crazy” wields as a way to dismiss women.  From Ophelia to Fatal Attraction, our media sources are saturated with images of women with mental illness.  Mental-illness language is widespread and powerful – especially for women.  “Crazy ex-girlfriend”, “hysterical”, “psycho”, “crazy bitch”:  these are the tropes and stereotypes that women, mentally ill or not, navigate.

Zoe Sottile ’17’s research paper and presentation investigate both the specific discrimination endured by women with mental illness and the cultural phenomenon of the “crazy woman” in modern media.  Her work ponders the intersection between ableist stereotypes about mental illness and sexist stereotypes about women, ultimately working toward progressive solutions that put women with mental illness in charge of their own narratives.

Faculty Advisor:  Tricia Har, Instructor in English


Personal Statement

“What’s worse, looking jealous or crazy?” sings Beyoncé on one of the most popular songs of her new visual album, Lemonade. The song, an assertive ode to a cheating lover, details Beyonce’s invalidation at the hands of those around her. Even though she knows her husband is cheating, she fears she’ll either be labeled as jealous for speaking out or crazy and paranoid for even suspecting him.  The lyric speaks to the power “crazy” wields as a way to dismiss women. Mental illness language is widespread and powerful – especially for women. “Crazy bitch”, “crazy ex-girlfriend”, “hysterical”, “psycho”: these are the tropes and stereotypes that women, both mentally ill and not, navigate.

There exists a long and storied history of women with mental illness, especially as visible figures of our literary and public imagination. Our stories fixate on crazy women, a vernacular that encompasses women with diagnosed mental illnesses, women clearly deviant but ambiguous in diagnosis, and women who are simply behaving badly. There’s Ophelia, raving senselessly with flowers in her hair, tragic Dido falling on her sword after Aeneas leaves her, Mrs. Rochester feral in the attic, the protagonist of The Yellow Wallpaper recovering from her “slight hysterical tendency.”  And while many celebrated texts, like Elaine Showalter’s The Female Malady and Sanda Gilbert and Susan Gubar’s The Madwoman in the Attic, have examined these historical works, there exists little follow-up on these women’s descendants – how the “crazy woman” of these texts has survived in our TV, film, and news media. 

There’s no doubt that women with diagnosed mental illnesses experience serious discrimination and prejudice: in one study, over half of people with mental illnesses reported experiencing discrimination in employment, housing, and interactions with law enforcement.1 But in this paper I’m also interested in the idea of the “crazy woman” as a cultural phenomenon that exists separately from any pathology. As Harris O’Malley writes, “At its base, calling women ‘crazy’ is a way of waving away any behavior that men might find undesirable while simultaneously absolving those same men from responsibility. Why did you break up with her? Well, she was crazy.”2 The fear of looking “crazy” has enormous social impact on how women police themselves and their behavior, like Beyoncé staying with a cheating husband rather than criticizing him. In an essay for the Huffington Post, Yashar Ali calls the perpetual labeling of women as crazy “gaslighting” – an emotional abuse tactic used to convince someone that they’re crazy to control their behavior. He writes that the fear of being crazy, “renders some women emotionally mute”, unable to protest abuse and harassment.3 The characterization of women as crazy also compounds other sexist stereotypes about women as inherently emotionally volatile, frail, carnal, and irrational. 

I started this research looking for analyses of the different tropes applied to women with mental illnesses. Yet while I could find plenty of typologies of the tropes of mental illness, few considered gender at all.4 In my own experience, the women coded or explicitly described as mentally ill in media were portrayed in ways that hinged on their femininity and its role to their perceived “craziness”. The men with mental illness I saw in the media were diverse: A Beautiful Mind treats John Nash with dignity, What About Bob is funny but not mocking, Dexter makes a serial killer relatable, Shutter Island’s hallucinating Teddy Daniels still gets to be the hero. Crazy men were still people; crazy women were just magnified versions of other female stereotypes, like Alex Forrest as the ultimate clingy, overly emotional girlfriend in Fatal Attraction

The primary question of this paper is how specifically women and mental illness are portrayed in media in the modern era. Have these portrayals changed at all overtime? What stereotypes do these portrayals reinforce? How do stereotypes and and expectations about women intersect with the public’s understanding of mental illness in general? While the answers to these questions are complex, it seems clear that in the media, illness and womanhood are intimately connected. To understand the nature of that connection, this study will begin with a summary of demographics of mental illness among women in the United States, an overview of general images of mental illness in the media, and a summation of how other researchers have categorized those images. I then intend to build off of those moving parts to analyze the tropes, categories, and stereotypes that make up depictions of women with mental illness in the media. 


Women and Mental Illness in the United States


Understanding media images of mental illness requires an understanding of the reality these images draw on and influence. After all, diagnoses of mental illness have almost always been gendered. In Victorian England, for example, women outnumbered men in asylums almost two to one.5 While thankfully the days of the asylum are over, inequity in mental illness diagnosis persists in the United States. One in four American women receive medication for mental health issues, as compared to only fifteen percent of men.6 The explanation for this difference remains unclear. One theory contends that doctors overprescribe drugs to women, a possible consequence of stereotypes about women’s emotional frailty. Alternately, some research shows that women are more likely to seek medical attention in general than men – another potential corollary of gender-based stereotypes.7 Still another explanation points out that women are more likely to survive rape and other trauma, leading to higher rates of Post-Traumatic Stress Disorder and related disorders. A report conducted by the Rape and Incest National Network in 1998 indicated that one in six American women has been the victim of attempted or completed rape over the course of her life, and that “30% of women report PTSD symptoms 9 months after the rape.”8 For whatever complex combination of reasons, women receive more medication for mental health issues than men, an important factor in considering media images of women and mental illness. 

The World Health Organization asserts that while rates of overall mental illness are similar between men and women, rates of specific disorders differ significantly by gender.9 Women tend to dominate diagnoses of depression, anxiety, somatic complaints, and eating disorders. According to WHO, a range of diverse nations consistently report that depression in particular is twice as common in women than men. Comorbidity of multiple diseases, a state linked to higher levels of disability and need for mental health services, is also much more prevalent in women than men. WHO attributes the high rates of depression, anxiety, and PTSD in women to the drastically higher rates of poverty among women, subordination in the workplace, and impact of gender-based violence. But experiments also indicate gendered biases play a role: when men and women present the same symptoms, health care providers diagnose many more women with depression and many more men with alcoholism.10 Diagnosis is political, and it remains unclear if these differences in diagnoses derives more from societal factors, like gender-based violence, or from cultural ideas about the specific ways women are mentally ill. The disproportionate depression diagnoses, for instance, may feed into a cycle where women are overdiagnosed with depression, stereotyped as emotional and prone to mood disorders, and subsequently overdiagnosed with depression. 

Eating disorders are another highly gendered diagnosis. Only ten percent of sufferers of eating disorders are male, though that figure is thought to be underreported.11 Research suggests that between one and five percent of young women suffer from anorexia nervosa, and three to seven percent from bulimia nervosa.12 Furthermore, a 2014 study found that eating disorders, histrionic personality disorder, body dysmorphia, and orgasmic disorder were perceived as feminine.13 Histrionic personality disorder manifests in “excessive emotionality and attention seeking.”14 The other disorders all involve the body, self-image, and sexuality. The characterization of these disorders as uniquely feminine reflects a common characterization of women as overly emotional, body-obsessed attention-seekers, and women’s mental illnesses as extensions of those character flaws. So although medicine is often thought of as an unbiased hard science, it seems clear that diagnoses and mental health treatment have a complex relationship with gender-based stereotypes and expectations. Health care providers’ assumptions about gender inform when and how they diagnose women with mental illness, confirming biases and contributing to a world where calling a women mentally ill has critical social and cultural consequences. 


Mental Illness in the Media


Given the complicated connection between mental health diagnoses and gender, media images may be a particularly potent source of assumptions and stigma. In 1990, a national survey found that the overwhelming majority of Americans identified the “mass media” as their primary source of information about mental illness.15 Dishearteningly, previous research established that individuals who receive most of their information about mental illness from electronic media were less tolerant than those who received it from other sources.16 One major source of this information in the media is television – in 2014, the average American watched over five hours of TV a day.17 Moreover, a study published in 2000 found that the more hours of TV participants watched per week, no matter the type of programming, the more negative their views on mental illness.18 Viewers trust the reliability of these images, taking them in as education as well as entertainment.

So what exactly are these negative images, and how common are they? Though there is little research dedicated specifically to female representations, mental illness in general is a popular subject in television programming. A 1982 study found that almost a third of prime time TV shows involved or mentioned mental illness.19 Mental illness is even more common in children’s shows: Wilson et al. found that of 128 episodes marketed to children under the age of ten, 59 contained at least one reference to mental illness.20 Half of the mentally ill characters played comedic roles, while half were villains. Though mental illness is not a significant predictor of violence,21 72.1% of prime-time characters with mental illness hurt or kill others.22 In one study, participants asked to describe mentally ill prime-time characters most frequently used the adjectives, “active,” “confused,” “aggressive,” “dangerous,” and “unpredictable”.23 There is little diversity for mentally ill characters on TV – they are either the butts of jokes or sources of fear. 

Similar violent and exaggerated representation of mentally ill characters dominates film. Like with television, this trend starts with children’s programming. In 2004, a study found that 85% of Disney films included references to or portrayals of mental illness.24 21% of their characters were labeled mentally ill, often through derogatory language such as “crazy,” “lunatic,” “nuts,” “out of one’s mind” and “not in touch with reality”. In a similar 2003 study examining 49 films for adults, almost a quarter of films contained a character linked to mental illness.25 They tended to be single white men who frightened other characters. Two-thirds of characters identified as mentally ill were violent or aggressive, and 64% of the other characters were afraid of them. Other characters often ascribed them labels such as “crazy,” “psycho,” and “lunatic.” One study of portrayals of schizophrenia similarly found that the majority of schizophrenic characters were violent white men.26 The researchers noted that this narrow image “fuels an ‘us versus them’ mentality that conveys the message that people with schizophrenia are different and should be feared and avoided.” That “us versus them” outlook colors many portrayals of mentally ill characters in film: mentally ill characters are fundamentally other.
Even in the news, a source often assumed to be unbiased, sensationalized violence that supports staid stereotypes of mentally ill people as villains prevails. 51% of Americans report that they receive most of their information about mental illness from television news, and 34% from print news.27 But that information is misleadingly fixated on violence. In 1998, a study found that 65% of people with mental illnesses featured on the news had committed violence.28 A 1999 analysis of 300 articles from major newspapers that mentioned mental illness found that “dangerousness” was among their most common themes.29 In the news, people with mental illness are only interesting if they are scary. Just like other media sources, the news sustains a single narrative of mental illness that hinges on hyperbole and fear-mongering. 

Though much of this research did not account for gender, it still supports important conclusions. These studies show the preeminence of a narrow story of mental illness that capitalizes on violence and ridiculousness to reduce mentally ill people to caricatures and ostracize them as other. These negative and inaccurate images have tremendous potential impact. In one experiment on the effect of negative media portrayals, participants who watched a made-for-TV movie starring a violent mentally ill man demonstrated markedly lower levels of sympathy towards mental illness than those who watched an unrelated movie with a violent character.30 Furthermore, research points to the ubiquity of these images in everything from soap operas to Disney movies and the authority viewers grant them as informational sources. Whatever stereotypes about women and mental illness appear in these representations, they are broadcast on a massive scale, and deeply absorbed into their consumers’ perceptions about the nature of women and their mental illnesses.


Existing Frameworks and Tropes


As noted previously, since little research specifically examines portrayals of women with mental illness, there are few frameworks for understanding the impact of these portrayals and how they interact with other sexist stereotypes. Still, there are some frameworks and definitions that describe images of mental illness in general. To begin, stigma is defined as a combination of stereotypes, prejudice, and discrimination.31 Stereotypes themselves are “especially efficient, social knowledge structures that are learned by most members of a social group.” 

Different aspects of the portrayals of women with mental illness enforce stereotypes and cultivate stigma. Psychologist and writer Otto Wahl emphasizes three especially stigmatizing aspects of depictions of mentally ill people: offensive language and slang, construction of “otherness” and emphasis on differences in “physical appearance, in background and character, even in basic humanity”, and the conflation of villainous murderers with mental illness.32 Alternately, in Ray Nairn, Sara Coverdale, and John H. Coverdale’s helpful framework for understanding portrayals of mental illness in the media, four cultural mechanisms intersect: language in use, culture, social practices, and institutions.33 The media modulate all of these aspects, using loaded language like “crazy” and “psycho” to describe the mentally ill, becoming part of our culture, demonstrating and thus reinforcing social practices in public, and influencing the makeup of our institutions. 

No two researchers categorize portrayals of mental illness the same way. In an analysis of films, Hyler and Gabbard established six stigmatizing stereotypes: “rebellious free spirit, homicidal maniac, seductress, enlightened member of society, narcissistic parasite, and zoo specimen.”34 Notably, only one of these refers specifically to women, and the authors rely almost entirely on men for examples of the others. Alternately, a film report by advocacy group Time to Change established four major stereotypes of people with mental illness in cinema.35 These were the comedic stereotype, “faking and indulgent” stereotype, pity-based stereotype, and “violent” stereotype, which emerges either in violence caused by momentary psychosis or “psychokiller” based horror films. Alistair Benbow sorts news stories about mental illness into five categories: the cure story, which documents a new miracle remedy; the scare story, which invokes fear; the money story, which discusses the dramatic cost of a treatment; the human interest story, in which the reporter tells an empathetic story about individuals or families coping with mental illness; and the ethics and profit story, in which the reporter presents the perspective of a pharmaceutical company or hospital.36

Some research does analyze the unique depiction of women with mental illness. In her research on mentally ill Victorian-era women, Elaine Showalter sets up three major Romantic images of the madwoman: the suicidal Ophelia, the sentimental Crazy Jane, and the violent Lucia. While, “all three established female sexuality and feminine nature as the source of the female malady, […] each also stood for a different interpretation of woman’s madness and man’s relation to it.”37 These categories, though specific to the Victorian era, are still helpful as a guide to modern-day depictions of mental illness. Teen drama depictions of self-harm echo Ophelia’s suicide; the passionate sensitivity of Crazy Jane comes in through jokes about crazy ex-girlfriends; and violent Lucia resonates with horror movies about women gone “psycho”. Similarly, though Easteal et al. don’t specifically focus on mental illness, their analysis of news coverage of women who kill parallels Showalter’s paradigms. They delineate women who kill as either “bad” – violent and often sexual to the point of monstrosity; mad – irrational, but sometimes sympathetic because of the uncontrollability of their condition; and sad, suicidal and victimized by the world around them.38 Both of these models emphasize the characterization of female mental illness in media as uniquely feminine and distinct from general models like Hyler and Gabbard’s. Both Easteal et al.’s and Showalter’s constructions double as descriptions of particularly “bad” aspects of femininity, like sexuality and sentimentality. Portrayals of women with mental illness confirm and authenticate sexist stereotypes of women. The stereotypes that define women portrayed as mentally ill reflect the narrow range of women considered “normal”. 

Images of Women with Mental Illness


Eating Disorders


This section begins with a study of eating disorders, which, while distinct from some of the other facets of the overall “crazy woman” stereotype, nonetheless carry highly gendered implications. When anorexia nervosa was first diagnosed in 1873 as a nervous disorder among adolescent girls in England and France, its average suffer was considered “the self-sacrificing Victorian heroine,” who, “acted out the most extreme manifestation of the feminine role.”39 Anorexic girls, in their overt desire to please and minimize themselves, were if anything good examples of Victorian women. Though that characterization has changed, certain threads of it – especially the predominance of vanity, fragility, and capitulation to patriarchal standards – prevail among modern-day depictions of women with eating disorders. The representation of women with eating disorders continues to meaningfully reflect cultural expectations about what women should be. 

Eating disorders have become a staple of teenage dramas and after-school-specials, where they are often presented as passing teen fads, the product of social pressures and a need for male approval. During 1988’s Heathers, a dark high school comedy about a clique of popular girls, as the girls adjust their makeup in the bathroom, the shy Heather Duke pulls Veronica into a stall to help her throw up her lunch.40 The leader of the pack, Heather Chandler, rolls her eyes: “Grow up, Heather. Bulimia is so ‘87”. Bulimia is just an immature trend gone passé, like a pair of unstylish shoes. More sympathetically, on hit teen sitcom Lizzie McGuire,  Miranda’s insecurity about her body snowballs into an eating disorder. Of course, by the end of the 22-minute episode, her loving friends convince her that she looks good, and the disorder disappears.41 The “disorder” was just a bad case of insecurity, as curable as a cold. Similarly, on Pretty Little Liars, Hanna confesses to Aria that she used to suffer from bulimia spurred by low self-esteem, but then she mysteriously “got better.”42 In flashbacks, the show reveals that at the height of her disorder, she was overweight – but now she’s stick-thin. It’s unclear whether “better” means that she miraculously recovered from the disorder or that she lost the weight. Girls, these characterizations suggest, are delicate, prone to insecurity. Their eating disorders are the natural result, mundane problems overblown into diagnoses that disappear with enough effort. 

This depiction of eating disorder as teen trend continues into the news. In a content analysis report published in 2007, researchers found that the vast majority of news sources positioned eating disorders as social phenomena restricted to young white women.43  Most of the articles focused on celebrities, sensationalizing their bodies and extreme diet plans. In reality, though social pressures are one contributing factor, medical professionals have established that eating disorders are “complex mental illnesses anchored to both genetic and environmental roots” with major health ramifications, including heart failure. But in these news depictions, the eating disorder is just an extension of normal teen girl problems. Viewers pick up on this: British researchers found in a survey that around a third of respondents feel that eating disorder patients “could pull themselves together” and “are to blame” for their condition.44 In the media narrative, teen girls are predisposed to melodramatic emotion and obsession; eating disorders are fads, not real diseases. Since eating disorders are by and large a female disease, the trivialization suggests that women’s problems and illnesses aren’t real. They’re just insecurity, and the women with them should be able to recover easily. 

While comedic TV shows and movies similarly minimize eating disorders, many take it a step further. They position eating disorders as the punchlines to cruel jokes about women who are vain, vapid, and irritating. In the 2000 film Miss Congeniality, when a group of models refuse pizza and beer on behalf of a friend because of their high calorie count, Sandra Bullock’s character exasperatedly refutes them: “It’s light beer and she’s gonna throw it up anyway.”45 She offers no consideration to the apparently troubled girl, just annoyance at her high-maintenance drama. On Scrubs, a stylish girl remarks blasély to J.D. that, “We were going to go to the gym. But I could just as easily throw up instead.”46 The comment emphasizes her stupidity and narcissism, painting her as a vapid socialite with no bigger concerns than her weight. On an episode of New Girl, Jess’s annoying stepmother-to-be twitchily reveals, “I haven’t eaten in three weeks. Trying to fit into my wedding dress. Had a dream about a crouton last night.”47 Once more, there is no sympathy for her apparent body-image problems, just mockery from other characters that she could care so much. Even on a popular Disney Channel show, Shake It Up, one malicious popular girl turned her own disorder into a joke: “You’re adorable! I could just eat you guys up. You know, if I ate.”48 Her friends laugh raucously. In all of these instances, girls with eating disorders are annoying narcissists. Their diseases are a source of humor, but so are their feelings, the moronic vanity that their diseases reveal. Like the disordered girls of Lizzie McGuire and Pretty Little Liars, they should just get over it.

Accordingly, many references to eating disorders are used more as slang for undesirable personality traits than diagnosis. On an episode of HBO’s Girls in which the protagonist, Hannah Horvath, is undergoing her own mental health crisis, she angrily calls friend Marnie “anorexic”.49 Glossy-haired Marnie is high-strung and uptight, the neurotic and often annoying overachiever of the group. The medical term codes for all of  Marnie’s worst qualities – that she’s vain, that she’s annoying, that she’s cloyingly desperate to be liked. This shorthand has dual effects: It trivializes a serious medical condition, and simultaneously pathologizes a woman’s unwanted characteristics, magnifying the archetype of the nagging and neurotic woman into a disease. 

And when the girl with the eating disorder becomes a self-absorbed stereotype, the girl insulting her looks cool and laidback. Feminism has largely become mainstream, with pop stars like Taylor Swift proclaiming that “There’s a special place in hell for women who don’t help other women.” Yet jokes about eating disorders persist as an accepted venue for women to insult different, “bad” women. In an interview, Kat Dennings, star of 2 Broke Girls, said of life in Hollywood that: “I tried being anorexic for four hours, and then I was like, I need some bagels.”50 Meghan Trainor made a similar joke in an interview with ET: “I wasn’t strong enough to have an eating disorder. I tried to go anorexic for a good three hours. I ate ice and celery, but that’s not even anorexic. And I quit.”51 These comments make them seem more authentic and easygoing, compared to the high-strung, obsessive anorexic myth. Gillian Flynn writes in Gone Girl that, “the Cool Girl […] jams hot dogs and hamburgers into her mouth like she’s hosting the world’s biggest culinary gang bang while somehow maintaining a size 2.”52 These jokes about eating disorders speak to Fynn’s conception of the “Cool Girl”. In a world where the ideal woman is effortlessly thin, the girl with the eating disorder is pathetic, needy, and trite. Women are punished for being overweight, but also punished for trying too hard to conform to narrow beauty standards. 

While dismissing women as vain or vapid is hardly new, repacking that dismissal in mental illness language reflects a relatively recent development. Women with eating disorders in the film, TV, and the news aren’t individuals suffering from serious mental diseases – they’re high-strung, boring girls who care too much what men think, or they’re just insecure teenagers. \. According to the insecure girl of teen dramas, eating disorders aren’t real problems – girls should just try hard and get over them. According to jokes about purging and anorexia, women with eating disorders are annoying try-hards; the ideal woman, of course, is thin without trying. The cultural message embedded in these portrayals dictates that women should be easy-going and casual, minimize their anxieties and problems. They dismiss women’s pathologies as annoying, their concerns as vacuous. Like the ideal Victorian woman, these images of and references to eating disorders encourage women to make themselves and their problems smaller.




If the shaming of eating disorders reflects double standards about women’s bodies, the association of sexuality with mental illness reflects double standards for women’s sexual desires and sexual performance.  Starting with hysteria, the construction of mental illnesses has simultaneously sexualized mentally ill women and pathologized women’s sexualities for centuries. Hysteria, the first mental disorder attributed specifically to women, was fittingly dubbed by psychologist Weir Mitchell, “the noso-logical limbo of all unnamed female maladies”.53 It was an umbrella term for all of women’s irrational complaints, and it was also inextricably linked to sexuality. Egyptian texts dating as far back as 1900 BC claim that the movement of women’s wombs in their bodies caused hysterical disorders.54 The disease was rooted in “unsatisfied sexual and maternal drives” and associated with inappropriate sexual urges. Already then, mental illness was the only explanation for a woman’s sexual desires. Today, sexuality endures as a common theme in portrayals of women with mental illness. As Hyler and Gabbard’s notation of “seductress” as a category all its own suggests, women are seen as inherently sexual, and so too are their mental illnesses.

In some instances, a woman’s sexual appeal can compensate for her mental illness – especially since most “crazy women” are depicted with a special, untamed sexuality. On the popular sitcom How I Met Your Mother, known playboy Barney Stinson devises a “hot-crazy scale” to explain how a women’s craziness may be balanced by her attractiveness.55 He implies that while crazy women are erratic and violent, they’re willing to do things most women wouldn’t for men. Thus, the drama of sleeping with a crazy woman is worth it if she’s hot enough. In a different episode, when Ted explains to his friends that he’s met a girl, Jeanette, who may have stalkerish tendencies, and admits that she doesn’t have “enormous cans”, Barney replies, “Then what we’re saying is she’s a crazy stalker bitch who pulled that fire alarm and you should run screaming.” An unattractive crazy girl is just a “crazy stalker bitch”; the only way for a mentally ill woman to be worthwhile is to be attractive.

Often, these women are depicted as or assumed by other characters to be more promiscuous because of their mental illness. On Skins, Cassie, a girl with an eating disorder and a loose grasp on reality, frequently makes explicit sexual advances toward other characters. After meeting her, Anwar, a shyer boy with girl troubles, remarks excitedly, “I bet she bangs like a fairy on acid.”56 Her illness and her mental illness are inextricably interwoven – she’s hot because of her craziness. Even the eating disorder that has reduced  her to her “fairy”-like size is attractive. The characterization of mentally ill women as more attractive or sexually free than other women lends itself to the dangerous reduction of women to their bodies. Women’s mental health doesn’t matter, so long as their mental illness makes them more sexually free and attractive to men. 

In other instances, women are called crazy because of their sexuality. In Girl Interrupted, Susanna’s therapists seem to treat her sex life as a bad habit on par with self-harm, with one tentatively asking her, “Is there something about sex which lifts your feelings of despair?”57 On 1999 teen comedy-drama Freaks and Geeks, Bill advises Sam to move his locker away from that of “psycho” Karen: “I think she’s a sex fiend. […] What if she comes to school really horny one day?”58 She’s crazy and sexual, and her sexual desire is a malevolent threat all its own. Her craziness is a natural extension from her sexuality, both examples of how deviant she is – a literal “fiend”. Crazy women, it seems, are attractive so long as they don’t have desires of their own. 

News coverage of women with mental illness likewise attributes mental illness to sexuality. In their analysis of news portrayals of female murderers – a group often lumped together as “crazy” – Easteal et al. highlight the framing of women who kill as “sexual deviants.”59 These women are doubly unnatural – inhuman by killing and unwomanly by their sexuality. In their words, the news depicted Rosa Richards, on trial for murdering her infant son, as an “unnatural mother” as well as “unable to love and sexually promiscuous.” After reports that Susan Smith, convicted of filicide and diagnosed with dependent personality disorder and major depression, had been sexually abused by her stepfather, she was portrayed as “‘a temptress who invited and enjoyed sexual attention’, [and] one news article stated that Smith had ‘succumbed to her own molestation as a teenager and grew up to become a promiscuous, sexually exploitive young adult.” In the media’s story, even seriously ill victims of childhood abuse are wanton seductresses. Likewise, media coverage of Karla Tucker, who stabbed two people alongside her boyfriend, fixated on her sexuality. She fed into this narrative, alleging that she orgasmed with every strike of the pickaxe on her victims. This salacious factoid dominated her media coverage, instead of the complicated and difficult causes of her crime. The sexuality of these women is treated by news coverage as important information that must explain something centrally wrong in all of them. Sexuality becomes a pathology of its own – of course, a promiscuous woman would kill her children, it seems. 

At the same time as these accounts of “crazy women” shame and villainize them for their sexuality, they stress women’s appearance and sexual appeal, a concern rarely considered in descriptions of men. A newspaper article took note of Karla Tucker’s “soft, brown eyes, bashful smile and long dark curls”. Coverage of Sanna Sillanpää, who opened fire in a club in Helsinki, killing three men and injuring a fourth, highlighted details of her body movement, facial expression, clothing, hairstyle, and make-up. Mentally ill women are evil when they pursue sex but interesting when they invite it. News sources, and perhaps their consumers, are much less interested in the complex motivations behind these women’s crimes or the crisis of mental health care around the world than they are in making these women sexy. News coverage’s focus on sexual appeal harmonizes with Barney Stinson – crazy women are only worthwhile when they’re hot. 

Even works that deliberately strive for more nuanced and realistic portrayals of mental illness often do poorly by their female characters and their sexuality. Silver Linings Playbook, a 2012 romantic comedy-drama, was lauded as “de-stigmatizing” by Harvard Medical School psychiatrist Dr. Steven Schlozman.60 Yet Tiffany, the aggressively sexual foil to bipolar Pat, acts as little more than a catalyst to Pat’s character development. Tiffany has impulsive sex, which seems tied to her illness. She explains that after the death of her husband she “had sex with everyone in [her] office”, and offers casual sex to Pat in an attempt to make friends.58 At first Pat rejects her as a “crazy slut”, telling her that she’s clearly crazier than him. But once she tells him the lurid details of her encounters with the women in her office, Pat pays rapt attention. She’s disgusting to him for being so sexual, but also useful – no matter the trauma behind her actions. Everything in her life revolves around men, from the ghost of her dead husband to her tumultuous relationship with Pat to her frequent sexual relationships. She preemptively identifies herself as “Tommy’s crazy whore widow”, as if the two are inseparable, her promiscuity and her illness. While her self-conscious remark would seem to suggest that she’s rejecting that simplification, the film never delves deeper into the roots of Tiffany’s problems. Pat’s relationships to his family, his illness, his medication, and his therapy are explored in depth – but Tiffany is left, for all intents and purposes, the “crazy whore widow” she calls herself. Though Tiffany and Pat connect over having used the same medications, her unspecified diagnosis lends itself to the feeling that her symptoms are just part of being a woman, and especially a “bad” one. By the end of the film, as she and Pat finally enter a successful relationship, her symptoms have all but vanished. A single dose of heterosexual monogamy, courtesy of Bradley Cooper, cures her disease for good.

To return to Showalter: “women, within our dualistic systems of language and representation, are typically situated on the side of irrationality, silence, nature, and body, while men are situated on the side of reason, discourse, culture, and mind.”62 The sexualization of women with mental illness is a double whammy of dehumanization, fixing women as inherently crazy and inherently of their bodies, nothing more than animals with irrational sex drives. Sexuality is always the answer, both symptom and cause: if she’s too sexual, she must be insane – “I think she’s a sex fiend” – and if she’s crazy she’s probably hot, even if she’s a murderer. Women who are sexual, according to media narratives, are deeply wrong, and the label of mental illness separates them from the rest of us. Women who are called crazy are “bad” women, shameful and disgusting, but useful to men – so long as they have “enormous cans”. Mental illness becomes just another way to name women who are bad at fulfilling an impossible expectation for women to be pure but also sexy. 


Tragedy and Romance


The flipside of the bad, slutty crazy woman shamed and exploited for her sexuality is the tragic, sad woman rewarded for her relative virtue. The tragic, romantic narrative of mentally ill women tracks all the way back to popular icons of female pain like Dido and Ophelia, scorned women driven to suicide by their callous lovers and their own sensitive natures. Depictions of their mental illness use turbulent emotions both as diagnostic criteria and examples of women’s inherent instability. And they draw on the audience’s sympathy to exploit these portrayals, turning women into sob stories or pity party narratives. 

Easteal et al. define this as the “sad” characterization of women who kill. As they describe it: “They may be depicted as ‘victims of circumstance’, with criminal behaviour linked to a biological malady or a medical condition […] the narrative for these ‘mad’ or ‘sad’ women is more likely to frame their act within an adherence to traditional female traits and fulfilment of domestic responsibilities and/or as sexually and religiously pure.”63 One such “sad” woman appears in Dennis Lehane’s 2010 Shutter Island. Even though protagonist Teddy kills his manic-depressive wife for drowning their children, the film depicts her sympathetically. Teddy remembers holding and kissing her in a floral dress.64 Before her illness, she fulfilled all of the requirements of a good wife, feminine and compliant, and she’s rewarded even after committing murder by kind representation. There a note of condescension in the sympathy awarded these women, an implication that they just couldn’t help themselves that alludes to perceptions of women as inherently frail and helpless. Showalter writes that by the end of the 19th century and up till today, “feminine” came to stand, “for all extremes of emotionality.”65 In images of women who commit crimes, mental illness seems blamelessly rooted in women’s delicate, feminine minds. They’re just women, it seems – unable in their volatility to stop themselves from even killing their children. 

When “sad” women aren’t hurting their children, they’re often seen hurting themselves. Like with hypersexual women, their mental illness revolves around their relationship with men, whether those men are the triggers for their illness – like Dido and Ophelia – or the saviors. Skins is a particular repeat offender. As previously mentioned, Cassie struggles with an eating disorder. She’s also a strange, whimsical girl, wearing children’s toys on a necklace and treating strangers with open affection – a nod towards Hyler and Gabbard’s “rebellious free spirit” trope. Her mental illness causes her problems, but it also maybe lends her a slightly unhinged sense of spontaneity. Her attraction to love interest Sid starts when he tells her that even if no one else cares about her disorder, he does. When he cancels on a date with her, she softly, almost sweetly, says, “I didn’t eat for three days so I could be lovely.”66 He’s the major impetus for her illness and a later suicide attempt, in a way that’s almost construed as romantic – a love worth starving for. On a much later season, a man heroically saves lead character Effy from her mental illness. She habitually uses drugs and alcohol, and eventually experiences psychotic episodes and delusions. She attempts suicide in a locked bathroom but her ex-boyfriend breaks in to save her.67 The image of him holding her wrists and crying, her eyeliner still pristine, is one of the most iconic of the whole series – the perfect snapshot of aestheticized illness. She’s beautiful even while hallucinating and attempting suicide. More than adding to Effy’s character development, the incident turned the boy in question into Skins’ ultimate hearthrob, a cute guy and a savior too. 

Indeed, the illness of a “sad” woman is almost always tied to the man who love her. Even on HBO’s Girls, a show lauded for its authentic representations of women, Hannah’s struggle with OCD ends with her romantic rescue by an old boyfriend. Locked in her room, hiding under her bed from her visiting friends, and unable to hear clearly because of a self-inflicted Q-tip injury, her breakdown has reached new depths. But when she accidentally video calls her ex-boyfriend, Adam, he realizes something is amiss. He runs shirtless across New York to her apartment, talking to her on his phone all the while. When she refuses to answer the door, ashamed of the filth of her apartment, he breaks down the door and barges in to literally sweep her off her feet. When she exclaims, “You’re here!”, he points out, “Well, I was always here” in a rom-com sweet ending.68 Hannah doesn’t need medication, friendship,  therapy, or motivation – just a tall man to pick her up and carry her to safety. The illness just raises the stakes of their romance and makes Adam all the more heroic. And her rescue implies that women are helpless and autonomous, their real problem not so much their illness but the lack of men to help them sort through their wild emotions. Illness renders men noble and women powerless.

Just like oversexaulized women, the “sad” woman is always beautiful, and that beauty makes her sadness tragic and significant. Ugly women who hurt themselves don’t deserve tragedy. In Heathers, when overweight Martha “Dumptruck” Dunnstock attempts suicide, she’s relentlessly mocked; at beautiful Heather’s funeral, Veronica observes, “suicide gave Heather depth.”69 Suicide turns beautiful women into iconic love stories and ugly women into jokes. 

Like eating disorders, women’s self-harm and suicidal thoughts also become punchlines. On Family Guy, teenage daughter Meg knowingly advises her father to cut his wrists “Sideways for attention, long way for result.”70 Of course the teenage girl self-harms – and of course she really just wants “attention”, the worst sin for a teenage girl. Kathy Griffin joked while introducing Jimmy Kimmel that, “I’m the person they call if Demi Lovato is cutting, or if Miley Cyrus flashed her crotch again.”71 Cutting is just what Demi Lovato does, just as ridiculous and dramatic as Miley Cyrus’s antics. Sad women’s pain is funny because it’s so overwrought and melodramatic. 

Susan Sontag writes that, “Sadness made one ‘interesting.’ It was a mark of
refinement, of sensibility, to be sad. That is, to be powerless.”72 Media favors its mentally ill women beautiful and powerless. Women, according to these stories, are just prone to overwhelming explosions of mental illness. They are either melodramatic, like Demi Lovato cutting, or pitiful and helpless, like Hannah Horvath. Mental illness makes their stories tragic and poetic, and, most important of all, offers a path to heroism for their male partners. Women are prone to uncontrollable emotions that must be tamed by a rational man. Their illnesses aren’t real – just histrionic heartbreak. Once again, women’s problems are reduced to character-building devices for men. When mental illness stops being beautiful and helpful to men, it starts being yet another joke about women as neurotic, overemotional, and performative. If you want your mental illness taken seriously, these patterns imply, put a man at the center of them and make your illness beautiful, subtle, and tragic.


Crazy Ex-Girlfriend and the Psycho Bitch


The “crazy ex-girlfriend” trope lies at the intersection of so many tropes about mental illness casually used to demean, dismiss, and humiliate women. Invoking “crazy ex-girlfriend” often includes nods towards women’s hypersexuality, general irrationality and overabundance of emotions, and an obsession with men and romantic relationships. As one wary AskMen article entitled “Getting Rid Of A Psycho Girlfriend” dubiously advises: “Firecrackers don’t behave like regular women. Normally, a man can light up a woman’s passion — much like a candle — and let her flame burn slowly. But Firecrackers are different; as soon as a man lights their fuse, they’ll blow up right in his face.”73 Calling these women “crazy” elevates their characterization as excessive and erratic to a pathology all of its own. 

In his seminal work on media images of mental illness, Wahl points out that the vast majority of “psycho-killer” horror films spring from male violence against women.74 He makes no mention of the portrayals of female psycho-killers, which frequently draw on fear of the wronged or obsessive ex-girlfriend. In these films, the women are obsessed beyond reason, and make innocent men their victims. These films are everywhere: Vanilla Sky, Obsessed, and Swimfan all revolve around crazed ex-girlfriends, though Fatal Attraction is maybe the most salient. After the protagonist, all-American father and husband Dan Gallagher, has a weekend affair with the charming Alex Forrest, she refuses to let him move on.75 When he tries to leave her apartment to return to his family and his life, she cuts her wrists – trying, it seems, to make herself a good “sad” girl. Her attempt works momentarily, but he loses patience as she demands more attention: she shows up at his office; she calls him at work and home; she confesses she is pregnant and pushes him to take responsibility for the child. As the climax of the film approaches, she kills and boils Dan’s daughter’s pet rabbit on the stove, then briefly kidnaps the daughter before returning her safe and sound. Finally, she appears in Dan’s home and attempts to kill him and his wife. Her portrayal is convoluted and contradictory, an amalgamation of all of the grievances with women that men characterize as mental illness: she’s suicidal and lonely, but also a villain wielding knives and boiling bunnies; she’s seductive and attractive but repulsively clingy. The crazy ex-girlfriend is every kind of annoying or unappealing woman combined. Out of context, Alex’s actions appear quite reasonable: a single woman who demands that the man who impregnated her treat her like a human being. In the film, asking that much warrants a bullet to the heart.

Gone Girl depicts a similar crazed ex, though the film seems to skip between critiquing this narrative and reinforcing it. It echoes Fatal Attraction in many respects: protagonist Nick Dunne is as carelessly unfaithful as Dan, Amy Dunne is another pregnant villainess demanding more.76 However, in this film Nick’s wife, not his lover, takes revenge on him. Sick of his apathetic infidelity and conscious of the media’s love of victimized women, Amy stages her own murder and frames him as the perpetrator. She hides out with her ex Desi but then, after realizing she wants Nick back, feigns that he kidnapped and abused her – classic crazy girl, making herself the victim. She has sex with Desi and slits his throat, returning home to clear Nick’s name. Nick wants a divorce, but Amy tells him she’s pregnant and urges him to stay with her and be a “happy family”. Like Alex Forrest, Amy is obsessive, irrational, desperate to stay with him but capable of great violence. But Gone Girl is more complex and provocative than Fatal Attraction, studded with moments of critique: Nick’s sister proclaims, “Everyone knows that ‘complicated’ is a codeword for bitch”.76 Still, many reviews and public commentaries focused on the simplest reading of the story, that of the manipulative evil ex trying to ruin a man’s live, with Vulture commenting: “Amy is a real grade-A bitch. Horrible. A truly legendary piece of work.”77 That seems to be Amy’s greatest offense: not that she’s a lying murderer, but that she’s a bitch. 

Other crazy exes, even those who aren’t murderers, are still bitches. In the How I Met Your Mother plotline referenced earlier, Barney takes great pleasure in recounting the antics of his own “crazy ex.” As he describes her: “She’d shave her head, then lose ten pounds. She’d stab me with a fork, then get a boob job.”78 Ted’s crazy ex, Jeanette, pillages his apartment after finding spam about porn in his email; she locks herself in his bedroom when he breaks up with her, then seduces him again, because after all, what is a crazy girl if not hot; then she sets off fireworks in his apartment.79 The crazy ex is irrational and violent, but hilarious. The characters mocking her make no note of any actual illnesses or problems that may have driven her behavior. She’s just a punchline, and a half-hearted justification for men to antagonize women. Though in reality women are by far the greater victims of domestic violence, the crazy ex-girlfriend myth suggests a mythical world where men are constantly pursued by desperate, violent women harassing them. 

Even when these irrational, violent, sex-hungry women aren’t exes, they’re still “crazy.” On Freaks and Geeks, two of the “freaks,” Kim Kelly and Karen Scarfoli, are dubbed “psychos.” Sam explains what he means clearly to Lindsay, his older sister and one of Kim’s friends: “Well, uh, they’re violent. They run around the school being evil.”80 Lindsay herself explicates the problem with this characterization of the girls: “She’s just different. […] Just ‘cause a girl speaks her mind doesn’t mean she’s a psycho.” Crazy women refuse to perform feminine correctly.  They aren’t quiet or subservient. On Scrubs, Carla begins confessing to J.D. all of the complex erratic emotions she can’t tell her husband for fear he’ll call her “crazy.”81 Being complicated, like Margo Dunne points out, really just means being crazy. Men want women to be simple and palatable. Crazy women have large and difficult emotions, and they articulate them to the men around them – men who quickly decide that what they say doesn’t matter, and try to shut them up, a la Dan Gallagher. Furthermore, “crazy” becomes an easy way to dismiss women and their thoughts. Representations of the “crazy ex” promulgate other harmful stereotypes of women as men-obsessed, volatile, emotional, and mendacious. But they also demonstrate the way that women are routinely dismissed in language that has taken on disturbing authority. Harris O’Malley writes: “At its base, calling women ‘crazy’ is a way of waving away any behavior that men might find undesirable while simultaneously absolving those same men from responsibility. Why did you break up with her? Well, she was crazy.”82 Crazy is a catch-all that pathologizes every aspect of being an unideal women.

Positive and Progressive Representation

If negative representations of women with mental illnesses hold such sway, it’s not unlikely that positive representations can sculpt public opinion in the opposite direction. Corrigan and Watson identify three tactics to combat stigma: protest, education, and contact. They note that, “Contact in particular seems to be effective for changing individual attitudes.”83 Oostdyk in her review of other mental health studies points out that individuals who either had direct contact with peers diagnosed with a mental illness or who had had classroom instruction on psychology were more empathetic and tolerant towards people with mental illnesses.84 But even when these studies unanimously point towards contact as a successful tool against stigma, it remains unclear how exactly “organized contact” should be executed. It seems that positive and progressive representation of women with mental illnesses in TV, film, and news, guided by these individuals’ own voices, could potentially approximate contact and reduce stigma. 

So many harmful portrayals of mental illness seem to play towards male audiences, emphasizing up the sexual appeal of a crazy girl or speaking to fear of an obsessive ex-girlfriend. Consequently, better portrayals of mental illness may come when women’s voices and perspectives are more fully represented. In Sex and the City, controversial but lauded for its intimate exploration of women’s relationships, ideas of craziness were sometimes critiqued. In one episode, as Carrie tosses stones up at an ex-boyfriend’s window, she simply but poignantly notes, “When men attempt bold gestures, it’s generally considered romantic. When men do it, it’s often considered desperate or psycho.”85 It was a simple comment, but succinctly illuminated the importance of a woman’s perspective.

Crazy Ex-Girlfriend, a romantic musical comedy that premiered in 2015, sets out its feminist allegiances in its intro, as lead Rebecca Bunch argues that “crazy-ex-girlfriend” is “a sexist term. […] The situation’s a lot more nuanced than that.”86 But the show, at least in part, fulfills its premise. Rebecca is a pitch-perfect crazy ex. Depressed and exhausted from her job as a New York lawyer, she sees a chance at escape when she runs into her summer camp ex-boyfriend, Josh.87 He tells her he’s moving back to his heavenly hometown of West Covina, California, and she impulsively quits her job and moves across the country in a move that recalls Alex Forrest. She’s self-aware of how this looks, and adamantly tells anyone who will listen that she didn’t move here for him, because “that would be crazy, and I am not crazy.” In another show, this could become a point of mocking – look at the stupid crazy girl, so obsessed with a guy. But on Crazy Ex-Girlfriend, Rebecca’s perspective is used to explore the rationale behind her decision. In West Covina, she tells her new friends that she got moved there because of a random job offer, not for Josh. When she’s forced to reveal her true motivation, most of her friends turn on her, disturbed. Not Josh. When the two share a moment and she explains that she was struck by how much he seemed to love his town, he admits that he understands: “I’m so happy you’re in town. And I don’t think you’re crazy at all.”88 That’s all that Rebecca needed to hear – that her decisions make sense, that her emotions are valid, and that someone understands her.

Rebecca isn’t “crazy” just because of her feelings for Josh. She also suffers from anxiety and depression, unbeknownst to most of her new friends in West Covina. After moving to California, she optimistically dumps all of her medication down the sink. Afterwards, she listens to an acidic voicemail from her overbearing mother: “I hope this isn’t another stunt like your big suicide attempt in law school. You didn’t even break the skin and you inconvenienced a lot of people.”87 Here, critically, the show alludes to one of the recurring judgments used to shame women with mental illness: that their problems aren’t real, that their pain is performative. Crazy women don’t even break the skin – they’re just trying to get attention. And they don’t care whom they hurt or inconvenience with the size or gravity of their emotions. 

When Josh moves in with his girlfriend, Rebecca spirals into depression again. Unable to convince her new therapist to prescribe her new medication on short notice, she doesn’t know what to do. She gets wasted on vodka at work, causing her boss to send her home with the helpful suggestion, “When you come back on Monday, I want you to be the happy Rebecca that we all know and love.” She fakes a smile: “Such a good tip. So helpful. Be happy.”89 Unlike in other media depictions of women with mental illness, Rebecca’s depression isn’t pretty or easy. She openly worries she has schizophrenia and takes a pill she found on the bathroom floor. In the end, it isn’t any of her love interests on the show that save her, but an agreement to start seeing her psychologist regularly. 

There are moments of critique folded into the show’s dialogue. Rebecca is a Harvard-educated feminist, and she’s aware of the sexist and ableist connotations of mental illness language. When someone asks what’s wrong with her, she bites back, “Off the top of my head, I’d say low self-esteem, a lack of maternal affection, and a genetic predisposition for anxiety and depression.”90 Later, she spitballs: “Crazy’s a pejorative term and it’s an over-generalization of a number of disorders.”90 But the show’s critique and subversion of usual tropes about crazy women also comes through in its dedication to letting viewers see things through Rebecca’s eyes. The show isn’t a story about a normal woman who’s cruelly shamed for no reason. Rebecca makes big-time crazy mistakes, even for zany sitcom world. One such moment happens when she accidentally sends a text to Josh telling him she loves him, then breaks into his house to delete the offending text, then concocts an elaborate lie that involves staging a breakin at her house.91 Her actions are awful, and reminiscent of every crazy ex joke. But through a song called “You Stupid Bitch”, viewers see the depth of her own self-loathing. She’s a full human being, not just a violent sex-crazed animal. When she tells Greg the incident with the text was complicated, he scoffs: “Something with you is complicated?” Rebecca demands complexity, attention, and empathy. Which, according to the people around her, is too much to ask. After all, asking for respect and understanding got Alex Forrest murdered. 

Crazy Ex-Girlfriend is one of multiple recent TV projects that use women’s specific experiences as the basis for stories about stigma, mental illness, and sexism. Crazy Ex-Girlfriend’s co-writer and creator, Rebecca Bloom, has said that she herself suffers from anxiety and depression, and was interested in undercutting some of the stereotypes tied to those diseases. HBO’s Girls, though problematic in its own right as discussed earlier, also used the details of creator Lena Dunham’s OCD to fully flesh out Hannah’s struggle with the same disease. Lady Dynamite, another recent Netflix show centered around comedian Maria Bamford’s struggle with bipolar disorder, has been celebrated as an authentic but still funny view of mental illness. Unsurprisingly, the best, most empathetic, and most realistic stories about women’s mental illness come from women with mental illness themselves. Where other depictions of women with mental illness regularly reduce them through any number of stereotypes to dehumanized narrative devices, these programs amplify women’s own voices and thus their humanity.


The stigma and stereotypes surrounding women with mental illness happen on two levels. First, there’s the blanket reality of mental illness stigma that affects men and women both, illustrated by violent or humorous portrayals in everywhere from Disney movies to broadcast news. When it comes to mentally ill women in particular, those stereotypes about mental illness combine with existing stereotypes about women. On this level, stereotypes affect both women with mental illness in particular and women at large, who also experience the impact of mental illness language like “crazy” or “psycho”. Consequently, popular images of women with mental illness are nothing but contradictory. Elaine Showalter writes that the, “dual images of female insanity – madness as one of the wrongs of woman; madness as the essential feminine nature unveiling itself before scientific male rationality – suggest the two ways that the relationship between women and madness has been perceived.”92  Whenever women with mental illness appear, their womanhood and illness bear some connection. Either their craziness is an example of how bad they are at being women, like the female murderers branded “bad mothers” to boot, or their particular illness is an example of how innately senseless all women are. 

As women’s rights have progressed, it has become increasingly difficult to dismiss women as irrational or vapid without cause. But references to mental illness remain a powerful means for men and women both to authoritatively disregard women. In the Victorian era, some suffragettes and other radical women were committed to mental asylums.93 For authorities who wanted to quiet these women, mental illness hid more shameful assertions – the real problem wasn’t that these women were seriously ill, but that they were asking for more than men wanted to give them. As Showalter observes, “insanity is a label applying to gender norms and violations, a penalty for “being ‘female’ as well as for desiring or daring not to be.”93 Likewise today, mental illness language codes for deeper accusations. Casual ableism masks casual sexism. Women are called “anorexic” for being too high-strung, “sex fiends” for expressing their own sexual desires, and “psycho” when they ask for anything more than apathy from the men in their lives. If these negative depictions act as examples of the far bounds of acceptable female behavior, they communicate a disturbing set of requirements for women. Women must be carefree while still being sexy, sexy without being sexual, and complacent in all of their shows of emotion. 

The mental illnesses that women do experience are routinely dismissed as trivial in these depictions. Eating disorders are a side effect of women’s narcissism; other diseases result from women’s natural tendency towards hysterics. In the media, serious diseases with complex roots are seen as nothing greater than a bad case of PMS. Even worse, in some cases mental illness just makes women more beautiful and tragic or more sexually appealing. In many instances, women’s mental illness serves as a plot device to magnify men. Men are the noble heroes who save sad women, or the grand objects of their sad lovers’ tragic love, or the rational counterparts to a crazy ex-girlfriend. The women in question are barely human at all.

The impact of these stereotypes is widespread. Stigma against people with mental illness has been noted as one of the major reasons people don’t seek help.94 Stigma also pushes people to reject those with mental illness, contributing to social isolation, the withholding of help, coercive treatment, and segregated institutions.95 Moving forward, for the sake of both women whose debilitating diseases are ridiculed and women whose behavior is constantly policed to avoid seeming “crazy”, these representations need to change. In a content analysis of major TV programs featuring mental illness, Diefenbach suggested open dialogue between mental health professionals and TV writers and producers to create more accurate and empathetic depictions.96 This open dialogue, with a specific bent towards women’s issues and representation, could be one way to achieve more realistic representation. But given the long history of pathologizing women’s emotions and sensationalizing mentally ill women in literature, producers and consumers of mass media need to have a more complex, nuanced understanding of context.  Jennifer Eisenhauer recommends five major changes in combating mental illness stigma in visual media: critically engaging viewers’ preconceptions, identifying missed opportunities, challenging language, contextualizing issues of representation, and understanding stigma.97 The critical acclaim of shows like Crazy Ex-Girlfriend , Lady Dynamite, and Girls suggest that allowing women with mental illness to articulate their own narratives may be pathway to less stigmatizing representations. Crazy Ex-Girlfriend, specifically, in its very title reflects a decision to critically engage viewers’ preconceptions. In moments like Rebecca’s aforementioned arguments about the word “crazy”, the show likewise challenges language and contextualizes issues of representation. 

Finally, more research is necessary to deepen our understanding of contemporary depictions of women with mental illness. While there exist numerous quantitative content analyses of TV programs, films, and news media of representations of any people with mental illness, there are very few devoted to the specific tropes and cliches surrounding women. To take down dangerous stereotypes of women with mental illness, we first need to understand what those images are.



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