Horror Films and Mental Illness

The idea of some escaped mental patient running around with an axe chopping up teenagers seems like a well used cliché, to say the least, at this point in horror movie history. Horror movies and the mentally ill have been very close siblings for many years and have been used together to create some of the most horrific, grisly, and oftentimes downright hilarious fright flicks ever to splat onto the silver screen. Films of this kind are plentiful with titles like Don’t Look in the Basement (1973), Edge of the Axe (1988), Nightmare in a Damaged Brain (1981), Night of the Creeps (1986), Clownhouse (1989), Edge of Sanity (1989), Dr. Giggles (1992), Sorority House Massacre (1986), Silence of the Lambs (1991), American Psycho (2000), and many others all sporting tag lines such as “The Day The Insane Took Over The asylum!” or “You Can’t Leave…They Want To Play.” The mentally ill in these films are portrayed as the villians in a most over-the-top sense, although it is in most cases done this way to make the film interesting to watch for the target audience, which in turns means increased revenue. The views of mental illness in these films can very well creep their way into your subconscious and leave you with a not so delightful and often times mistaken impression of the mentally ill. I want to look at mental illness in horror films and examine how it is portrayed and talk about the real illnesses that are prevalent in each film. My hope is to educate horror fans and other interested parties on the topic of mental illness and give insight into each specific illness that is portrayed and what the illness is really like. In this section I will focus on three specific films: Psycho (1960), Halloween (1978), and Maniac (1980).

Psycho was released in 1960 and directed by the infamous filmmaker Alfred Hitchcock. It tells the story of Norman Bates and his Bates Motel and an unfortunate woman, Marion Crane (played by Janet Leigh), who ends up at the motel after leaving town and embezzling $40,000.00 from her employer. Norman (played by Anthony Perkins) is a mild-mannered young man who takes a liking to the beautiful Marion. Norman seems to have a close relationship with his mother, whom he talks to but the audience doesn’t get to see, at least at first. Marion soon has second thoughts about stealing the money and decides to take a shower and prepare to leave and return the money. While she is undressing she is being watched by Norman through a hole in the wall. As she showers she is attacked and killed by a shadowy figure that looks like a woman. At this point the audience believes that Norman’s mother has done the killing as previously you could hear her talk to Norman about not wanting him to ‘bring in strange girls for supper’. What is found out as the movie progresses and reaches a conclusion is that Norman has a case of dissociative identity disorder, or what most people know as multiple personality disorder. His mother was not alive in the movie and had indeed been dead for years. What happened was that when Norman’s father died and his mother found a new boyfriend Norman became extremely jealous and enraged and killed them both. He then felt guilty about the crime and dug his mother up, mummified her, and basically brought her back to life inside his head. So when Norman was himself his mother was still in his mind telling him what to do, and in this case the mother side felt jealous of Norman’s feelings for Marion and wanted him to kill. His ‘mother side’ would cause him to act, speak, and dress just as his mother had, explaining why it looked as if a woman had murdered Marion in the shower.

Dissociative identity disorder is a real thing and here is a definition from the website WebMD.com,

Dissociative identity disorder is a severe form of dissociation, a mental process, which produces a lack of connection in a person’s thoughts, memories, feelings, actions, or sense of identity. Dissociative identity disorder is thought to stem from trauma experienced by the person with the disorder. The dissociative aspect is thought to be a coping mechanism — the person literally dissociates himself from a situation or experience that’s too violent, traumatic, or painful to assimilate with his conscious self.’


Norman Bates had dissociated himself from the murder of his mother as, like the defintion says, it was too painful to assimilate with his conscious self. Dissociative identity disorder is said to be the most severe and chronic type of the dissociative disorders that cause multiple personalities. The main symptom is, of course, a split personality with there being at least 2 or more different personalities that have power over the person’s behavior. A person’s memory can also be affected greatly and they can forget important personal information. This can flucuate with the person’s multiple personalities. The person’s other personalities have their own way of walking, talking, and acting in general and also their own age, sex, and race. Besides human alter egos the individual can also have an animal alter ego. When an alter ego is taking over a person it is called ‘switching’ as they are switching into another personality. People with this disorder can also suffer from suicidal tendencies, depression, eating disorders, headaches, mood swings, amnesia, drug and alcohol abuse, and “out of body experiences”. Some cases include self-sabatoge, self-persecution, and violence. The violence can be directed at themselves or another person. They may also find themselves doing things they would not normally do like stealing, being wreckless with driving and other activites, and doing compulsive things or rituals. Different events in a person’s life or enviromental triggers can cause them to switch personalites.

            Many people who get this illness, 98%-99%, were abused, mentally and physically, as a child, usually before the age of 9. If they were not abused then the illness is also attributed to some horrendous event or events that happened to them at a sensitive age. This is a rare illness as it only affects .01%-1% of the general population although 7% of the population may have the illness but remain undiagnosed. Some treatments for DID include medications such as antidepressants, talk therapy, psychotherapy, hypotherapy, and other therapies such as art therapy. There is no exact cure for DID but if a patient goes along and sticks with the treatments available then they can see much improvement.

            I hope this information on dissociative identity disorder gives you a more realistic view of the illness and all that it entails. Psycho is definitely an amazing achievement in film and it’s portrayal of DID is taken to a considerably higher level than the actual illness but makes for an unforgettable cinematic experience. 

The next film I will discuss is the quintissential stalk and slash film, Halloween. Halloween was released in 1978 and directed by John Carpenter. The story starts with a young boy, Michael Myers, killing his sister Judith on Halloween night. Micheal is found by his parents later in the night in a trance like state and is institutionalized. Michaeal’s doctor in the mental hospital is Dr. Sam Loomis (brillitanly portrayed by Donald Pleasence). After years of treatment, Michael is deemed ‘pure evil’ by Loomis. When Michael is 21 he escapes from the hospital and goes back to his home town of Haddonfield. In Haddonfield, he stalks three girls on Halloween, one being Laurie Strode (played by Jamie Lee Curtis). Throughout the last half of the film Michael kills Laurie’s friends and then proceeds to come after her in the white-knuckled climax. Dr. Loomis follows after Michael and ends up shooting him in the climax of the film. Michael falls off the balcony after being shot and when Loomis looks over the balcony to see the body there is no one there. With Michael Myers it is assumed in the movie that he is evil, that he is not human but is evil in the shape of a human. I want to push aside the idea of pure evil and talk about what real illness(s) Michael exhibits and give you some information on them. From what you see in the movie (Michael’s violent actions) I think it is safe to assume that one prevalent illness he suffered from was some type of psychosis. Halloween seems to be the film that many other ‘escaped mental patients run amok’ movies were based off of and it seems like the standard (at least in horror films) of what we consider a masked psycho killer. Since there are several forms of psychosis I will now talk about another film dealing heavily with psychosis and other mental issues and then give information about the different types of psychosis.

            Maniac is a serial killer film released in 1980 and directed by William Lustig. The movie stars Joe Spinell as Frank Zito, a not so attractive Vietnam veteran who is a landlord of a small apartment building and a sick, depraved serial killer. Frank lives by himself with a bunch of mannequins strewn throughout his apartment. When he kills someone he scalps them, takes their clothing, and puts the scalp and the clothes on his mannequins, whom he also talks to. Throughout the movie Frank experiences delusions and hallucinations varying from seeing his dead mother rise from the grave to the bloody finale of the movie where he has hallucinations of the manniquins in his room turning into his victims and attacking and murdering him on his bed. This film takes mental illness and really gives it a dirty, gory, wild appearance that is disturbing, shocking, and throughly entertaining.

            While Halloween definitely shows Michael Myers having a form of psychosis, Maniac shows nearly every form of psychosis in the most twisted fashion. Psychosis brings with it all types of illness including disorientation, delusions, social issues, hallucinations, and others. Psychotic disorders are defined by a loss of contact with reality and extreme deterioration of the mind. The Canadian Mental Health Association describes psychosis:


Psychosis is a serious but treatable medical condition that reflects a disturbance in brain functioning. A person with psychosis experiences some loss of contact with reality, characterized by changes in their way of thinking, believing, perceiving and/or behaving. For the person experiencing psychosis, the condition can be very disorienting and distressing. Without effective treatment, psychosis can overwhelm the lives of individuals and families.


Some aspects of psychosis consist of people not being able to perform normal, everyday tasks and having a hard time in social situations or interaction with others. The delusions related with psychosis cause people to hold onto false beliefs that are often times bizarre and irrational. The delusions can also cause paranoia. Hallucinations are when the individual sees or hears things that aren’t really there. The hallucinations cause their perception of the world to be distorted, sometimes immensely and are most of the time auditory hallucinations where the individual hears voices. They can also be sensory hallucinations, yet those are much less frequent. Another illness portrayed in Maniac is schizophrenia. Schizophrenia is the most debilitating and complex illness of the psychoses and includes many of the symptoms I have described such as hallucinations and delusions. Psychotic disorders usually affect older individuals (about 1 out of 50) and a good number of them have paraphrenia, which consists of hallucinations and paranoid delusions. The cause of psychotic disorders is somewhat unknown but some have been attributed to heredity, alcohol and drug abuse, strokes, drugs such as digioxin, and severe infection. Many tests including blood tests can be done to diagnose psychosis. The blood tests will see if there is a certain drug in the persons system that could cause psychosis or tell if another physical disorder may be the cause. MRI’s of the brain are also employed at times to diagnose or help treat the person. The treatment of psychotic disorders usually comes in the form of drug therapies. A major part of treatment comes from doctors, family, and friends of the person with the illness. With their help, reassurance, kindness, and love the person with psychosis can deal with, and a majority of the time recover from the illness and go on with their life.

            The illnesses in these films are all real illnesses that real people suffer from and while they are sometimes taken to various extremes in the films, they at times show you some reality of the illness. The truth is that one in four people is affected either directly or indirectly by mental illness. I just hope you all remember that and ask that you just treat others with kindness and respect as you don’t know if they are ill or what their lot in life may be.  If you haven’t seen these three films and are interested in the horror genre I would highly suggest you seek them out.

Works Cited:

Sifers, Sarah K. Ph.D. Abnormal Psychology. Clarksville: Collins, 2006.

Dissociative Identity Disorder. Web MD. April, 2010. <www.webmd.com>


Schizophrenia. April, 2010. <www.schizophrenia.com>

Psychosis. MedlinePlus Medical Encyclopedia. April, 2010. <www.nlm.nih.gov>

Psychosis, Mental Health Disorders. The Merck Manual of Health and Aging. April, 2010. <www.merck.com>

Psycho. Wikipedia. April, 2010. <www.wikipedia.org>

Halloween. Wikipedia. April, 2010. <www.wikipedia.org>

Maniac. Wikipedia. April, 2010. <www.wikipedia.org>


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