Mental Illness on Screen: Homeland, Bipolar and ECT

Watching C4 drama Homeland over the last few weeks I’ve been intrigued by – as well as the teeniness of Damian Lewis’s mouth – the portrayal of bipolar disorder which began as an incidental aspect of lead character Carrie’s (Claire Danes) life, later becoming a major plot changer.

wow, that really *is* a tiny mouth

It’s rare to see mental disorders, especially bipolar, represented in a serious manner by TV. Usually we’re a bit of a joke, seen as losers and undesirables, the ones shouting ‘gerbils!’ at the side of a road. So it was refreshing to see Carrie, in early episodes, portrayed as somebody with strengths as well as weaknesses, managing a successful career as well as a personality disorder.

The realism of Carrie’s need to cover up her condition in order to maintain that career especially rang true, and while I’m certainly not a high flying CIA spy or working in any industry requiring one not to be a card carrying nutcase, I have often debated whether or not to confess all (perhaps not all) on an application form and have met people who keep their condition a secret from employers. It’s an interesting debate – should those with mental illnesses be exempt from certain jobs? – though sadly not one that was explored during the course of the series.

During the latter episodes of Homeland, as Carrie’s ascent towards mania continued I felt that the sensitivity was lost somehow. While Danes’s performance was impressive it felt at times that she’d been directed with ‘you’re mad, really mad! MORE crazy eyes!’ to fit in with a script plucked from Wikipedia’s ‘Bipolar’ page.

While I wouldn’t for a moment deny that the symptoms of Carrie’s bipolar – promiscuity, obsessiveness, an inability to look after oneself, risk taking – were true to bipolar life, they were lazy choices that barely scratch the surface of the complexity of the condition. It certainly appeared that Homeland’s scriptwriters had little experience of bipolar and had they took the time to explore further they may have created a more nuanced character and one who was infinitely more likable. It says a lot that for the most part the obsequious wannabe terrorist was a more sympathetic character than the mentally ill woman he was conning.

Even less believable was Carrie’s final scene. I mean, ECT, seriously? I understand that the series is set in the US and doubtless mental health care works differently there, but I find it hard to believe that somebody would walk off the street to be administered a serious, highly controversial treatment that here in the UK is an absolute last resort. Carrie appeared to have requested the ECT but in reality would somebody in a high state of mania have been considered fit to choose? And would her sister, also a health care professional, have allowed her to jump directly from medication to fizzing the fuck out of her brain? Hadn’t she heard of CBT? Perhaps she might have suggested a few lifestyle changes, you know; more sleep, eat right, less shagging of married, high profile ex-hostages?

yep, sign me up for some of that!

What really overshadowed all of these ‘uh?’ moments though was the portrayed administration of the ECT. I know that my horror at this is entirely due to my own morbid fear of being carted off to be electrocuted until I’m a vegetable (but at least a sane vegetable), but did we need a graphic version of ECT on our screens? Was the fact that in real life anti-convulsants are administered prior to ECT, that the treatment is stopped after a only a few seconds to avoid the good old Jack Nicholson convulsions, just too inconvenient when a crazy woman fitting on a bed provided a wonderfully shocking finale?*  While I accept that in terms of realism Homeland’s version of shock therapy was an improvement on films of the past (although it should be remembered that many of those films were made at a time when ECT was a far more torturous procedure), only ever so slightly exaggerated, it felt almost worse to see it taking place so casually, just an addendum to a story.  At least those films – One Flew Over The Cuckoo’s Nest, The Snake Pit, Requiem for a Dream – pushed us to question the brutality of such a treatment.

To my mind, what was an opportunity to really explore bipolar in a form that would reach a wide international audience became an exercise in shock tactics, the realities of mental illness buried beneath a lot of fast-talking and crazed expressions, Carrie’s only trump card, the only thing that proved that she wasn’t entirely insane – the truth about Brody – was even snatched away by the writers (alright, they had to do it, I want series two as well) at the last minute. It felt as if Homeland went from offering the first realistic bipolar TV character to dropping a final curtain scrawled with ‘and this is why we can’t trust nuts’.

*information courtesy of several morbid hours a month spent checking out ‘all the things they might do to me’.

Incidentally if you’ve ever experience Electroconvulsive Therapy I’d love to hear your thoughts – did it work?  Who made the decision to administer ECT? If it was you, why?…