Though I often do reviews on books pertaining to mental health, I thought I’d try something different today. Initially impressed by the trailer for Words on Bathroom Walls, I was excited to watch the entire film; after all, schizophrenia is one of the most stigmatized mental health conditions of them all. In this post, I will give an overview of the film, doing my best not to spoil the plot. I will also provide clarification on the various terms and symptoms related to schizophrenia.
What’s this movie about?
Words on Bathroom Walls is a fictional story and is rated PG-13. Adam is a seventeen-year-old high school senior who is diagnosed with schizophrenia after experiencing his first psychotic break during a chemistry class. The movie follows Adam through his senior year as he gains awareness of the positive and negative aspects of his illness. The film does a great job breaking down a complex psychiatric condition into a digestible and captivating experience.
Schizophrenia, its symptoms, and related terms
In the DSM 5 (the bible of mental health,) schizophrenia falls under the category of “psychotic” disorders.
Before I go further, the term, psychotic, is often misused. Psychosis does NOT mean crazy, violent, dangerous, evil, etc. Psychosis is a CLINICAL term used to descibe symptoms that involve losing touch with reality. Psychosis is NOT a character or personality trait; rather, it results from a chemical imbalance that results in symptoms of hallucinations and/or delusions.
Now that we’ve got that straight, what are hallucinations and delusions? The simplest way to distinguish the terms is to know that delusions are beliefs that are out of touch with reality whereas hallucinations are experiences that are out of touch with reality. For example, some of Adam’s delusions include the belief that his mom’s boyfriend has poisoned his psych meds and/or is plotting to send him away to a psych ward in an effort to get rid of him. Paranoia is another clinical term used to describe this particular type of delusion.
Since hallucinations are experiences that result from psychosis, it’s important to know that there are three types: visual, auditory, and tactile. Visual hallucinations are seeing things that aren’t there, auditory hallucinations involve hearing things that aren’t there, and tactile hallucinations involve feeling things that aren’t there. For example, Adam experiences all three types; most significantly, negative and commanding voices in addition to a cast of characters* that serve different roles (a macho bodyguard, a male teenage horndog, and a female hippy/free spirit.)
The last sentence requires clarification. Please don’t read “cast of characters” and assume that those with schizophrenia also have multiple personalities or split personalities. Split personalities occur within personality disorders, which is a completely different class of psychiatric diagnosis than what I’m discussing in this post. In Adam’s case, the “cast of characters” is simply a vivid presentation of audio, visual, and tactile hallucinations. The three aforementioned characters (bodyguard, horndog, and hippie) are NOT aspects of Adam’s personality/identity. My one critique of the film is that they didn’t make this distinction clearer to the audience who most likely is not trained in mental health.
Finally, the film describes Adam’s schizophrenia as treatment-resistant. Treatment-resistant means that Adam hasn’t experienced significant benefits from the various treatment options common for schizophrenia including medication and therapy.
Treatment-resistance is not a term exclusive to schizophrenia. I follow a blogger that has treatment-resistant depression and some folx are treatment-resistant to cancer drugs, surgeries, etc.
The treatment methods for Adam’s schizophrenia included psychiatry (medication management of symptoms), psychotherapy (counseling), and occasionally, psychiatric hospitalization (admission to a psych ward.)
The film doesn’t paint psychotherapy in a great light; however, the gold standard for treating psychosis is often a combination of counseling and psychiatry (medication).
The movie does do a great job discussing the nuances of medication management for mental health including side effects, clinical trials, and medication non-compliance (skipping doses or taking more than prescribed). The film emphasizes how those experiencing mental illness often have to try a variety of medications/doses/combinations before finding the right balance.
Stigma is especially common when dealing with psychotic disorders and is often based on ignorance, lack of education, and having a judgmental outlook on those perceived as different than oneself. Adam experiences a lot of stigmas; for example, after his first psychotic break, he’s expelled from public school and is admitted to a private school with conditions (that were human rights violations, in my opinion.) The school administration treats him as more of a liability than a person; more specifically, they assume that because he lives with schizophrenia that he’s violent, dangerous, and unstable.
Adam also experiences bullying from peers because of his illness; for example, one bully nicknames him “Straightjacket” and taunts him by saying, “Where’s your straight jacket, freak!?”
“I’m Adam. I have an illness but I’m not the illness itself.”
“When you’re a cancer kid, people can’t wait to flock to your aid and are so eager to grant any wish you have before you die. But when you have schizophrenia, people can’t wait to make you someone else’s problem. That’s why we end up on the streets, screaming at nothing… waiting to die. No one wants to grant our wishes.”
I really enjoyed Words on Bathroom Walls and I would recommend this film to adolescents and adults because it humanizes what is perceived as an extreme form of mental illness. This movie serves as a great reminder that we’re all going through something. With that being said, we must be mindful of our common humanity; after all, my problems don’t make me more or less human and deserving of dignity and respect than your problems.
Thanks for reading!
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Originally published at https://panoramiccounseling.com on April 17, 2021.