Movie Review: Major Depressive Disorder in It’s Kind of a Funny Story

Thitrat Pongprajuc
Professor Emily Putnam
PSY 2300
December 11, 2023
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Movie Review: Major Depressive Disorder in It’s Kind of a Funny Story

Introduction
Depression or Major Depressive Disorder (MDD) is a major health issue that affects
people all over the world. In 2008, the World Health Organization (WHO) ranked Major
Depressive Disorder (MDD) as the third leading cause of disease burden worldwide. The WHO
predicts that by 2030, MDD will become the top-ranked cause of disease burden. (Bains &
Abdijadid, 2023). Depression is a medical condition that can be diagnosed when a person
experiences persistent feelings of sadness or a low mood. This can be accompanied by a lack of
interest in pleasurable activities, feelings of worthlessness or guilt, low energy levels, difficulty
concentrating, changes in appetite, sleep problems, and thoughts of suicide. Psychomotor
retardation or agitation may also be present. This essay covers the History of Major Depressive
Disorder, its symptoms, etiology, differential diagnoses and assessment, the recommendation for
treatment, description of the movie's portrayal of the disorder, critiques of the movie, application
reflection, and conclusion.

History of Major Depressive Disorder.

Depression dates back to Mesopotamia around the second millennium B.C.E. It was
believed to be a spiritual condition caused by demonic possession and was handled by priests
rather than physicians (Reynolds & Wilson, 2013). Depression was once linked to demons and
evil spirits in various cultures. Physical punishment, restraint, and starvation were some of the
treatments used to drive out these "demons." However, Greek and Roman doctors used a more
therapeutic approach, employing methods such as gymnastics, massage, diet, music, baths, and
medication made from poppy extract and donkey's milk (Tipton, 2014). In the 18th and 19th
centuries, depression was considered a weakness of temperament and an inherited condition that
couldn't be changed. Later, doctors suggested that aggression was the underlying cause of
depression (Svab, 2016). In the past, doctors had different beliefs about the causes of depression.
Treatments included water immersion, spinning stools, diet changes, horseback riding, and
vomiting. These treatments were considered effective at the time (Svab, 2016).
In 1917, Freud wrote about mourning and melancholia, suggesting that psychoanalysis
can help resolve conflicts caused by loss. Other doctors at the time believed depression was a
brain disorder (Schimelpfening & Morin, 2023). Behaviorists believed that depression was a
learned behavior that could be unlearned. They used principles such as association and
reinforcement to establish and reinforce healthier behaviors, which helped people overcome
depression (Schimelpfening & Morin, 2023). In the 1960s and 1970s, some theories emerged
about how negative thinking and a sense of helplessness could contribute to depression.
Cognitive psychologists believed that interpreting negative events in a certain way or feeling
helpless and unable to change one's circumstances could lead to depression. Cognitive models of
depression have played a significant role in the development of cognitive behavioral therapy
(Pluskota, 2014).
Clinicians in the United States coined the term Major Depressive Disorder (MDD) in the
1970s, and it was officially recognized as part of DSM-III in 1980 (Depression 2023). Medical
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Movie Review: Major Depressive Disorder in It’s Kind of a Funny Story

professionals use DSM criteria as a primary tool to diagnose depressive disorders. While our
understanding of the condition has improved, scientists are still studying its causes. Depression is
believed to be caused by a combination of biological, psychological, and social factors. It can
cause disruptions in sleep, appetite, and activity levels. In turn, poor sleep, diet, and exercise can
make depression symptoms worse (Depression 2023).

Symptoms of Major Depressive Disorder

According to Desk Reference to the diagnostic criteria from DSM-5, depression symptoms
can vary from mild to severe and can include:
1. Depressed mood most of the day, nearly every day, as indicated by either subjective
report or observation made by others.
2. Markedly diminished interest or pleasure in all, or almost activities most of the day,
nearly every day.
3. Significant weight loss when not dieting or weight gain, or decrease or increase in
appetite nearly every day.
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day.
6. Fatigue or loss of energy nearly every day
7. Feelings of worthlessness or excessive or inappropriate guilt nearly every day
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a
suicide attempt or a specific plan for committing suicide.
To be diagnosed with MDD, a person must have five symptoms presented. Symptoms must
last at least two weeks and must represent a change in your previous level of functioning for a
diagnosis of depression (American Psychiatric Association 2013).
According to the American Psychiatric Association, depression can affect anyone. In fact,
6.7% of adults (or one in 15) experience depression each year. Depression can appear at any age
but tends to first appear during the late teens to mid-20s (18-29 age group). Depressive disorders
affect women more than men. Women are 1.5 to 3 times more likely to develop these disorders,
with a lifetime prevalence rate of 21.3%. Suicide is more likely to happen in men and individuals
who have attempted suicide in the past (Bridley & Daffin Jr, 2022). About 16.6% of people will
experience depression at some point in their lives (What is depression? 2020).

Etiology
The etiology of Major depressive disorder is believed to be multifactorial, including
biological, Cognitive, behavioral, and sociocultural factors.
Biological causes: Genetics plays a role in depressive disorders. Research shows that if
there is a genetic predisposition to depression, there will be a higher rate of depression within
families. Identical twins are more likely to have depression than fraternal twins (Bridley &
Daffin Jr, 2022). This suggests a strong genetic link in the development of depression.
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Movie Review: Major Depressive Disorder in It’s Kind of a Funny Story

Depression is being studied at a molecular level, with gene abnormalities as a possible cause.
The 5-HTT gene on chromosome 17, responsible for serotonin activity, may be linked to
depression. However, research is limited due to sampling issues and low power (Bridley &
Daffin Jr, 2022). Depression is linked to low levels of certain chemicals in the body, such as
norepinephrine and serotonin. Brain structures like the prefrontal cortex, hippocampus, and
amygdala are connected to mood disorders like depression. Changes in blood flow throughout
the prefrontal cortex have been shown to be connected to depressive symptoms as well.
Cognitive causes: Depression can be caused by negative thoughts and beliefs, according
to the cognitive model. Another theory called learned helplessness suggests that if someone
experiences things they cannot control, they may start to believe they are powerless, even in
situations where they could take action. People who tend to blame themselves for negative
events are more likely to experience depression (Bridley & Daffin Jr, 2022). This happens
because they see things in a negative light and interpret daily events negatively. This negative
habit of thinking can make them more vulnerable to depression. Factors such as attributional
style, maladaptive attitudes, cognitive triads, errors in thinking, and automatic thoughts help
explain the cognitive model of depressive disorders.
Behavioral causes: Depression can occur when a person experiences a decrease in
positive rewards and an increase in negative punishments in their life. This can be caused by
various factors such as work, family, relationships, or the environment. The decrease in positive
rewards can lead to reduced engagement in constructive activities that were once important to the
person. This can eventually lead to a vicious cycle of continued poor performance and decreased
positive rewards.
Sociocultural causes: Depression is a mental illness that affects people globally, but
women are twice as likely to experience it. Separation or divorce can cause depression. Marital
problems, stress, and children can also increase the chances of depression. Depression symptoms
vary depending on the cultural background of the individual. In the United States, there are no
significant differences in depression rates and symptoms among different racial and ethnic
groups except for a difference in the rate of depression recurrence among Hispanics and African
Americans.

Differential Diagnoses & Assessment for Major Depressive Disorder

Major Depressive Disorder (MDD) is a mental health condition that can be difficult to
diagnose and treat because it shares similar symptoms with other conditions. Some of these
conditions are Adjustment Disorders, Bipolar Disorder, Dysthymia, Post-Traumatic Stress
Disorder (PTSD), and Schizophrenia. Adjustment Disorder has similar symptoms to MDD but
usually gets better within six months after a stressful event. Bipolar Disorder is characterized by
both manic and depressive episodes. Dysthymia is a long-term form of depression that lasts for at
least two years. PTSD may have depressive symptoms and trauma-specific symptoms such as
flashbacks and nightmares. Schizophrenia may have depressive symptoms, but it also includes
hallucinations and delusions (Bains & Abdijadid, 2023).
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Movie Review: Major Depressive Disorder in It’s Kind of a Funny Story

Depression often goes undetected in primary care settings as patients often visit for
physical problems caused by it. In almost half of the cases, patients do not admit to feeling
depressed. They are often brought in by their families or sent by their employers to be evaluated
for social withdrawal and decreased activity. It is very important for doctors to assess patients for
thoughts of suicide at each visit.
According to the National Library of Medicine, doctors often use a questionnaire called
the PHQ-9 in primary care to identify, diagnose, and track treatment progress for MMD. The
PHQ-9 is a self-report scale that asks nine questions based on the DSM-5 criteria for MDD and
also measures how depression affects daily life. Scores on the scale range from 0 to 27, with
scores of 10 or higher indicating possible MDD. Other scales used to assess depression include
the Hamilton Rating Scale for Depression (HAM-D, the Montgomery-Asberg Depression Rating
Scale (MADRS), the Beck Depression Inventory (BDI), the Zung Self-Rating Depression Scale,
the Raskin Depression Rating Scale, and other questionnaires (Bains & Abdijadid, 2023).

Recommendations for Treatment

Managing major depressive disorder involves various treatments, such as medication,
therapy, lifestyle changes, and other interventions. The first step in treating MDD usually
involves medication and/or therapy. Combining both medication and therapy has been proven to
be more effective than using either treatment alone.
Depression is commonly treated with antidepressants that affect the neurotransmitters in
the brain. There are different types of antidepressants, including SSRIs, tricyclic antidepressants,
and MAOIs. SSRIs are usually recommended because they have fewer side effects and are
effective at low doses. While they can cause nausea and insomnia, they are a valuable option
with minimal adverse effects. Tricyclic antidepressants are effective but have been replaced by
SSRIs due to their side effects. They may be more effective for people who don't respond well to
other medications, but they have serious side effects, including heart problems. MAOIs are
effective but not recommended as a first-line treatment due to safety concerns and dietary
restrictions.
Cognitive behavioral therapy (CBT) is an evidence-based approach that aims to improve
mood by addressing thoughts, behaviors, and emotions. Behavioral activation (BA) aims to
improve mood by increasing positive behaviors and reducing negative ones. Interpersonal
therapy (IPT) recognizes the impact of psychosocial life events on depression and identifies four
main interpersonal problem areas to address. Multimodal treatment is a combination of
psychological and pharmacological treatments that work together to maintain wellness. This
treatment can be given all at once, in succession, or step-by-step, according to the patient's
preferences. Patient involvement in treatment decisions is emphasized. Multimodal treatment has
been found to be effective in treating patients (Bridley & Daffin Jr, 2022)

Description of the Movie Portrayal of the Disorder

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Movie Review: Major Depressive Disorder in It’s Kind of a Funny Story

The movie "It's Kind of a Funny Story" tells the story of Craig Gilner, a teenager who
struggles with school pressure and family expectations. Because of this, he thinks about ending
his life. However, he decides to go to a mental health hospital instead. While there, he makes
friends with other patients who also have mental health issues. Bobby, one of the patients, helps
Craig navigate his struggles. Throughout the movie, Craig learns valuable lessons about self-
discovery, seeking help, and the power of human connections. The movie combines humor and
touching moments to deliver a heartwarming exploration of mental health, resilience, and
personal growth (Boden & Fleck, 2012).
The movie depicts Major Depressive Disorder (MDD) through the character Craig. The
portrayal highlights different signs and symptoms that are commonly associated with depression.
Depression can cause a persistent low mood and feelings of sadness, hopelessness, and
emptiness. In the movie "It's Kind of a Funny Story," the main character, Craig, experiences
these emotions and struggles to cope with them. Many people with depression also have trouble
sleeping and may struggle with insomnia. Craig finds it difficult to fall asleep or stay asleep
throughout the night. Difficulty with concentration and decision-making are also common in
people with depression, and Craig's struggles with these issues are depicted in the film.
Depression can also cause thoughts of suicide, and the movie sensitively explores this aspect of
mental health through Craig's contemplation of suicide. Individuals with depression may lose
interest in activities they used to enjoy, which is also depicted in the movie through Craig's
disinterest in drawing. Finally, depression can also cause intense feelings of worthlessness and
guilt, which Craig experiences throughout the film.

Critique of the Movie

The movie "It's Kind of a Funny Story" portrays a relatable story of a character with
Major Depressive Disorder (MDD), showing the struggles, emotions, and interactions they face.
This can help people who have gone through similar challenges feel seen and understood.
The movie encourages people to seek help for mental health issues by showing the protagonist's
decision to voluntarily check into a psychiatric hospital. This sends a positive message about the
importance of acknowledging one's mental health and seeking professional support.
The film addresses the gravity of suicide by shedding light on its seriousness and how it affects
individuals and those around them. This can raise awareness about the topic and encourage open
conversations about mental health. The movie shows how supportive relationships can make a
difference in mental health recovery. Positive interpersonal connections formed in the psychiatric
hospital highlight the significance of empathy, understanding, and community when facing
mental health challenges.
On the other hand, depicting mental health issues on screen can be challenging, and the
film simplifies the complexities of major depressive disorder (MDD) to fit within the narrative
structure. However, this simplified representation may not fully capture the spectrum of the
disorder. Additionally, the movie predominantly features characters from a specific demographic,
which could limit its representation of how MDD affects individuals from diverse cultural
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Movie Review: Major Depressive Disorder in It’s Kind of a Funny Story

backgrounds. Depression manifests differently across cultures, and a more diverse portrayal
could have enriched the narrative. There's also a risk of romanticizing the experiences within the
psychiatric hospital setting, even though the film aims to balance humor with seriousness. This
portrayal may inadvertently downplay the severity of the struggles faced by individuals with
MDD.
The movie has a positive impact on reducing stigma related to mental health issues. It
presents a sympathetic view of the main character's journey toward recovery from Major
Depressive Disorder (MDD). Showing the challenges that he faces both internally and externally
helps the audience to understand and empathize with people struggling with MDD. This can
foster greater understanding and compassion towards those who are suffering from mental health
issues. However, the film may unintentionally reinforce negative stereotypes about mental health
facilities. While the aim of the movie is to destigmatize mental health treatment, some viewers
may develop negative perceptions of psychiatric hospitals based on the movie's portrayal.

Application, Reflection, and Conclusion

To promote better understanding of Major Depressive Disorder (MDD) and other mental
health issues, we need to encourage mental health education initiatives. This includes school
programs, community workshops, and awareness campaigns.
We can also contribute to a more comprehensive understanding of mental health
challenges by advocating for more diverse and nuanced portrayals of mental health in films and
other media. This means representing the experiences of individuals from different cultural
backgrounds. Creating supportive environments in educational and workplace settings that
prioritize mental health can go a long way in fostering good mental health. This includes
promoting open discussions, providing resources for mental health support, and combating the
stigma associated with seeking help.
We need to advocate for increased accessibility to mental health services, including
therapy, counseling, and crisis intervention. Reducing barriers to treatment and increasing
awareness of available resources is crucial in supporting individuals with MDD.
Promoting holistic approaches to treating MDD is also important. This could include a
combination of psychotherapy, pharmacotherapy, and lifestyle interventions. It's important to
consider the unique needs and preferences of each person when creating individualized treatment
plans.
The movie "It's Kind of a Funny Story" tells a story that shows how Major Depressive
Disorder affects people. It helps us understand how it feels inside, how important it is to get help,
and how much support from others can help. We should remember, though, that the movie only
shows part of what having MDD is really like. People with MDD are very different from one
another, and their experiences are complex.

The movie helps to reduce the negative attitudes people have towards mental illness.
However, we should also be aware that it has some problems. It could make MDD look better
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Movie Review: Major Depressive Disorder in It’s Kind of a Funny Story

than it really is, and it doesn't show the experiences of different cultures. When we watch the
movie, we should use it as a way to start talking about mental health, not as a complete picture of
what MDD is.
In conclusion, Major Depressive Disorder is a mental health condition that is complex
and multifaceted, requiring a comprehensive and compassionate approach to treatment and
understanding. The movie "It's Kind of a Funny Story" can spark a dialogue and bring to light
the internal struggles that those with MDD face, emphasizing the importance of seeking help.
To overcome the challenges associated with MDD and the way it is portrayed in media, it is
crucial to prioritize mental health education, advocate for diverse representations, and create
supportive environments. By fostering open conversations, reducing stigma, and promoting
access to mental health services, society can contribute to a more empathetic and informed
approach to supporting individuals dealing with Major Depressive Disorder.
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Movie Review: Major Depressive Disorder in It’s Kind of a Funny Story

References

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American Psychiatric Association. (2020, October). What is depression?. Psychiatry.org - What

Is Depression? https://www.psychiatry.org/patients-families/depression/what-is-depression

Bains, N., & Abdijadid, S. (2023, April 10). Major depressive disorder - statpearls - NCBI
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Bridley, A., & Daffin Jr, L. W. (2022). MODULE 4: MOOD DISORDERS. Fundamentals of
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Pluskota, A. (2014). The application of positive psychology in the practice of Education.

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Reynolds, E. H., & Wilson, J. V. (2013). Depression and anxiety in babylon. Journal of the
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Svab, V. (2016). Stigma and mental disorders. Mental Illnesses - Understanding, Prediction and
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Schimelpfening, N. (2023, March). When were the earliest accounts of depression?. Verywell
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Tipton, C. M. (2014). The history of “Exercise is medicine” in ancient civilizations. Advances in

Physiology Education, 38(2), 109–117. https://doi.org/10.1152/advan.00136.2013

U.S. Department of Health and Human Services. (2023, September). Depression. National
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YouTube. (2012). It’s Kind Of A Funny Story. Retrieved December 8, 2023, from
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