Except for extreme cases such as paranoid schizophrenia, or conditions with sympathetic social connotations (Down Syndrome; severe autism), there is a tendency in media to regard mental disorders as some kind of put-on or character flaw that is amusing at best and annoying at worst (not that the extreme illnesses are exactly treated like cancer-victims; in fact they can be treated worse than milder forms). The two most "comical" conditions are Obsessive-Compulsive Disorder and Tourette's Syndrome, both of which can be significant, sometimes disabling problems in real life.
At the very worst, a person is portrayed as being completely able to break out of their illness if they were to simply try hard enough — in other words, they're just plain lazy in addition to the behavior itself. Depressive? Cheer up! Manic? Just take a deep breath and calm down. Obsessive-compulsive? Relax already. Delusional? Get a grip on that overactive imagination. An eating disorder? Please. You look fine! Hyperactive? Control yourself, my God. Paranoid? It's not all about you, you know! Anxiety with panic disorder? Suck it up, coward!
A genuinely good character will, however, treat the mentally disturbed with kindness and will nicely ask whether they went off their meds and that's why they're acting up again.
This prejudice contributes to the mentally disturbed being Acceptable Targets for the most merciless cruel humor and parodization. This pertains to sociological stereotypes that most people will tend to blame the victims of misfortunes, in order to take credit for their own good fortune, rather than owning it up to plain luck of the draw (often because luck runs out, and this means that it's only a matter of time for them).
Note that this also pertains to the illusion of control that society presents regarding one's mental state, vs. one's physical state; i.e. few, if any, will blame victims of cancer (except for lung cancer), leukemia, or similar organic physical illnesses or injuries, telling the person to "toughen up" and "get over it", or otherwise calling them "weak" or "lazy."
See also: Hollywood Personality Disorders, Insane Equals Violent, Funny Schizophrenia, Categorism as a Phobia, Black and White Insanity, Acceptable Target. If the exact nature of the disturbance isn't spelled out, it may be a case of Ambiguous Disorder.
- Sayonara, Zetsubou-Sensei takes this one to its logical extreme. Half the cast, or more, suffers from some form of severe mental disorder, which is usually played for laughs (albeit intentionally dark and disturbing laughs).
- Alphonse and Edward from Fullmetal Alchemist display all signs of PTSD when confronted with their old teacher, who was a firm believer in Training from Hell. Naturally, we're supposed to laugh. Meanwhile the trauma from the botched resurrection of their mother, which resulted in the loss of Al's entire body and two of Ed's limbs, is portrayed with the weight it deserves.
- Sakon Daimaru from Gamaran used to be sane, but became mentally disabled after the Training from Hell he suffered. Add his incredible martial arts to the lot and you get an Handicapped Badass and a Screaming Warrior in battle.
- Yukishiro Enishi of Rurouni Kenshin is severely disturbed because he witnessed the death of his older sister Tomoe at the hands of the protagonist Kenshin, who killed her by accident and the trauma is very apparent. His hair went white soon after, he hallucinates seeing Tomoe, and if he tries to harm young women he becomes physically ill. To say nothing of his violent behavior.
- Mirai Nikki has Yuno Gasai. The series initially paints her as a typical Yandere, but slowly starts pulling the curtain away and revealing that her situation is much more complicated than it first seems: she essentially has horrific PTSD from being tortured by her parents and then accidentally permanently killing Yukki in the first run. Her actions are half from trauma and half from guilt, and when we're shown a Yuno with a much happier life in the Third World, she's much better adjusted.
- One could make a very good case for Char Aznable qualifying as clinically insane during the events of Mobile Suit Gundam: Char's Counterattack. He's having constant flashbacks, he sees things and hears voices, and his cognitive dissonance has become so strong that he can somehow mentally reconcile dropping a meteor on the planet with his end game of "saving the world."
- Mobile Suit Gundam SEED Destiny has Stella Loussier. Experimented on as a child, and subjected to massive quantities of mind-altering drugs, Stella is an Idiot Savant who can fly a Humongous Mecha, but otherwise functions at the mental and emotional level of a five year old. Terrified of the world around her, she lashes out at anything that her superiors tell her is going to hurt her, burning down most of Berlin in a panicked effort to "make the scary things go away."
- Ken Kaneki from Tokyo Ghoul gains considerable mental problems after his torture at the hands of Yamori, with his hair turned white from the trauma. Though he pretends to have things under control, several of his friends recognize that he is slowly spiraling into madness and worry deeply for him. He's very clearly traumatized, mimicking the behavior of his tormentor and obsessed with becoming strong enough to protect everyone he cares about. When stressed, he suffers bouts of hallucinations or loses sight of himself to the extent he starts using different pronouns to refer to different pieces of himself. This ultimately comes to a head when he gains his half-Kakuja form, suffering from a complete psychotic breakdown and nearly killing his True Companions in the process. It makes him realize how far gone he really is, forcing him to begin recognizing that his actions have been self-destructive. He spends the final chapters of the series having another psychotic break, hallucinating for much of his battle with Arima and finally resolving that the only thing left for him to do is to "rest and have a peaceful dream". The sequel has left his ultimate fate ambiguous, thus far.
- He's still alive, though without his memories...and insanity. Even then, he loses control sometimes. Later on, he regains his memories and slaughters ghouls left and right.
- In the Monster Island arc of Cyborg 009, one of the scientists engineers insects that cause any people they sting to go insane. The victims seem to mentally regress to being infants, wandering around and needing others to feed and care for them. The cyborgs discover that scaring one of the victims sufficiently causes him to temporarily become sane, but he ends up reverting back after the shock wears off. While this is treated as a danger, the actual behavior of the victim the cyborgs find is Played for Laughs, with several joking about how 003 is being motherly towards him.
- Most comic book villains are not this trope, with Arkham Asylum in particular standing as a tribute to the fact that most people do not understand insanity or the insanity defence.
- The Flash villain Hunter Zolomon/Zoom is a legitimate example of a mentally disturbed individual. Traumatised by, among other things, discovering his father was a Serial Killer (whose last victim was his mother), being crippled in the same shootout that killed his father-in-law, and being crippled again by Gorilla Grodd a short time after learning to walk, Zoom believes that Misery Builds Character, and that he is helping the DC Universe's heroes by hurting them. Delusional, paranoid, holding a view of the world that is fundamentally at odds with reality, and verging on suicidal, Zoom is badly in need of institutionalization and therapy.
- The Flash Rogue Heat Wave is a pyromaniac who burned down his childhood home and killed his parents in the process because he just couldn't help it. He's disturbed by his own insanity and has attempted therapy, albeit unsuccessfully.
- Batman villain Killer Croc is another legitimate example. Having suffered massive amounts of abuse growing up and burdened with an increasingly monstrous set of deformities, Croc's mind was broken even before his condition started to eat away at his sentience. Nowadays his intelligence comes and goes Depending on the Writer. When it's gone he'll act more animal than man and it's an open question whether he can be held accountable for his actions.
- Two-Face may not have a real mental disorder, but there is no doubt that he is mentally ill. With a fractured psyche that leaves him totally dependent on coin tosses to make decisions, Two-Face is void of moral agency, and is one of the few patients at Arkham to actually belong there.
- Hank Pym is said to be bipolar in the short-lived Avengers A.I., and has had numerous mental breakdowns over the course of his history.
- Depending on the Writer, The Riddler is sometimes depicted as this, with his fixation on riddles being an actual compulsion rather than a typical supervillain's focus on their gimmick. He's often tried to commit the Perfect Crime by not leaving behind clues, but always ends up doing so. One story even had him try to get around it by leaving riddles to other villains' plans, keeping his own a secret, only to unconsciously structure his riddles so that they formed one large riddle pointing to him when put together.
You don't understand... I really didn't want to leave you any clues. I really planned never to go back to Arkham Asylum. But I left you a clue anyway. So I... I have to go back there. Because I might need help. I... I might actually be crazy.
- Wonder Woman: In addition to being a pretty obvious narcissist, Priscilla Rich—the first Cheetah—suffered from dissociative episodes, psychotic breakdowns, and a split personality. Not a mentally well woman.
- Mr. Jones: The main character (Richard Gere) is bipolar, and hospitalized when he nearly jumps from a roof in his manic state because he likes the idea of being able to fly. It isn't portrayed as something he can just snap out of at all though, and he undergoes therapy in a psychiatric ward. Also, though he feels exhilarated during his manic episodes, with an infections charm and energy which attracts other people (especially women) his depressive states are also treated realistically, with the subsequent risk of suicide.
- Bird Box: Mentally ill people are not driven to suicide by the creatures' influence; instead they force others to look instead.
- The Belgariad's Taur Urgas, who in addition to being an Axe-Crazy psychopath is also prone to fits in which he foams at the mouth, chews on furniture, and otherwise completely loses touch with reality. This is actually played for a degree of sympathy when Eriond notes that Taur Urgas' madness was so severe as to excuse him from responsibility for his crimes, something that the rest of the cast had not considered.
- The Elenium:
- Adus is an illiterate, unwashed savage who acts as Martel's muscle. Barely capable of speech, and prone to eating raw meat, Adus is so dimwitted that the possibility of his being mentally handicapped becomes increasingly obvious. He's also prone to increasingly violent fits; by the end he's chopping his way through his own men to reach the heroes.
- Azash's worshipers tend to end up this way, especially once they lose their connection with him. The Lady Bellina, already cannibalistic and sadistic, completely loses her mind once her link to Azash is broken. Unable to speak or indeed, do anything beyond scream unintelligibly, she is confined to a tower in order to prevent her from harming herself or others.
- Christian Grey from Fifty Shades of Grey has a number of psychological issues that he blames entirely on his dead mother (although she died when he was four and he was raised by a loving foster family after that), which include a violent personality, a desire to control everything in his life, freaking out when his chest is touched, hating blonde women (because he somehow was traumatized by a blonde policewoman carrying him away from his mother's body), and choosing young brunette women as submissives because they resemble his mother. These alternate between being treated by Ana as a series of endearing, if occasionally exasperating, quirks and being Played for Drama so Ana will treat him sympathetically. His therapist suggests to Ana that she's healing his issues simply with the power of love. Also, his love of BDSM and dislike of vanilla sex is treated as a symptom of how messed up he is.
- We are repeatedly informed that the Mad Wizard Antryg in The Windrose Chronicles is - well, mad - but it affects his behavior so little that it manifests as peculiar dress sense and being a bit of a Nightmare Fetishist, or even pure Obfuscating Insanity (a tactic he legitimately uses a lot). But this is more down to plot momentum and Law of Conservation of Detail than anything, with the third book clearly establishing that even at his most lucid he has some delusional beliefs, such as a conviction that the secrets of creation are encoded in the shapes of tortoises' shells. His madness is said to be the result of serious emotional abuse he received as adopted son of the Dark Lord coupled with years of confinement and punishment from the wizards, but it's also established he was slightly unhinged at the beginning - in fact, as a student of the Dark Lord he'd tried to repress his own insanity to be better, and failed. By the time the books start he's well aware he's mad and more than comfortable with that, a state of mind he requires in order to function normally.
- In Impossible, the curse on the Scarborough family causes any of them who fail to solve the impossible tasks before giving birth to be inflicted with some vague mental illness that causes them to wander aimlessly, be unable to properly communicate with others, and otherwise be incapable of caring for themselves. It's implied that the Scarborough women tended to be shunned in society for the shame of having insane mothers and Miranda's foster parents give up on her as a lost cause from the start, figuring that she'll just have whatever mental issues her own mother had. The fact that Lucy's foster parents aren't like this is pretty much the main reason she has a shot of beating the tasks herself - Soledad and Leo treat Miranda's insanity with sensitivity, hoping that professional help and modern medicine can help her. While they do get her to a state-of-the-art mental clinic at one point, it's let unanswered if it would have helped. she's magically abducted away not long after.
- Rabble Starkey: Mrs Bigelow has some kind of mental disability that prevents her from truly looking after her children. It is seen as problematic but something everyone can live with until Mrs Bigelow nearly kills her four-year-old son by dunking his head underwater in a pond trying to baptize him. After that, she goes into a mental hospital where she stays for months.
- Game of Thrones: It's less that Selyse is evil or mean-spirited and more that she could really, REALLY use a therapist.
- Our Miss Brooks: Mrs. Davis' reference to increasing "absentmindedness" (as well as that of her sister Angela's and brother Victor) isn't funny if, like the example of Forgetful Jones below, you view it as the first signs of dementia. Especially notable is "Phone Book Follies", where Mrs. Davis' is inadvertently and absentmindedly pocketing people's phone books when she visits.
- Scrubs usually plays right into this one for a cheap laugh but takes a long look at individual characters to find some genuine problems. This ranges from the psychologist's two o'clock client running into a shot just long enough to inform characters that "they've landed" to a surgeon unwilling to leave the operating room hours after performing surgery because he's still washing his hands.
- This latter scene developed into a serious, very well done, and poignant scene in which the main character sees just how much the surgeon with OCD actually suffers because of his condition, while prior to this it had been played mostly for laughs.
- As a kid watching Sesame Street, Forgetful Jones is quite funny. But when you look back at it as an adult, you are wondering what person thought it would be great to make fun of a man suffering from advanced dementia, who appears no longer be able to do anything unsupervised.
- In a throwaway joke in Extras, Andy balks at the prospect of being set up with a woman with bipolar disorder and says something like, "She'll forget to take her lithium and kill me."
- In Glee, Emma Pilsbury's OCD is mostly shown as a strange character quirk instead of the debilitating mental illness that it is. The show also keeps making jokes about how Emma's OCD and germphobia has caused her to be a virgin at her age, as she can't make herself get intimate with people. It took until the end of season 2 for the show to actually treat her OCD seriously, by having her go to a therapist to get help, at which point she admits that she's actually ashamed of it and that it's basically destroying her life.
- In one episode of CSI, Grissom befriends the schizophrenic sister of the victim, who was driven insane by the same circumstances that led to the vic's death and is now a rambling bag lady. The end of the episode shows Gris walking next to the sister as she pushes her cart, having a lovely and surprisingly philosophical conversation with her regarding her delusions (she believes she's searching for something important, and when she finds it she can finally rest).
- Canadian television series Cracked deals with a team of police officers and psychiatrists assembled to deal with crimes involving the mentally ill—whether as perpetrators, victims, or witnesses. Main character Aiden Black is himself suffering from symptoms of Post-Traumatic Stress Disorder and undiagnosed anxiety and mood disorders, stemming from his involvement in two fatal shootings, and as such has a great deal of sympathy for the victims of mental disorders. In the main, the show treats the mentally unwell as people, with a strong emphasis on treatment; one Season 1 episode, "No Traveller Returns", focuses on Aiden and resident psychiatrist Daniella Ridley having to make the case to a review board that cannibal, murderer, and paranoid schizophrenic Mandar Kush is fit for release from the mental ward he has been in for the past eleven years. They turn out to be entirely right—Kush has not had an episode in a decade, deeply regrets what he did, and is looking to make amends and reintegrate into society.
- Justified: Season 3 Big Bad Robert Quarles spent his formative years being raped and abused by his heroin addict father's clients. As an adult he's deeply angry, prone to fits of irrational behaviour, dependent on pain-killers in order to remain mentally functional, and prone to reenacting the abuse he suffered, typically taking it out on male prostitutes. Damaged on a fundamental level, Quarles comes off as a very disturbed man trying to figure out why anybody would want to do this in the first place.
- Commonly, we're reminded in Doctor Who that the Doctor is 'mad' or 'a madman' - particularly in the Steven Moffat era, which made the description of the Doctor as a 'madman in a box' one of its Catchphrases. Like everything else about the Doctor, his actual mental health state is heavily Era Specific, and the tone with which it's depicted goes up and down from kooky comedy-madman antics, to reasonably well-researched PTSD and/or depression, to Obfuscating Insanity, to Knight Templar Black and White Insanity, to being a Nightmare Fetishist, to having a god complex, to genuinely being unable to understand human faces, or to just wearing silly clothes and making puns at the monsters. On top of this, a few of the actors playing the Doctor had real-life mental health issues which they allowed to inflect their performances, though this was likely for personal colour rather than an attempt to play the Doctor as actually being mentally ill.
- The Doctor's madness in the Moffat era arguably peaks at the end of Series 9. In the wake of a Trauma Conga Line that includes betrayal, capture and total isolation from anyone save the Monster of the Week, Cold-Blooded Torture, and Clara Oswald's unjust death, the Twelfth Doctor suffers a severe Sanity Slippage and in the Season Finale "Hell Bent" becomes obsessed with the Tragic Dream of saving Clara from the grave despite the threat it poses to the continued existence of space and time. A key reason he pulls off the Batman Gambit required to attempt this is because none of the other characters recognize or care about what he's recently endured, and even criticize him for being angry enough about it to overthrow and banish the people responsible for his suffering. After it becomes clear that he's gone insane, only one character ( Clara herself) recognizes the horrors of what was done to him and shows him real sympathy; in the end, returning to his best self requires him to undergo Mind Rape of his memories of her to get rid of the anguish and rage that drove him to this point. Ouch.
- Metallica has Sparky, who's clearly insane, merrily strapped into an electric chair, and played entirely for laughs.
Sparky: Hmmmm, smells like fried chicken!
Robert Trujillo: Smells like little crazy bastard to me.
- In the New World of Darkness, the most common source of "derangements" is from losing points on the Karma Meter due to misdeeds. Several sourcebooks include "This Is a Work of Fiction" disclaimers that the trope is being played for Gothic Horror and that real-life mental illness is not a sign of moral turpitude.
- Final Fantasy VII protagonist Cloud Strife suffers from bouts of delusions, hallucinations, remembering things that never happened to him, and subconsciously appropriating his friend Zack's life for his own. At one point he even has a spectacular mental breakdown, ending up in a clinic. He eventually does come to terms with a lot of his problems after his friend Tifa takes a jaunt through his mind, and manages to be an effective hero nonetheless. Some have commented that the conceit of Final Fantasy VII: Advent Children - that Sephiroth will continue returning to fight Cloud for as long as Cloud lives, but that, with support from his friends, he can deal with it - works very nicely as a metaphor for recurring mental illness or depression.
- Despite being a survival horror game set in a mental hospital, The Evil Within has a suprisingly sympathetic portrayal in the form of Leslie Withers; he's clearly suffering from something severe enough that he can barely form a sentence or hold a thought, but he's certainly not violent or aggressive and tries desperately (as best he can) to warn you when something bad is about to happen.
- Hellblade protagonist Senua is a traumatized Celtic warrior who faces psychosis manifestations created by her own mind.
- Kane and Lynch, of all things, got this one absolutely right. Lynch is a diagnosed schizophrenic with acute psychotic episodes. Where most media of the same caliber would be tempted to play this for laughs, Lynch is instead presented as a deeply troubled individual with enormous difficulties dealing with everyday life, and whose reactions to what he does during his episodes after they wear off are just as crippling as the episodes themselves.
- In The Lizzie Bennet Diaries, the trope is maybe criticized with Lizzie's views about Mrs. Bennet. Lizzie sees her as this, but everyone else insists that she is pleasant and kind, whatever annoying opinions and form of interest she takes in her daughters's current love life, which makes clear that Lizzie may be actually projecting her anxiety over her life on her mother, the only one to share it. The best example is the spinster/witch costume, leading to much Alternate Character Interpretation.
- On the humor website Something Awful, Asperger's Syndrome is apparently considered a great punchline, and this is starting to catch on in other places around the web. At least some of the humor is derived from the tendency of non-professional internet denizens to self-diagnose for the condition, as a way of stating that social ineptness is not their fault. Obviously, it takes more than just social ineptness to be diagnosed with Asperger's, but that doesn't stop the self-diagnosed from leaping to conclusions.
- In the Whateley Universe, there's a disease that some mutants have. Diedrick's Syndrome. It makes the sufferers sometimes break down into 'crazed supervillain' ranting and such. The best-known case at Whateley Academy is a popular target of the school bullies and elitists.
- Cracked: Frequently averted and deconstructed, which has many articles that point out how reductive a viewpoint this is, and how it completely ignores genuine mental anguish that needs to be addressed. In particular John Cheese, who himself suffers from Depression, seems to be angered by it and wrote that going to see a counselor or feeling depressed doesn't make you crazy, and urged young people to seek help if they're going through a crisis.
- The aversion is more notable considering it's a comedy site. However this is not to say, there aren't jokes in their articles about mental illness. Just that they treat mental illness as a serious condition. This aversion is justified because a lot of the articles about neurological disorders are either written by people who have them or people who have interviewed mentally ill persons beforehand.
- The Flintstones: In "A Haunted House Is Not A Home", Fred's crazy but wealthy Uncle Giggles. For the fun of it, he has Fred spend the night in his mansion and deal with three homicidal servants to inherit the property. But Fred's suffering turned out to be a Secret Test of Character! It turns out Uncle Giggles, bedecked in a barrel for the heck of it, was hiding in his portrait and watching the show while periodically laughing maniacally at Fred and Barney's attempt to save their lives. Definitely not a sympathetic or realistic portrayal of mental illness!
- Ren from The Ren & Stimpy Show is probably the most famous example from Western animation. However, unlike most examples, his psychotic freak-outs weren't always played for laughter. While he did display Insane Equals Violent behavior, it was always when he was being normal; when his manic side was triggered, that's when he snapped into batshit terrifying, yet non-violent mode. Examples include "Stimpy's Fan Club", in which a quite long and elaborate scene is dedicated to him considering killing Stimpy (complete with rambling that "his hands are dirty, the dirt won't come off" and that "with these hands, he holds the fate of millions"), but he doesn't lay a finger on him throughout all of it. There's also "Sven Hoek", in which he becomes furious with his cousin Sven and Stimpy, leading to another disturbing monologue. It truly gives a twist to Ren's personality, at least before he was flanderized post-season 2.
- Taken Up to Eleven in Kaeloo, where one episode showed the entire cast to be in need of intensive psychotherapy.
- In My Little Pony: Friendship Is Magic, "Screwy", a clearly insane patient in the Ponyville Hospital's mental ward, is literally barking mad. Fortunately, in a later episode, she has a cameo that shows she's recovering, now living in a regular house with a nurse to look after her.
- On Total Drama, Mike has "multiple personality disorder" that is pretty much Played for Laughs and a Loves My Alter Ego-styled Love Triangle involving Anne Maria and Zoey. It takes a much more central role in All Stars, where a new personality is revealed, who takes over Mike's body completely and becomes the Big Bad.
- In Adventure Time, the Ice King suffers from an Alzheimer's-like dementia and hallucinations; while he's usually Played for Laughs, (especially in the beginning) he has some truly heartbreaking moments. The Ice King's condition is due entirely to his magic crown messing with his mind. His 'hallucinations' are also implied to be him actually seeing into other dimensions due to the crown. In one episode his sanity was immediately restored when the crown was temporarily depowered.
- The Trickster is implied to be this in the Justice League Unlimited episode "Flash and Substance". The Flash (with whom he's good friends) lightly admonishes him for not taking his medicine, he's genuinely surprised when he's pointed out he's in his supervillain suit, and he agrees to give information on other villains in exchange for Flash visiting him in the hospital to play darts. The soft kind.
- Samuel Cartwright identified drapetomania, a common mental illness among 19th century American slaves that irrationally compelled them to run away from their owners. He recommended treatment by flogging. It should be noted that this idea was widely mocked even at the time; Cartwright's contemporaries noted that, as European indentured servants would also run away, clearly the disease was European in origin and had been introduced to Africa by slave traders.
- In the Soviet Union, being a dissident was considered a sign of mental illness, as well—and was used as a thin veil for torture in mental hospitals, disguised as "treatment."
- And not only in the Soviet Union; Hitler's first euthanasia victims were 28 mental patients, while the United States likewise sometimes classified non-conformity to various legal requirements as mental illness—and subjected victims to similar treatments, despite later being proven wrong.
- Oppositional Defiant Disorder is a real diagnosis that is often misapplied to any child with behavioral problems, just like ADD is often misapplied to any child who gets bad grades.
- Any term used to describe the mentally handicapped gets used as an insult. Retard (from retarded) is merely the best known in a long line of these—"stupid" was once a medical term. People, mostly on the internet, often use autistic as a synonym for social ineptitude, or say someone has ADD when they have trouble focusing. This process is known as the euphemism treadmill, and is inevitable, due to human love of simile, metaphor, hyperbole, and insult.