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manic-depressive disorder via colorful characters that represented specific human emotions. The
characters were Joy, Sadness, Fear, Anger, and Disgust; they all lived and portrayed the
emotions of an 11-year old girl named Riley. According to the DSM-5, depressive disorders
have the following common features: presence of sad, empty, or irritable mood, accompanied by
somatic and cognitive changes that significantly affect the individual’s capacity to function
(American Psychiatric Association, 2013). The movie depicted this disorder when Sadness took
over the emotional control panel during Riley’s sudden move to San Francisco with her
family. The once happy Riley started illustrating common signs of depression such as rejecting
her favorite activities and feeling irritable and angry all the time. Another disorder portrayed in
the movie was anxiety. The National Institute of Mental Health (NIMH) defines generalized
anxiety disorder (GAD) as feeling extremely worried or nervous for no specific reason that
inhibits performance of daily tasks due to lack of focus and extreme anxiety (NIMH,
2016). Whenever Fear took over the control panel, Riley gets anxiety attacks where she starts to
worry excessively and begin to imagine a million worst case scenarios all at once. Bipolar
mood, energy, and activity levels that affect a person’s ability to carry out day-to-day tasks
(NIHM, 2016). Riley revealed manic-depressive disorder during Joy and Sadness’ intense battle
The movie Inside Out had several main characters but the two that were most significant
were Joy and Sadness. Joy is a character who portrays Riley’s happiness. She is the group leader
within Riley’s emotional characters. Joy sees the good and fun in any situation no matter the
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circumstance. The fact that Joy is the prominent emotion within Riley makes her an extremely
happy child with an optimistic outlook on life. Sadness is the opposite of Joy in that she focuses
on the sad aspects of every situation. For example, Joy and Sadness were talking about what they
like about the rain. Joy says “I love rain because you get to jump in puddles and play.” Sadness
says “I love how the rain fills your boots and your feet get wet and squishy”. In this scene it
shows Riley playing in the rain and miserable and wet based on which emotional character was
in control. The main lesson learned from Joy and sadness is that you cannot have one without the
other. Moments in life can be sad but the support you get from others can transform the memory
complexity to the characters. Each of the emotional characters Joy, Sadness, Anger, Fear and
Disgust portrayed different psychiatric disorders as stated above. Analyzing the movie from
inside Riley it may appear she has a schizotypical personality disorder as each emotion has their
regarding the intent or response of others, and difficulty setting goals, determining their own
beliefs, and other alterations in identity (Halter, 2014). Each character had their own personality
based on the emotion in which portrayed. There was a scene where Riley was eating dinner with
her family and her mother was asking about her day. Joy and Sadness were not in headquarters,
so Anger, Fear and Disgust were left to respond to her mothers’ questions. Each took turns acting
like Joy but were unsuccessful which lead to an altercation between Riley and her parents. Riley
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is normally a very happy child but was suffering from a temporary internal conflict when Joy and
The movie Inside Out would be a valuable tool to use when a patient needs help
understanding why they are having certain feelings and what the effect is of that feeling is,
especially if the patient is a child or adolescent. The use of animation makes difficult concepts
easier to identify and is more relatable to the masses. Each character is an emotion that Riley
experiences, and the movie shows the effect that each individual emotion/character has on Riley
when they’re at the control panel. When they fight over the control panel Riley’s moods change
drastically depending on who’s in control, but ultimately Joy takes control because she feels
Riley needs to be happy all of the time. As Riley ages and the movie progresses, the character
Joy realizes that there’s a time and place for each emotion, and that multiple emotions can
coexist together with a positive outcome. This concept is extremely helpful when dealing with
patients who suffer from anxiety or depression. Patients respond well when they are able to
identify the emotion they are experiencing and discussing other feelings that might be more
appropriate. Cognitive Reframing is a prime example because the goal “... is to change the
individual’s perceptions of stress by reassessing a situation and replacing irrational beliefs ...
The evidence supports the portrayal of depression and anxiety well. Halter references
pleasurable activity, also known as anhedonia ...; fatigue; sleep disturbances; changes in appetite;
concentrate or make decisions; and a change in physical activity” (2014). Riley shows a lack of
interest in playing hockey and talking to her friends; she also demonstrates poor decision making
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when she decides to run away all because Fear, Anger, and Disgust were controlling the control
panel. Halter goes on to state that anxiety occurs when “Maladaptive use of defense mechanisms
... are used in excess, particularly in the overuse of immature defenses” (Halter, 2014). Riley’s
defense mechanisms are challenged when the move to San Francisco forces her to an entirely
new life at a young age. She doesn’t have the familiarity that she was used to and doesn’t know
how to deal with everything around her changing. A once happy Riley becomes angry, fearful
and disgusted with her family, friends, and social environment mostly because her defense
mechanisms are immature. Inside Out is a relatable tool that should be considered when
therapeutically communicating to younger patients suffering from a mood disorder, and anyone
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
Halter, M. J. (2014). Varcaroli's Foudations of Psychiatric Mental Health Nursing. St. Louis:
Elsevier.
The National Institute of Mental Health. (2016). Generalized Anxiety Disorder: When Worry
from https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-
gad/generalized-anxiety-disorder_124169.pdf
The National Institute of Mental Health. (2016). Mental Health Information: Bipolar
disorder/index.shtml