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Running Head: INSIDE OUT 1

Inside Out and Psychiatric Disorders


Mariam Sarain, Andrea Suan, and Wendy Keil
University of South Florida
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Inside Out and Psychiatric Disorders


The movie Inside Out explored psychiatric disorders such as depression, anxiety, and

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

disorder or manic-depressive disorder is characterized by the NIMH as severe dramatic shifts in

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

for power over the emotion control panel.

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

into a happy one.

Watching the movie from a psychiatric perspective added an additional layer of

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

own personality. Schizotypical personality disorder is defined as personality alteration

characterized by altered interpersonal boundaries, eccentric behavior, eccentric use of language,

restricted or socially inappropriate expression of emotion, increased mistrust and sensitivity

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

Sadness were missing from headquarters.

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 ...

with more positive self-statements” (Halter, 2014)

The evidence supports the portrayal of depression and anxiety well. Halter references

Wasserman’s description of depression demonstrated “by a lack of interest in previously

pleasurable activity, also known as anhedonia ...; fatigue; sleep disturbances; changes in appetite;

feelings of hopelessness or worthlessness; persistent thoughts of death or suicide; an inability to

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

else the nurse feels would benefit.


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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental

disorders (5th ed.). Washington, DC: Author.

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

Gets Out of Control. Retrieved

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. Retrieved from https://www.nimh.nih.gov/health/topics/bipolar-

disorder/index.shtml

Wasserman, D. (2011). Depression. New York: Oxford University Press.

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