top of page

Exploring Mental Illness through the Horror Movie Genre

Updated: Jan 28, 2021

Horror movies come in all forms, from axe-wielding psychopaths to haunted houses. The genre hosts everything from vampires stalking the night for a drink of blood, flesh-prowling zombies, to shadow-lurking demons whispering messages to the naive from spirit boards. There are many ways for horror writers and filmmakers to frighten audiences into tossing the sheets over their heads and questioning every bump in the night, and that's with the so-called silly scares.

There's an element to horror that's a whole lot scarier than the stuff that only exists on screens, and horror writers have captured it in a uniquely fascinating and terrifying sub-genre known as psychological horror. These are the movies that deal with mental illness at their core and pose the question: what if the enemy is inside our head?

As with most things, a sort of desensitization occurs the more repeated something becomes. Arguably, the same is true for horror (and thriller) movies. A lifelong fan of the genre, it takes quite a bit to get under my skin. When I was younger, I was terrified of Jason and Michael Myers--those silent killers hiding in the shadows, waiting to leap out and murder their unsuspecting victims.

As I grew older, I regarded slasher movies as more of a joke than serious horror. Over the top gore, and icepick-wielding psychopaths no longer held the same appeal. While I enjoy a good vampire movie (Martin) and zombie movie (Dawn of the Dead '79), I can't say that they ever scared me. And when I say 'scared me,' I'm not talking about the occasional jump scare that happens when cat leaps out of window, I'm talking about the kind of dread that stays with you for days after a movie ends.

No, that type of scare is reserved for the realism. The ongoing dread happens in the setting of something that makes you reflect and say, "Holy sh*t. That could really happen." And that... that's the impact that a well-crafted psychological horror can have on the viewer.

It's done in a few subtle, but effective ways. First, horror movies might use mental illness as the metaphor for the fear. We see that in Babadook and Hole in the Ground. The fear is depicted as an actual monster on screen, thereby terrorizing both the audience and the main character.

Second, psychological horror plays on common audience fears (depression, anxieties, psychoses), but uses the filter of the horror flick, the monster, the demon, etc. to demonstrate its subject. If it's done effectively, the movie often ends up leading the viewer down the path of questioning whether or not it's the main character or "everyone else" that's fallen subject to the illness; and that is a truly unsettling feeling.

Here's the thing. Maybe there's a pretty creepy vampire movie out there, but there's good reason to believe you're not going to turn into a vampire. However, can situational stressors such as extreme anxiety, postpartum issues, etc. cause you to develop a psychosis? Scary stuff. Please know we're not making light of it by comparing it to cinema. We're truly talking about the horrifying effect of seeing it put to the big screen in someone's visual and written adaptation.

Lastly, there's the question of the unreliable narrator, and how horror uses this element to play with the audience. There are movies where you think the main character is showing an accurate portrayal of events only to find out, their story is wildly inaccurate, or vice versa. Perspective in these movies is often everything.

Here are a few examples we've found to be fascinating, horrifying, and heartbreaking.

Babadook: When a single mother and her troubled son find a strange book their family is ripped apart by paranoia and fear.

The Hole in the Ground: A single mother living in Ireland with her son begins to think that something is wrong with her son after he returns from being lost in the woods.

The Lodge: When a woman is snowbound with her fiancé's children, dark memories of her childhood emerge.

Repulsion: An introverted woman sinks into depression and terrible visions when her sister leaves her alone in their apartment for a weekend.

The Invisible Man: Elizabeth Moss descends into madness when she gaslighted by her abusive husband who she thinks is dead.

Possum: A failed puppeteer returns home to find that he cannot escape his traumatic childhood. This movie gets points for having one of the scariest puppets ever committed to screen.

Black Swan: A ballet dancer's commitment to her role as the Black Swan in Swan Lake drives her to the brink of insanity.

Mental Illness is a serious condition. If you are in crisis or you think you may have an emergency, call your doctor or 911 immediately. If you're having suicidal thoughts, call 1-800-273-TALK (8255) to talk to a skilled, trained counselor at a crisis center in your area at any time (National Suicide Prevention Lifeline). If you are located outside the United States, call your local emergency line immediately.

Like our post? Hit the heart button! If you really liked it...

Related Links:

946 views3 comments

Recent Posts

See All


Bryan Fog
Bryan Fog
Nov 22, 2022

re: the discussion of slasher movies - pretty narrow minded of you to look down on them. You're perpetuating the already large divide between "elevated" horror and more common horror. Alright article with the exception of that.


Eric Keegan
Eric Keegan
Jan 27, 2021

This was a very interesting read and I'd never previously connected the idea of a character's delving into madness, versus the output reaction from an audience. Real horror, cut and dry no frills (excluding gore factor of course) induced mania to me will always represent more of the slasher genre. To compare with Jason, I still find bouts of hair-raising terror in those films because if you remove the movie magic, it's basically a plausible concept of what could happen out in the woods at any given time. Being a Boy Scout for years, this thought ran through my head many nights when the sun settled in for a slumber and the world became dark. Were there maniacs livin…


There are many people who claim that horror movies are not always accurate depictions of mental illness, but as a person with Schizoaffective Disorder (diagnosed 4 years ago at age 15), I can confirm that many of the experiences portrayed on film are actually quite accurate to what psychotic episodes feel like. Unreliable narration is actually very realistic to how delusions can form (such as creating a false persona for each person in my life, the girlfriend becomes a drug pusher without any evidence and now I shouldn't answer her texts because she wants to drug me and hurt me). I'm glad that this article wasn't one of those "horror movies are bad at depicting mental illness", because I find…

bottom of page