Millions of Indians suffer from mental illnesses, yet to this day, the stigma associated with these medical conditions can be overwhelming. In a country with a population of 1.2 billion citizens, there are a mere 4,000 psychiatrists — compared to the roughly 50,000 psychiatrists in America. In 2012, The Lancet published a nationally representative survey of India that demonstrated suicide as the second leading cause of death among Indians between the ages of 15 and 29. Unfortunately, the country’s largest film industry’s portrayal of mental health issues usually leaves much to be desired. Let’s take a look at some examples from the past decade to get a better idea of the Bollywood’s subpar treatment of mental illnesses, intellectual disabilities and autism (major spoiler warning — while discussing some of these movies, I’ll essentially be giving away the story).

Aashiqui 2 — Alcoholism

Aditya Roy Kapur made swarms of women across the world fall in love with him after his portrayal of the alcoholic singer Rahul Jaykar in this 2012 romantic drama. The movie highlights Rahul’s downfall at the hands of alcoholism while paralleling the rise of his musical mentee, Aarohi Keshav Shirke (played by Shraddha Kapoor). Over the course of the movie, Aarohi and Rahul fall in love, and as expected, Rahul’s alcoholism takes a huge toll on both their relationship and Aarohi’s career.

Aashiqui 2 does a great job with demonstrating the way in which Rahul’s addiction penetrates every aspect of his life, professional and personal. In fact, his character easily demonstrates each facet of the often used medical screening tool for alcoholism: the CAGE questionnaire. He knows he needs to cut back, he feels regularly annoyed when others criticize his drinking, his guilt even forces him to push Aarohi away, and it’s implied that he requires an eye-opener drink to steady his nerves. Why was this on-screen celebrity never shown entering a rehab facility? Instead he goes on an alcohol abstinent weekend getaway with his girlfriend, where he miraculously suffers little to no alcohol withdrawal symptoms:

This movie’s shortcomings lie in its failure to properly portray alcoholism as a disease — a medical condition with both physical and mental components of alcohol dependence that requires proper treatment. Aarohi tries to “love away” Rahul’s alcoholism when he tells her he needs help, and when this doesn’t work for painfully obvious reasons, the film culminates in tragedy for this deeply afflicted protagonist. The battle faced by alcoholics is real, and while the treatment is a lifelong process, their lives aren’t as hopeless as Aashiqui 2 might lead us to believe.

Anjaana Anjaani — Depression

This 2010 romantic drama set in NYC featured Ranbir Kapoor as devastated Wall Street banker Akash and Priyanka Chopra as the betrayed-in-love Kiara. Akash and Kiara meet on the George Washington Bridge while they’re both planning on committing suicide for different reasons. Strangers before this chance meeting, their failure to kill themselves on this fateful night leads them to pledge to “live to die” together until December 31, 2009 — on which night they plan to jointly commit suicide. Yes, you read that correctly, the movie’s entire story consists of 2.5 hours of suicide romanticization.

If I were to guess as to what was really going on with both of these characters, I’d say Akash was suffering from Acute Stress Disorder after the stock market crash, and Kiara was suffering from an Adjustment Disorder in the aftermath of her fiancé’s adultery. But Anjaana Anjaani chooses to take the path of least resistance by throwing substance out the window for the sake of a half-baked love story between two severely depressed protagonists. In doing this, the movie incredibly undermines legitimate mental illness and the seriousness of suicidality. About the only thing the movie gets right is that if somebody has tried to commit suicide once, they will likely try again — as evidenced by Kiara’s attempts to slit her wrists, suffocate herself, fall to her death, and poison herself with bleach.

Karthik Calling Karthik — Schizophrenia

WARNING: MAJOR SPOILERS AHEAD

This 2010 thriller starred Farhan Akhtar as the title character — a young man who spends the entire first half of the movie getting unsolicited advice from an unidentified caller. This mystery phone confidante coaches the shy and reserved Karthik to both professional and personal success. He has the perfect job with his dream girl, Shonali (played by Deepika Padukone) by his side — so what could possibly go wrong?

Right about when you’re pondering this critical question, Karthik begins to realize that he’ll have to tell Shonali about his nightly phone-a-friend conversations. The mystery caller strongly cautions Karthik against telling anybody about their conversations, in fact, the caller threatens to punish Karthik if he lets anybody in on their little secret. Unfortunately, Karthik is unable to keep this secret from his girlfriend, and Shonali’s shock and disbelief is only rivaled by the mystery caller’s wrath. Before long, Karthik’s boss fires him and he loses Shonali all because of the middle of the night offensive phone conversations he has with them … but Karthik doesn’t even remember having these conversations?

Confused, frustrated, and depressed, Karthik disconnects his phone line and moves far away from what little is left of his Mumbai life. He assumes that getting rid of the phone will get rid of the mysterious caller who’s out to ruin his life. But the viewer soon realizes that Karthik can’t escape the caller, because Karthik is the caller. No matter where he goes or what he does, Karthik cannot escape the caller’s taunting voice, because the caller forms the essence of his psychosis. The phone conversations with a person who only reveals himself to Karthik can be extrapolated to encompass the delusions and hallucinations that plague many individuals with schizophrenia.



The beauty of this film lies in its treatment of mental illness after the viewer realizes that Karthik suffers from schizophrenia. Karthik Calling Karthik actually shows its protagonist seeking treatment from a psychiatrist. And Shonali, the love of Karthik’s life, does not abandon him when she learns about his diagnosis. Rather, the movie shows the couple leading a life together while coping with Karthik’s mental illness. This is by no means an all-inclusive film about the highs and lows of a patient with schizophrenia, but it’s a step in the right direction that manages to sensitively integrate a character’s mental health struggles into the overall story.

Barfi — Autism

Ranbir Kapoor and Priyanka Chopra reunited in 2012 for this Anurag Basu film that featured Priyanka as Jhilmil, a young woman with an Autism spectrum disorder. I know this movie was loved by many after its release, and Priyanka’s performance was lauded by critics — but I left the theater not really understanding what I had just watched. The movie never clearly addressed Jhilmil’s diagnosis, so the audience was left to presume that she has autism plus/minus some intellectual disabilities. Ultimately, I don’t think the film did a major disservice to the field of mental health, but there was ample room for improvement.

After watching Barfi, many experts agreed that Jhilmil’s characterization had multiple inconsistencies in its depiction of autism spectrum disorders, which is unfortunate given the movie’s widespread success. These same experts praised Aamir Khan’s well-researched portrayal of developmental learning disabilities in his hugely successful 2007 directorial debut, Taare Zameen Par, so I know Bollywood has the potential to do infinitely better than Barfi. And in a time when one in every 150 newborns born in India is being diagnosed with autism, I need Bollywood to do better.

From the first few minutes of the 2008 film U Me Aur Hum, it’s fairly obvious that the story is heavily inspired by the 2004 movie The Notebook. Ajay Devgan plays a psychiatrist (conveniently also named Ajay) who falls in love with Kajol’s Piya on a cruise. The story then transitions to show their marriage take a devastating detour courtesy of Piya’s Alzheimer’s diagnosis. And this key fact is where the story significantly differs from The Notebook — Piya is diagnosed with her disease in her 30s unlike her The Notebook counterpart who is diagnosed with dementia much later in life.

According to the National Institute on Aging, this early-onset Alzheimer’s dementia can be seen in patient’s aged 30 to to 60 years old, but is exceedingly rare compared to most Alzheimer’s patients who are diagnosed after the age of 60. I can only presume that the makers of U Me Aur Hum chose to demonstrate early-onset dementia for the sake of convenience in the context of the movie’s plot.

On the other hand, in Sanjay Leela Bhansali’s 2005 film Black, Amitabh Bachchan’s character Debraj, the teacher to Rani Mukherjee’s deaf and blind character Michelle McNally, is shown to suffer from Alzheimer’s at a much older age. Both movies introduce the afflicted character’s initial symptoms of forgetfulness through different, yet accurate ways. In U Me Aur Hum, Piya forgets how to get to her house, while Debraj completely forgets he left Michelle waiting on a bench after going to get her ice cream in Black.

Both of these examples carefully illustrate the memory loss, increased confusion, and heightened anxiety that can be seen with the early signs of Alzheimer’s dementia. This type of accurate representation in India is especially important in light of estimates suggesting that there will be over 14 million citizens over the age of 60 with dementia by the year 2050. Looks like all the turmeric in the Indian diet won’t solve the country’s dementia woes after all.

Woh Lamhe — Schizophrenia

Before Kangana Ranaut wowed the world as Queen, she starred in this 2006 drama written by Mahesh Bhatt as schizophrenic actress, Sana Azim. Shiney Ahuja plays Sana’s love interest, struggling film-maker Aditya Garewal, and Woh Lamhe is reportedly based on the story of yesteryear actress Parveen Babi and her 1970s affair with Mahesh Bhatt. The movie tells its story through flashbacks that start after Sana attempts suicide by slitting her wrists.

Over the course of the film, Sana is shown to experience deeply disturbing and inescapable auditory and visual hallucinations that reinforce her persecutory delusion that somebody is trying to kill her. All of these signs and symptoms would be consistent with the paranoid schizophrenia that Parveen Babi allegedly suffered from. Both Kangana Ranaut’s powerful performance and Mahesh Bhatt’s writing help Woh Lamhe paint a compelling, and fairly accurate portrait of a character as emotionally and mentally afflicted as Sana Azim.

My Name is Khan — Asperger’s Syndrome

This lengthy 2010 Karan Johar directed drama featured Shah Rukh Khan as Rizwan Khan, a young man with Asperger’s, a syndrome which also falls under the umbrella of autism spectrum disorders. The film’s journey shows Rizwan on a quest to meet the president of the USA to tell him that he is “not a terrorist.” From the perspective of Asperger’s Syndrome, a review with a neuropsychology focus essentially gave this movie a pass for its portrayal of Rizwan’s character, so who am I to argue? My biggest issue with this movie had to do with its convoluted plot that seemed to drag on and on, so if you can get past that, then this is a pretty good example of how to integrate a character with a mental illness into the filmy world.

I really enjoyed Hasee Toh Phasee, but I’m not sure where I should even start the mental health discussion surrounding this joint Karan Johar-Anurag Kashyap 2014 rom-com production, which features Parineeti Chopra as the “mental” Meeta and Siddharth Malhotra as her savior, Nikhil. Meeta is shown to be the brilliant youngest daughter of a Mumbai sari-business mogul who steals money from her father and disappears for seven years to work on her post-doctoral research project in China. This very same brilliant Meeta is called “Mental Meeta” by the film’s pre-release promotional material, so you know we’re headed down a slippery slope.

Watch ahead to get an idea of how the movie introduces viewers to Meeta when she returns to Mumbai to attempt reconciliation with her family for her sister’s wedding to Nikhil:

If you watch the clip above, your impression of Meeta by the end of the promo is probably more or less the impression I had of her at the end of the movie. Frequent blinking, excessive jitteriness, nose twitching, and insatiable hunger are all part of the “sensations” Meeta feels intermittently over the course of the movie. What does she do to control these feelings? She pops handfuls of mysterious pills, which then lead to bizarre sugar and toothpaste cravings.

I would guess that anyone who suddenly returns home after completely isolating themselves from their loved ones for seven years really would feel a combination of anxious and depressed emotions that could translate to the bizarre reactions Meeta displays in the film. So, I could have let it all go, especially in light of Parineeti Chopra’s fantastic performance, if it weren’t for the scene where Nikhil unveils the identity of the mystery pills made up of the imaginary ingredients “Dichlorosystrin, zincodestrin and oxidisulphide” as “selective serotonin reuptake inhibitors” (SSRIs). FACE PALM.

So, Bollywood, you’ve taken unusual tics, treated them with your protagonist’s amalgamation of fake ingredients, and then given these pills the name of a very real medication?! Fail, fail, fail. SSRIs are first-line medications prescribed by primary care physicians around the world for the management of patients who are suffering from very real and often debilitating symptoms associated with anxiety and depression. Contrary to Nikhil’s brilliant supposition that taking anti-depressants means Meeta is a “coward,” studies have long since established the safety and efficacy of SSRIs in combination with therapy to achieve clinical improvement in certain patient populations.

As if there already isn’t enough stigma surrounding the treatment of mental illnesses, let’s add unfounded SSRI side effects to that list. In reality, if Meeta were to pop that many SSRIs in one go, I’d be less worried about those random tics and more worried about serotonin syndrome. But what do I know?

******

I’m often asked why I enjoy Bollywood so much. The answer to this question is probably deeper and more multifaceted than anybody would expect, but a component of my love for Bollywood comes from the film industry’s ability to penetrate almost every level of Indian society. Rural versus urban populations, local versus non-resident Indians, elite versus impoverished citizens, and educated versus illiterate viewers all share a common filmy thread.

And in India itself, a movie and its scenes, dialogues, songs, and performances all hold an immense amount of potential for the audience. Will the audience walk away from the film more enlightened than before? Or will they walk away with gross misinformation that at the very least leaves them with a surface level misunderstanding of key issues? For some of the films we’ve discussed here, it’s tragically obvious that Bollywood still falls incredibly short in the domain of mental health. We’re all well aware of the stigma surrounding mental illness and mental healthcare in the global South Asian community, so here’s hoping Bollywood filmmakers stop disseminating information that exacerbates the existing problem and instead start focusing on generating appropriate awareness.

Farah Naz Khan is an internal medicine resident at Emory University. After graduating from college in Boston, she returned to her Alabama hometown to attend medical school, and was reunited with the mix of Southern hospitality and South Asian culture that had shaped her childhood. Follow her on Twitter @farah287 or read some of her thoughts at farah287.blogspot.com.