Movie Review:

Major Depressive
Disorder in
It’s Kind of a Funny
Story
By Thitirat Pongprajuc
History of Major Depressive Disorder
 Depression has been around since Mesopotamia during the second millennium B.C.E. At that time, people believed that
it was caused by demonic possession and was treated by priests instead of physicians.
 In some cultures, depression was once believed to be caused by evil spirits possessing the individual. To cure this, harsh
methods such as physical punishment, restraint, and starvation were used to exorcise the "demons".
 Ancient Greek and Roman doctors used therapeutic methods like gymnastics, massage, music, baths, and medication
made from poppy extract and donkey's milk.
 Doctors in the past used to believe that depression was caused by aggression. As a result, they treated it with remedies
like water immersion, spinning stools, diet changes, horseback riding, and vomiting, which were believed to be effective
at the time.
History of Major Depressive Disorder
 Freud discussed the topics of mourning and melancholia. He believed that psychoanalysis could help people work
through the conflicts that arise from experiencing loss.
 At that time, some doctors believed that depression was a brain disorder.
 Behaviorists believed that depression was a learned behavior that could be unlearned. They used principles like
association and reinforcement to establish and reinforce healthier behaviors, helping people overcome depression.
 Cognitive psychologists believed that interpreting negative events in a certain way or feeling helpless and unable to
change one's circumstances can lead to depression.
 Clinicians in the United States coined the term Major Depressive Disorder (MDD) in the 1970s, and it was officially
recognized as part of DSM-III in 1980
Symptoms of Major Depressive Disorder
 To be diagnosed with MDD, a person must have five symptoms presented. Symptoms must last at least two weeks
and must represent a change in your previous level of functioning for a diagnosis of depression

Diagnostic criteria
1.Depressed mood most of the day, nearly every day
2.Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
3.Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
4.Insomnia or hypersomnia nearly every day.
5.Psychomotor agitation or retardation nearly every day.
6.Fatigue or loss of energy nearly every day.
7.Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
8.Diminished ability to think or concentrate, or indecisiveness, nearly every day.
9.Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a
specific plan for committing suicide.
Etiology
Biological Cause
• Genetics plays a role in depressive disorders.
• higher rate of depression within families.
• Identical twins are more likely to have depression than fraternal twins.
• Gene abnormalities – The 5-HTT gene on chromosome 17 is responsible for serotonin activity.
• Low levels of certain chemicals
• Norepinephrine and serotonin
• Brain structures
• Prefrontal cortex, hippocampus, and amygdala
• Significant changes in blood flow occur throughout the prefrontal cortex.
• Having a smaller hippocampus results in having a lower number of neurons.
• The amygdala, which controls our flight-or-fight response, experiences increased activity and blood flow.
Etiology
Cognitive Causes
• Depression can be caused by negative thoughts and beliefs
• According to learned helplessness theory, when someone goes through situations
they can't control, they may start to believe that they're powerless. This feeling of
powerlessness may lead them to not take action even in situations where they could
have control.
• People who tend to blame themselves for negative events are more likely to
experience depression.
• Because they see things in a negative light and interpret daily events negatively
Etiology
Behavioral Causes
• Depression is a condition that can happen when a person experiences less positive rewards and more negative
punishments in their life.
• Various factors like work, family, relationships, or the environment can cause it.
• The lack of positive rewards can result in reduced participation in activities that were once important to
individuals.
• Continued poor performance can create a harmful cycle that leads to fewer positive rewards.

Sociocultural Causes
• Women are twice as likely to experience MDD.
• Separation or divorce can cause depression.
• Marital problems, stress, and children can also increase the chances of depression.
• Depression symptoms vary depending on the cultural background
• Depression rates and symptoms do not differ significantly among various racial and ethnic groups in the United
States. However, there is a difference in the rate of depression recurrence between Hispanics and African
Americans.
Statistics
 Individuals will only experience symptoms of depression.
 Especially affects 18-29 age group.
 About 16.6% of people will experience depression at some point in their lives.
 Women are 1.5 to 3 times more likely to develop depressive disorders than men, and they have a
lifetime prevalence of 21.3%.
 Men and individuals with a history of previous suicide attempts are more prone to suicide.
 Major Depressive Disorder is a condition where a person experiences symptoms for at least two weeks.
In the United States, it affects around 7% of the population.
Differential Diagnoses & Assessment for
Major Depressive Disorder
 Major Depressive Disorder (MDD) is a mental health condition that can be challenging to identify and treat because it
has similar symptoms to other conditions.
 Adjustment Disorder has similar symptoms to MDD but usually gets better within six months after a stressful event.
 Bipolar Disorder is characterized by both manic and depressive episodes.
 Dysthymia is a long-term form of depression that lasts for at least two years.
 PTSD may have depressive symptoms and trauma-specific symptoms such as flashbacks and nightmares.
 Schizophrenia may have depressive symptoms, but it also includes hallucinations and delusions
Differential Diagnoses & Assessment for
Major Depressive Disorder
 Depression is often not recognized in primary care
settings because patients usually come in for physical
symptoms caused by depression.
 They often don't acknowledge that they are feeling
depressed.
 Many people are brought in for evaluation due to social
withdrawal and decreased activity, either by their
families or by their employers..
Differential Diagnoses & Assessment for
Major Depressive Disorder
Doctors in primary care often use a questionnaire called the PHQ-9 to identify, diagnose, and track treatment
progress for major depressive disorder (MDD).
• The PHQ-9 is a questionnaire that asks 9 questions about depression and how it affects daily life. It uses the DSM-5
criteria for Major Depressive Disorder.
• A scale measures scores up to 27. If a score is 10 or higher, it may indicate possible Major Depressive Disorder (MDD).

Other scales used to assess depression:

• Hamilton Rating Scale for Depression (HAM-D)

• Montgomery-Asberg Depression Rating Scale (MADRS)
• Zung Self-Rating Depression Scale
• Beck Depression Inventory (BDI)
• Raskin Depression Rating Scale
Recommendations for Treatment
Antidepressants are commonly used to treat depression by affecting the neurotransmitters in the brain.
There are three main types of antidepressants, including SSRIs, tricyclic antidepressants, and MAOIs.

SSRIs are usually recommended because they have fewer side effects and are effective at low doses. While
they can cause nausea and insomnia, they are a valuable option with minimal adverse effects.

Tricyclic antidepressants are effective but have been replaced by SSRIs due to their side effects. They may be
more effective for people who don't respond well to other medications, but they have serious side effects,
including heart problems.

MAOIs are effective but not recommended as a first-line treatment due to safety concerns and dietary restrictions.
Recommendations for Treatment
Cognitive behavioral therapy (CBT)
• aims to enhance mood by targeting thoughts, behaviors, and emotions

Behavioral activation (BA)

• aims to improve mood by increasing positive behaviors and reducing negative ones

Interpersonal therapy (IPT)

• recognizes the impact of psychosocial life events on depression and identifies four main interpersonal problem areas to
address.
Multimodal treatment
• is a combination of psychological and medical treatments that work together to help people stay well. Patients can
receive this treatment all at once, one after the other, or in steps, depending on what they prefer. It's important for patients
to be involved in deciding which treatment is best for them.
• Multimodal treatment has been proven to be effective in treating patients.
Movie Review
 The movie "It's Kind of a Funny Story" tells the story of Craig
Gilner, a teenager who struggles with school pressure and family
expectations. Because of this, he thinks about ending his life.
However, he decides to go to a mental health hospital instead.
While there, he makes friends with other patients who also have
mental health issues. Bobby, one of the patients, helps Craig
navigate his struggles. Throughout the movie, Craig learns
valuable lessons about self-discovery, seeking help, and the power
of human connections. The movie combines humor and touching
moments to deliver a heartwarming exploration of mental health,
resilience, and personal growth. https://www.youtube.com/watch?v=7unkueyyqxI
Movie Review
 The movie depicts Major Depressive Disorder (MDD) through the character Craig. It highlights different signs and
symptoms that are commonly associated with MDD.
 The main character, Craig, experiences low mood and feelings of sadness, hopelessness, and emptiness and struggles to
cope with them.
 Many people with depression also have trouble sleeping and may struggle with insomnia.
 Craig finds it difficult to fall asleep or stay asleep throughout the night.
 Difficulty with concentration and decision-making are also common in people with depression.
 Craig's struggles with these issues are depicted in the film.
 Depression can also cause thoughts of suicide.
 The movie sensitively explores this aspect of mental health through Craig's contemplation of suicide.

 Individuals with depression may lose interest in activities they used to enjoy.
 It is also depicted in the movie through Craig's disinterest in drawing.
 Depression can also cause intense feelings of worthlessness and guilt
 Craig experiences these feelings throughout the film.
Critique of Portrayal of
Major Depressive Disorder
The movie "It's Kind of a Funny Story" portrays a relatable story of a character with
Major Depressive Disorder (MDD), showing the struggles and emotions they face.

The protagonist's decision to voluntarily check into a psychiatric hospital

encourages people to seek help for mental health issues.

It highlights the seriousness of suicide and its impact on individuals and their loved
ones, promoting awareness and open discussions about mental health.

The film highlights the seriousness of suicide and its impact on individuals and
those around them, raising awareness and promoting open conversations about
mental health.
Supportive relationships are important for mental health recovery. The movie
emphasizes the significance of empathy, understanding, and community during
mental health challenges.
Critique of Portrayal of
Major Depressive Disorder

Depicting mental health The movie tries to balance

issues on screen is humor with seriousness
challenging, especially The movie mainly shows when portraying life in a
when trying to condense characters from a specific psychiatric hospital.
the complexities of major group, which might not However, it's important to
depressive disorder within accurately represent how consider that this portrayal
the narrative structure of a depression affects might romanticize the
film. This simplified individuals from diverse experience and not show
representation may not cultural backgrounds. the true severity of the
encompass the full struggles faced by people
spectrum of the disorder. with MDD.
Reflection
 We should promote mental health education initiatives to improve understanding of MDD and other mental health issues. This
includes school programs, workshops, and awareness campaigns.
 We need to promote diversity in mental health portrayals in media, create supportive environments, and combat stigma
associated with seeking help to foster good mental health.
 Supporting those with MDD means increasing access to mental health services, like counseling and therapy, by reducing
barriers and raising awareness.
 To treat MDD, use a holistic approach. Combine psychotherapy, medication, and lifestyle changes. Customize treatment plans
to the person's needs and preferences.
 The movie "It's Kind of a Funny Story" portrays the impact of Major Depressive Disorder and emphasizes the significance of
seeking help and support. However, it is important to note that MDD is a complex and diverse condition, and individual
experiences may vary.
 The movie can help to reduce negative attitudes towards mental illness, but it has some issues. It might make MDD seem less
severe than it is, and it doesn't show how different cultures experience mental illness. We should watch the movie as a way to
start conversations about mental health, but we should keep in mind that it doesn't give a complete picture of what MDD is.
Conclusion
MDD is a complex mental health condition that
requires a compassionate approach to help sufferers. The
movie 'It's Kind of a Funny Story' can teach us about the
internal struggles of those with MDD and the
importance of seeking help.
Promoting mental health education, diverse
representations, and supportive environments can help
individuals overcome Major Depressive Disorder
(MDD) challenges and reduce stigma. Encouraging open
conversations and access to mental health services can
create a more empathetic and informed approach to
mental health.
References
 American Psychiatric Association. (2013). Major Depressive Disorder. In Diagnostic and statistical manual of mental disorders (5th ed.).
https://doi.org/10.1176/appi.books.9780890425596
 American Psychiatric Association. (2020, October). What is depression?. Psychiatry.org - What Is Depression? https://www.psychiatry.org/patients-
families/depression/what-is-depression
 Bains, N., & Abdijadid, S. (2023, April 10). Major depressive disorder - statpearls - NCBI bookshelf. Major Depressive Disorder - StatPerls - NCBI
Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559078/
 Bridley, A., & Daffin Jr, L. W. (2018, January 5). MODULE 4: MOOD DISORDERS. Fundamentals of Psychological Disorders.
https://opentext.wsu.edu/abnormal-psych/chapter/module-4-mood-disorders/
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https://doi.org/10.1177/0141076813486262
 Svab, V. (2016). Stigma and mental disorders. Mental Illnesses - Understanding, Prediction and Control, 17(9), 1250–1253.
https://doi.org/10.5772/30735
 Schimelpfening, N. (2023, March). When were the earliest accounts of depression?. Verywell Mind. https://www.verywellmind.com/who-discovered-
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 Tipton, C. M. (2014). The history of “Exercise is medicine” in ancient civilizations. Advances in Physiology Education, 38(2), 109–117.
https://doi.org/10.1152/advan.00136.2013
 U.S. Department of Health and Human Services. (2023, September). Depression. National Institute of Mental Health.
https://www.nimh.nih.gov/health/topics/depression
 YouTube. (2012). It’s Kind Of A Funny Story. Retrieved December 8, 2023, from https://www.youtube.com/watch?v=7unkueyyqxI.