10 Most Realistic Films About Going Insane

Spider star Ralph Fiennes
Ralph Fiennes stars in ‘Spider’ (Photo © Sony Pictures Classics)

Going insane is a terrifying thing and it’s often been used as the foundation for horror films ranging from Psycho to The Shining. Depicting a deteriorating mind is tempting for filmmakers but often the resulting films are designed as showcases for actors who want to chew up the scenery (this happens in a good way with Whatever Happened to Baby Jane?) or as glossed over stories of recovery (A Beautiful Mind, Girl, Interrupted). Here is a list of films that either place you in the head of a character who is insane to convey what that outlook on the world is like or that realistically try to depict what mental illness is like. There are a lot of films to choose from but this is a starting point of some of the best and most serious or sincere explorations of the topic.

1. A Woman Under the Influence (1974)
John Cassavetes directs his wife Gena Rowlands in this portrait of a wife and mother who struggles with mental illness. Rowlands is heartbreakingly good as Mabel and Peter Falk, as her husband Nick, shows the role love and patience can play in coping with mental illness. An honest, raw, and deeply moving film that is one of the most realistic explorations of insanity ever put on film.

2. Repulsion (1965)
Roman Polanski’s Repulsion is perhaps the best film (although stiff competition from Spider and many of the works of David Lynch) at conveying what it might feel like to be inside the mind of someone going insane. Catherine Deneuve (no stranger to playing insane, see her work in Belle Du Jour) is a woman repulsed by sex and by the behavior of her sister’s boyfriend. The film provides a first person perspective on a descent into depression and madness, stunningly conveying the kind of horrific visions Deneuve’s character is haunted by.

3. Spider (2002)
David Cronenberg’s Spider is right up there with Repulsion for putting us into the head of someone slipping into madness. Both films create worlds where we can’t tell what’s real and what’s in the character’s head. Cronenberg and Polanski make us understand how that inability to distinguish that difference is the very root of their characters’ insanity. Ralph Fiennes is a mentally disturbed man who lives in a halfway house and is thought to be on the road to recovery. But through the course of the film he slips back into a world he has created where he replays a pivotal moment from his childhood. Meticulously crafted and absolutely riveting, this is one of the most unnerving portraits of what it feels like to lose your grasp on the real world.

4. Frances (1982)
This biography of actress Frances Farmer is chilling in the way it portrays the mental health world of the recent past when lobotomy was considered acceptable treatment for someone who might have just been stubborn, strong-willed, opinionated, and just not willing to conform to a conventional lifestyle. The film is realistic in depicting how someone can lose control over his or her own life and be subjected to sanctioned abuse and horrific institutional treatment. Jessica Lange delivers a ferocious performance, which makes the character’s tragic end all the more painful.

5. The Snake Pit (1948)
Anatole Litvak’s film is very much a product of Hollywood but it is significant for being one of the first films to tackle the taboo topic of mental illness, and to try and remove the stigma from people who have been labeled as mentally ill. Based on Mary Jane Ward’s autobiographical book, the film served up a scathing indictment of how psychiatric patients were treated. Litvak asked star Olivia DeHavilland to visit mental institutions and attend psychiatric lectures, and she supposedly threw herself into doing research for the film. A little dated now but no less powerful, and extremely significant in terms of turning attention to mental health treatment and its patients.

6. Through a Glass Darkly (1961)
Ingmar Berman has dealt repeatedly with characters that are suffering from mental illness of varying degrees and it was difficult to pick which one was best. Persona and Hour of the Wolf were also strong contenders but Through a Glass Darkly stands out as the most realistic. It focuses, as with A Woman Under the Influence, on how a family copes with the deteriorating mental state of one member. In this case, it is the eldest daughter played by Harriet Andersson.

7. Betty Blue (1986)
Jean-Jacques Beineix’s film starts almost like a romantic comedy but then descends into a brutal portrait of a woman whose insanity often results in violence. Beatrice Dalle is terrifyingly good as a woman whose proclivity for violence can be dangerous to both those around her and to herself.

8. We Need to Talk About Kevin (2011)
Lynne Ramsay’s film looks at mental illness from the outside taking the point of view of a mother (magnificently played by Tilda Swinton) whose son displays increasingly disturbing and manipulative behavior. This film explores the darker side of insanity to ask what happens if we can’t reach or help a family member and feel challenged to continue loving him or her.

9. Taxi Driver (1976)
Martin Scorsese’s film about Travis Bickle is an intense look at what can unhinge a mind and lead to violence. The irony here, though, is that the violence gets interpreted by society as something heroic. Robert De Niro’s performance as Travis captures a man who is wound too tight and ready to explode. It provides insights into the kinds of things that can trigger violence in someone like Travis Bickle.

10. The Fisher King (1991)
Terry Gilliam has dealt with elements of insanity in many of his films be it Jonathan Pryce’s character in Brazil who escapes torture by going to a world he’s created in his head or the drug induced insanity of Fear and Loathing in Las Vegas. But in The Fisher King the setting and the exploration are the most rooted in the real world. Jeff Bridges plays a former radio shock jock who becomes depressed and suicidal after his on-air advice leads to violence. He meets up with a homeless man played by Robin Williams who is on a quest for the Holy Grail. The film depicts two kinds of mental illness, one that might be manageable with treatment and one that might not. Plus it has Gilliam’s outrageous cinematic style.