This article contains spoilers.
There is something overwhelmingly lonely about suffering from a condition that is so misunderstood, so feared and so shrouded in stigma that you could go your whole life without seeing it depicted accurately on TV.
Those of us with Borderline Personality Disorder know this all too well. When it comes to watching ourselves on screen, we can pick from two equally miserable options. Option A includes a plethora of unfair portrayals that reduce us to a tired set of tropes. Characters with BPD (and women in particular) are viewed as cold, narcissistic, abusive and sexually deviant, sometimes all at once — and they’re rarely protagonists, instead relegated to crazy exes or quirky side characters. Option B are the characters who are semi-relatable — they might have traits of BPD, but this is never confirmed, with writers not wanting to label them with such a stigmatised condition. More often than not, filmmakers don’t bother at all, instead opting to depict more ‘palatable’ conditions like depression and anxiety.
Maniac (2018) breaks this mould spectacularly by presenting us with a new option, a dazzling examination of Borderline Personality Disorder that is equal parts joyous and heart-wrenching, and all the time utterly realistic.
The dark comedy-drama series follows Annie (Emma Stone) and Owen (Jonah Hill) as they participate in a controversial drug trial that is intended to cure them of their trauma, while unequivocally binding them together in the process. The experiment involves taking three pills, each of which causes vivid dream-like hallucinations, or ‘reflections’, in the patient. Pill A forces you to relive your worst trauma, Pill B highlights your defence mechanisms, and Pill C brings you full circle to confront your inner demons and hopefully banish them forever.
All of this takes place amidst a Kubrick-inspired, semi-futuristic backdrop, complete with a conscious supercomputer. There’s something so cutting about the setting — with intrusive, personalised adverts reminiscent of today placed next to old, bricky computers. It feels almost like a reflection itself, a vision of the future dreamed up by someone in the 80s. Perhaps this is intentional; a world inhabited by robots trained to pick up dog-poop, yet without meaningful tech that allows us to better our mental health serves as a mirror into our own vapid and capitalistic society.

When we meet Annie, she is already addicted to the A pill, using it to revisit and revisualise the traumas in her life, primarily her sister’s death in a car accident, which she considers to be her fault. Annie’s borderline traits are immediately apparent here: she self medicates with drugs, makes risky decisions and feels disconnected from the world around her – her apartment a jumbled amalgamation of obscure things that don’t quite fit together. ‘You’re the last one’, she vows as we see her crumble up a pill. Annie yearns for recovery, but her trauma is so visceral, so all-consuming that she once again relapses, leading her to seek out the trial as a way of legally obtaining the drug. She doesn’t pass the Rorschach-style entrance test, but makes her way in through other means, fuelled by desperation and an innate sensitivity to rejection — hallmarks of BPD.
During the trial, we see Annie’s recollection of the night before her sister Ellie died in harrowing detail in the second episode, Windmills. One of the more stigmatised symptoms of BPD is splitting — the tendency for interpersonal relationships to oscillate between idealisation and devaluation. Annie splits on Ellie seemingly out of nowhere, with their laughter in the car quickly devolving into a bitter argument at the motel. There is deep, vitriolic anger emanating from Annie as Ellie tells her she plans to move to Salt Lake City. Annie reacts by pushing her sister away, “Now I won’t have to feel bad about not calling you.” It’s difficult to watch, but we later understand that this comes from a deep fear of abandonment resulting from the girls’ abusive mother, who left when they were young. Drawing attention to this is essential, as stats show that people with BPD are 13 times more likely to have experienced childhood trauma than the unaffected, with an overall rate of 71%. Unstable parent-child relationships are integral to Maniac, from Annie and her mother (or father, who spends his time social-distancing from the world in a pod), to the doctors overseeing the trial, one of whom has a strained relationship with his psychiatrist mother.

We then see Annie take the B pill and watch her friendship with Owen, who has paranoid schizophrenia, grow. The connection between the two is both mental and physical — their wires cross during the trial leading to a colourful array of shared reflections, from married couple Linda and Bruce in Long Island to con artists Arlie and Ollie searching for the lost chapter of Don Quixote. Owen’s presence in Annie’s reflections serves as a source of validation as he reassures her and provides unconditional friendship and support. In her fantasies, Annie is also able to live out healthy relationships — including being married with children — that she has never experienced nor desired before, partly because she feels she doesn’t deserve them, “They were realities that mattered more than mine.” Toxic relationships are a huge part of BPD — a disorder which, contrary to harmful stereotypes, is more likely to lead sufferers into abusive relationships than make them abusive. Annie’s budding friendship with Owen, who she initially rejected due to fear of abandonment, demonstrates that healthy relationships for BPD sufferers are possible and that they are crucial to recovery. In many ways, a good support network takes precedence over sterile, money-obsessed pharmaceutical companies — represented here by the doctors leading the trial who are dithering around, disobeying protocol and literally dropping dead in the background.
There is a myth that BPD is incurable, something which Annie herself initially believes, stating that “No therapist has ever been able to understand me.” Over time though, she begins to understand and address her problems and work on coming to terms with them. Annie’s reflections allow her to pinpoint unhealthy coping mechanisms, with each one morphing into something less intimidating yet often more absurd, in true Maniac style. For example, in the fourth episode, Furs by Sebastian, Annie’s addiction to the A pill becomes an overreliance on antihistamines, “They’re no good for me”, she acknowledges, holding in a sneeze. Her guilt and feeling of responsibility manifest as a lemur named Wendy, who she must recover by breaking into a fur shop, while an old woman dying of natural causes can be interpreted as a metaphor for her sister. Annie becomes lucid at the end of this reflection, realising who she is, and demonstrating that she has gained a stronger sense of self. This realisation leads to her diagnosis of Borderline Personality Disorder in the subsequent episode, which was spit out by a computer after a series of calculated interrogations reminiscent of the soulless, tickbox style diagnosis present in the real world. It was a cathartic moment for me — one I had half-anticipated, adding up her traits as I watched along — but one I never ultimately thought would materialise.

By the time Annie takes the C pill in Ceci N’est Pas Une Drill – the seventh episode – she is ready to tackle her trauma head-on. This time, we head into a medieval, Lord of The Rings-style reflection, where Ellie is an Elven princess and Annie is a ranger “Blurred by drink and greed.” These characterisations demonstrate Annie’s unhealthy coping mechanisms and her newfound recognition of them, as well as her tendency to put her sister on a pedestal — both of which are inherent traits of BPD. After almost being trapped in a vegetative state by the experiment’s grieving supercomputer — one of the series’ more abstract conceptions of mental illness — Annie escapes, and in the penultimate episode Utangatta speaks to her sister for the last time. She apologises and can finally let go of the guilt she has harboured for so long, “I’m sorry I was drunk at your funeral”, she cries, ”and I’m sorry I was so awful to you at the motel.” Coming to terms with the more challenging parts of her diagnosis — her tendency to split, to erupt with anger and her disorganised attachment style — and working on them without returning to a cycle of self-loathing, is a crucial part of recovery, and reminiscent of the skills learnt in DBT. It’s refreshing to see someone grow in self-awareness so much, from using relationships to manipulate her way into the trial at the show’s beginning, to developing connections that are empathetic and emotionally fulfilling. Annie continues these relationships in Option C, the final episode , reconciling with her dad and maintaining her friendship with Owen.
In contrast to its visual and narrative absurdity, Maniac serves as a refreshing dose of reality for those of us with BPD. We see for the first time a protagonist with the condition who is neither demonised nor romanticised and whose illness — despite dominating her relationships and causing her a great deal of pain — does not minimise her personality. Maniac’s writers have ensured that Annie’s character is fully fleshed out; she is empathetic, loyal, intelligent, funny, and so much more. Owen’s schizophrenia is explored too in a sensitive and informative way that is more than deserving of a separate analysis. There is a real sense here that Maniac’s writers are breaking boundaries by deliberately focusing on highly stigmatised conditions, which director Cary Fukunaga admits to wanting to do here in an interview with Bustle.

Depictions of Borderline Personality Disorder are rarely one-size-fits-all — we can best understand the condition as more of an umbrella term that encompasses a variety of different experiences. While I and some Reddit users have found this portrayal accurate, others might not — and that’s ok. Watching the series for a second time with post-therapy eyes admittedly gave me a different lease on it, one far more critical of Annie after having spotted unhealthy coping mechanisms in myself.
I’m reminded of a Baruch Spinoza quote Annie’s dad says to her at the beginning of the show: “All things excellent are as difficult as they are rare”. Maniac is all of these. It is entirely excellent, difficult in parts and so preciously rare. It provides many of us with Borderline Personality Disorder with the Option C we’ve been aching for all along.