Abnormal Psychology Assignment: Analyzing Schizophrenia Through Horse Girl

Understanding mental health disorders through film analysis has become an increasingly popular approach in psychology education. This comprehensive assignment examines the portrayal of paranoid schizophrenia in the Netflix film “Horse Girl,” providing students with practical insights into diagnostic criteria and treatment approaches.

Understanding the Character: Sarah’s Journey

Sarah, the main character in Horse Girl, works as a saleslady at a craft store and lives what appears to be a quiet, introverted life. However, beneath this surface lies a complex mental health condition that gradually unfolds throughout the movie. Her family history reveals a troubling pattern – both her mother and grandmother struggled with depression and schizophrenia, with her mother ultimately taking her own life after her depression diagnosis.

What makes Sarah’s case particularly compelling for psychology students is how her symptoms develop progressively. Initially, she seems like just another shy person who prefers solitude. But as the story progresses, we witness the emergence of severe psychiatric symptoms that align perfectly with clinical diagnostic criteria.

Family History and Genetic Factors

The film doesn’t shy away from exploring the hereditary aspects of mental illness. Sarah’s grandmother had paranoid schizophrenia, and her mother battled depression before her suicide. This family history serves as a crucial backdrop for understanding Sarah’s condition. In real-world scenarios, genetic factors play a significant role in schizophrenia development, making family history an essential component of any diagnostic assessment.

DSM-5-TR Diagnostic Criteria for Schizophrenia

The Three Stages of Schizophrenia

Schizophrenia typically progresses through three distinct stages, each presenting unique challenges:

Stage 1: Onset Phase

• Withdrawal from social activities
• Increased anxiety levels
• Loss of motivation
• Poor personal hygiene
• Subtle changes in behavior patterns

Stage 2: Active Phase

• Full manifestation of symptoms
• Prominent delusions and hallucinations
• Disorganized speech patterns
• Unusual or erratic movements
• Severely impaired functioning

Stage 3: Residual Phase

• Symptoms appear less severe
• May seem like recovery
• Risk of returning to active phase
• Ongoing need for monitoring and support

Clinical Requirements for Diagnosis

For a schizophrenia diagnosis using DSM-5-TR criteria, patients must meet specific requirements:

Diagnostic Requirement	Time Frame	Impact Areas
Two or more core symptoms	Present for at least 1 month	Social and occupational functioning
Continuous signs	Evident for 6 months or longer	Personal relationships
Functional decline	Significant impairment	Work or academic performance
Rule out other conditions	Through comprehensive testing	Medical and substance-related causes

Necessary Diagnostic Tests

Healthcare providers use several diagnostic tools to confirm schizophrenia:

• Brain Imaging: MRI and CT scans rule out tumors, strokes, or injuries
• Laboratory Tests: Blood and urine samples eliminate infections or toxins
• Neurological Assessment: EEG monitoring tracks brain electrical activity
• Psychological Evaluation: Comprehensive mental health assessment

Sarah’s Symptoms: A Detailed Analysis

Early Warning Signs

The movie brilliantly captures the subtle onset of Sarah’s condition. Her roommate’s boyfriend, Brian, first notices her standing motionless in the kitchen – an early sign that something isn’t quite right. He also observes her sleepwalking behavior, which becomes a recurring theme throughout the film.

During her birthday celebration with roommate Nikki and friends, Sarah experiences her first major episode. After drinking and smoking, she develops a nosebleed and begins having vivid dreams about being in white surroundings with unknown individuals.

Progressive Symptom Development

As the story unfolds, Sarah’s symptoms become more pronounced and disturbing:

Hallucinations and Delusions

• Recurring dreams about white rooms and mysterious figures
• Believing she encounters dream characters in real life
• Conviction that aliens are abducting her
• Delusion that she’s her grandmother’s clone

Memory and Time Distortions

• Waking up in unfamiliar locations
• Finding her car at a tow station with no memory of leaving it there
• Extended periods of missing time
• Confusion about when events occurred

Behavioral Changes

• Creating makeshift beds with multiple pillows on the floor
• Scratching marks on walls
• Stripping naked at work (leading to hospitalization)
• Attempting to convince others to dig up her mother’s grave

The Hospital Experience

Sarah’s psychiatric hospitalization reveals the inadequacy of her treatment. She continues sleepwalking and experiencing alien-related dreams even in the controlled hospital environment. The appearance of a woman from her dreams in the hospital setting further blurs the line between reality and hallucination.

Unfortunately, her social worker provides minimal support, speaking with her only on admission and discharge days. This lack of proper therapeutic intervention leads to Sarah leaving the hospital in worse condition than when she arrived.

Treatment and Management Strategies

Current Approaches to Schizophrenia Treatment

While schizophrenia cannot be cured completely, modern treatment approaches offer hope for management and recovery. Many individuals with schizophrenia can achieve significant improvement and lead fulfilling lives with proper care.

Medication Options

First-Generation Antipsychotics (Typical)

• Target dopamine neurotransmitters
• Help reduce positive symptoms like hallucinations
• May cause more side effects
• Require careful monitoring

Second-Generation Antipsychotics (Atypical)

• Affect both dopamine and serotonin systems
• Often better tolerated
• Address broader range of symptoms
• Still require regular medical supervision

Additional Medications

Healthcare providers may prescribe supplementary medications to:

• Address concurrent symptoms (depression, anxiety)
• Manage medication side effects
• Treat physical symptoms like tremors
• Support overall treatment goals

Psychotherapy Interventions

Cognitive Behavioral Therapy (CBT) CBT proves particularly effective for schizophrenia patients by helping them:

• Identify and challenge delusional thoughts
• Develop coping strategies for symptoms
• Improve social and communication skills
• Manage stress and triggers

Long-term Therapy Benefits Extended therapeutic relationships can address:

• Substance abuse issues
• Concurrent depression and anxiety
• Social skills development
• Family relationship improvement

Alternative Treatment Options

Electroconvulsive Therapy (ECT) In severe cases where:

• Medications prove ineffective
• Patient poses risk to self or others
• Immediate intervention is necessary
• Traditional treatments have failed

ECT can provide rapid symptom relief and stabilization.

Applying Treatment Principles to Sarah’s Case

Early Intervention Opportunities

Sarah’s story highlights several missed opportunities for early intervention:

Family History Screening

Given her family’s mental health history, Sarah should have received:

• Regular mental health screenings
• Genetic counseling and risk assessment
• Preventive mental health education
• Early warning sign recognition training

Community Awareness

The people around Sarah lacked understanding about mental health:

• They dismissed symptoms as “craziness”
• No one recognized early warning signs
• Stigma prevented appropriate help-seeking
• Lack of mental health literacy delayed treatment

Support System Analysis

Support Person	Role	Effectiveness	Areas for Improvement
Nikki (Roommate)	Daily companion	Poor – focused on boyfriend	Mental health awareness training
Darren (Boyfriend)	Romantic partner	Confused, unhelpful	Education about supporting mental health
Ex-stepfather	Family member	Minimal – only offered money	Emotional support skills
Joan (Coworker)	Friend/colleague	Best available – knew family history	Professional mental health resources

Treatment Gaps and Solutions

Hospital Care Deficiencies Sarah’s hospitalization failed because:

• Inadequate therapeutic intervention
• Minimal social worker interaction
• Lack of comprehensive treatment planning
• Poor discharge preparation

Recommended Improvements

• Daily individual therapy sessions
• Group therapy participation
• Family education and involvement
• Structured discharge planning with community follow-up

The Role of Support Systems in Recovery

Family and Friends Education

Effective schizophrenia treatment requires educated support networks. Sarah’s loved ones needed training in:

• Recognizing symptom changes
• Providing appropriate emotional support
• Understanding medication compliance importance
• Knowing when to seek professional help

Community Resources

Successful treatment often involves:

• Case management services
• Vocational rehabilitation programs
• Peer support groups
• Housing assistance programs
• Transportation services for appointments

Sarah’s story demonstrates that effective schizophrenia treatment requires more than just medication or hospitalization. It demands a comprehensive approach that includes proper diagnosis, appropriate medication management, regular therapy, family education, and strong community support systems.

The film serves as a powerful reminder that mental health conditions affect not just individuals but entire families and communities. By understanding the complexities of conditions like schizophrenia through detailed case studies like Sarah’s, we can work toward better recognition, treatment, and support for those affected by these challenging disorders.

For psychology students, analyzing characters like Sarah provides invaluable insights into the real-world application of diagnostic criteria and treatment principles. It bridges the gap between textbook knowledge and practical understanding, preparing future mental health professionals for the complexities they’ll encounter in their careers.

The key takeaway from this analysis is clear: early intervention, proper diagnosis, comprehensive treatment, and strong support systems can dramatically improve outcomes for individuals living with schizophrenia. Sarah’s story, while fictional, reflects the experiences of many real people who struggle with this condition and highlights both the challenges and possibilities within mental health treatment.

Frequently Asked Questions