Summary:
I chose the movie “Inside Out” primarily because this is a children’s movie that I have
seen previously and wanted to get a second look at the movie through a different perspective.
This movie is based off of an individual named Riley, who lives a relatively normal life. Riley is
a pre-teen going on teenage girl that has a general family dynamic with mom and dad in the
home. Riley is an only child. Riley’s mom is a stay at home parent and homemaker who’s
primary role is taking care of the needs of others. Rileys dad is your general businessman who
works well outside the 9-5 business life, often brings work home, and is consistently taking
phone calls regarding work, in which mom makes up for and defends. Riley and her family are
forced to leave their family home that resides in a very nice suburban neighborhoods, where they
are established and have built life-long lasting relationships with many people. Riley and her
family move to San Francisco in a predominately substandard neighborhood, and is shown in the
movie that Riley and her family are generally concerned with the new below par home. The enter
the home and it was dirty and had rodents, which only adds insult to the home. Riley does her
best to make the best of the situation and starts to envision her belongings in the new home and
play games with her parents, but the demise become more and more apparent as their moving
truck becomes lost and doesn’t arrive for weeks, Riley starts a new school and attempts to pick
up on old hobbies by trying out for a hockey team, but is unsuccessful and becomes very
frustrated up to the point she makes the ultimate decision to run away and return to her previous
life. Once Riley recognizes she has a support system, she is able to truly progress in her new life
and new town and move forward.
Psychopathology:
The general mental health condition displayed in this movie is depression. I also noticed
another underlying disorder that is causing depression, adjustment disorder, which is apparent
given the adjustment from her old life to her new life. Generalized signs and symptoms of
depression include “features of sadness, feeling empty, irritable mood, and somatic and cognitive
changes that significantly affect their persons ability to function.” (Keltner and Steele pg 269).
The main character Riley, shows all signs and symptoms of depression. She is having features of
sadness, which we see internally from ‘Sadness’ the character attempting to touch all the joyful
memories and turn them said, something she states she is having very little control over. She
shows feeling of emptiness as she reminisces of past memories of her previous life and they turn
sad. Riley is losing all of her personality islands as well since her core memories are lost with
Joy and Sadness. This is a resemblance of her emptiness and disassociation, not being interested
in things in which she once showed interest. We see Rileys irritable mood when she is at hockey
try outs and missed the shot and fell, she them throws the hockey stick and leaves in a furious
rush. Riley has somatic and cognitive function changes that we see throughout the movie with
Joy and Sadness being absent from her mind and everything she once knew and loved began to
change.
Nurse/Patient Interation:
One example of a non-therapeutic response from the movie was when Riley’s mom
noticed that Riley was feeling a bit snippy or standoff-ish with her while her mom asked her
questions about her first day and trying out for hockey. Riley went to her room and soon her
mom followed, Riley told her she was having trouble adjusting and her mom responded with, her
parents needed her to continue to be their “happy girl” while they are transitioning in their move.
Which is essentially asking Riley to put her own feelings aside to make the transition easier for
her parents. One example of a therapeutic response is when Riley’s parents finally ask her and
talk to her about what is going on with her. This is the first time they ask her about how she is
feeling since moving. Riley breaks down and tells her parents she wants to return to Minnesota
and they tell her they want to as well. The relate to her, sit down and had an actual conversation
and this leads to the progression of the film and their new life. Rileys defense mechanism was
running away. Nursing interventions to help with Riley’s depression are establishing a trusting
relationship with the patient based on honesty and general concern for the patient and educating
Riley on group therapy and coping with her new lifestyle and spend time with her 1 to 1 and
reinforce her strength and accomplishments in the adjustment to her move. Rationale for these
interventions is “spending time with patients is constructive, allowing patients to isolate is not
constructive, patients need to know they are accepted right where they are before they can feel
able to verbalize their inner world” Depressed patients have a negative view of self and this is
the best approach to recapture in some sense of value. (Keltner and Steele pg 282).
Psychotropics:
Two medications that are commonly used for Depression are Cymbalta, the number one
selling drug for depression and Zoloft. There are various others such as, Pristiq, Viibryd, Celexa,
Zoloft, Prozac, Desyrel, Lexapro, Paxil, and Effexor. Cymbalta is also duloxetine which is a
SNRI. Side effects may include nausea, dry mouth, constipation, and insomnia. Effects may not
be seen for 1-4 weeks.
Mental Status Examination:
Rileys appears he is casual, well groomed and had good hygiene. She appears quiet and
calm, she only shows brief aggression when frustrated with hockey. Her behavior is normal with
no unusual movements or psychomotor changes. She has normal rate, tone, volume, without
pressure in speech. Riley had a depressed affect and is tearful at specific times in the movie.
Through most the movie Riley is euthymic, however she has episodes of depressed mood. Rileys
thought process is goal-oriented and logical. Her thought content was free of suicidal ideation,
homicidal ideation, delusions, phobias, and obsessions. Rileys cognition was awake, alert,
orientedx4, and insight and judgement were poor, due to the ultimate decision to run away back
to Minnesota, however she does turn around and return to family.
Reflection:
Upon entering this course I didn’t have stereotypes or biases primarily because I have a
strong opinion on mental health and the background surrounding it. My though process has
stayed the same, if anything expanded, due to the lack of availability of mental health care and
how some don’t believe in mental health due to being unable to see the disease process. The
movie “Inside Out” was interesting rewatching from a standpoint strictly related to mental
health. One aspect of the movie not mentioned above is which emotion is in control of the
control panel in each individual. This aspect of the movie sheds light on how in different phases
of life, we allow different emotions to control our body and mind. For instance, Riley is
controlled by Joy. She primarily runs the control panel until Sadness becomes too much to bear.
In Riley’s mom, Sadness is in control of the panel and everyone looks to her as the leader. In
Dad, Anger is head of the control panel. It’s also intriguing how Riley seemingly has male and
female emotions, and mom and dad have strictly male emotions in dad, and female emotions in
mom. The movie displayed great example of how false positivity can be toxic and how
depression or sadness is typically perceived as a negative emotion, however the movie shows
you have to have moments of sadness to bring moments of great joy.