PERCEPTION 

While it seems that both Frank and Richard could reasonably be diagnosed with the same mental disorder by the DSM-5 criteria despite having vastly different manifestations of symptoms, there are several consequences of such a diagnosis, one being that it could pathologize their experience of life. Not only do diagnoses of mental disorders pathologize the set of behaviors that constitute them, the experience of having a diagnosis pathologizes people through the way other people interact with them. Diagnostic labels attach meaning to the experience of symptoms, classifying them as part of an illness rather than a regular part of that person, therefore influencing their perception of themselves. As they begin to understand their behavior through the lens of mental illness, their experience becomes defined by pathology and thus, diagnosed individuals become pathologized. 

The family treats Frank as if they are following a similar framework as provided by a concrete diagnosis, and interact with him in ways that highlight his mental (un)wellbeing. Sheryl is adamant that they follow the guidelines given to them by Frank’s doctor about how to minimize his chance of attempting suicide again. Her rigid adherence to these guidelines is supported by the doctor telling her that he would “prefer to keep him” if not for the insurance being unable to cover his stay at the hospital (4:31). To her, this is a concrete reason to take Frank’s care seriously and justifies her strict compliance with his doctor’s orders. When Sheryl declares that Frank will sleep in Dwayne’s room with him, Frank seems unwilling, yet she pushes back, reminding him that “the doctor said… we can’t have you sleeping alone” (6:05). Frank expects to fall back on old dynamics with Sheryl, but has to quickly adjust to this new reality. Following this, when the family is trying to determine who is going to travel to the Little Miss Sunshine competition with Olive, Sheryl demands that Frank join them, as she was “told explicitly to not leave Frank by himself” (18:59). Frank quietly accepts. While it is true that later in the movie this dynamic shifts back towards a more normal sibling relationship, it is clear that when Sheryl first brings Frank home she views him as a patient rather than as her brother. While Frank is initially resistant to this, he adapts and seems to accept his new treatment by his sister and her family.

The fact that Frank is pathologized by his family is made even more clear when it is shown how the family behaves toward Edwin, the Grandfather. They are careless about making death-related comments to him and almost completely dismiss his addiction to heroin, ostensibly because he is not medicalized in their minds. While in the van, it is revealed that Edwin was dismissed from his nursing home for getting caught with heroin, and the family seems more annoyed than concerned with his behavior. They treat Edwin as though he has made poor choices that were uninfluenced by any sort of mental illness or addiction. When Frank questions their lack of concern, Sheryl is dismissive, claiming “the intervention was a fiasco, he’s worse than a two-year-old” (28:28). While Richard is clearly uncomfortable, asking to talk about something else, this seems to stem more from his disapproval of his dad ‘giving up’ rather than the very real possibility of his father’s choices being fatal. This is unlike how they treat Frank. In another scene, Richard says to Olive that Frank is “a sick man,” and leans heavily into mental illness to explain Frank’s behavior. While he still frames the choices Frank makes leading up to his suicide attempt as Frank “[giving] up on himself, which is something winners never do” (15:17), the suicide attempt itself clearly illicits a different reaction from him. Where Edwin is blamed wholly for his own actions, Frank is partly excused by his assumed mental illness.

The difference in how each character is treated illustrates the difference in care and concern shown toward their situations. The fact that they are treated differently alludes to the idea that they are perceived differently by the family members they interact with, and the differing levels of concern demonstrate how this perception manifests. While there is no baseline example of how the family interacts with Frank before his suicide attempt, Olive provides insight into how he might have been previously perceived. Olive, who does not seem to understand the significance of why her Uncle Frank is staying at her house, treats him amicably and inquisitively, and when it is revealed to her that Uncle Frank tried to kill himself, she jumps into trying to understand his motives. She bulldozes straight past the rest of the family’s discomfort regarding the subject and treats Frank similarly to how she treats everyone else. Notably, she treats Frank like she treats Edwin, and is unafraid to question them and look to them for guidance. This implies that, because she does not understand the medical aspects to Frank’s suicide, and therefore does not pathologize him like the rest of her family, that there is something about Frank being pathologized by his attempted suicide that changed how his family frames their interactions with him.

This movie is a good example of the variations in mental illness manifestation. This, alongside the idea that the same diagnosis could accurately describe a variety of different people and their different manifestations, leads to the conclusion that two (or more) of the characters could be diagnosed with the same mental disorder despite the wide variety of personalities and manifestations shown on screen. This idea follows a sort of convergent model of mental illness diagnosis, bringing together a broad group of people under the same diagnostic category. We then argue that the process of being diagnosed changes both someone’s perception of themselves and others’ perception of that person, demonstrating a consequence of having a diagnosis. While the DSM categories are indeed broad enough to cover many of the characters in the movie, it would lead to similar consequences seen with Frank, who is pathologized by his family due to his attempted suicide and presumed mental illness diagnosis. Therefore, a stronger claim would be that, despite being able to describe many characters in the movie (and many people in the world), diagnoses of mental illnesses should be distributed with restraint.