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Horror Film 101: How Horror Affects Mental Health


What makes scary movies keep us awake at night? Maybe it is the fear of the unknown, maybe it is the subtle Shepard’s tone, which gives us unconscious goosebumps, or maybe it is the theme music of the dreaded monster. There is no one answer to explain why people are drawn to horror, but if it were not for the sound, or lack of it, the mise-en-scène, the male gaze, or the infamous antagonist, we would not lie awake in the dark thinking something might be lurking outside our windows. This series examines the psychology behind what makes horror films so successful in terrifying people and the benefits of watching these anxiety-driven films. Plus, why do these films stick with us, especially when we are alone?

Horror Film 101: What Makes Horror Movies So Scary is divided into the following chapters of content:

1. Horror Film 101: The Soundscape of Terror

2. Horror Film 101: Fear of the Unknown

3. Horror Film 101: Surviving the Male Gaze

4. Horror Film 101: Behind the Mise-en-scène

5. Horror Film 101: How Horror Affects Mental Health

6. Horror Film 101: The Psychology of Terror

Horror Film 101: How Horror Affects Mental Health

It is no secret that watching horror films can have an impact on one's mental health. They can arouse feelings of discomfort and even trigger post-traumatic stress disorder (PTSD), which alters the brain's chemistry (Sultana, 2021, p. 2). Horror has also had a negative impact on people's attitudes toward the mentally ill. Moreover, horror incorporates some of the most dreadful phobias people have had since birth. There are even horror films that give people psychosis. Long-term and even short-term effects of the stress brought on by horror can make people feel like they are having a heart attack or eventually create one. Horror and mental health go hand in hand; this article aims to point out the negative effects of this genre on the human mind and body.

How Mental Health is Perceived in Horror Films

Amongst the most common assailants shown in horror films are the mentally ill. Take, for instance, Michael Myers in Halloween (Carpenter, 1978). In fact, the film begins with Michael escaping an asylum, and mental patients wandering around the front lawn in the dark. D. W. Griffith created the "deranged mental patient stereotype" in his short film, The Maniac Cook (1909), and since then it has become popularized (Goodwin, 2014, p. 202). This can be problematic for people dealing with real-life mental illness. This conception of mental illness being depicted as bad is most common in the horror genre (Goodwin, 2014, p. 201). This becomes detrimental in how it affects the lives of viewers with mental disorders and it spreads misinformation. Even diagnoses are described wrongly, like in the movie Schizo (Walker, 1976), which defines "schizophrenia as 'a mental disorder sometimes known as multiple or split-personality [...] [c]haracterized by loss of touch with environment and alternation between violent and contrasting behaviour patterns'" (Goodwin, 2014, p. 201). Mentally ill viewers watching these movies may self-diagnose incorrectly or internalize the fact that they are dangerous too, which can be devastating (Goodwin, 2014, p. 202). Films influence culture and can create barriers for the mentally ill (Goodwin, 2014, pp. 202-203). In the horror film The Roommate (Christiansen, 2011), the protagonist, Sara, begins her freshman year at college with a new roommate, Rebecca. Rebecca becomes obsessed with Sara to the point of killing anyone who comes between them. After Rebecca invites Sara to a Thanksgiving dinner, Sara discovers through Rebecca's mother that her daughter has not been taking her medication. The protagonist finds Rebecca's prescription for Zyprexa pills, which are often used for bipolar disorder and schizophrenia (Christiansen, 2011). Sara is threatened by Rebecca with a gun and soon discovers all of her victims, including another friend who is tied up. Sara realizes the only way to escape Rebecca is to kill her. Although The Roommate (Christiansen, 2011) is a successful horror film when it comes to terrifying the audience, it can be harmful to the mentally ill. This film depicts Rebecca's homicidal tendencies as a symptom of her mental illness, which is inaccurate and damaging. Anyone who may take Zyprexa may relate to Rebecca on-screen and then may be rejected by society as she represents a violent murderer. A recent study "revealed that a third of people would not be interested in being friends with someone who had mental health difficulties; a fifth believed mental health difficulties are associated with lower intelligence; 62% would not hire someone with a history of mental illness; and 42% believed seeking help to treat mental ill health is a sign of weakness" (Goodwin, 2014, p. 203). The film The Roommate (Christiansen, 2011), amongst many others, continues to alienate people with mental disorders and leave them with no one to turn to. The mentally ill are "portrayed as violent" and, therefore, feared instead of helped when they are the ones in most need of support and empathy. Even the way a film is shot with "killers experiencing mental ill health [...] framed in POV shots (and by the gaze) encourages a lack of empathy with them, forcing derision, and persuading the audience to shun and stigmatize them" (Goodwin, 2014, p. 205). The way mental health is portrayed in horror movies isolates real-life mentally ill people from society and causes them an array of obstacles in addition to their disorder.

Figure 1: Cam Gigandet, Minka Kelly, and Leighton Meester in "The Roommate" (Christiansen, 2011).


A phobia is different from normal fear; it "is the expression of extreme distress when exposed to the feared stimuli and/or impairment in functioning" (Milosevic, 2015, p. 4). These stimuli can range from vomiting (emetophobia) to spiders (arachnophobia) and can cause people severe distress to the point where they cannot function. As stated in previous articles in this series, fear was an adaptive response to humanity's survival. It kept people safe from dangers and now translates to unthreatening things as well, such as emetophobia. Phobias were first studied by "the Greek physician Hippocrates who described a man with a severe fear of flute music. Five hundred years later, Roman physician Celsus (25 BC–AD 50) used the word phobia for the first time to characterize an individual's extreme fear of water due to rabies, which he termed hydrophobia" (Milosevic, 2015). The term "phobia" was coined "from the Greek word phobos. Phobos was the son of Ares, the Greek god of war" (Milosevic, 2015). This is fitting, as the mind is in conflict with the feared stimuli. Phobias about animals, the environment, and heights are usually instilled between the ages of five and thirteen. But "situational phobias", like driving, confined spaces, and flying, come at a later time in life, around thirteen and twenty-one (Milosevic, 2015, p. 4). Children younger than thirteen present phobias of the dark and supernatural creatures, and shortly after, they have phobias of illness and bad performance in school (Milosevic, 2015, pp. 4-5). Horror movies target these phobias, which a majority of people have, like agliophobia, which is the fear of pain (Milosevic, 2015, p. 5). The horror comedy Arachnophobia (Marshall, 1990) is no joke for someone who suffers from this ailment. In the film, a small family faces an infestation of dangerous and hostile spiders in their town. This can be terrifying to watch, as most people are afraid of spiders; however, someone suffering from arachnophobia might not be able to endure the thought of it. The term "arachnophobia" also originates from Greek ("arachne" means spider, and "phobos" is phobia) (Milosevic, 2015, pp. 34-35). This phobia does not refer only to spiders but also includes other arachnids, such as scorpions, mites, and tics. This fear stops people from functioning and can occur just by thinking about such creatures. People with arachnophobia may stay away from certain environments, like the outdoors and older buildings, to avoid coming across a spider; in warmer climates, in fact, such creatures are present all year round. Phobias like arachnophobia can induce panic attacks when encountering the feared stimuli (Milosevic, 2015, pp. 34-35). This phobia affects 3.5% of people, and the specific treatment used to combat it is exposure therapy (Milosevic, 2015, pp. 34-35).

Watching horror films can trigger fear and panic attacks, but, because the viewer is experiencing the fear in a safe environment, the person with the phobia may be able to overcome it if they can endure the film (Clasen, 2017, p. 58). Fear processing is located in the brain's amygdala, which contains "a collection of anatomically and functionally distinct nuclei located deep within the temporal lobes" (Milosevic, 2015, p. 14). Phobias are, indeed, created by a dysfunctional amygdala. The whole world can change around a person when they are in a state of fear. People exhibiting phobias are more reactive to aggressive faces than happy or neutral ones (Milosevic, 2015, p. 15).

During a horror film,

brain activity of the viewers becomes time-locked not just in the sensory cortices that process the incoming information in same timescale, but also in the key nodes of the emotion and fear circuits. Such synchronization is most prominent during the most aversive episodes, suggesting that fear and other negative emotions tune brains into intrinsic fight-or-flight survival mode that is consistent across viewers. [...] While viewing a horror movie, brain activity becomes synchronized across viewers. This synchronization is particularly strong during the "jump-scare" (Nummenmaa, 2021, p. 6).

Another common phobia is acrophobia, which is the fear of heights and can cause dizziness and anxiety even when looking at photos of heights. This may be due to a disturbance of the balance system within these individuals, who are more reliant on their eyes than their bodies (Hüweler, 2009). Individuals "with acrophobia interpret ambiguous bodily sensations as threatening, and have an increased tendency to report physiological symptoms of anxiety such as dizziness and nausea, which is similar to patients with panic disorder" (Hüweler, 2009). This can be very stressful for the person undergoing this disorder, as it causes physical harm. The film Fall (Mann, 2022) is a horror intended to scare people with acrophobia, as it takes place on top of a 2,000-foot TV tower in an isolated setting. After the protagonist and her adrenaline-seeking friend climb this tower, the ladder falls out from below them, and they are trapped. This extreme height nauseates the viewers and makes them feel as if they were experiencing it themselves. Phobias prevent people from functioning and can even cause physical discomfort and damage to the body, which is what horror movies thrive on.

Figure 2: "Fall" (Mann, 2022).


Psychosis is defined as a "severe mental disorder characterized by gross impairment in reality testing, typically manifested by delusions, hallucinations, [disorganised] speech, or catatonic behaviour" (Goodwin, 2014, p. 201). A person experiencing psychosis may have a hard time adapting to reality and being mentally present. Horror movies have been known to cause psychosis and even "cinematic neurosis" in the audience, lasting for a short or long time after the movie (Goodwin, 2014, p. 202). A horror movie famous for causing psychosis in its viewers is The Exorcist (Friedkin, 1973). One of the directors working on the film, William Friedkin, incorporated subliminal images to upset the audience and even auditory clips of bees to trigger fear in people (Mucci, 2016). The images used are hard to notice with the naked eye. One of these is the "white face" that flashes in a fraction of a scene. It was an image of Linda Blair's double in white makeup with bright red lips; it can be viewed by pausing the movie during the scene when Damien Karras has a dream about his dead mother (Mucci, 2016). These tools make the film much more frightening and may contribute to the psychosis experienced after the film. The film is famous for causing this mental disorder in "susceptible people" and

[c]lassical symptoms and disability were observed following viewing the movie. There are elements in the movie, such as possession with resultant loss of impulse control, that are likely to threaten people with similar problems, and to exceed their "stimulus barrier" (Bozzuto, 1975, p. 43).

After four people were extensively studied, they revealed that the movie induced "symptoms of insomnia, excitability, hyperactivity, irritability, and decreased appetite, as well as loss of sex drive, substance abuse, impulse control, and paranoia" (Bozzuto, 1975, p. 46). Only one of the four had a prior psychiatric history, but the other three's cause of psychosis was linked to this very film (Bozzuto, 1975, p. 46). The Exorcist (Friedkin, 1973) and other horror movies are so potent with their fear tactics that they can make a sane person unstable.

Figure 3: Shot of the white face in "The Exorcist" (Friedkin, 1973).

How Horror Films Impact Physical Health Through Mental Health

Horror movies are known to cause anxiety in the viewer, but what about the other effects of horror films? At first, horror movie provokes temporary adrenaline and an increase in cortisone, but it may trigger PTSD in some people as the altered brain's chemistry can mimic the same effects from past traumatic experiences (Sultana, 2021, p. 2). Scary video games and films can also alter the brain's chemistry, making people more belligerent, sleepless, and suicidal (Sultana, 2021, pp. 3-4). Horror movies especially affect youth between twelve and seventeen, who undergo constant nightmares after witnessing the violence onscreen (Sultana, 2021, pp. 3-4). If horror produces such atrocious effects, why do they watch it? A study was conducted on children between ten and seventeen who loved horror. The research showed "that young people really love to enjoy the sense of relief coming at the end. Most movies are based on true incidents, which fascinate the guys more. [...] In the end, [the] researcher concluded that horror films satisfy the psychological urge of youngsters to feel frightened and terrorized. It can help them in facing fear in a controlled setting, but it is not a good way" (Sultana, 2021, p. 4). Horror movies may be far more detrimental than healthy for children. Studies have shown that even adults, who watch horror, may find it more appropriate than others to harm somebody or use vulgar language (Sultana, 2021, p. 4). Violence in the media begets more violence in real life. As well as external damage, horror can cause short and long-term mental strain. The purpose of stress in evolution was to protect people in fight-or-flight scenarios; however, people's bodies are not equipped to handle the long-term effects of this stress (Dhabhar, 2014, p. 193). Short-term stress can "[last] for minutes to hours [...], stress experienced during immune activation enhances innate/primary and adaptive/secondary immune responses. Mechanisms of immuno-enhancement include changes in dendritic cell, neutrophil, macrophage, and lymphocyte trafficking, maturation, and function as well as local and systemic production of cytokines" (Dhabhar, 2014, p. 193).

On the other hand, "long-term stress suppresses or dysregulates innate and adaptive immune responses by altering the Type 1–Type 2 cytokine balance, inducing low-grade chronic inflammation, and suppressing numbers, trafficking, and function of immunoprotective cells. Chronic stress may also increase susceptibility to some types of cancer by suppressing Type 1 cytokines and protective T cells and increasing regulatory/suppressor T cell function" (Dhabhar, 2014, p. 193). While short-term stress may harness people's survival instincts, prolonged stress can lead to a long-term strain, which may be destructive to one's health. Long-term stress can last for many hours or even months (Dhabhar, 2014, p. 194). This leaves the body vulnerable to infections, cancer, and disease (Dhabhar, 2014, p. 195). Even short-term stress can dysregulate the immune system (Dhabhar, 2014, p. 200). This means horror movies disrupt the body's ability to work properly, and movies that can induce psychosis, like The Exorcist (Friedkin, 1973), make people susceptible to illness. Stress has also been linked to hypertension, which is "persistently elevated blood pressure [...] in the arterial vessels. Although [hypertension] initially is an asymptomatic condition, it chronically evolves into a major risk factor for cardiovascular, cerebrovascular, and renal diseases that, in turn, represent crucial causes of morbidity and mortality in industrialized countries. [...] It originates from a complicated interaction of genes and several environmental risk factors including aging, smoking, lack of exercise, overweight and obesity, elevated salt intake, stress, depression, and anxiety" (Breznican, 2012, p. 1). Therefore, the tension brought on by horror may lead to chronic stress and eventually death.


Horror films are fun to watch because the audience is not actually enduring the stressful situations within the movie, yet, because they are so realistic, they can cause disastrous effects on one's mental health. Through the representation of the mentally ill, the incorporation of phobias, psychosis arising from particular movies, and the short and long-term effects of stress on the body, horror films can have catastrophic effects on people's lives and leave them in a continuous nightmare.

Bibliographical References

Breznican, A. (2012). "The Exorcist": 10 creepy details from the scariest movie ever made. Retrieved April 18, 2023, from,before%20VHS%2C%22%20Friedkin%20laments.

Bozzuto, J. C. (1975). Cinematic neurosis following "The Exorcist". Report of Four Cases. The Journal of Nervous and Mental Disease, 161 (1), 43–48.

Clasen, M. (2017). Why Horror Seduces. New York: Oxford University Press, Oxford Scholarship Online.

Dhabhar, F. S. (2014). Effects of stress on immune function: the good, the bad, and the beautiful. Immunologic Research, 58 (2-3), 193–210.

Goodwin, J. (2014). The Horror of Stigma: Psychosis and Mental Health Care Environments in Twenty-First-Century Horror Film (Part I). Perspectives in Psychiatric Care, 50 (3), 201–209.

Hüweler, R., et al. (2009). Behaviour Research and Therapy. The impact of visual flow stimulation on anxiety, dizziness, and body sway in individuals with and without fear of heights, vol. 47, no. 4, 345-352.

Milosevic, I., & McCabe, R. E. (2015). Phobias: The Psychology of Irrational Fear. [eBook edition]. ABC-CLIO, LLC.

Mucci, N., et al. (2016). Anxiety, Stress-Related Factors, and Blood Pressure in Young Adults. Frontiers in Psychology, vol. 7, 1-10.

Nummenmaa, L. (March 4, 2021). Psychology and neurobiology of horror movies. PsyArXiv. Web.

Sultana, I., et al. (2021). Effects of Horror Movies on Psychological Health of Youth. Global Mass Communication Review, vol. VI, No. 1. Accessed 13 April 2023.

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Melanie Rose Gazvoda

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