This post is part of my Mental Health in the Movies project and is a discussion of the film(s) portrayal of psychopathology and/or psychotherapy.

Mental illness was a theme in film from the beginning. The first narrative film was released in 1896 (Gaines, 2004) and the first film featuring an asylum patient was released in 1904 (Sabo, 2016). Prior to moving pictures, madness was a popular theme in theater from Sophocles to Shakespeare to Ibsen. Television, too, is littered with storylines about mental disorders (Korobkova, K. et. al., 2022). Psychopathology provides characters with conflict, motive, and potentially catharsis and/or empathy. Mad characters make for interesting characters.

The animated series Arcane: League of Legends (Netflix, 2021) is not about mental health. It is much more broadly about societal health. However, it is clearly and distinctly about trauma as motive, particularly for the character of Jinx, the central antagonist. Jinx, also known as Powder, is a young woman with an undiagnosed mental disorder who becomes, depending on your point of view, a revolutionary or a mass murderer. Or both.

Jinx is one of my favorite character archetypes. The accepted name would probably be ‘antihero’ but I like to use ‘chaos demon’. I describe them here as “passionate, volatile, destructive characters. The ones who try to fit in, try to be patient with the slow march of progress, try to work within the system and affect change on a small scale. And when none of that works, when they’ve twisted themselves into something unrecognizable, a ghost of who they wanted to be, and it’s still not enough for a world that deliberately chooses not to understand them— then those characters decide to burn it all down in order to start again.”

They are almost universally recognized as villains. And they are mad (crazy) as well as mad (angry). And that conflation of violence and madness perpetuates the public stigma against mental illness (Aracena, 2012).

Arcane and the video game the series is based on are wildly popular and there are hundreds of YouTube videos and Tumblr posts about Jinx’s mental disorder and whether or not it is good, bad, ugly, or other media representation. Many of these posts choose to diagnose her with a specific disorder, others focus on symptoms, and still others on motive. I find them all valuable. Everyone brings their own perspective to their perception of the story. That Jinx fits more than one diagnosis or diagnostic narrative is more inclusive, and encompasses a wider spectrum. That’s a positive. This is my take on Jinx as psychotic representation in media. 

Diagnosis is a process.

Diagnosing a mental disorder is a difficult and lengthy process that requires many components. Normally it starts with a patient or caregiver presenting evidence of symptoms to a medical provider who then conducts an exam. A full clinical workup involves a medical history, a physical and/or neurological exam, and a psychological exam. Based on the findings and the severity of the symptoms it may include bloodwork, brain scans, or other medical tests, or multiple therapy sessions for extended observation. 

All of these pieces are vital. The physical exam is used to rule out or identify medical conditions unrelated to mental disorders that may be treated with medications, surgery, or even a change in diet. The physical and mental exams together paint a full picture of the patient’s experience of their symptoms. The psychological evaluation provides insight into the severity and longevity of the symptoms and valuable context of the patient’s daily life. A full medical history includes:

• any diagnosed medical conditions
• past injuries and surgeries
• current or past prescribed medications
• history of recreational drug use, tobacco, and alcohol
• diet, exercise, and sleep patterns
• work, sexual status, and history
• medical and psychological history of close relations (at least parents and siblings)

Making a diagnosis without these details is dangerous.

Therefore, we cannot diagnose Jinx.

Observation is a component of diagnosis. As Doctor House (House M.D.) reminds us, “It’s a basic truth of the human condition, that everybody lies.” (“Three Stories”, 2005) How a patient answers a question may be as important as what they answer. However, observation alone is not enough to diagnose a mental disorder. Jinx only exists on screen. It is impossible to conduct a physical or mental exam on her. No tests can be run on her. No questions can be asked of her. Our only avenue is observation. We can watch her. That’s it.

Moreover, Jinx’s reality is not ours, not Earth. Arcane tells the story of Piltover, a utopian city guided by a ruling council, and Zaun, the oppressed underground that rises against them. There are similarities between these communities and our own, but it is a fantasy world. We cannot contextualize Jinx’s experiences because her culture does not exist and, again, we can only observe it.

Finally, Jinx is an unreliable narrator. The series plays with points of view and to bring in Dr. House again, everybody lies, even to themselves. We watch Jinx interacting with her family, her peers, her enemies, and herself and we learn a lot about her from those observations. But they are contradictory. She is contradictory.

Signs and Symptoms

Let’s discuss the symptoms and circumstances that Jinx experiences on screen.

Adverse Childhood Experiences

This is key because the story is about an inciting incident that “creates” the antagonist Jinx. Arcane begins in Jinx’s childhood when she is still going by ‘Powder’. She is introduced as the youngest member of a team of criminal children led by her elder sister Violet and mentored by former terrorist/current collaborator Vander. Powder’s life is a checklist of adverse childhood experiences:

☑Orphan

Powder and Vi discover the dead bodies of their parents in the first minutes of the series. 

☑Poverty

The world of Arcane is split into two distinct populations: the utopian society of Piltover, a shining city led by a ruling council of aristocratic families, and the dystopian society of Zaun, a city located beneath Piltover led by a group of violent drug lords.

☑Violence

After the death of their parents, Powder and Vi are raised by the leader of Zaun’s failed rebellion against Piltover, alongside two other orphans. Vi, Mylo, and Claggor are taught to fight. Though deemed too young for training, Powder accompanies them on missions. Violence is also the norm on the streets of Zaun. After the inciting incident, Powder is raised by the crime lord Silco.

☑Oppression

Piltover explicitly subjugates Zaun through a militarized police force known as the Enforcers. Piltover has a school system that is not accessible to Zaunites. Zaun has no voice in Piltover politics while Piltover has full control over Zaun’s rights.

☑Neglect

Powder is younger than the children she is raised with and receives significantly less attention from her adopted father and adults in general. She is left to her own devices on more than one occasion. Her sister is the exception, however leading up to and after the inciting incident Vi also leaves her behind.

☑Bullying

Mylo bullies Powder for being younger, slower, and not a fighter. He calls her out as a problem and coins the name ‘Jinx’. Claggor bullies Powder to a lesser extent, and Vi eventually attacks her.

The inciting incident occurs at the end of episode three. Powder is left alone while Vi, Mylo, and Claggor attempt to rescue Vander (their adoptive father) from Silco (his former partner who continues terrorist attacks on Piltover and now considers Vander a collaborator). Desperate to help, Powder follows them, taking with her a bomb she’s designed and an ancient (arcane!) power source (“hextech”) she recently discovered during a robbery in Piltover. Powder has not studied it in depth but knows it creates large explosions and when she arrives she sets off her weapon. Unfortunately, rather than assisting her friends, the explosion turns the tides against them. Vi blames Powder for the deaths of Vander, Mylo, and Claggor. She physically attacks Powder, calls her a jinx, and abandons her. Powder is discovered by Silco and begins her life of violent crime.

Emotional Dysregulation

Jinx is emotionally erratic. Here is a video titled “Arcane Jinx’s every mental breakdown scene”. It is nearly ten minutes long and importantly begins with a scene from her childhood that occurs before the inciting incident. In fact, Powder’s emotional dysregulation causes the inciting incident. She is not able to contain or control her emotions and in her frenzied state, she makes an impulsive decision that ends in tragedy.

Throughout the series, Jinx’s impulsivity is linked with her emotional dysregulation. She feels too much. Too much anger, too much fear, too much sorrow, all of her emotions are disproportionate to the situation and they get worse when she tries to reign them in. She then acts without thinking and with no consideration for consequences. 

Psychosis

Jinx exhibits positive symptoms of psychosis. She explicitly hears voices, sometimes having entire conversations, other times trying to shut them up. The voices are most often her dead friends and sometimes we observe visual manifestations of these ghosts. However, it is not clear to me whether Jinx sees them or if they are included for artistic reasons or for the audience’s benefit.

“The distinction between a delusion and a strongly held idea is sometimes difficult to make and depends in part on the degree of conviction with which the belief is held despite clear or reasonable contradictory evidence regarding its veracity.”  (DSM-5)

Jinx also appears to suffer from delusions but they are contextualized in the story. Her adoptive father Silco raises her to believe that she is important, special, and destined for greatness. He instills a sense of superiority and encourages a sense of urgency. There is a later scene where he literally baptizes her, suggesting a Christ parallel. The heightened sense of self can also be understood as a trauma response. Powder suffered greatly and it makes sense for Jinx to want that suffering to serve a purpose, i.e. to believe that she had to suffer to become Jinx and save her society. 

Jinx is also observed to be paranoid. She distrusts everyone, including her father and her sister, and assumes everyone is an enemy. While there are scenes in which her paranoia is unfounded, Jinx’s experiences validate her beliefs that everyone is out to get her and that bad things happen to her and to the people she loves regularly. 

As with the artistry of Jinx’s hallucinations, the validity of her delusions is due to her existence as a fictional character. Jinx IS the (anti)hero of the story and the plot continuously happens to her.

Other behavioral symptoms of psychosis that Jinx exhibits include disordered speech and deliberate social isolation. In childhood, Powder wanted to be included and was denied but as a young adult, Jinx chooses to spend time alone with facsimiles of her former friends. Until Vi reappears Silco is the only living person she seeks out or shows interest in. He is also the only person who can easily decipher her confused speech. 

Diagnostic Criteria

So, what does that all mean? Based on evidence the following diagnoses might apply to Jinx. I’ve listed the diagnostic criteria from DSM-5 for each potential disorder for analysis.

Schizophrenia

This is the most popular diagnosis for Jinx that I’ve encountered online. However, I think it points to the audience conflating psychosis/hallucinations with schizophrenia. 

Does Jinx meet the diagnostic criteria for Schizophrenia as laid out in DSM-5?

A. Two (or more) of the following, each present for a significant portion of time during a 1 -1-month period (or less if successfully treated). At least one of these must be (1 ), (2), or (3):

1. Delusions.
2. Hallucinations
3. Disorganized speech (e.g., frequent derailment or incoherence).
4. Grossly disorganized or catatonic behavior.
5. Negative symptoms (i.e., diminished emotional expression or avolition).

Analysis: LIKELY. We witness Jinx’s hallucinations, disorganized speech, and potential delusions. 

B. For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning).

Analysis: NOT ENOUGH DATA. The DSM-5 states “The diagnosis [of Schizophrenia] involves the recognition of a constellation of signs and symptoms associated with impaired occupational or social functioning.” Jinx’s social functioning might be considered impaired in that all her significant relationships are complicated and often antagonistic. Her occupational functioning cannot be determined.  

C. Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).

Analysis: LIKELY. The timeline is not disclosed but suggests this is true. 

D. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.

Analysis: UNLIKELY. I think Schizoaffective disorder is as or more likely than Schizophrenia (see below).

E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

Analysis: NOT ENOUGH DATA. Substances are rampant in Zaun and Silco is a dealer. Jinx uses a painkiller with unknown properties on screen. Without more information and a physical exam, this is impossible to determine.

F. If there is a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month (or less if successfully treated).

Analysis: NOT ENOUGH DATA. Without a medical history, this is impossible to determine.

Conclusion: Jinx does not meet the criteria for Schizophrenia. I think Jinx potentially comes closer to meeting the criteria for Schizoaffective Disorder, specifically Bipolar type, as much of her behavior could be described as manic, or Schizotypal Personality Disorder. However, for any of them, more information is required. 

Bipolar and related disorders

Jinx shows signs of mania and to a lesser extent depression. However, the timeline is vague and we cannot measure how long the episodes last.  We need more data for any analysis of symptoms.

Antisocial Personality Disorder

This is the most popular diagnosis for villains and Jinx is a violent character.  

Does Jinx meet the diagnostic criteria for Antisocial Personality as laid out in DSM-5?

A. A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by three (or more) of the following:

1. Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.
2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.
3. Impulsivity or failure to plan ahead.
4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
5. Reckless disregard for safety of self or others.
6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.
7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

Analysis: LIKELY. Jinx exhibits most of these. Failure to conform, impulsivity, and reckless disregard for safety are some of her core character traits. 

B. The individual is at least age 18 years.

Analysis: MORE DATA NEEDED. Jinx’s age is not disclosed.

C. There is evidence of conduct disorder with onset before age 15 years.

Analysis: LIKELY. Powder exhibits symptoms of conduct disorder. However, she is socialized to rebel against Piltover by stealing property and causing disruption and destruction.

D. The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder.

Analysis: MORE DATA NEEDED. Jinx exhibits symptoms of both; we cannot diagnose or discount either.

Conclusion: Jinx potentially meets the criteria for Antisocial Personality Disorder. However, again, she is a fictional antagonist and she is set up to do so. 

Posttraumatic Stress Disorder (PTSD)

This is the diagnosis I think fits best. Jinx’s behavior is a reflection of her trauma. The memories haunt her and she experiences flashbacks on screen. Both her psychosis and her violence can be explained by PTSD.

“[B]eliefs reflecting a lack of safety, control and self-esteem account for the interactions between PTSD and psychosis.” (Hardy A. et al. 2021) 

Does Jinx meet the diagnostic criteria for Posttraumatic Stress Disorder as laid out in DSM-5?

A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:

1. Directly experiencing the traumatic event(s).
2. Witnessing, in person, the event(s) as it occurred to others.
3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.
4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse).

Analysis: YES. We observe this on screen.

B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:

1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).
2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).
3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.)
4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

Analysis: YES. We observe this on screen.

C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following:

1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

Analysis: NO. Jinx surrounds herself with reminders. 

D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:

1. Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).
2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted,” ‘The world is completely dangerous,” “My whole nervous system is permanently ruined”).
3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.
4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).
5. Markedly diminished interest or participation in significant activities.
6. Feelings of detachment or estrangement from others.
7. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).

Analysis: YES. We observe this on screen. 

E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:

1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
2. Reckless or self-destructive behavior.
3. Hypervigilance.
4. Exaggerated startle response.
5. Problems with concentration.
6. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

Analysis: YES. We observe this on screen.

1. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.

Analysis: LIKELY. The timeline is not disclosed but suggests this is true. 

1. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Analysis: NOT ENOUGH DATA. However, I would be more likely to count what we observe on-screen towards this than the similar criterion in Schizophrenia.

1. The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

Analysis: NOT ENOUGH DATA.

Conclusion: Jinx potentially meets the criteria for Post Traumatic Stress Disorder. Moreover, most of the diagnostic criteria are observed on screen and this diagnosis is not automatically attributed to psychopathy aka villainy.