If you look back at some of the most celebrated female performances in film over the past 20 years, a surprising pattern emerges: many women who take on the “madwoman” trope end up winning Oscars. Cate Blanchett won Best Actress two years ago for her portrayal of a mentally unstable socialite in Blue Jasmine. The year before, Jennifer Lawrence won for her performance as Tiffany in Silver Linings Playbook, a woman possibly diagnosed with borderline personality disorder. In 2010 Natalie Portman took home the award for her performance as an increasingly disturbed ballerina in Black Swan. The list goes on and on. Yet all this acclaim for portrayals of the “madwoman” may be unwarranted. These media portrayals of female mental illness are often flawed, filled with stereotypes, gender bias, and stigmatization. It becomes clear that there exists a biased working narrative about who the “madwoman” is and how she behaves in film and television.

Professor Khary Jones, a drama professor at Tufts who specializes in screenplay, explained that the movie Fatal Attraction (1987) solidified this image of mentally unstable women in film. In the film, Alex Forrest (Glenn Close) seduces a married man (Michael Douglas), using her sexuality as a means of manipulation. When he refuses to leave his wife for her, her true madness comes out: she begins to stalk the family, temporarily kidnaps their daughter, and, in the end, attempts to murder her former lover. Alex Forrest is the poster child for popular film portrayals of female mental illness—the “madwoman” is unhinged, manipulative, and, above all, sexual.

Sexuality has become the trademark symptom for any mentally ill woman in popular media. In Black Swan, a film about a ballerina’s attempts to secure the lead role in Swan Lake, we as an audience are supposed to tell that Natalie Portman’s character is becoming unhinged by her increased sexual behavior as she attempts to seduce her director, and sleeps with her fellow ballerina. In the film Girl, Interrupted, Susanna (Winona Ryder) was institutionalized following a suicide attempt, and her therapists point to her promiscuity as a self-destructive tendency related to her illness. Jennifer Lawrence’s character in Silver Linings Playbook displays symptoms of borderline personality disorder, but is instead often referred to throughout the film as a “sex addict.” An article in Psychology Today claimed that CIA agent Carrie Matheson (Claire Danes) in the hit show Homeland represents an exemplary, accurate portrayal of bipolar disorder in part because “it’s hard to know whether her seductions of Brody (season one) and Ayam (season four) are the result of zealous dedication to her job or bipolar-driven promiscuity.”

Yet that’s just the problem. In each of these cases, it’s implicitly assumed that increased or “unnatural” sexual behavior is a sign of mental illness, or a product of it. In the article “Homicidal Maniacs and Narcissistic Parasites,” psychiatrist Dr. Steven Hyler asserts that a common film trope is the “female patient as a seductress,” in which “females with mental illness are depicted as nymphomaniacs with seductive powers that can destroy men”—the same trope embodied by Alex Forrest in Fatal Attraction. Dr. Vera Chouinard, a social and feminist geographer, notes in her article “Placing the Madwoman” that Susana’s promiscuity in Girl, Interrupted is portrayed as “an aberrant or unfeminine way of expressing sexual desire.” Nina Sayers’ (Natalie Portman) sexual relations with her fellow ballerina in Black Swan are viewed as a sign of her unraveling mental state rather than a manifestation of rational desire. Carrie’s one night stands in Homeland are portrayed as a product of her bipolar mood swings. There’s a clear tendency to either dismiss female sexual agency as a product of illness, or portray women with mental illness as sexualized creatures. This sexuality is linked with “madness,” implying that female promiscuity is an unnatural symptom of illness. Either she’s “crazy” because she’s having sex, or she’s having sex because she’s “crazy.”

This sexualization of female mental illness in popular media contrasts starkly with some of the most celebrated male performances on the same topic. The Oscar winning film A Beautiful Mind portrays the life of John Nash (played by Russell Crowe), a schizophrenic math genius. The Soloist adopts a similar portrayal, as homeless schizophrenic Nathaniel Ayers (Jamie Foxx) is celebrated as an incredible cellist. In the Oscar-winning Good Will Hunting, Will (Matt Damon) is seeing a therapist for an attachment disorder, while simultaneously working with a MIT professor on groundbreaking mathematical equations. It seems that while mentally ill women are likely to become sexualized in film, mentally ill males are likely to be correlated with genius. This is not to discount the ways in which popular media also stigmatizes male mental illness, of which there are countless examples. There are also a few exceptions to this pattern, most notably the film The Hours, which portrays writer Virginia Woolf’s (Nicole Kidman) genius and her struggles with depression. Yet it does seem that there are some discrepancies—one is much more likely to find a male portrayal of a mentally ill genius than a female.

Why are these misogynistic narratives of the “madwoman” prevailing? Professor Jones points to what he calls a “feedback loop.” “Any film that attempts to take on that kind of narrative” says Jones, “is going to write itself into narratives that have preexisted it.” It is these preexisting narratives that are informed by misogyny. The mentally ill woman very easily becomes stigmatized as the “madwoman”, a sexual, unfeminine being whose refusal to conform to gender roles is a symptom of illness. As this stereotype is perpetuated in society through film and television, viewers begin to expect this kind of portrayal of female mental illness, these expectations inform writers who craft these characters, and so on and so forth.

Even more troubling, Professor Jones cites a “failure of the imagination” as a potential reason for these continuing biased narratives. A recent report by the Center for the Study of Women in Television and Film at San Diego State University noted that 58 percent of female characters in film were defined only by their domestic roles, such as wife, mother, or girlfriend. Women represented only 30 percent of speaking roles, and accounted for only 4 percent of protagonists in films written by men. These statistics indicate that female characters are often flat, presented as minor, domestic figures more often than as complex heroes. “Among male writers” says Jones, “there is less imagination for what a complex female life looks like unless it is the obviously complex struggle of someone who is dealing with mental illness.” This indicates a deeper problem. If storytellers, directors, and actors can’t comprehend and portray a complex female character without some kind of mental illness, this speaks volumes about the way women are perceived and represented in society. Perhaps, then, troubling portrayals of female mental illness in media are merely a reflection of the biased, unimaginative, and overall lacking female protagonists.

Regardless, the portrayal of the “madwoman” in film is harmful on multiple levels. It stigmatizes female mental illness, portraying mentally ill women as highly unstable and sexually promiscuous. It enforces gender roles by positing any “unfeminine” activity as the product of illness, and lumps all symptoms of mental illness into one ambiguous “madness.” In the end, it seems to matter little whether the character is bipolar, manic-depressive, or suffering from split-personality disorder. No matter the diagnosis, or lack thereof, she is unhinged, irrational, and sexual. Perhaps it’s time we stop rewarding these troubling portrayals of female mental illness with the highest accolades the Academy has to offer, and instead evaluate these “madwomen” narratives for their reflections of gender bias and stigmatization of mental illness.