'Mindhunter' Season 2 Owes a Key Plot to the "Father of Psychopharmacology"
Netflix’s Mindhunter likes to borrow from history. From the Atlanta child murders that make up the premise for Season 2 to John E. Douglas, the real-life FBI agent Holden Ford (Jonathan Groff) is based on, the show leans heavily into the true history of criminal psychology. But it also borrows directly from two large psychological and pharmacological movements in the 1970s and 1980s that reveal a little bit more about the world in which our heroes are operating.
Spoilers for Netflix’s Mindhunter Season 2 below.
Mindhunter’s first season ends with Ford experiencing a massive on-screen panic attack that lands him in the hospital as Season 2 begins. He is eventually diagnosed with panic disorder in the season premiere — a condition characterized by persistent, sometimes unexplained panic attacks, and such a strong crippling fear of these attacks that one’s behavior is negatively impacted. We see these symptoms play out during a conversation with Ford’s former boss, Robert Shepard, who informs Ford that his careless actions were the real cause for Shepard’s early “retirement,” triggering yet another panic attack.
Plot-wise, Ford’s panic disorder serves as a somewhat hypocritical parallel to his own crusading attitude about mental health and criminal behavior. While he’s eager to use mental health insight as a tool in his work with the Behavioral Analysis Unit, he struggles to cope with mental illness himself. But perhaps he’s not entirely to blame for failing to see the connection. In real life, in the ‘70s and ‘80s, scientists were only just starting to understand “panic disorder” and how to properly treat it.
The timeline of Mindhunter falls right during a crucial movement in the real-world understanding of the condition. Due largely to the work of Dr. Donald Klein, the “father of psychopharmacology” during the late ‘60s and ‘70s, “panic disorder” finally gained recognition from the American Psychiatric Association. Coincidentally, on the same day that Mindhunter Season 2 premiered, Klein died in New York at the age of 90.
Why Is Donald Klein Relevant to Mindhunter?
Before Klein’s research, the term “panic disorder” wasn’t a part of the diagnostic language for mental health professionals. Many people who exhibited panic symptoms similar to Ford’s were thought to be schizophrenic, Klein said in an interview with the American College of Neuropsychopharmacology.
"I published that in the early 1960s, but nobody believed it."
During an experiment at Hillside Hospital on Long Island in 1964, he observed that when those patients were put on Thorazine — the drug used to treat schizophrenia at the time — they got worse, not better as he’d hoped. Instead, he showed that antidepressant drugs were promising treatments for panic attacks and in most cases outperformed the traditional drugs.
“I published that in the early 1960s, but nobody believed it. They thought it was just some sort of crazy idea,” Klein said in the ACN interview.
That finding set the stage for Klein to flesh out a definition of “panic disorder” that differentiated it from other anxiety disorders. But it also gave scientists clues as to how to treat it. In 1980, “panic disorder” was fully defined in the the DSM-III, the American Psychiatric Association’s manual of all psychological conditions. The DSM-III was also the first to include diagnostic criteria that could be used to identify conditions.
The emergence of Holden’s panic disorder happens slowly over the course of Season 1, which takes place in 1977, so the timeline doesn’t line up perfectly. But in that timeline, Klein would have been well on his way to finally establishing the modern definition of panic disorder. Holden would have been among the first ever to get a panic disorder diagnosis with the backing of the DSM-III. Which, at least in part, explains some of the pushback he faces from his colleagues about his diagnoses, specifically his partner Bill Tench (Holt McCallany), who essentially tells him to pull himself together after he picks him up from the hospital.
He also would have been among the first to receive a treatment with an anti-anxiety medication, which happens right on schedule in Mindhunter.
Benzodiazepines in the ‘70s and ‘80s
In the show, Ford is eventually prescribed Valium — a benzodiazepine that later became known for treating anxiety. Though Klein often worked with the tricyclic antidepressant imipramine, benzodiazepines were truly the drug of the hour in the ‘70s and into the early ‘80s. A review in The Consultant Pharmacologist notes that in 1978 and 1979, benzodiazepine prescriptions peaked when Americans consumed 2.3 billion tablets each year.
In 1979, The Washington Post quoted Dr. Charles F. Stroebel, the former director of Hartford’s Institute of Living in Connecticut, in a story about changing attitudes toward benzodiazepines. At the time, he told The Post that “every time [doctors] encounter a stress-related disorder, they take out a prescription pad and write a prescription for Valium.”
Fittingly, that’s exactly what happens in Mindhunter. The first thing that Ford is prescribed for his condition is Valium. Today, though, it’s not used to treat panic disorder.
Later on in the ‘80s and beyond, psychiatrists would go on to establish that benzodiazepines came with their own dark sides — they can be addictive, and possibly even deadly. They’re also commonly abused in conjunction with opioids. But those risks would have been less apparent in the ‘70s — or at least not in the forefront of all prescribers’ minds.
In the late ‘70s world of Mindhunter, Holden’s character is sitting directly between two large movements in psychological science that are unfolding around him: the establishment of panic disorder and the rise of a now infamous class of drugs in US medical history. Whether or not that will play any further role in the show remains to be seen in Season 3, but they do tell us a little bit more about the world in which Ford is operating.