Therapy in a pill: Breaking down the science behind the strange, surreal world of Netflix's "Maniac"

But what's undeniable is the fascinating world that the show presents. The story unfolds over 10 episodes, and the plot revolves around an experimental pharmaceutical trial to test whether a course of three pills can replace cognitive-behavioral therapy for people experiencing psychological trauma.

The show relies on theoretical and fantastical science; its style is reminiscent of the films "Inception" and "Eternal Sunshine of the Spotless Mind," and the television series "Black Mirror."

But "Maniac" does actually incorporate many facets of current psychology. A lot of the technology and science used in the show, like ink-blot tests and brain monitors, exist in real life.

We took a look at seven of the science concepts seen in "Maniac" to see how they stack up to the real research they're based on. Potential spoilers lie ahead, so tread carefully.

In the show, participants in the trial get tested for defense mechanisms. Those tests are actually used to screen for mental illness.

In the show, participants in the trial get tested for defense mechanisms. Those tests are actually used to screen for mental illness. BusinessInsider

The three tests in the pre-screening are all really used by psychologists to scan for mental abnormalities or signs of PTSD in patients. They are:

In the show, the three pills are designed to replace cognitive-behavioral therapy. Here's what that really is.

In the show, the three pills are designed to replace cognitive-behavioral therapy. Here's what that really is. BusinessInsider

Many elements of the characters' diagnoses are consistent with real-life conditions and symptoms.

Many elements of the characters' diagnoses are consistent with real-life conditions and symptoms. BusinessInsider

Real psychiatric pharmaceutical trials are very different than the one depicted in "Maniac."

Real psychiatric pharmaceutical trials are very different than the one depicted in "Maniac." BusinessInsider

The sequence of drugs being tested in the show's pharma trial is supposedly the 73rd iteration, following a long string of failures. A real-life drug that failed in 73 rounds of human clinical trials would probably not fly with the FDA, especially if (spoiler alert) the trials caused some patients to become brain-dead.

In reality, clinicians are required to file an Investigational New Drug Application with the FDA and update the agency with safety and progress reports throughout the trial process. (Here are the full FDA requirements for clinical research.)

There are, however, 916 real trials going on right now for trauma- and stress-related disorders. That's according to ClinicalTrials.gov, a database of privately and publicly funded clinical studies going on around the world.

These trials are experimenting with a variety of treatment techniques, including drugs, cognitive and behavioral therapy, psychotherapy, motor interference, oxygen exposure, deep brain stimulation, virtual reality simulations, online support, and exercise.

Could a drug actually help treat trauma and other psychological disorders by rewiring the mind? Research into psychedelics seeks to answer that question (to some degree).

An fMRI showing two levels of the brain — areas in orange were more active in healthy people than in people with schizophrenia. BusinessInsider

"The mind can be solved. Pain can be destroyed," Dr. James K. Mantleray promises in the show. But could a real drug replace therapy and erase trauma by altering patients' minds?

Besides antidepressants and other mood-stabilizing medications, psychedelic drugs may be the closest thing we have right now to the pills in the show.

MDMA, a psychoactive compound also known as ecstasy or molly, has also gotten attention in the past couple of years for its potential to treat patients with PTSD. In fact, the FDA

A computer in the show relays patients' brain activities to doctors. Machines we use today can perform the same functions.

A computer in the show relays patients' brain activities to doctors. Machines we use today can perform the same functions. BusinessInsider

The researchers in the show also use a computer program called GRTA to guide patients through their experience on the pills, kind of like an artificially intelligent therapist.

The closest real-life version of that may be AI therapy chatbots. But those algorithms are based on fairly simple computer codes, and they don't contain an "empathy program" like GRTA, so wouldn't become sentient or psychotic.

Temporary, hysterical blindness is a real condition.

Temporary, hysterical blindness is a real condition. BusinessInsider

In episode 9, during a climactic moment in the show, Dr. James K. Mantleray experiences temporary, dramatic, and hysterical blindness as a result of intense stress and anxiety.

In reality, neural messages from the retina can and do get lost along the transmission pathway to the processing center in rare cases.

High levels of emotional stress, for example, can cause blood pressure to rise and blood vessels near the eye to constrict, resulting in temporary vision loss. The rare condition, called amaurosis fugax, can be caused by migraines and other physical health conditions, stress from physical exercise, and even sexual intercourse.

Therapy in a pill: Breaking down the science behind the strange, surreal world of Netflix's "Maniac"

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