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Until Dawn: Josh's Mental Health

Until Dawn has become one of my favorite games not just because of Josh but he is a major part of it. The Game Theorist made a video about the mental state of Josh from Until Dawn. He concluded that Josh had schizophrenia. I disagree. He has bipolar disorder with trauma induced psychosis.

NOTE: I am not a medical professional, but I am bipolar without psychosis. Not an expert though.


Josh did not have hallucinations until his sisters disappeared. His friends had little to no idea that he was so sick although they were worried about him after the tragedy. However, one of Hannah's diary entries talks about Josh getting home from the hospital. It is a hidden entry. The player has to flip one page back. This is what it says:

October 29th: I really think Josh is doing better now that he's out of the hospital. I saw him today and he seemed better. He's pretty upbeat, but he talked like he's been doing therapy for such a long time. I guess I didn't know. Mom and Dad never let on. Funny how you can not even know your own brother. I kinda need a good cry thinking about how lonely he must feel...

It is also possible to reveal texts from Dr. Hill asking Josh to come in and if he is still taking his medication. We do not know if he is or not but I do not think it matters. He would have symptoms either way.

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As you can see in Josh's medical report, he was constantly treated with anti-depressants. If he was bipolar, antidepressants alone would have made his manic episodes worse.

After the incident, Josh started taking stronger doses of his medication without his doctor's advice, Amitriptyline. Side effects include Restlessness, seeing or hearing things that are not there, feeling more excited or energetic than usual, racing thoughts, thoughts of hurting yourself or others. All of these symptoms describe Josh's mental state during the game. After he was taken off of Amitriptyline, he was put on Phenelzine which also has the side effects of feeling more excited or energetic than usual, unusual behavior, thoughts of hurting yourself or others. We know that Josh stopped taking his medication which according to his medical file can cause hallucinations, paranoia, and aggressiveness.

Schizophrenics also have trouble focusing and completing projects. He spent an obscene amount of time and effort on making his "house of horrors" perfect. Second, the ability to learn and use information is a major part of schizophrenia. Josh learned a lot through his father and researching what he needed for the prank all his own. Chris had known Josh since 3rd grade and became close friends. His sisters only knew he had mental issues and to a very minimal extent.


Could losing both of his sisters be enough of a catalyst for him to break down so severely? If we look around the house, there are several clues on how close Josh was to his sisters; photos, gifts, and Josh being friends with Hannah's crush, Mike. At no less than two points in the game does Josh talk about how busy his father was and how little time he spent with his son. Josh and his sisters had their mother in the picture but there is little mention of her role in their lives. She is the one who smooths over relations with the local native tribe.


I am not a professional, but I think Josh is manic with severe trauma induced psychosis. When he lost his sisters, started the new medication (and possibly stopped it), the visions started to occur. He put together this elaborate plan to get revenge (while subconsciously trying to win his father's love through his use of the horror genre), snaps even more when Chris and Mike tie him up in the barn, and finally is a zombie in the mines. He can barely speak at that point as his mania has subsided. What goes up must come down and he comes down hard.

If you missed Part 1

  • Just Joshin' Ya
    WARNING: This post contains major spoilers for the PS4 game Until Dawn. Also, I know this is a fictional story with fictional characters. It is a great story with decently rounded characters. I just have social commentary about it. Ahem... I have...

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