The Frank Gallagher Effect: Why TV Depictions of AUD Can Be Harmful

Seeing a similar struggle to yours on screen can feel like a salve of comfort, and sometimes, spur people to realize they might have a problem drinking. 

Frank Gallagher is a character played by William H. Macy on the show Shameless, who is notoriously known for his alcohol use disorder (AUD). 

Shameless follows the challenging and colorful lives of Gallagher’s seven children, who are left to fend for themselves due to parental neglect. The family is low-income, scraping by with odd jobs in lieu of Gallagher’s support. 

Gallagher is the catalyst for the family’s dysfunction, prioritizing himself before the family, yet returning home when it serves him, to steal groceries or sleep. As AUD can run in families, later in the series, Gallagher’s oldest children, Fiona and Lip, also struggle with alcohol use. 

Mental health representation is necessary and helpful, but, when does it have the potential to harm?

Reinforcing Addiction Stereotypes

Gallagher embodies just about every stereotype of someone with AUD. He is selfish, unemployed, unmoored, and fumbles through or avoids most obligations. He chooses alcohol over life responsibilities (almost) every time unless it deeply impacts his survival. 

Even then, he has a way of twisting systems to work in his favor. He is also a source of comic relief, fumbling through his consistently poor decisions yet always prepared with a defensive retort. 

At times, Gallagher’s portrayal of alcohol use disorder and how it hits a family is cutting and accurate. However, not everyone will feel represented by this depiction. 

AUD can manifest differently across people, depending on multiple factors like severity or access to resources. Someone might not meet each stereotype of AUD and not all stereotypes are criteria for having the condition. 

TV shows frequently can lean on clichéd depictions of AUD and exclude a large portion of experiences. Gallagher is seen as reckless and hopeless. This type of representation reinforces harmful stereotypes that those struggling with AUD are fundamentally flawed or incapable of change. These depictions ignore the fact that AUD is a brain condition, not a failing of character. 

By only presenting characters who fit these stereotypes, TV shows can fail to show the diverse lived experiences of people with AUD. While it’s true that AUD can affect every part of someone’s life, it’s also true that many people suffering from the disorder lead otherwise functional lives, maintaining jobs, relationships, and familial responsibilities, unlike Gallagher. 

The oversimplified portrayal of addiction stereotypes can cause viewers to misjudge the real-world experiences of those with AUD, creating stigma and misunderstanding that make it harder to identify AUD when it does not look like Gallagher’s.

Heavy Drinking Comparison

The risk of someone with AUD watching Gallagher’s flailing through addiction might cause the viewer to think that their own experience does not mirror his, and conclude that they do not have the condition. 

Alcohol use is usually shown in excess on TV shows and highly normalized, leading to skewed perceptions of what moderate versus excess drinking looks like. This might influence people to think they can drink more than is recommended—which is one drink a day for women and two a day for men. 

The CDC defines binge drinking as four or more single drinks on one occasion for women and five or more for men. Some characters exceed moderation and binge drinking thresholds nearly every night, yet their alcohol use is never vocalized as problematic; they are rather shown as the life of the party. 

The Myth Of Bad Enough

Shameless perpetuates the myth that AUD only applies to those who hit rock bottom or have such a bad disorder, that anyone can spot it a mile away. Gallagher is depicted as having extreme consequences like liver disease, destroying relationships with his children, or publicly falling over.

This portrayal creates the false belief that AUD only exists if someone's life is visibly unraveling. In reality, many people struggle with high-functioning AUD, and signs can be less obvious. These inaccurate depictions can prevent individuals from recognizing their own problems or seeking help because they feel their drinking isn’t bad enough to qualify as AUD.

Whether you’ve watched Shameless and found Gallagher to feel relevant, relatable, or left-field from your own experience, you never have to get to the point of “bad enough” to seek help for AUD. Getting help before the disorder worsens can be life-changing and life-saving. 

A Discouraging Take on Recovery

With AUD, relapse is very common. It’s estimated that two-thirds of people treated for the condition will relapse within six months. Gallagher never commits to recovery, though he has occasional bouts of attempting sobriety, usually for ulterior reasons. 

It can be helpful for people to watch depictions of AUD where the protagonists get the help they need. It’s also useful to show recovery through the lens of science-backed approaches, other than solely showing abstinence or going cold turkey, which can be dangerous.

There are scant references to the three evidence-based recovery models for AUD in Shameless other than through Lip’s experience with Alcoholics Anonymous (AA). These treatments include:

• Behavioral health
• Mutual
• FDA-approved

Without accurate representations of recovery, viewers may feel that seeking help is futile or that their struggle does not qualify for assistance. They might believe that if they cannot simply stop drinking on their own, they are beyond help. According to the National Institute on Alcohol Abuse and Alcoholism (NIAA), people with AUD can maximize their success when they are presented with the gamut of evidence-based treatments. 

There is no denying the pain, havoc, and health harm that can ensue from AUD. But it’s also important for viewers to see depictions of characters who get better and build healthy and meaningful lives. 

Stories are powerful tools to help us understand addiction. More accurate, compassionate, and nuanced portrayals of AUD are necessary to reduce stigma, encourage understanding, and promote healthier attitudes toward alcohol use and recovery. 

Gallagher never gets better. His family suffers tremendously because of it. Whether AUD is severe, moderate, or mild, and whether it looks like Gallagher’s a little or not at all, help is available.

Contrary to the show, you don’t need to hit rock bottom to receive care for AUD, or to qualify for the disorder. 

Are You Drinking Too Much?

Is drinking affecting your job? Is alcohol harming your health or relationships? Does your drinking worry you? Ever tried to drink less but failed?

If any of this sounds familiar, Oar Health might be right for you. Oar Health offers medication FDA-approved for the treatment of alcohol problems. A daily pill to drink less or quit. 

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