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Mental Health in The Last of Us Season 1: Grief, Trauma, and the Power of Human Connection
- Schoen Clinic UK
- 2 days ago
- 7 min read
Updated: 2 days ago
With Season 2 of HBO’s The Last of Us premiering tonight, revisiting the mental health themes of Season 1 offers a fresh perspective on grief, PTSD, and resilience in an apocalyptic landscape—echoing the rich narrative of the original Sony PlayStation exclusive game.
This is an opinion piece that includes ***SPOILERS*** for season 1 of The Last of Us.
Although The Last of Us is set in a post-apocalyptic world overrun by infected and desperate survivors, its true strength lies in its deep exploration of the human psyche. Through moments of heartbreak and resilience, the series charts a course through grief and trauma that resonates with anyone who has experienced loss or emotional pain.
At Schoen Clinic, our mental health specialists see parallels between these narratives and the challenges many individuals face every day. Let’s delve into the specific moments in Season 1 that spotlight these mental health struggles and offer hope for healing.
If you're affected by any of the mental health issues raised throughout The Last of Us, please don't hesitate to get in touch with our team.
Joel’s enduring grief: A silent battle with PTSD
From the very first episode, The Last of Us grips us with the raw, unfiltered pain of Joel—the man whose life changed forever when he lost his daughter, Sarah, in the chaos of the outbreak. A heartbreaking opening scene shows Sarah’s tragic death, a loss that casts a long shadow over Joel’s every action.
Key Moments:
Flashbacks and panic attacks: Throughout the season, Joel is seen grappling with intense moments of internal turmoil. In several scenes, his body tenses up, and a look of stark vulnerability flashes across his face—indicative of panic attacks or anxiety. These manifestations mirror the flashbacks often experienced by individuals with Post-Traumatic Stress Disorder (PTSD). His haunted eyes and reserved demeanour speak volumes about a man who is trying to bury his past while being pulled back by sudden, painful memories.
Hypervigilance and emotional numbing: There are sequences where Joel displays hypervigilance—scanning every shadow and movement—while his voice remains flat, distancing him from the emotional world around him. This numbing is his way of shielding himself from the pain of loss, yet it prevents him from forming meaningful connections, even with Ellie, whom he is charged to protect.
The weight of survivor’s guilt and compounded loss
Joel doesn’t just battle the anguish of losing Sarah; he is also burdened by survivor’s guilt further compounded by the loss of his partner, Tess. When Tess dies during an attack from the infected, the solitude of Joel’s grief becomes all the more palpable.
A closer look:
Stoicism as a defence mechanism: Rather than openly mourning Tess, Joel channels his grief into a relentless drive to complete his mission. This stoicism is characteristic of many who have experienced compounded trauma—using distraction and over-focus as a temporary relief from unbearable pain.
The unspoken impact: For many viewers, Joel’s refusal to express grief openly is a silent scream—a psychological barricade that keeps his emotions in check, even if it means living with constant internal turmoil. The show subtly reminds us that trauma often leaves its scars hidden beneath the surface, influencing behaviour in unexpected ways.
Ellie’s Journey: Lingering Trauma and Abandonment
Though Joel’s grief dominates The Last of Us, Ellie’s story is equally complex—defined by deep-seated abandonment and trauma.
Early loss and abandonment: Growing up as an orphan, Ellie experienced loss from a young age. She lost her dear friend Riley and was left in the care of others, with Marlene eventually passing the responsibility to Joel and Tess. This early pattern of loss laid the groundwork for her enduring sense of isolation.
Key moments of rejection: Tess’s death after being bitten by the infected removed another source of stability. Later, when Joel encouraged her to join his brother Tommy, it reinforced her fear of being left behind. In one striking moment, Ellie declares, “Everyone I have cared for has either died or left me. Everyone—except for you,” capturing her deep-seated isolation and longing for connection.
The emotional fallout: These repeated experiences have led Ellie to build a protective shell around herself. While she learns to rely on her own strength, she still yearns for genuine closeness—a duality that profoundly influences her actions.
Moments of respite and connection: Even amidst the trauma, the series offers brief moments of hope. For example, a heartwarming scene shows Ellie feeding a giraffe—a small, tender reminder of connection and resilience in a tumultuous world.
Bill and Frank: A tender love story amidst chaos
One of the most emotionally rich storylines in Season 1 is the episode centred on Bill and Frank - characters whose relationship is given a level of intimacy and depth rarely seen in video game adaptations. In the original Sony PlayStation exclusive game, the hints at a connection between these characters were subtle. However, the show reimagines their relationship in a way that celebrates the resilience of love even in a bleak world.
Exploring their story:
Living with terminal illness: Although Frank is not formally diagnosed with a mental health condition, it is clear that he is battling cancer. The series handles his illness with refreshing honesty. Frank’s acceptance of his condition, combined with his choice to live life to the fullest despite the inevitable, underlines a powerful message: quality of life matters, and emotional well-being can be maintained even in the face of terminal illness.
A happier outlook: Unlike the game - where Bill and Frank’s relationship ends on a bitter note - the show gives them a relatively happy life together. Their story reminds us that supportive, loving relationships can serve as vital anchors in times of crisis, helping individuals cope with chronic illness and existential despair.
Affirming LGBTQ+ resilience: Their narrative is not just a side story; it is central to the exploration of non-heterosexual love thriving despite overwhelming odds. It challenges stereotypes and demonstrates that enduring human connections are possible, even when faced with societal or personal hardships.
Moral injury: The cost of survival
In the world of The Last of Us, survival requires making tough decisions that can deeply conflict with one’s personal values. These actions, taken out of necessity, can leave long-lasting emotional wounds—a phenomenon known as moral injury.
The burden of tough choices:Characters like Joel and Ellie are forced to make decisions in moments of extreme pressure. These choices, while necessary for survival, often push them to act against long-held ethical beliefs. This constant internal conflict is a core part of their struggle.
Understanding moral injury:Moral injury occurs when someone’s actions, or even inactions, conflict with their core moral values. In the series, this is shown through the deep regret and internal turmoil that follow their life-altering choices. The psychological impact can include lingering feelings of guilt, sadness, and a diminished sense of self-worth.
Long-term psychological effects:The weight of these decisions does not simply fade away. Instead, it can lead to persistent emotional distress—highlighting how the cost of survival isn’t just physical but also deeply mental and emotional. For characters in The Last of Us, every difficult choice reinforces the reality that survival in a harsh world comes at a profound personal price.
Connecting on-screen trauma to real-world healing
The mental health struggles depicted in The Last of Us remind us that trauma does not discriminate. Whether it’s a single parent losing a loved one, a teenager grappling with the loss of innocence or the loss of a parental figure, or an individual managing a terminal illness, the experience of grief and trauma is universal.
Why these stories matter:
Breaking the silence: Media representations like these help dismantle the stigma attached to mental health challenges by illustrating that even in extreme fictional environments, the pain of trauma is real and universally understood.
Encouraging dialogue: Open discussions about these themes, both on-screen and off, foster a supportive environment for those dealing with similar issues. Whether through therapy, support groups, or heartfelt conversations, acknowledging one’s pain is a crucial step toward healing.
How Schoen Clinic can help
At Schoen Clinic Chelsea, we are dedicated to providing specialised mental health care for those dealing with complex trauma, grief, and the long-lasting impact of stress. Our holistic approach is built on evidence-based therapies that not only address immediate symptoms but also facilitate a deeper healing process.
Our Services Include:
Trauma-Focused Therapies: We offer tailored approaches, such as EMDR and Trauma-Focused Cognitive Behavioural Therapy (TF-CBT), to help individuals process and overcome traumatic experiences.
Grief and Bereavement Support: Our compassionate counselling supports those navigating the challenging process of mourning and loss.
Adolescent Mental Health: We provide focused support for young people contending with a wide range of mental health challenges.
Couples and Family Therapy: Our therapies help repair and strengthen relationships by addressing the complex dynamics that emerge in the aftermath of trauma.
Reflecting on the legacy of The Last of Us
As The Last of Us transitions into its second season, the groundwork laid in Season 1 continues to resonate deeply.
The show’s exploration of mental health challenges reminds us of the strength inherent in the human spirit.
In portraying these challenges, the series not only deepens our understanding of trauma and resilience but also encourages us to empathise with those who experience similar struggles in real life.
It compels us to recognise that healing is not just about overcoming despair, but also about cherishing and nurturing the fleeting moments of joy that bring us back to life.
As Season 2 unfolds tonight, we invite you to reflect on the multifaceted themes of trauma, resilience and hope portrayed in The Last of Us. If you or someone you love is wrestling with the fallout of grief or the symptoms of trauma, remember that help is available.
At Schoen Clinic Chelsea in London, our dedicated team is here to support you on your journey to healing and wellness.
Contact us today for specialist mental health support.