Hektoen International

A Journal of Medical Humanities

Breaking Bad: A case study of antisocial personality disorders

Jason Liu
San Francisco Bay Area, California, United States


Both psychopathy and the non-clinical “sociopathy”1 have been diagnosed in infamous serial killers such as Jeffrey Dahmer and John Gacy, and popular films and TV shows, like American Psycho and Dexter, have drawn from these diagnoses. Psychopathy and sociopathy are amongst the most complex mental disorders. Both of these conditions fall under the official diagnosis of antisocial personality disorder, though psychopathy is rarer.2 People with psychopathy are keen, intelligent, and highly manipulative. Generally appearing stable and “normal,” they are usually hard to spot, tend to have diminished emotional responses, and have trouble forming emotional connections with others.1 Psychopathy is rare: roughly 1.2% of adult men and 0.5% of adult women in the US have clinically significant levels of psychopathic traits. People can develop such traits from environmental influences or genetically.2

Sociopaths, like psychopaths, struggle with forming emotional relationships. Due to their difficulty in recognizing emotions, sociopathic individuals cannot empathize and are generally considered callous. An early 2000s study showed that 3.7% of the general population meets the criteria for sociopathy, a higher proportion than psychopaths.1 However, unlike psychopaths, sociopaths can, in certain cases, form limited attachments. For example, a sociopath can bond with significant others, parental figures, or like-minded individuals.1 They are manipulative, impulsive, and more erratic than psychopaths. Because they do not recognize the negative aspects of their behavior, they often cannot comprehend the difference between right and wrong; they deceive and violate the rights of others and tend to care more about themselves than others. Like psychopathy, sociopathy can be developed or inherited.3 And while television series are primarily entertainment, they can effectively explore the nuances between these two conditions.

Breaking Bad is a prime example of a television series able to capture this complexity. The morally complex story incorporates gritty realism and real-life family drama, focusing on the transformation of Walter White from chemistry teacher to drug dealer through his confrontation with ruthless drug kingpins.

Giancarlo Esposito as Gustavo Fring in Breaking Bad. Fair use. Source

One way Breaking Bad captures these disorders is through the character of Gus Fring, who constantly demonstrates psychopathic tendencies. Gus is a drug distributor and former cartel member. He operates, with his partner Max Arciniega, in the guise of a manager of a fast food restaurant chain called Los Pollos Hermanos. Initially, Gus and Max approach a Mexican cartel to propose a drug distribution partnership. The cartel leader, Eladio Fuentes, strikes down their offer and has his associate kill Max in front of Gus for selling meth without his permission; this act scars Gus, who vows to avenge his beloved partner. Gus’s hatred for the cartel fuels his violent tendencies and apathy towards others.

In season four, episode one (“Box Cutter”), Gus and his henchman, Victor, confront Walter and partner Jesse Pinkman about Gus’s former partner, Gale Boetticher, who Jesse had shot dead. Walter pleads with Gus, who is clearly outraged by this murder, to spare them. Unexpectedly, Gus grabs Victor and slits his throat with a box cutter. Gus stares intensely at Walter and Jesse while Victor gasps for air and his throat spurts blood, leaving the duo in shock.

While Gus’s violent act may seem out of the blue, he had made the decision after careful consideration. Victor went to Gale’s apartment after he was shot, which makes Victor a potential suspect to the police. He also cooked meth in their superlab without Gus’s approval. Gus ultimately kills Victor because he is a loose end and cannot be trusted. Additionally, this action serves as a message to Walter that the very same could happen to him if he were to step out of line again. While both Walter and Jesse appear flabbergasted and disgusted, Gus stands calmly in front of them while keeping the convulsing Victor in his arms—he is clearly unphased by the gore. Even though he worked with Victor for a long time, Gus has no emotional connection to him. Gus’s calculated action and emotional indifference attest to his psychopathic nature. Gus does not hesitate to eliminate him in the grand scheme of controlling Walter and Jesse to secure his business.

Another illustration of Gus’s psychopathic qualities appears in season four, episode eleven (“Crawl Space”). Gus visits Hector Salamanca, a cartel boss, who is in a nursing home after becoming severely disabled from a stroke. Gus actively taunts and demeans Hector, telling him he is all alone now because Gus has killed all of his family members and the rest of the cartel as a way of exacting revenge for the murder of his partner Max Arciniega. Gus repeatedly tells Hector to look him in the eyes as recognition of the worthiness Hector has never given him. Even though Hector is old, ailing, and clearly not the same man he was when he shot Gus’s partner, Gus does not hesitate to abuse him. Gus’s lack of empathy, disregard for human life, and propensity to hurt others aligns completely with that of a psychopath.

Raymond Cruz as Tuco Salamanca in Breaking Bad. Fair use. Source

Whereas Gus is calm and always in control of his emotions while executing his plans, Tuco Salamanca, a drug kingpin and cousin of Hector Salamanca, is an extremely violent sociopath who seems to show no restraint. Tuco, because of his sadistic and brutal conduct, is seen as one of the most physically intimidating villains in Breaking Bad. While Gus is cruel because he deems it necessary for vengeance, Tuco derives pleasure from it.

In season one, episode seven (“A No-Rough-Stuff-Type Deal”), right after Tuco finishes making a deal with Walter and Jesse, Tuco lashes out at his henchman, No-Doze, when he speaks out of line. Walter tries to defuse the situation by telling Tuco to calm down. Tuco laughs, as if he was jokingly acting angry, but then suddenly punches No-Doze to the ground and continues bashing his face in. When Tuco stops, he gets up and shows his bloody fists proudly to Walter and Jesse—his outrage ends up killing No-Doze on the scene. At this point, Tuco’s behavior suggests he could be either a psychopath or a sociopath.

While Tuco does show emotional detachment towards others’ well-being, what differentiates him from a psychopath is his impulsive behavior. When No-Doze spoke out of place, there was no reasonable motive for Tuco to kill him. Whereas Gus would carefully calculate and weigh the benefits and consequences of his actions, Tuco does not think before acting. He enjoyed beating up No-Doze and found pride in doing so.

In another instance, in season one, episode two (“Mijo”) of Breaking Bad spinoff Better Call Saul,  two skaters show up at Tuco’s home, seeking compensation for being hit by his grandmother’s car. Tuco kidnaps them and takes them to the desert to torture and kill them, all because they called his grandmother a “biznatch.” If it was not for the titular character Saul Goodman intervening in the situation, Tuco would have skinned them “like javelinas.” Although his decision to kill them in the desert puts his entire operation at unnecessary risk, he acts without considering future consequences, a prominent sign of sociopathy. Tuco impulsively takes his actions to excess at the slightest disrespect or frustration, making him emotionally unstable and a societal danger.
While both are ruthless drug dealers, Gus Fring and Tuco Salamanca operate very differently, one a cynical and apathetic business magnate and the other a sadistic and capricious drug lord. Their actions and attitudes make them key cases for analysis of psychopathic and sociopathic tendencies. However, examples of these mental disorders extend beyond these two characters, with Walter’s former accomplice, Todd Alquist, and Tuco’s cousin, Lalo Salamanca, exhibiting similar traits. The universe of Breaking Bad gives us a glimpse into the psychological traumas and instability people can be consumed by, but learning more about these disorders’ origins allows for the better diagnosis of those affected.

The DSM-5, the fifth and latest edition of The Diagnostic and Statistical Manual of Mental Disorders, is a widely used tool for diagnosing mental disorders. Because we do not fully understand the origin and development of mental disorders, especially antisocial personality disorders, classifying them remains a somewhat subjective and ambiguous task. Clinical professionals often need to use their own judgment in diagnosing such patients.

Analyzing movies and television shows like Breaking Bad can be valuable in helping the general public and medical researchers alike better understand mental disorders and identify conditions based on their symptoms.



  1. “Sociopathy.” Psychology Today. Sussex Publishers. Accessed April 11, 2023. https://psychologytoday.com/us/basics/sociopathy.
  2. DeAngelis, Tori. “A Broader View of Psychopathy.” Monitor on Psychology, March 1, 2022. https://apa.org/monitor/2022/03/ce-corner-psychopathy.
  3. “How to Recognize Signs of Sociopathy.” Cleveland Clinic. Cleveland Clinic, September 10, 2021. https://health.clevelandclinic.org/sociopath-personality-disorder/



JASON LIU is an honors student at Saratoga High and an independent writer for his school’s Soundings magazine and for literary organizations such as YoungArts and Scholastic Arts and Writing. He has written several short stories, poems, and screenplays, one of which has received an honorable mention from Scholastic. After taking a general psychology course, Jason embarked on a project to explore portrayals of mental disorders in television shows.  


Spring 2023  |  Sections  |  Psychiatry & Psychology

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