Nerve: Josh Biggs is a silent sufferer living with social anxiety disorder (SAD). His co-worker, Aurora, recognizes this and recruits Josh to take part in her graduate thesis, titled “Social Anxiety in Dating Initiation.” She believes that she can help Josh overcome his anxiety through exposure-based therapy, and gives him the first of several assignments: receive thirty rejections in one day. Josh struggles with Aurora's tasks at first, and it is very clear that he harbors a fear of intimacy--he avoids forming relationships with other people because he believes they will label him as unworthy once they know him. So he assumes a quiet, agreeable persona that does not engage with others. For example, Josh does not confront his roommate for cocaine use, even though he disapproves, and remains silent as the roommate harasses him for eating peanut butter straight from the jar. Any confrontation would result in a panic attack which he describes as “feeling like I'm dying.”

Josh realizes that he has a problem, and is willing (with Aurora's help) to change. With each task, we can see that he is trying to break out of his shell by going above and beyond her directions. After receiving thirty rejections, she instructs him to begin talking with people he would not normally speak to, strangers he encounters during the day. He responds by befriending homeless individuals, inviting them to live with him, and taking care of them.

We begin to see Josh develop boldness through these encounters--he starts taking dares, speaking out, and defending his opinions. When Aurora separates from her boyfriend, also a former patient, Josh starts to visit her apartment frequently, eventually staying overnight. He finally confesses his love for her, saying that she is his cure. He believes that he would not have been able to express these feelings a month ago without her help. Unfortunately, Aurora is still upset about her ex-boyfriend, and rejects Josh.

As tension builds between doctor and patient, life at Josh's apartment also becomes increasingly stressful. His new roommates are unemployed and do not contribute to the rent, which leaves him with total responsibility. His boldness escalates to aggression very rapidly as his anxiety increases. In one instance, he assaults a man for cutting in front of him in a restaurant line and is jailed. But while he is more aggressive, he also becomes detached and isolated. His performance at work suffers, and he is terminated. Josh enters a downward spiral, and begins drinking regularly. His dares become dangerous—for example, hanging off of his apartment's balcony for money. Exposure-based therapy has allowed him to voice his thoughts, but it is clear that other issues, as well as suicidal tendencies, have surfaced. Aurora senses this, but when she prompts him about his life and childhood, he reveals he has gaps in his memory and cannot talk about it.

As the movie comes to an ugly end, we are left with pervasive feelings of uncertainty regarding Josh's future. Aurora reconciles with her boyfriend, Josh and his roommates are evicted from the apartment, and he begins a new life, homeless and unemployed. He has failed to overcome his dysfunction.

Nerve is an excellent portrayal of social anxiety disorder. The protagonist captures the hallmark characteristics of social anxiety disorder. These symptoms include persistent fear of social situations, scrutiny from others, and complete avoidance or withdrawal in circumstances that are potentially threatening. When Josh was forced to endure, he often suffered from heart palpitations and debilitating panic attacks. His anxiety is not substance-related, and he recognizes that the disorder is negatively impacting his quality of life.

Anxiety disorders respond to cognitive strategies and pharmacotherapy, but Nerve does not present any current, accepted treatment options. Instead, Aurora hurries Josh through some experiments with her thesis deadline as the goal. It is not reasonable to expect an individual to improve in such a short period of time. We believe that she actually harms Josh more than she helps him. While the movie's representation of treatment options fails, it does demonstrate the complexity of Josh's disorder. It realistically shows the impact of inappropriate treatment, as opposed to giving the viewer a cinematic ending where he improves regardless of the quality of therapy.

Nerve is an obscure film which adequately portrays the signs and symptoms of social anxiety disorder, as well as the hazard of treating it too casually. This movie makes one appreciate the complexity of human anxiety, its sources, and thought disorders that can arise as a result. It leaves a bitter taste in the mouth, but could potentially be used for educational purposes in a more advanced application.