Winona Ryder portrays Susanna Kaysen, a young woman with borderline personality disorder who spends 18 months in a mental institution.
Angelina Jolie plays Lisa Rowe, a charismatic and unpredictable patient with sociopathic tendencies who befriends Susanna.
Brittany Murphy assumes the role of Daisy Randone, a patient with eating disorders who has a troubled history with her father.
Clea DuVall is cast as Georgina Tuskin, Susanna's roommate at the institution, who has a diagnosis of schizophrenia.
Elisabeth Moss portrays Polly Clark, a notably young patient with severe disfigurement due to self-inflicted burns.
Whoopi Goldberg plays Valerie Owens, a no-nonsense nurse whose tough love approach impacts the patients.
Vanessa Redgrave takes on the role of Dr. Wick, the empathetic psychiatrist who runs therapy sessions at the institution.
Jared Leto is cast as Toby, Susanna's boyfriend who represents her life outside of the institution.
Jeffrey Tambor assumes the character of Dr. Melvin Potts, a therapist who assesses Susanna’s condition.
Travis Fine plays Nurse John, a staff member at the institution who has interactions with the women.
Angela Bettis portrays Janet Webber, a patient with anorexia who shares her experiences with Susanna and others.
Jillian Armenante takes the role of Cynthia Crowley, one of the patients in the institution with her own unique struggles.
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