Silver Linings Playbook: Mental Illness

Introduction: Silver Linings Playbook is a 2012 American romantic-comedy-drama film written and directed by David O.Russell. Background: The film was based on Matthew Quick’s 2008 novel The Silver Linings Playbook. It stars Bradley Cooper and Jennifer Lawrence, with Robert De Niro, Jacki Weaver, Chris Tucker, Anupam Kher and Julia Stiles in supporting roles. Cooper plays Patrick ‘Pat’ Solitano Jr., a man with bipolar disorder who is released from a psychiatric hospital and moves back in with his parents. Pat is determined to win back his estranged wife. He meets a young widow, Tiffany Maxwell, who offers to help him get his wife back if he enters a dance competition with her. Thesis statement: The two become closer as they train and Pat along with his father and Tiffany examine their relationship with each other as they cope with their personal situations.

Topic sentence: After eight months of treatment in a mental health facility for bipolar disorder, Pat is released into the care of his father Patrizio Sr. and mother Dolores at his childhood home in Upper Darby, Pennsylvania. His main focus is to reconcile with his ex-wife, Nikki. She has moved away and obtained a restraining order against him after Pat beat the man, she cheated on him with. During his time in the clinic, Pat befriends Danny McDaniels who is an easygoing man who is embroiled in a legal dispute with the clinic over whether or not he is eligible to leave. Pat’s therapist, Dr.Patel does his best to convince him to keep taking his medication, as a repeat of his violent outbursts might send him back to the clinic. But Pat tells him that he has a new outlook on life: he attempts to see the good, or silver linings in all that he experiences. Pat employs the Latin phrase ‘Excelsior’, translated as ‘always higher’ or ‘ever upward’, as the mantra of his new optimistic outlook. Meanwhile, Pat experiences a series of anxiety attacks in his new life, including a violent reaction to Ernest Hemingway’s ‘A Farewell to Arms’, which he throws into the yard, destroying his bedroom window in the process.

Evidence & citing: As per the Harvard Medical School psychiatrist, Dr.Steven Schlozman, they do their best to get the folks to take their medicines. He says ”We do our best to get the folks to take their medicines. We can check to see whether they’re taking them in other ways, through blood levels and stuff like that. But you always assume a certain level of lack of adherence to the regime, for a while, as people are getting better. And you can understand it, I mean, if you lack insight into the fact that there’s something not right, it’s hard to come up with a good reason to take the medicine. And even if you know you’re better off on your medicines, a lot of them have really not-nice side effects. So there’s a lot of reasons that you might decide not to take them.” He further adds “Even though we picture bipolar disorder as this kind of sine wave thing where you go up and down, most people have mixed states when they’re decompensating. So they’ll be highly irritable, going a million miles a minute, but not euphoric.”

Pat is curiously confident and upbeat for a man just released from a mental hospital and under a restraining order from his wife. That’s because he’s determined to repair the damage he has done to his life and surprise everyone by moving ever onward and upward. His motto is ‘Excelsior!!’ At the top of his priority list is rebuilding his marriage with his wife, after they split, he beat up her new boyfriend, but what’s past is past. Pat assures his parents that all will be well. They’re not so sure. One of the charms of “Silver Linings Playbook”, the screwy new comedy is how Dolores is a sane and caring woman and has had long experience in dealing with compulsive behavior, because her husband is a fanatic fan of the Philadelphia Eagles stadium for fighting, Pat Sr. now focuses uneasily on his TV set, convinced that the Eagles will win only if his several superstitions are fulfilled. He is harmlessly obsessed with the Eagles, gratefully in love with his wife and cluelessly supportive of his son, who he doesn’t realize is an apple who has fallen very close to the tree. One of the ingenious and sort of brave accomplishments of Russell’s screenplay which is inspired by a novel by Matthew Quick is the way it requires both father and son to face and deal with their mental problems and against all odds finds a way to do that through both an Eagles game and dance contest.

Topic sentence: On the other hand, judged from the standards of realism in regard to psychiatric diagnosis and mental health treatment, the film is not perfect. Pat is labeled as having bipolar disorder, this complicated diagnosis is controversial and confusing even among mental health professionals and in Pat it appears to manifest itself primarily in aggressive and violent outbursts. Similarly, Tiffany, Pat’s love interest, has her compulsive and self-destructive promiscuity explained too simplistically (a compensation for the guilt she feels for inadvertently causing the death of her husband). It’s hard not to see that character and wonder a little about borderline personality disorder for her. I think we’re probably supposed to feel bad about thinking that after we hear her history - which is silly, because people are allowed to have horrible histories and people are allowed to have borderline personality disorder, and there’s nothing wrong with either of those things. So she’s had a significant response to a pretty awful trauma, the death of her husband. Making an assumption that there’s depression, because someone put her on Effexor, which is an antidepressant. But you can have both: You can have depression and borderline personality disorder. Also, the film wraps up the pieces much too neatly, suggesting that Pat and Tiffany’s successful performance in a dance contest and their passionate love for each other are enough to diffuse all of the simmering psychological and interpersonal tensions. Falling in love is an absolutely awesome and wonderful thing, but it’s not going to cure bipolar disorder any more than it’s going to cure diabetes. It just doesn’t work that way. The flipside of that is, we know from all sorts of really good studies, that people with psychiatric illnesses - horrible depression, bipolar disorder even schizophrenia - they do better when they’re in love. That’s one of the things that confers resilience. So it’s not an unheard - of story, the part that’s unheard of is that you suddenly don’t need your medicines and life goes on fine forever. Finally, the portrayal of the therapist, Dr.Patel is problematic. He intentionally provokes Pat by playing a song that reminds him of a traumatic event and later in the film, he completely abandons his professional role in favor of joining with Pat as a maniacal Eagles fan. The narrative formula of such films is probably like: two people met and are attracted to each other, however they have personal issues that prevent them from immediately starting a healthy relationship, through a series of poor decisions and misunderstandings, they learn and mature and eventually they manually declare their love for each other and live happily ever after. To criticize hope in any guise as unrealistic perhaps misunderstands the nature of hope. Admittedly, the object of hope is always about the future, and the future is always uncertain. But the feeling of hope can be sustaining in the present, and the troubled characters in Silver Linings Playbook offer an inclusive vision of that feeling that is that much more universal and powerful.

In Silver Linings the mania and the meltdowns have a serious side and a diagnosis. Pat is practically vibrating with intensity as he returns to his parent’s house armed with new knowledge about his disorder, required visits to a therapist and medication he’s disinclined to take. Obsessed with the delusion that he’s going to win his wife back who by the way has taken out a restraining order against him - he spends a lot of time running around the neighbourhood to keep in shape, wearing a garbage bag over his clothing to induce more sweating. The depiction of mental illness is sharp and engaging with immensely talented leading actors playing flawed but terribly likeable people. And they’re surrounded by more of the same: family and friends who are odd and obsessive themselves, but also warm and forgiving and unembarrassed by eccentricity. Part of the message of the movie is that it takes a lot of mutual support for people to be themselves, whether or not mental illness is involved. And that if we’re not afraid of mental illness, we don’t try to hide it, we can help people manage their symptoms and live up to their potential. It’s when Pat realizes who his real love interest is that he is motivated to take his medication and give up his delusions. There’s a recognition that mental illness is real and needs to be treated that way, with therapy and medication - whatever works but the feelings and behaviours involved aren’t alien to any of us. The more we accept that and the more we aren’t ashamed or afraid, the better off we all will be.

Topic sentence: The film underplayed the behaviour, emotions and mentality of a person struggling with bipolar disorder. I felt Pat’s character’s antics and excitability were more characteristic of a man with quirks and anger issues. I couldn’t possibly see how the audience could understand the severity of a person with manic depression if Pat’s actions were merely written off as the actions of a quirky man who threw temper tantrums. At certain points in the movie, we experience the trauma and turmoil. For example, when Pat starts freaking out because he cannot find his wedding video and he goes into this wild outburst, tugging at his hair, circling the room and shouting that he can’t find the wedding video. He is so loud that he wakes up the neighbours. He accidentally strikes his mom in the face, and someone calls the cops on him. Lucky for Cooper, the cop only told him to quiet down. He didn’t drag him back to the mental clinic. It is an outside entity that causes something inside of you to connect to an old emotion or trauma and almost instantaneously bring back all previous emotions, fears and doubts you felt when that entity first caused the trauma. Both Pat and Tiffany don’t take their meds until later on in the film.Tiffany can handle this. Pat cannot as demonstrated through his outbursts and erratic behaviour.

Topic sentence: It is expected that one or both of a romantic comedy’s protagonists will go a little crazy in some way. But this film takes things a step further. Pat is released from a mental hospital and Tiffany is battling her own demons. Neither, however, has the typical Hollywood version of mental illness. Pat’s bipolar disorder and Tiffany’s unnamed condition manifest themselves in ways that are realistically, even heartbreakingly mundane, Tiffany texts relative strangers for booty calls when she gets depressed and Pat channels his mania into long jobs and rants about Hemingway. Yet the film has generated controversy among some viewers about its portrayal of mental illness.

Evidence & citing: Dr.Steven Schlozman, a Harvard Medical School psychiatrist when asked about the movie said “It’s Hollywood, so there are still going to be things that are there more for the story than for accuracy. But they did a very nice job of depicting manic depressive illness or bipolar disorder in somebody who is quite bright and who has limited but present insight on it. Only about 40 percent of people with bipolar disorder will look back on a manic episode and realize that they were manic”.

Topic sentence: Bipolar disorder also known as manic depression is a disorder associated with episodes of mood swings ranging from depressive lows to manic highs. Commentary: The exact cause of bipolar disorder isn’t known but a combination of genetics, environment and altered brain structure and chemistry may play a role. It is very common, as there are almost more than 10 million cases per year in India. Treatment can help but this condition can’t be cured. It is chronic and can last for years or even a lifetime. It requires medical diagnosis. Any kind of lab tests and imaging is not required. The symptoms of manic episodes are high energy, reduced need for sleep and loss of touch with reality. Depressive episodes may include symptoms such as low energy, low motivation and loss of interest in daily activities. Mood episodes last days to months at a time and may also be associated with suicidal thoughts. The treatment is usually lifelong and often involves a combination of medications and psychotherapy. Some of the therapies include Support group, Cognitive behavioral therapy, Psychoeducation, Family therapy and Psychotherapy. Anticonvulsant, Antipsychotic and SSRIs can be used as medications. The person suffering from bipolar disorder can be hospitalized for supportive care.

According to the American Psychiatric Association, there are four major categories of bipolar disorder: bipolar I disorder, bipolar II disorder, cyclothymic disorder and bipolar disorder due to another medical or substance abuse disorder. Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include: Having a first-degree relative, such as a parent or sibling, with bipolar disorder. Periods of high stress, such as the death of a loved one or other traumatic event. Drug or alcohol abuse. Bipolar may worsen with age or over time if this condition is left untreated. As time goes on, a person may experience episodes that are more severe and more frequent than when symptoms first appeared. Without effective treatment, bipolar disorder can cause severe high and low mood episodes. The symptoms of these episodes may negatively affect a person’s life. Bipolar disorder may also increase the risk of self-harm and suicide. Studies report that some people with bipolar disorder have complained of memory impairment during high moods, low moods and at times in between. As a person’s mood shifts, they may report changes in their memory, too. As the mood becomes more extreme, memory problems can increase. The blood of bipolar patients is toxic to brain cells and affects the connectivity ability of neurons, a new study shows. The blood of the bipolar patients is toxic to brain cells and may affect the connectivity ability of neurons.

Conclusion paragraph: In conclusion, anyone can get bipolar including children and teens. There is a higher chance of persons having bipolar disorder seeking help when they are depressed than when undergoing mania or hypomania. Thus, a careful medical history is necessary to affirm that bipolar disorder is not erroneously identified as major depression.

References:

• Jones, S., Deville, M., Mayes, D., & Lobban, F.(2011). Self-management in bipolar disorder, the story so far. Journal of Mental Health (Abingdon, England), 20(6), 583-592.
• Wilkinson, G.B., Taylor, P., & Holt, J.R. (2002). Bipolar disorder in adolescence: Diagnosis and treatment. Journal of Mental Health Counseling, 24(4), 348-357.