Silver Linings Playbook (2012)
Silver Linings Playbook (2012)
Silver Linings Playbook is a romantic and a comedy-drama film produced in 2012 by David O. Russell. The film was adopted from the novel “The Silver Linings Playbook” written by Matthew Quick. The film is based on the main character Pat Solatano Jr, who is released from a mental health facility in Baltimore after undergoing eight month treatment for bipolar disorder. He returns home to her mother Dolores and father Pat Sr, who takes care of him after being discharged from a mental health facility. After return, he notices that his wife Nikki had moved away. He seems determined to bring his life back to normal, and with hopes to reconcile with Nikki. Nikki moved away after his husband violently assaulted her. His therapist D.R Cliff explains the reasons why Pat was hospitalized. Pat was a teacher. After engaging into conflict with the school’s principal, he decided to go home, only to be shocked when he found his wife romancing in the shower with a history teacher from his school. He beat the man almost to death. Despite this encounter, Pat stated that he was okay and has decided to take a new outlook on life. However, life was still challenging for him. This attempt to look for goo or silver linings developed the title for the film.
As depicted in the film, Pat was confined to a psychiatric institution for eight months. Now, Pat has completed the detention and he has no job, but to stay with his parents. Despite the previous disaster, Pat thinks that he can have a good life to a silver lining, if he stays positive. After a close look at the Diagnostic and Statistical Manual of mental disorder, the character is not only suffering from bipolar disorder, but also an intermittent explosive disorder (DSM-V-TR: American Psychiatric Association, 2000). The estimated life time prevalence of bipolar disorder is at 3.9 percent and that of intermittent explosive disorder is estimated at 5.2 percent in U.S (Kessler, et al, 2005). There is enough evidence seen in the films scenes to prove that Pat had also intermittent explosive disorder. For example, Pat flies into several ranges; he gets a fight at the football game, and hits his parents.
It seems that Pat is not the only person with mental problems in the family. His father Pat Sr. is also an intermittent violent man. He has a gambling disorder and obsessive compulsory disorder. He is deeply sunk into superstitions. He thinks he can place a bid and win the bets for his favorite tem “The Philadelphia Eagles”. He engages himself with unlike imaginations even where his best team has no probabilities of winning. His brother also has some mental problems. The only mentally normal person in the family is his mother, Jacki Weaver, who has tirelessly worked to ensure Pat regains his normal life.
Pat seems affected by the disorder in several occasions. For example, he looks at himself and thinks of how he can reconcile with his wife. He tries to do things that will attract her by the look. For example, he plans to lose weight in order to become attractive. He also tries to read all the literature books that his wife undertakes in her course. In the film, Pat is seen reading a hardcover book of Hemingway’s (1929) a farewell to Arms. When he completes reading the book, he breaks the window when he throws the book out of it because he is furious that the Protagonist’s woman-friend dies. At four o’clock, he burst in their parent’s bedroom complaining against Hemingway. This reveals that, the bipolar disorder does not only make one sleepless, but also lack of consideration for others.
When Pat visits her sister Tiffany, who has also been suffering from depression, they discuss about the side effects of the psychiatrist drugs they were recommended to be taking. Their conversation took place while taking dinner. They agreed that the drugs make one confused, which is worse that the disease they are meant to treat. When Pat is in the institution, he is given a pill, puts it under the tongue and then spits it out when he realizes that no one is watching. When someone is suffering from a bipolar disorder, he/she thinks is not sick and that is treated for a disease he/she does not possess. They think they are okay, but this is not the case. The relationship between Pat and Tiffany grew stronger. He makes a commitment to Tiffany to help her dance for the competition that was ahead. He helps her with a promise that she would take a letter to his wife. He worked harder at dancing and he becomes calmer and focused.
There is a positive message that viewers can grasp from this movie. The director stresses the importance of relationship for recovery from bipolar disorder. When individuals are subjected to a plan of activities, they becomes more focuses and calmer, thereby, improving their mental status.
DSM-5 Diagnosis Criteria for Pat
According to the fifth edition of Diagnostic and Statistical Manual of mental disorder, bipolar disorder can be classified as either bipolar I or bipolar II. Bipolar I disorder is characterized by at least one manic episode, or in a mixed episode characterized by distinct depressive features. Bipolar II disorder is characterized by one or two depressive episodes of depression, and at least one hypomanic episode (Martin & Smith, 2013). In 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorder was introduced, and made changes to the criteria of diagnosing mental illnesses. In the case of Pat, his bipolar disorder can be described as bipolar I, which is characterized by at least one manic episode and other depressive features. The symptoms for manic includes, decreased need for sleep. In the film, Pat spends a whole night reading various books of literature, and when he complete reading the book written by Hemingway, he gets enraged and go in his parents’ bedroom at four o’clock to disrupt their sleep. He spends most of the night without sleeping. The second symptom for bipolar I is distractibility. Attention is pulled by simple and irrelevant things. For example, Pat gets furious because the Protagonist’s woman-friend dies. He becomes too disturbed such that he could make noise and distract his parents’ sleep. The third symptom of manic episode is when individuals increase in goal-directed activity. For example, when Tiffany tells Pat to help her practice dancing, he accepts on condition that she would take a letter to his wife. He becomes committed in dancing since he knows at the end; his sister will take the letter to his wife. These episodes reveals that Pat was suffering from bipolar I disorder. In DSM-5, the criterion for manic and hypomanic also includes changes in mood and energy (American Psychiatric Association, 2013). DSM-5 is based on specified bipolar and related disorder. The criteria have specificity for anxious distress, and can be used to differentiate patients with anxiety symptoms, which are not part of the bipolar disorder. This method also specifies other critical symptoms of bipolar disorder such as anxiety, binge eating, risk taking behaviors, and cognitive problems, among others. This explains why Pat engaged himself with risk taking behaviors such as beating his parents, and violently behaving in a football pitch.
Best Treatment for Pat
Bipolar disorder cannot be cured, but the patient can be treated effectively for a long time. Even though proper treatment can be given, mood changes can occur. Mostly, the best treatment program for bipolar disorder is the NIMH-funded System Treatment Enhancement Program (STEP-BD) (Perlis, et al, 2006). It is a long term outpatient program aimed to study a combination, or the best treatments, which are effective for treating episodes of mania and depression. The program is also aimed to prevent the recurrence of episodes for patients with bipolar disorder. STEP-BD support researchers to assess different options available for the treatment of bipolar disorder such as psychosocial interventions, mood stabilizing medication, atypical antipsychotic medications, and antidepressants (Perlis, et al, 2006). These options depend on the symptoms revealed by the patient. The program entails a combination of best available options for the treatment of bipolar disorder, depending on the symptoms and the intensity of the disorder. The medication administered to patients is determined by the intensity of the disorder and the type of the STEP-BD option of treatment being chosen. Most of the used medications include the mood stabilizers such as Lithium also referred to as Lithobid, or Eskalith, which are used for the treatment of both depressive and manic episodes. The STEP-BD method could hold efficient for treating Pat up to the recovery moment.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC.
American Psychiatric Association. (2013). Highlights of changes from DSM-IV-TR to DSM-5. Accessed April 30, 2014.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM–IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62, 593–602. doi:10.1001/archpsyc.62.6.593
Perlis RH, Ostacher MJ, Patel JK, Marangell LB, Zhang H, Wisniewski SR, Ketter TA, Miklowitz DJ, Otto MW, Gyulai L, Reilly-Harrington NA, Nierenberg AA, Sachs GS, Thase ME. (2006). Predictors of recurrence in bipolar disorder: primary outcomes from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatry V. 163(2):217–224.