Movies provide us with endless entertainment and there is not many
people that can say they don't like to get under a warm duvet on a cold day,
make some popcorn and watch a marathon of movies. Many movies have portrayed
mental disorders or have had mental disorders as underlying themes, some paint
a great picture of what these disorders are truly like but most paint an
unattractive and inaccurate picture. You may be wondering why this is a problem
because "It's just a movie right?" but research has proved that most
people get their knowledge and perceptions about mental illness from these
types of movies. This results in them having this fear of and
discrimination towards people with mental illness feeding directly from the
perspective they have had painted from them in their minds from a movie they
have watched. These movies don't only cause damage to the viewers and their
perceptions, it also leads to discrimination of people living with mental
illness as a result of the stigma that has become attached to it.
We were requested to do an essay on a movie depicting a mental illness
focusing on how accurately the movie depicted the particular mental illness
with reference to the DSM IV criteria. I did mine on Silver Linings Playbook
and below is the essay that I wrote. It should give some insight into the issue
that I am talking about here. Quite honestly though if I weren't studying OT I
would not know any better and my perception of mental illness would be the one
was given to me from the media. So here it is:
Silver linings playbook is a film
about a man, Pat, who snaps upon discovering his wife in the shower with
another man and in pure rage beats the man almost to death. As a result he
loses his job and is sent to a mental health facility when it is discovered
that he has undiagnosed bipolar mood disorder. After eight months of treatment
he is released from the facility into the care of his mother and father. He soon
learns that his wife has left him and obtained a straining order against him
after the violent episode. He is determined to get his life back and to
reconcile with his wife. The main focus of the analysis will be on how the main
character Pat displays symptoms common in bipolar mood disorder during the
film.
People
with bipolar disorder can experience both manic and depressive episodes due to
the fact that it is a mood disorder that involves both ends of the spectrum.
Pat displays characteristics typical of a manic episode throughout the film. The
following are common symptoms displays during a manic phase:
- “Excessive happiness, hopefulness, and
excitement
- Sudden changes from being joyful to being
irritable, angry, and hostile
- Restlessness, increased energy, and less need
for sleep
- Rapid talk, talkativeness
- Distractibility
- Racing thoughts
- High sex drive
- Tendency to make grand and unattainable plans
- Tendency to show poor judgment, such as
impulsively deciding to quit a job
- Inflated self-esteem or grandiosity -
unrealistic beliefs in one's ability, intelligence, and powers; may be
delusional
- Increased reckless behaviors (such as lavish
spending sprees, impulsive sexual indiscretions, abuse of alcohol or
drugs, or ill-advised business decisions)
Some people with bipolar
disorder become psychotic, hearing things that aren't there. They may hold onto
false beliefs, and cannot be swayed from them.” (Goldberg, 2012)
At the
beginning of the film Pat is in denial about his illness which is a common
symptom for patients with a mental illness and serves as a defence mechanism
for them. It is very common for patients in the recovering process to begin
lacking in compliance with their medication as they begin to feel better. This
is not only an issue of denial but also a lack of intellectual insight into
their condition. For patients with bipolar it is hard to find a reason to take
medication if they do not have insight into the fact that there is something
wrong with them. This is displayed by Pat in the movie through actions such as
spitting out his pills when no one is watching, arguing with his mom about
going to therapy and saying “I am not sick, I do not want help” as well as when
another character in the movie who is also mentally ill says to him “I’m like
you” his reaction is one of pure shock and offense as he does not believe that
he has an illness and is “crazy” like her. These all display to us that Pat is
in denial and is extremely defensive when it comes to accepting that he has a
mental illness - he does not think he is sick, he is angry with his doctors and
does not want their help and believes that he can beat his illness on his own
which tells us that he has decreased intellectual insight into his condition
which is a typical symptom of bipolar disorder. (Watkins, 2012)
During a
manic phase patients can present with an elevated mood and hyperactivity where
they have delusions of grandeur, meaning they have an inflated self-esteem and
feel they are invincible and are superior to others. This leads to
characteristics such as having a decreased need for sleep, channelling of their
increased energy into a particular behaviour or task as well as disturbances of
speech such as flight of idea’s, pressured speech and loosening of
associations. In the film Pat has no desire to sleep and stays up all night
reading only sleeping for short periods of time when he does go to sleep. Pat
also runs excessively. He goes for extremely long distance runs every day
during which he wears a black plastic bag so that he can sweat more in order to
lose weight which he explains is so that he can get into shape for Nikki his
ex-wife. Pat also displays disturbances in his speech as throughout the film he
talks incredibly fast rarely stopping to take a breath. He is also grandiose in
the film which is evident in a particular scene in the movie when he passes the
comment “Maybe people like me, Dani and Tiff (all characters in the film with
mental illnesses) know something you guys don’t know. Maybe we understand
something you guys don’t”. This displays that he believes he is superior and
has some form of “super power” that the average normal person does not. These
indicate to us that Pat meets the criteria for mania as he does not sleep, he
is grandiose and he has pressured speech.
Patients
experiencing a manic episode not only have impaired intellectual insight but
also impaired emotional insight. This can be combined with impaired judgement
resulting in behaviours and features such as not considering other people and
their feelings, not understanding the consequences of their behaviour and often
being intrusive and tactless. These particular characteristics are very evident
in the film. Pat upon finding his wife in the shower with another man nearly
beats the guy to death. This seems like a perfectly normal and explanatory
reaction to such a situation however it is his reaction to the situation
afterwards that shows us that his behaviour is abnormal and is characteristic
of a manic episode. After being released from the facility Pat believes he is
going to get Nikki his ex-wife back, he lacks insight into the situation and
does not understand the consequences of what he did. He cannot recognise that
what he did was over the top seen through his confusion and disbelief as to why
his ex-wife would have a restraining order against him. He believes he can get
her back by simply reading every book in her syllabus. Pats impaired judgement
and emotional insight is also displayed when he gets angry about the ending of
one of the books he was reading and consequently wakes his parents up in the
middle of the night and throws rage at them because of this frustration. It is
acceptable to get frustrated over a book however it is inappropriate to throw
the book through a window, wake up your parents and scream and shout at them
about it. Pat also makes inappropriate comments to people such as when asking
another character about her husband’s death he up right says “how did Tommy
die” and saying blatantly to his friend that “his marriage is a f**k up” and “you are the problem”. This therefore clearly
displays Pat’s inconsideration, tactlessness and lack of understanding of the
consequences of his behaviour on other people. (Watkins, 2012)
Often
during a manic episode patients can be emotionally labile meaning their
emotions fluctuate randomly often resulting in unpredictable moods that can be
explosive and aggressive. Pat during his rage over the ending of the book hits
his mother and ends up in a tussle with his father after which he suddenly
breaks down and cries. Another situation where this symptom of mania comes in
is when he accompanies his brother to a football match during which his doctor,
who he happens to bump into there, gets into argument with a group of men
resulting in Pat getting involved in an aggressive fight with these men due to
him being unable to contain his anger.
As
previously stated bipolar mood disorder involves both ends of the mood
spectrum. Throughout the film Pat only displays symptoms characteristic of a
manic episode but there is no alternating to periods of depression. Pat never
goes through a period of isolation, loss of interest in activities, suicidal
ideation or feelings of extreme worry and emptiness. The movie only hints that
he may have been in a depression previous to his admission into the facility
when he is sitting in his psychologists room and explains how the week before
the incident with his ex-wife having an affair he called the cops and told them
his wife and the history teacher were plotting against him which he himself
states was not true but was actually a delusion. It is common for people in a
depressive state to experience delusions however Pat’s particular delusion of
paranoia is only one indication and there is not enough evidence to say that he
experienced a period of depression.
The film
therefore creates a good picture of the manic side to bipolar disease however
it does not capture the entire spectrum of what bipolar disease is in terms of
the alternating from mania to depression on a cyclic basis. This may give
viewers who have limited knowledge about mental illness an incorrect perception
of this particular disorder. In this film it could be said that Pat is in
actual fact just experiencing traumatic stress after the incident that happened
and is therefore experiencing a manic episode as a result of this. Bipolar mood
disorder has its name because of the two “opposite sides” it has to it and so
the film needed to include both of these in order to truly depict this mental
illness. (Stewart, 2013)
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