Silver Linings Playbook was a film released in 2012 that examines mental illnesses through the characterization and depiction of Bipolarism. Pat Solatano play by Bradley Cooper in the film lost his wife and job and was just released from a mental institution to return home to his parents. He later acknowledges that this is his illness and wants to be in control of it. He goes through a series of ups and downs and eventually meets Tiffany (Jennifer Lawrence) who ends up being a good thing in his life. While Bipolarism is the mental illness the main character is battling, it is important to understand that other characters have some sort of mental illness on a spectrum. Tiffany demonstrates depression with borderline personality in the film. It is essential to understand from a clinical perspective what mental illness consists of in order to identify how effectively it is depicted in the film.
“Bipolar disorder is characterized by mood swings from profound depression to extreme euphoria (mania); with intervening periods of normalcy” (Townsend, Morgan, 2018, p.534). Mania is the elevated periods where clients can experience symptoms of erratic, and irritable moods, increased goal directed behavior, and grandiosity. Hypomanic episodes can be milder than manic episodes and may not affect daily functioning. Certain individuals can be predisposed to bipolar disorders due to a family history, or biochemical factors such as genetics and brain structure and function. Treatments for this diagnosis usually include a combination of drugs such as mood stabilizers, atypical antipsychotics, and antidepressants. A widely used mood stabilizer is Lithium which has a narrow therapeutic range of 0.6-1.2 mmol/L. This is important to keep in mind as a clinician because blood levels have to be checked in order to avoid toxicities. Other psychotherapies include family therapy, group therapy, and cognitive therapy.
In addition to psychotherapies and medications, the recovery model is a form of “obtainable objectives” to aid in treatment (Townsend, Morgan, 2018 p. 548). The approaches include aspects a nurse can implement into a plan of care for a client presenting with Bipolarism. Making the client self-aware of their illness, becoming an expert on the disorder, taking medications regularly, identifying source of stress and reducing it, and knowing when to get help are a few steps the nurse can take to help the patient in understanding goal outcomes. With the client aware of these strategies, he/she can better take control of their illness.
In Silver Lining, Bipolarism is portrayed fairly accurate. While Pat was in the mental institution, while receiving his medication he slips it under his tongue and does not ingest it. This is a pretty accurate description of what takes place in institutions and hospital units. Another scene in the film when Pat and Tiffany were at the dinner table talking about medications is a important scene. Tiffany asks Pat what medications he’s on and he responds with “nothing now”, He also states he was on Lithium, Seroquel, and Abilify. These are anti mania, antipsychotics that a true client with bipolar disorder would take. This scene is a good demonstration of reality for a lot of mental health patients. Pat and Tiffany continue to joke about taking Klonopin and Trazodone which are sedatives that may also be used as antidepressants. This helps clue in both of their diagnosis implying they both needed sedatives and antidepressants to manage their symptoms.
Furthermore, Pat’s manic exacerbations are seen in the Hemingway scene where he throws the book out the window and wakes his parents up in the middle of the night and goes on a rant about the book’s ending. He talks excessively and frantically walks back and forth. He experiences a flight of ideas evident in his demeanor, how he talks, and facial expressions. These are classic manic symptoms, which is also seen in a scene where he looks for his wedding tapes. Pat, during a therapy scene states he had delusions in the past when discovering his diagnosis states, he had “mood swings with weird thinking brought on by severe stress which is rare” Verbalizing the condition he has and understanding why is critical for better treatment and is a perfect example of utilizing The Recovery Model.
Overall, the comedy-drama does a fairly well job of demonstrating the reality of mental illness with some aspects exaggerated for entertainment purposes. Watching this film has definitely made me become more aware of what signs a person could exhibit with Bipolarism. This is eye-opening for me because it took theoretical and didactical information turned it into clinical manifestations. Triggers, stressors, or stressful situations could happen to anyone and whether I am there for initial diagnosis or in the middle of treatment it is essential I recognize possible signs and this movie has allowed me to do that.
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