Why "Silver Linings Playbook" Deserves an Oscar

By Lee Wolfson, M.Ed., Psychological Counseling and Referral Services, University of Pittsburgh School of Medicine

Who doesn’t love Jennifer Lawrence and Bradley Cooper, not to mention Robert De Niro?  But beyond the star-studded cast, Silver Linings Playbook gave genuine insight into what it’s like to live with bipolar disorder, and how it affects family members.

Often in movies, mental illness such as bipolar disorder is misrepresented and stereotypes don’t get it right.  Yet this is the first movie I’ve seen in a long time that really captured the nuances of somebody living with bipolar disorder.

To start, there are two kinds of bipolar disorder: bipolar I, which is characterized by distinct periods of severe mood swings from mania to depression, and bipolar II, a milder form of mood episodes. Bradley Cooper, who portrays a man named “Pat” in the movie, falls into the former category.

Individuals undergoing a manic episode may display some of these behavior:

• Rapid, pressured, speech
• Quickly changing from one idea/topic to another(racing thoughts)
• Increased energy and a decreased need for sleep (think how often Pat goes for a jog in the movie!)
• Goal driven behavior without regard for consequences

In the movie, Pat’s speech is pressured and driven, and at times he was unable to filter his thoughts; he often had a one-track mind.  For example, the only thing that mattered to Pat was getting his marriage back together, but he didn’t have the ability to see that his wife was cheating on him.  He came home one night looking for his wedding video, displaying a single-focused energy where he couldn’t stand to be impeded (he even unintentionally hits his mother in the process).  This overstimulation is an accurate portrayal of individuals in a manic phase.  

The movie also addresses the challenges faced by friends and family of a loved one with bipolar disorder.  No one wanted to upset Pat because they feared sending him into a manic phase and sparking another violent episode, since he had previously beat up the man who was sleeping with his wife.  This fear shows the stigma about mental illness that is unfortunately still prevalent today.  Yet despite being frustrated with him, his family defended him, and wanted him to succeed and be happy. 

As for treatment options, Pat notes towards the beginning of the movie that his medications make him feel “cloudy” so he didn’t take them.  This is a common complaint of those with bipolar disorder: The challenge is that being manic is often like being in a state of euphoria – and yet they are being told that their feelings are disordered.  It’s easier to get someone’s attention and to have them take meds when they’re depressed.  Interestingly, it takes men more episodes of mania than women before they start to realize that they need medication to help them. After the manic episode where Pat searched for the wedding video and accidentally hurt his mom, he started taking his meds again.

Lastly, I love the role of the psychiatrist working with Pat.  Psychiatrists are often portrayed as aloof or arrogant, but the psychiatrist in this movie was great.  He worked to collaborate with the patient, and to form an alliance with the patient, e.g., he noted to Pat, “you need a strategy.”  This is an effective and real-life approach that works!

Sure, the movie was dramatized for Hollywood, and love can’t solve all problems.  But the movie showed the complexities of mental health disorders.  About 25 percent of us have a mental health illness or concern, and 2.6 percent of us are bipolar. That’s approximately 5.7 million people.  

At those rates, it’s important we all have a much better understanding of what those with bipolar disorder (and their families) go through.  That’s why this Sunday I’ll be rooting for Bradley and Jennifer to take home a golden statuette.