Shruti Bansode
‘Silver linings playbook’, a movie released in 2010 portrays an insight into having bipolar disorder and its effects on family members. The protagonists are played by Bradley Cooper as ‘Pat’ and Jennifer Lawrence as ‘Tiffany’. The film commences with Pat returning home from a psychiatric residential facility as a plea for beating his wife, Nikki’s boyfriend for cheating. During his sentence, he is diagnosed with delusional and bipolar disorder (BD), hence therapy, medication and exercise help him in treatment. He has been given a restraining order to stay away from Nikki for her safety. Simultaneously, Pat’s love interest Tiffany is facing depression and borderline personality disorder (BPD) due to her husband’s death.
Exercise and Bipolar Disorder
The movie speaks of Pat’s physical transformation. He gained weight before being diagnosed this indicates that people with BD have a sedentary lifestyle, which can be linked to added comorbidities-a lower quality of life, reduced functioning and increased symptoms of bipolar disorder (Carneiro et al, 2016; Ho et al, 2016). During his sentence, he focuses on exercises to improve his condition. Therapy for BD is based on pharmacological and non-pharmacological interventions (Geddes and Miklowitz, 2013; Kendall et al., 2014; McCormick et al., 2015), with exercise being non-pharmacological. This approach is supported by exercise's anti-inflammatory qualities, additionally the significant comorbidity of obesity, diabetes, hypertension, and cardiovascular disease worsened by psychotropic action (Morriss and Mohammed, 2005; Petersen and Pedersen, 2005).
“You’ve changed, lost a lot of weight”, “he is unrecognizable”, and “you look good”- some comments passed on Pat’s transformed appearance indicating his physical transformation. Pat is seen going as far as refusing to consume his medicines because they made him bloated. The medicines also made him dizzy, resulting in him not being able to exercise. These behaviours may allude to pat feeling dissatisfied with his body. This explains that Pat experienced dissatisfaction with his body image. BD patients specifically have more extreme anxieties about their bodies than those with severe depressive disorder (Pan et al. 2018). The restraining order ensured an emotional disconnect with his wife inducing mania. The emotional trauma intensifies their concerns about appearance which is closely linked to sadness (Ji et al. 2012) which Pat felt strongly about.
Mood and Bipolar Disorder
Extreme mood swings brought on by mania or hypomania (formerly known as manic depression) and emotional lows (hypomania) are symptoms of bipolar disorder (depression) (Mayo Clinic, 2021). In a scene, Pat reads a book, and angry with the ending he throws it outside the window, at 4 am wakes his old parents to rant- insomnia and mania. Moreover, he assumes his dad is hiding Pat’s wedding videotape, unable to find it- frustrated, hyperactive, and yelling. He could hear his wedding song in his head, and unable to control his nerves, he mistakenly hits his mom, then hits his dad as well and begins to apologize and cry.
Bipolar illness Daily mood swings are significantly more pronounced and can be quite challenging to moderate. They won't be able to calm down or find comfort for very long periods of time, and their mood can shift abruptly. These feelings may include great excitement followed by furious rage or sadness as seen with Pat. They might start talking very quickly and be unable to concentrate on a specific topic of conversation. When a bipolar individual has a depressive episode, their emotions change to intense melancholy and low self-esteem (Bipolar Disorder Mood Swings: Triggers & Coping Strategies, n.d.).
Genetics and Bipolar Disorder
Support from one’s loved ones is extremely pertinent when battling BD. BD is an inheritable illness with the dysfunction of the limbic-cortical system, and neurotransmitter systems (especially those involving dopamine and serotonin). The ability to control emotion may be affected, namely, by increased activity in the amygdala and decreased activity in the frontal-cortical areas (for review, see Miklowitz & Johnson, 2006). The family intervention of communication, medication adherence, problem-solving, intervention at an early stage and reassurance improves the condition (Miklowitz, 2007).
Simoneau, Miklowitz, and Saleem (1998) showed that in families with minimal emotional expression (EE), responses to unfavourable statements made by family members or patients were likely to be neutral or supportive. Low-EE family members were able to successfully stop unfavourable interactions before they got out of hand. In contrast, low-EE families communicated negatively quickly, leading to bidirectional outbursts.
Identifying Depression in Tiffany
The movie doesn’t explicitly address Tiffany’s condition, however, symptoms directed towards depression after the death of her spouse, Tommy. She is sad, hopeless, easily irritated, lack of sleep and appetite as she only orders tea for dinner. Younger widows and widowers are at higher risk of having depression after the death of their spouse, as seen with Tiffany (Zisook & R Shuchter, 1991). As she feels lonely due to self-isolation and abrupt life changes, she is sexually active with various colleagues- increasing her vulnerability. Notwithstanding, proven by GAD-7 and PHQ-9 scores by Mollaioli et al., (2021) sexual activity decreases psychological distress. In Tiffany's case, it was a temporary distraction from feeling the pain, until she found a friend, Pat. Pat and Tiffany understood each other’s condition to a great extent.
The movie is themed around ‘excelsior’, which means ever upwards. It is interesting as both characters believe in improvement, optimism and want to feel better. They are individually and together helping one another overcome their condition. It is very difficult to have a positive attitude and especially stay determined to find ways of improving, for instance running for Pat and dancing for Tiffany. Acknowledging their suffering and finding ways to feel better is depicted by all characters making the film a solid hit.
References
American Psychiatric Association. (2022). Psychiatry.org - DSM. Psychiatry.org. https://psychiatry.org/psychiatrists/practice/dsm
Bipolar Disorder Mood Swings: Triggers & Coping Strategies. (n.d.). Www.bakersfieldbehavioral.com. Retrieved October 17, 2022, from https://www.bakersfieldbehavioral.com/node/3028
Mayo Clinic. (2021, February 16). Bipolar disorder - symptoms and causes. Mayo Clinic; Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955
Melo, M. C. A., Daher, E. D. F., Albuquerque, S. G. C., & de Bruin, V. M. S. (2016). Exercise in bipolar patients: A systematic review. Journal of Affective Disorders, 198, 32–38. https://doi.org/10.1016/j.jad.2016.03.004
Miklowitz, D. J. (2007). The Role of the Family in the Course and Treatment of Bipolar Disorder. Current Directions in Psychological Science, 16(4), 192–196. https://doi.org/10.1111/j.1467-8721.2007.00502.x
Mollaioli, D., Sansone, A., Ciocca, G., Limoncin, E., Colonnello, E., Di Lorenzo, G., & Jannini, E. A. (2021). Benefits of Sexual Activity on Psychological, Relational, and Sexual Health During the COVID-19 Breakout. The Journal of Sexual Medicine, 18(1), 35–49. https://doi.org/10.1016/j.jsxm.2020.10.008
Pan, B., Zhang, B., Tsai, H., Zhang, Q., Yang, R., Yang, Y., Wang, C., Jia, Y., & Wang, W. (2019). BODY IMAGE CONCERNS IN BIPOLAR I AND II DISORDERS: THEIR RELATIONSHIPS WITH PERSONALITY STYLES AND AFFECTIVE STATES. Psychiatria Danubina, 31(1), 37–42. https://doi.org/10.24869/psyd.2019.37
Wayda-Zalewska, M., Kostecka, B., & Kucharska, K. (2021). Body Image in Borderline Personality Disorder: A Systematic Review of the Emerging Empirical Literature. Journal of Clinical Medicine, 10(18), 4264. https://doi.org/10.3390/jcm10184264
Zisook, S., & R Shuchter, S. (1991). Depression through the first year after the death of a spouse. American Journal of Psychiatry, 148(10), 1346–1352. https://doi.org/10.1176/ajp.148.10.1346
Comments
Post a Comment