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Silver Linings Playbook

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by

Holly Staunton

on 14 November 2013

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Transcript of Silver Linings Playbook

Characters:

Bradley Cooper plays Pat, a middle school teacher who returns to his parents' house in the suburbs of Pennsylvania after eight months in a mental instution.

He comes home against doctors wishes, and is still obsessed with keeping a positive attitude in hopes his estranged wife will come back to him.
Characters:
Jennifer Lawrence plays Tiffany, a recent widow that Pat meets at his bestfriend's house.
As a way of "dealing" with her husbands death she resorts to having sex with multiple people, subsequently losing her job.
Reason for Pat's breakdown:
Pat walked in on his wife, Nikki, in the shower with another man, who told him he should leave. Enraged, he nearly beat the man to death. This is what landed him in the mental institution. As well as a restraining order from his wife.
Pats DSM 5 Diagnosis:
Bipolar 1 Disorder, manic episodes.
He shows many manic episodes through out the movie.
However, he never really shows depression, just signs of defeat and then rage that follows.

Pat's GAF Score:
11-20

Throughout the movie once Pat is released from the mental institution, you see many of the people he comes in contact with are avoidant of him and a little scared of how he may react once they come in contact with him.
Pat's Epidemiology
and Etiology
Onset: When an individual has experienced at least one manic episode in his/her lifetime. A manic episode is a period of abnormally elevated mood accompanied by abnormal behavior that disrupts life.
Prevalence: about 2.5% of the United States population suffer from bipolar disorder; most common in teens and early 20's when symptoms appear.
Causes: Unknown, although symptoms are thought to be triggered by an imbalance of chemicals in the brain.
Pat's Epidemiology
and Etiology:
Prognosis: Can be severe and long term or it can be mild with in frequent episodes.

Treatment: No cure for bipolar; it is a life long and recurrent illness and needs to be treated long term to maintain control.
Tiffany
DSM 5 classification:
Major Depressive disorder/Borderline Personality disorder
Rapid mood changes
Easily angry
Referred to as a "sex addict"
Impulsive and compulsive self-destructive activities like unsafe sex and substance abuse.
History of self harm
Difficulty having stable relationships
Tiffany's GAF scale:

23
Serious impairment in communication and judgement, acts inappropriately, inability to function in almost all areas (No job, self harm, public outbursts).
Tiffany's
Epidemiology & Etiology
Begins no later then adolescence

Equally found in men and women
(Originally thought to be a women's disease)

Prevalence of Borderline personality disorder is about 1.6% of the general population.
Causes for borderline personality disorder:
Genetics

Parental Relationships

Biological
If someone has borderline disorder their first degree biological relative is 5 times more likely to have it as well.
Borderline Treatment:
If suicidal thoughts are prevalent then hospitalization should be required.

The most popular form of treatment is psycho-therapy through Dialectical Behavior Therapy which seeks to teach the client how to take control of their own lives, emotions, and themselves through self-knowledge and emotion regulation.

Drug therapy can be helpful, but the possibility for suicide attempts make this treatment controversial.
References
Cormer, R. J. (2013). Fundamentals of abnormal psychology. (7th ed.). New York, NY: Worth Publishers.
Fear of abandonment in people with the disorder suggest early parental relationships to be a cause, relating to neglect and abuse.

Has also been linked to biological abnormalities, such as an overactive amydala (structure tied to fear, megative emotions.
Lower brain serotonin activity in those who are particularly implsive.

Underactive prefrontal cortex (linked to planning, self-control, decision-making).
http:/psycentral.com/lib/borderline-personality-disorder-treatment/0001065
http://www.mentalhealth.com/dis/p20-pe05.html
Full transcript