Mood Disorders and Bipolar Disorder

The movie "Silver Linings Playbook" (2012) tells the story of Pat Solitano (Bradley Cooper), a man who is released from a psychiatric hospital after being diagnosed with bipolar disorder. Pat is determined to get his life back on track, but he struggles with his anger and his inability to control his emotions. Pat moves back in with his parents and starts attending therapy sessions. He also meets Tiffany Maxwell (Jennifer Lawrence), a young widow who is struggling with her own mental health issues. Tiffany and Pat form a bond, and they help each other to heal. Clinical Syndrome: Bipolar disorder is a mental illness that causes extreme mood swings, including emotional highs (mania) and lows (depression). People with bipolar disorder may also experience changes in their energy levels, sleep patterns, and thought patterns. Diagnostic Criteria: According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnostic criteria for bipolar disorder are as follows:

• A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary).
• During the period of mood disturbance, three (or more if the mood is only irritable) of the following symptoms must be present to a significant degree and represent a change from usual behavior:
  • Increased self-esteem or grandiosity.
  • Decreased need for sleep (e.g., feels refreshed after only 3 hours of sleep).
  • More talkative than usual or pressure to keep talking.
  • Flight of ideas or racing thoughts.
  • Distractibility (i.e., attention is easily drawn to irrelevant or unimportant stimuli).
  • Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation.
  • Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).
• The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent self-harm or harm to others.
• The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse or a medication) or to another medical condition (e.g., hyperthyroidism).

How Pat Solitano Meets the Diagnostic Criteria for Bipolar Disorder:

• Abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week: When Pat is first released from the hospital, he is in a manic state. He is extremely talkative, energetic, and impulsive. He also has delusions of grandeur and believes that he is destined to be a famous writer.
• Increased self-esteem or grandiosity: Pat believes that he is better than everyone else and that he is destined for great things. He is also very arrogant and dismissive of others.
• Decreased need for sleep: Pat can go days without sleeping and still feel energetic.
• More talkative than usual or pressure to keep talking: Pat is always talking and he has difficulty listening to others. He often interrupts people and talks over them.
• Flight of ideas or racing thoughts: Pat's thoughts are constantly racing and he has difficulty focusing on one thing at a time. He often jumps from one topic to another and his speech can be difficult to follow.
• Distractibility (i.e., attention is easily drawn to irrelevant or unimportant stimuli): Pat is easily distracted and he has difficulty staying focused on tasks. He is also very impulsive and he often acts without thinking.
• Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation: Pat is very active and he has a lot of energy. He is also very impulsive and he often acts without thinking.
• Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments): Pat is very impulsive and he often engages in risky activities, such as gambling and drinking. He also has a history of violence and he has been arrested for assault.

Conclusion: Pat Solitano clearly meets the diagnostic criteria for bipolar disorder. He experiences extreme mood swings, including mania and depression. He also has difficulty controlling his emotions and he often acts without thinking. Pat's bipolar disorder has had a significant impact on his life, but he is determined to get better. With the help of Tiffany and his therapist, Pat is able to start managing his symptoms and rebuilding his life.  

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