In 'Silver Linings Playbook,' Hollywood Finally Gets Mental Illness
Among the films nominated for Academy Awards this year is the quirky picture Silver Linings Playbook. It's quirky because it defies traditional categories of film. Part romantic comedy, part intense drama, the movie also provides a bit of education on a topic Hollywood historically covers disastrously: mental illness.
The movie follows Pat, played by best actor nominee Bradley Cooper, as he tries to rebuild his life after eight months in a psychiatric hospital. Overall, the treatment of mental illness is surprisingly good. Especially when compared to the usual fare, it's quite sensitive and accurate. If you've seen the film, place it against the visual backdrop of movies like One Flew Over the Cuckoo's Nest, Fatal Attraction, Misery, and Psycho. Silver Linings Playbook represents a dramatic improvement, portraying the characters who struggle with mental health as human, sympathetic, and in most ways ordinary—and with a lot of living left in the wake of diagnosis and hospitalization.
Although it's not perfect, Silver Linings Playbook does offer helpful lessons for anyone wanting to better understand mental illness and how it affects people in the real world:
Mental illness is common.
Several characters in this movie have mental health "issues." This might seem like Hollywood overkill, but it's fairly realistic, especially since much mental illness has hereditary components and tends to run in families. Most people don't realize just how common mental illness is: In any given year, just over 25 percent of American adults experience a diagnosable mental disorder. In addition, one in five children experiences a seriously debilitating mental disorder. Next Sunday, statistics say, one of the four people sitting next to you at church will be suffering with a mental illness.
Stigma is everywhere.
Unfortunately, although mental illness is highly treatable, less than 33 percent of people with such illness actually receive treatment. This is partially due to the difficulty many have in obtaining services, but it's also due to stigma. In the movie, Pat runs into this in several places: His brother and his friend didn't visit him in the hospital; his brother's friends mock him at a football game; and the teenager across the street keeps showing up at his house with a camera, mocking him but claiming he wants to interview him for a school project about mental illness. Pat even wrestles with his own stigma, especially when deciding whether to take the medications he needs. In our society, mental illness is ridiculed, dismissed, feared, marginalized, and ignored. It takes great courage for people to admit they need help and healing, let alone to go public with their efforts to manage an ongoing disorder.
Medication is a mixed blessing.
Pat provides a good illustration of the difficulty many people have with taking the medication they need. Especially once an initial crisis of symptoms has passed, many people want to believe they no longer need the medications that helped them reach a point of relative health. And psychiatric drugs can have powerful side effects, which sometimes feel just as bad as the symptoms of illness itself—or even worse.
Life goes on.
Despite their struggles with mental health, the two main characters, Pat and Tiffany (played by Jennifer Lawrence, who is also nominated), find themselves out in the real world, interacting with others and thinking about the future. They have not officially and permanently "lost it;" they aren't what our popular culture would call "deranged" or "lunatics." Pat, who suffers from bipolar disorder, has a relatively serious and chronic diagnosis, but he is not the mental equivalent of a "vegetable." Contrary to popular impression, a mental health diagnosis or hospital stay does not mean the end of a person's hopes for productive life. Most mental disorders are highly treatable, with common success rates up to 80 percent, especially with early intervention.
Neither does a struggle with mental health jeopardize a Christian's position before God. As Romans 8:35-37 assures us, "Can anything ever separate us from Christ's love? Does it mean he no longer loves us if we have trouble or calamity, or are persecuted, or hungry, or destitute, or in danger, or threatened with death?…No, despite all these things, overwhelming victory is ours through Christ, who loved us."
Though no depiction could possibly portray all the possible symptoms and expressions of mental illness, Silver Linings Playbook does have a few flaws when compared to the real-life experiences of many people. To be fair, some are due to the constraints of the movie format.
Pat engages in several public altercations and outbursts. With the exception of an initial event that got him incarcerated before the movie takes place, his encounters with law enforcement are fairly light-handed. In the real world, he probably would have been arrested at least once, especially as someone with a criminal record and a documented history of violence. In the chaos of domestic disturbances and public displays of rage, most law-enforcement officers are quick to remove a problem person from the scene. Pat's world was more forgiving of his problems than most people find the real world.
Also, the families in Silver Linings Playbook apparently had enough resources to absorb the costs of helping their loved ones stabilize and pursue health. For example, Tiffany converted her parents' garage into a dance studio to help her cope with depression. The cost of psychiatric medications didn't seem to be an issue. Neither did covering eight months of inpatient treatment. In real life, such expenses can sink a family right into poverty. And even court-appointed hospital stays are not necessary covered by the judicial system; families are on the hook. In some cases, medications can be so expensive, people have to choose between groceries and drugs. Especially considering so many people in the movie are unemployed (which is realistic for many people who struggle with mental illness), their ability to absorb such expenses does not reflect reality.
The movie focuses on high-intensity episodes and displays of symptoms that are apparent to the viewer. This is typical for bipolar manic episodes, which Pat experiences. But for real people with mental illness, including those who suffer with bipolar disorder, many symptoms don't express themselves in visible intensity. Many people suffer quietly, often through mind-numbing boredom or crushing depression. And most people with mental illness have plenty of days when they don't experience intense symptoms. Struggling with mental illness doesn't always mean losing control, usually doesn't create such exciting interactions between people, and typically doesn't mean living with the frequency and intensity of symptoms displayed in a two-hour movie.
Throughout the movie, we see Pat keep going because he has hope. He's looking for that silver lining—and because this is Hollywood, he finds it in romance. In real life, romantic love is not a cure for mental illness—nor is it always easy to find. But such relationships aren't the only place we can find hope. This is one of the things the church can offer people with mental illness—hope for now and for eternity. The world we live in is marred by sin, and we all feel its effects in our bodies and our minds. But someday that will all change, when we will experience the ultimate in healing, at the hands of the Great Physician. "While we live in these earthly bodies, we groan and sigh, but it's not that we want to die and get rid of these bodies that clothe us. Rather, we want to put on our new bodies so that these dying bodies will be swallowed up by life" (1 Corinthians 5:4).
It's part of the mission of the church to reach out and love the downtrodden and forsaken. We don't have to look far—we are surrounded by suffering people, marginalized by shame and ignorance. If we are to fulfill the mission Christ has given us, we can't afford to look the other way. Movies like Silver Linings Playbook can help us build a better understanding of mental illness. It's up to us to pursue greater insight—and to act on what we learn.
Amy Simpson is editor of Christianity Today's Gifted for Leadership, a freelance writer, and author of the forthcoming Troubled Minds: Mental Illness and the Church's Mission (InterVarsity Press). You can find her at AmySimpsonOnline.com and on Twitter @aresimpson.