Pat, By Bradley Cooper

3. What mental health treatment modalities would be helpful to Randy in addition to medication?

Once he was released, Pat lived with his parents since his wife still had a restraining order on him. In various scenes, we see ways in which Pat is expansive in his thoughts about getting back together with his wife, Nikki. He also became extremely joyful when he felt like things were going in a step in the right direction on his mission to win back his wife, and grew particularly irritable otherwise. Scarred by the moment he found Nikki having an affair with their wedding song playing, Pat develops hallucinations about the song causing him to hear it even when it wasn’t on. Hearing the song, whether it was actually playing or only playing in his head enraged Pat, causing him to experience a manic episode. Pat’s excessive optimism about getting back together with his wife caused him to have irrational thoughts, which drove him to make poor judgments and partake in reckless behavior like when he broke his

Based on class lectures (Trainor, 2014), I would diagnose Pat with Bipolar I disorder. The main requirement for this diagnosis is a Manic episode. One manic episode is described when Pat caught his wife and another man having an affair. He beat the man, and then he was arrested and taken to the hospital. He remained in the hospital for several months. Prior to this event, he felt that his wife and the

In the movie, ‘Silver linings Playbook’ Pat Solitano is diagnosed with clinical bipolar disorder 1 and struggles with stress-induced manic outbursts. This is revealed by a manic episode where Solitano is seen to almost beat to death a co-worker, who he caught cheating on with is wife. The repercussion of Solitano’s actions results in termination of his job, estrangement from his wife who takes out a restraining order and sees Solitano institutionalized for eight months in a psychiatric hospital.

He asks the secretary to turn it off, but she does not have the control to do so. Pat starts to get extremely upset and starts throwing objects aside to find the speaker. The song acts as a trigger for Pat’s mood to accelerate into rage. However, Pat refuses to take medication because he does not like the side effects, including a “foggy” mind. It is during this session that Pat discusses his father also has issues with rage, describing an incident in which his father got kicked out of a football stadium for beating up Eagles fans; Pat refers to his father as the “explosion guy”. While his father has not been diagnosed with bipolar disorder, it seems probable that Pat inherited his father’s mood disorder. Bipolar disorder tends to run in families. Some research has suggested that people with certain genes are more likely to develop bipolar disorder than others (Bipolar Disorder in Adults).

Annie displayed many traits and showed many signs that would justify her as having a psychological illness. Throughout the movie, Annie’s character had constant mood swings and outbursts. Her mood would often go from happy and energetic to sad or angry. She started off seemingly friendly and normal. As the movie quickly progressed her friendliness turned to wickedness. In the beginning, the first sign of borderline personality disorder that she displayed was after she convinced Paul to let her read the draft for his new book. She explained that she wasn’t fond of curse words and told Paul that he should take them out. When Paul rejected her suggestion, her persona changed and she became enraged and began screaming, “[A]nd the bank do I tell Mrs. Bollinger, ‘Oh, here's one big bastard of a check, give me some of your Christ-ing money?’ There, look there, see what you made me do,” spilling soup on him (Nicolaides, Reiner, Scheinman, & Stott, 1990). This was an example of her uncontrollable emotions. Alongside uncontrollable emotions, Annie expressed signs of suicide. In one scene she explicitly stated “[N]ow the time has come. I put two bullets in my gun. One for me, and one for you” (Nicolaides et al, 1990). This was in regard to her possibly committing a murder-suicide between she and Paul. Annie went through extreme measures, such as breaking Paul’s ankles and killing the sheriff, to avoid being abandoned by Paul. She also showed signs of dysphoria during the film. For instance, the quote:

I agree with the diagnosis that was given to Pat Jr. which was bipolar disorder. He shows examples of both depression and mania. For mania, he shows a decreased need for sleep, specifically when he reads A Farewell to Arms by Ernest Hemingway. In this scene, he stays up until four in the morning, reading this book. He throws the book out the window, showing examples of poor judgement and irritation/agitation/aggressive behavior.

Pat was diagnosed with Bipolar one disorder shortly after arriving at the mental institution. I agree with this diagnosis for many reasons. I believe that it would have to be Bipolar one because Pat displays manic episodes. With Bipolar two disorder, there has never been a manic episode. Bipolar two disorder also must display at least one major depressive episode. From the information from the movie, Pat didn’t really display a depressive episode. Pat demonstrates several symptoms of Bipolar one disorder, many falling into the mania category. His manic episodes cause a great deal of distress in his life. Before the incident with his wife’s lover even occurred, Pat was having severe delusions. He told the school board that his wife and the history teacher were plotting against him. The delusions did not stop once he was out of the mental institution. When pat caught, his wife cheating on him their wedding song was playing. Now every time Pat hears the song he goes into some kind of psychotic episode and puts everyone around him in danger of becoming his next victim. As I mentioned earlier Pat does not take his medication as it is prescribed. He said it makes him too foggy. This could be due to the fact that he enjoys how his mania makes him feel. Throughout the movie, Pat refers to his ex-wife as his wife. He is obsessed with this delusion and honestly believes that he will win her back over. Even though she has made it perfectly clear

My Recommendation for Frankie would be to continue treatment for a week to look for signs of improvement and then reassess the options again. This option gives the family more time to decide how to precede with the situation. If Frankie regains conciseness with in the week then he may be able to make the decision for himself depending on if he has decisional capacity. If he does not regain conciseness than Frankie’s family should consider the pros and cons of continuing treatment. When explaining this recommendation to Frankie’s father, mother, and sister I would recommend them carefully considering all the options and then coming to a mutual agreement. Disagreeing on a decision as big as Frankie’s life can create problems with in the family. It would be a good idea for the family to seek family consoling to help understand everyone’s different opinion and the reasons that they feel that is the best opinion.

Although during most of his life being surrounded by those who are odd and obsessive as he is they were also warm and unembarrassed by his idiosyncrasy. With all of that put into context I believe Pat Jr. has Bipolar I Disorder with mood swings and Delusional Disorder brought on by severe stress but happens rarely.

As per the requirements in the DSM-V, in order to diagnose someone with Bipolar I, they need to have had at least one manic episode (American Psychiatric Association [APA], 2013). A manic episode is one that lasts for a minimum of one week would require hospitalization or have psychotic symptoms. This is differentiated from a hypomanic episode in that, for hypomania, the symptoms last four or fewer days, doesn’t require hospitalization and does not include psychotic feature. I will distinguish between the two using the presence of psychotic symptoms. Pat’s psychotic symptoms can be seen as both delusions and hallucinations (Cohen et al., 2012). His delusions are shown very early on in the movie; he is completely

Current diagnostic criteria for Angela’s manic episode is described through criterion A – D in the following. Criteria A requires the individual to meet at least a one week period of distinct abnormal and persistently elevated, expansive, or irritable mood and abnormal and persistently increased goal-directed activity or energy. Angela has currently been experiencing this particular episode for ten day now and has demonstrated symptoms of increased activity for example the West Coast fight that the booked and the amount of money she has put into textbooks. Criteria B requires that during this time Angela must be experiencing at least three of the listed symptoms that represent a significant degree of noticeable change from her usual

Pat the main character of the movie has bipolar disorder. Bipolar Disorder is also known as Manic Depressive Disorder. Bipolar Disorder consists of mood swings from the lows of depression to the highs of mania. These mood swings may happen as often as a few times a day to a few times a year. The exact cause of Bipolar Disorder is still unknown. Since the exact cause of Bipolar Disorder is unknown it is unknown what parts of the brain is exactly affected by Bipolar Disorder. Current research indicates that structural abnormalities of the amygdala, basal ganglia, and the prefrontal cortex are the parts of the brain that are affected by Bipolar Disorder.

Encountering stressful or traumatic situations is inevitable in a human lifetime. Human beings are faced with a gruesome situation, have a period of grief, and finally overcome the emotions that came along with the event as a wiser and more mature individual. But what about the small portion of human beings that are not able to survive the trauma? What is stopping them from their own recovery? A member of this small portion of human beings is the main character of Matthew Quick’s novel The Silver Linings Playbook, Pat Peoples. From the first lines on the first pages of the novel the reader can tell that Pat’s brain is not in mint condition. He has a distorted perception of time, he has several different triggers that spark violent outbursts, and his mental state has affected the people that love him the most. From these traits and several other symptoms, it is obvious that Pat Peoples suffers from posttraumatic stress disorder but cannot properly recover from this mental illness due to also having bipolar disorder.

Behavior- Throughout the movie Pat appears to have episodes of manic behavior. Manic behavior is defined in our textbook as, a “state of persistently elevated mood, feelings of grandiosity, over enthusiasm, racing thoughts, rapid speech, and impulsive actions.” An example of Pat’s manic behavior is when he doesn’t fall asleep and instead stays up all night to read and Ernest Hemingway novel. He reads the book, in the hopes of winning back Nikki.