Mental Illness on the Big Screen: Are There Really Silver Linings?
This week we're stacking up David O. Russell's (The Fighter, I â„ Huckabees) new film Silver Linings Playbook against the reality of families living with severe mental illness. Based on the debut fiction novel, although I suspect it was not the first novel he wrote, by Matthew Quick, Silver Linings is the story of Pat Solitano (Bradley Cooper). Recently signed out from a court-ordered stint in a mental health facility by his mother, Pat is returning to the family home with the hopes of getting in shape and reconciling with his wife, despite her restraining order against him. From the start there is a sense of everyone being on edge. Enter neurotic, recently widowed Tiffany (Jennifer Lawrence) and watch everything begin to unravel.
The anxiety the family feels about Pat's mental stability is palpable from the very beginning. Standing in the foyer by the front door, Pat and his parents exchange a series of brief glances that say everything about mental illness and caregiving. In the audience, I immediately began shifting in my seat, squirming, My God, they've finally put us on the big screen. Time and time again I have exchanged those very glances with my parents, with my brother who is diagnosed with paranoid schizophrenia. In those wordless looks there is so much being churned up: Is everything okay? How could everything be okay? Please be okay. Please don't say or do anything...
So often mental illness is portrayed in film and TV by simple, heartwarming quirkiness (a la Running with Scissors, Fringe) which never glances the surface of real mental illness. Like Stephen Marche said in Esquire:
Madness in the movies, and in art generally, usually takes one of two forms. In serious work, madness is a kind of glamorous otherworldliness, a portal into deeper perception. Of course, as anyone who has actually been close to anyone with real mental illness knows, the insane are not glamorous. They are terribly, terribly dull, except that their dullness is shot through with moments of pure terror.Â
It isn't funny, although we try so hard to make light of it all the time. It isn't easy. A feature of bipolar disorder and schizophrenia called anosognosia refers to the inability for the afflicted to recognize their illness. Their diagnosis isn't like when your new dermatitis was finally explained to you by your doctor: the light bulb going off, Ah, it finally all makes sense. Here diagnosis can be confusing, it doesn't seem to fit the bill for them or they simply distrust the doctor giving it. Even those who could report, Yes, I have bipolar, don't necessarily connect their feelings (depression, paranoia, delusions) to their condition. Anosognosia plays a key role in noncompliance with medication they are recommended, not to mention the adverse side effects like sedation, weight gain, etc. Furthermore, films would have you believe that it's simple to get help for these individuals. That couldn't be further from the truth. Without a violent outburst and court-ordered hospitalization like Pat's, there may have been no hope of ever getting him help. Family's like mine face this fact every year, every cycle, when they go from "Being in a good place" to "His troubles are back again."
As the movie begins, you learn Pat's mother has taken him out of the hospital early. My heart immediately sank. I thought, "Why did you take him out? He was safe there. He was on his meds. Don't you know a good thing when you see it?" On the big screen and TV they still portray that obsolete One Flew Over the Cuckoo's Nest version of mental hospitals (or worse American Horror: Asylum). While they don't give me the warm fuzzies, for many of us hospitalization is the result of a period of scary behavior and admittance marks the definitive moment your loved one is officially SAFE. They cannot be kept there against their will for more than 3-10 days (depending on the state). They can be kept longer if they are a harm to themselves or to others OR the court has ordered them to stay, in which case a crime has already been committed. Now you understand the link between mental illness and homelessness.Â
I could, however, appreciate his mother's decision, her desire to have him under her own roof. No matter how you feel about the illness, all you can think is how scared and confined they must feel institutionalized. Rarely does the sense of being utterly lost, frightened and alone in our tribulations find it's way into a film. Silver Linings finally captures the struggle of caregivers: The wrestling between your heart and your mind. Your mind says: He needs critical care. You heart: He needs to be home, where he is loved, he is ours. It's hard to let someone in and trust that they will help your loved one. Well what if that person isn't even a professional? What if it's just some girl with a string of her own dirty laundry?
"She's had a lot of therapy," a character says of Tiffany.
"I've had a lot of therapy," Pat points out.
This is another hyperrealistic feature here: People who have no formal diagnosis are considered more messed up than someone with a formal diagnosis. Pat's mind is broken and he's medicated, so at least we understand the depth of his issues. Nothing could be more wrong. Any diagnosis barely encompasses or reveals anything about one's mental illness.
One can't go without noticing, the Solitano family is screwed up. His mother is an enabler, his father is OCD with a delusion about the Philadelphia Eagles that has grown into a monster over the years, and both the father and Pat's brother are violent, confrontational men. If I suggest this environment played a part in the development of Pat's illness, you could easily argue "If that's the recipe, then when isn't his brother sick? And why isn't this the same environment that every bipolar patient comes from?" Of course there's no recipe for bipolar. Suffice to say families with severe mental illness are an odd bunch. We aren't angels or demons, we aren't criminals or abusers, but we are dysfunctional. You only think your holidays are tough. You have no idea. That is the honest truth, and it's humbling to see it on the big screen.
Pat is in for a bumpy ride. He said himself, he had "white-knuckled" through is problems for years before he was diagnosis. In fact, you'd be wrong in imagining a bright future for Pat. Things will go wrong again, and this family with muscle through some familiar and brand new rough times ahead.
You have to do everything you can, and if you stay positive you have a shot at a silver lining.
That statement is true for every single person suffering with mental illness and for the people who love and care for them. The family can't plan on the illness flaring up or lying low forever. You have to face each thing as it comes to you. Whether they become convinced you are conspiring to ruin their life, whether they get arrested, hurt someone or themselves, whether they go through all the shrinks in town, you get through it just like you got through everything else. And you need each other to keep reminding you of that.
Sarah Fruchtnicht is a writer and editor in Brooklyn, NY.
