generallyanxious.com

THE SILVER LININGS PLAYBOOK, by DAVID O. RUSSELL (Based on the novel by Matthew Quick)

The Silver Linings Playbook is about Pat Solitano, a man with bipolar who, after 8 months in a mental institution, is full of positive energy and ready to rebuild his life.

Unemployed and separated from his wife, Pat moves back in with his parents. The story unfolds as Pat discloses details of his condition to his therapist, Dr. Patel. He meets Tiffany, a very brash woman with her own problems who seems to want to spend lots of time with Pat.

This movie does a good job showing both the inner and inter personal struggles that mental illness can cause, especially amongst families. It also sheds light on the importance of having a positive attitude and positive outlets in life as a way forward.

If you’re interested, here is a link to the screenplay.


After reading an unhappy ending to a Hemingway novel, Pat wakes his parents up at 4am. It’s easy to root for him – he wants so desperately for life to be positive…

PAT:  …and he does. He does. He survives the war, after getting blown up he survives it, and he escapes to Switzerland with Catherine. But now Catherine’s pregnant. Isn’t that wonderful? She’s pregnant. And they escape up into the mountains and they’re gonna be happy, and they’re gonna be drinking wine and they dance — they both like to dance with each other, there’s scenes of them dancing, which was boring, but I liked it, because they were happy. You think he ends it there? No! He writes another ending. She dies, Dad! I mean, the world’s hard enough as it is, guys. It’s fucking hard enough as it is. Can’t somebody say, ‘Hey, let’s be positive? Let’s have a good ending to the story?’


Pat talks to his therapist, Dr. Patel, about dealing with his condition by “white-knuckling it” (don’t try this at home, kids; it’s exhausting!) and then eventually getting diagnosed with bipolar.

PAT:  Yeah, about a week before the incident, I called the cops and I told them that my wife and the history guy were plotting against me by embezzling money from the local high school, which wasn’t true. It was a delusion. And we later found out from the hospital that’s because I’m, uh…

DR. PATEL:  …undiagnosed bipolar.

PAT:  “Yeah. With mood swings and weird thinking brought on by severe stress, which rarely happens, thank God. And then the shower incident happened and that’s when everything snapped, so I then realized that, oh, wow, I’ve been dealing with this my whole life. And without any supervision I’ve been doing it all on my own with no help and basically I’ve been white-knuckling it this whole time.

DR. PATEL:  That had to be hard.

PAT:  Yeah. It’s a lot to deal with, especially when you don’t know what the hell is happening, which I do now. Sort of.


Here is Pat – lovable, positive Pat – recounting his hospital stay to Dr. Patel, his therapist:

PAT:  This is what I believe to be true. This is what I learned in the hospital. You have to do everything you can, you have to work your hardest, and if you do, if you stay positive, you have a shot at a silver lining.


In this scene, Tiffany, Pat’s new friend who also deals with mental instability, explains her self-acceptance to him, and how important it is (rather brashly).

TIFFANY:  I was a big slut, but I’m not anymore. There’s always gonna be a part of me that’s sloppy and dirty, but I like that, with all the other parts of myself. Can you say the same about yourself, fucker?! Can you forgive? Are you any good at that?


Dr. Patel gives Pat advice on controlling his outbursts – recognizing, then redirecting the harmful thoughts.

PAT:  Let me just set the record straight about last night. Hurting my mother was a mistake and I hate myself for
it, and I hate my illness and I want to control it. My father, on the other hand, had no trouble slapping the shit out of me last night, which I did not return ‘cause I could’ve killed him and I didn’t. He’s sixty-five years old. You don’t think I could’ve beat the shit out of him? I mean….

DR. PATEL:  He was scared for your mother and you hurt him as well.

PAT:  Yes, last night was a mess. Okay? And I think he probably just tried to do his best.

DR. PATEL:  Pat, you have to have a strategy. I told you earlier. You need to recognize these feelings coming to
you, otherwise you will be sent back to Baltimore. So when you get these feelings, you need to get to a quieter place, and be at peace with yourself, however you can.

PAT:  Yeah, but that’s easier said than done.


Pat is ashamed of being on medication, as most of us are. It’s always good to hear someone else say it.

PAT:  Yeah. So they put me on medication, which I feel ashamed of.

TIFFANY:  Yeah.

PAT:  So I know.

TIFFANY:  You do.

PAT:  I just gotta get a strategy, you know?


Tiffany gives Pat a realistic perspective on his violent outbursts when he hears his wedding song.

TIFFANY:  You gonna go your whole life scared of that song? It’s just a song. Don’t make it a monster.

TIFFANY (CONT’D):  There’s no song playing. There’s no song. Breathe, count backwards from ten. That’s it.


Pat and his friend from the hospital, Danny, try to explain themselves to Pat’s mom, Dolores. I’ve sometimes wondered about something like a “sixth sense”; although I think I’d be content with just five.

DOLORES:  Pat, you’re up to something, I know.

PAT:  People like Tiffany, or Danny, or me, maybe we know something that you guys don’t know, okay? Did you
ever think about that? Maybe we understand something because we’re more–

DANNY:  We have a sixth sense. I mean, everybody’s got it. Everybody’s just not in touch with it.


In this scene, Tiffany gives Pat a little history of her marriage. This line is a good example of how difficult intimate relationships can be – something that seems so natural to most people can be so hard for others. Thank you David O. Russell for including this in the movie. I have been there, it’s a horrible place, and hearing her say this gave me a small sense of comfort. Thank you.

TIFFANY:  We were married for three years and five days, and I loved him. But for the last couple months, I just wasn’t into sex at all. It just felt like we were so different and I was depressed. Some of that is just me, some of it was he wanted me to have kids and I have a hard enough time taking care of myself. I don’t think that makes me a criminal.

Coming of Age on Zoloft…, by Katherine Sharpe – Living with It

 

LIVING WITH IT:

I thought about whether part of being an adult is realizing that no one else cares as much as you about the things you do. It seemed like a lonely thought, but maybe it didn’t have to be. If it didn’t matter as much to anyone else, maybe it was time to start taking responsibility. Maybe that’s what responsibility meant. That you might as well try to make yourself happy—that nobody else was going to tell you how to, not because they were mean or uncaring but because they didn’t really know how, and anyway, it wasn’t any other person’s job as much as it was your own. I did squeeze in a few more days without doing homework, just to see how it felt. Nothing bad happened.

 

I found myself placing more importance on things like getting enough sleep, going home when I was through feeling social, running in the park. I made a conscious effort not to overburden myself or my schedule with commitments. In my journal, I wrote that I felt like a tightrope walker performing the same old routines, without a net this time. The simplest things felt a little more exciting, and I went around with a new consciousness that it was important to be careful.

 

I had to be nice to myself; no one and nothing else was going to do it for me.

 

I’m the first person to say that if you’re depressed, or if you’re anxious, the last thing you want to do is anything. You don’t want to eat, you don’t want to shower. You definitely don’t want to go out on a hike or go to the mall or something like that. But you have to do something. Once you isolate yourself, that’s when you’ve crossed over to letting it get you. Even if all you do is go for a walk, and say hi to one person that you pass during the walk, that’s an accomplishment. —Shannon, age twenty-six

 

Several people described feeling as though they had become better at noticing their own needs and taking action to meet them—a combination of being both more vigilant and more relaxed.

 

But now, I allow myself some, like, “Oh, if you want to chill out, that’s cool, you can just chill out for an hour,” and limit the number of things that I expect myself to do in a day. Which I often exceed. It’s not that I have to struggle through all my days, but lowering my demands on myself has been big. —Isabel, age twenty-seven

 

the passage of time had often acted as a powerful intervention of its own. They talked about seeming to acquire a new resilience as they got older—as if living were a skill that they were improving at with age.

 

I’ve gotten so much better at not mistaking a negative mood for reality,”

 

I do feel like life has gotten easier to manage, but I relate to the sense that while time and experience dial them back, old issues never truly disappear. And sometimes—in February, or after a breakup, or during a period of stomach-knotting stress at work—I ask myself whether another way might be better.

 

And I’ve come to accept that the person I wish I was is not someone I can be, at least not for longer than a couple days, a week at most. But for me, it has always been borrowing against something, in terms of both emotions and energy level. So let it level out: I’m always going to be introverted, and slightly nervous, and self-critical, and slightly scattered, and easily distracted.

 

Other people who are drawn to the idea of quitting will discover that it isn’t practical for them. While I think that self-care and lifestyle changes can make a big difference, I know they’re not a panacea. As a personal reminder, I sometimes think back to a moment that occurred near the end of my time in California. I was at the Berkeley YMCA, trying to “manage” my need for medication with exercise, in the last week or two before I packed it in and called the psychiatrist. A few weeks later, when I was feeling better, I tried to wring a little humor out of the memory by saying to myself, Okay, when you’re doing exercise to try to feel better, and you’re actually crying while you’re doing the exercise (crunches for me, if I remember), maybe that’s a signal that it’s time to bring out the big guns. I have a friend who had a therapist who once told her that depression is when you feel like it’s almost impossibly effortful to get through the things you need to do. By the same token, keeping yourself in an acceptable frame of mind shouldn’t feel like an exhausting, full-time job, let alone one you’re slowly failing at.

 

what so many people feel as they grow into their adult selves: a greater sense of knowledge about what she needs and wants, and a greater willingness to reach out and grab it—to insist on it for herself, with ever-lessening amounts of conflict or doubt.

 

While some of us will need medication, or want it, we all need things that medication can’t provide—things we shouldn’t overlook in our enthusiasm for easily classified problems and quick, high-tech solutions. We need things that can’t be commodified or manufactured, that can’t be rendered more efficient, and that will never make any company rich. In our society, with its glistening surfaces, we all need reality checks. We need to talk to each other, as honestly as we can. We need help sorting out what’s worthwhile from what isn’t, what makes us feel good from what makes us feel bad. We need the comfort of feeling like we’re not alone. We need meaningful work and real rest, or at least the hope of these. We need connection and love. And we need to learn, by trial and error, how to take care of ourselves.

 

All I knew was that I felt like I’d finally crawled up on dry land, and I was pleased and comforted that my friends seemed to be doing the same. Looking back, I have no sophisticated explanation for the change. I think what happened was, quite simply, that we grew up. I don’t want to exaggerate the luxuries of this new place. Sometimes there are earthquakes. Sometimes the fog rolls in and stays for weeks. But it’s fertile land, and arable too. It feels like a place where you can get some living done. While the storms aren’t over, they do feel different now. And I’m confident in a way that I couldn’t have imagined years ago of my ability to weather them. Maybe you know this feeling, this place. Maybe you see it, up ahead, as a promise. I want to tell you that you’ll get here too. Medication won’t prevent you from making the trip, but it won’t get you here on its own. You will get here by living, by engaging with the world, by loving and fighting and making mistakes, by picking yourself back up and trying again. You’ll do it by taking support where you can—from medicine, from the people around you, from your interests and beliefs. If you are lucky, you’ll find a guide who will help by listening to you and sharing the story of her own way across. The trip won’t always be comfortable, but it will feel real, unique, and yours.

 

Maybe you are here already. If so, maybe you have experienced how, on a good day, the breezes change direction, and the feeling in the air shifts a little. The voices inside that once asked “Who am I?” quiet down, and into the silence a different, but related voice says softly, “Here you are. What will you do?”

 

Coming of Age on Zoloft…, by Katherine Sharpe – Therapy

 

THERAPY:

THERAPY DIDN’T CONVINCE me that antidepressants were useless, but it did move me toward a more specific estimation of the things they can and can’t do. For me, I decided, antidepressants were great at blasting through the most acute states of anxiety and sadness. When I’d lost the ability to eat and sleep normally, or interact socially without suppressing tears, medication knocked me back to a calmer, more cheerful place, and quickly. But as I continued in therapy, I saw more clearly that there were things I had needed for a long time, as much or more than I needed drugs. Antidepressants had gotten me moving, but they hadn’t given me the sense of direction I craved.

 

Critically, therapy taught me about the magic of cause and effect: that the things I do really affect the way I feel. I learned that emotional junk food—“shortcuts” to intimacy, or whatever kind of immaterial gratification you may be seeking—will make you feel as queasy and malnourished later as real junk food will. Emotional life is not unlike cooking or growing a plant: if you take your time and put in quality materials, chances are that you will get good stuff out in the end.

 

Most of all, therapy helped by making me see that some of the things I like most about myself and some of the things I like least stem from the same sources. Before I came to John, I was used to feeling two different ways. Sometimes I felt capable, well composed, on top of the world. Other times I felt abject and lost and horrible. Antidepressants had contributed to this tendency; one group of feelings meant “sick,” the other, “well.” John taught me to reexamine those assumptions, to think about the relationship of the bad to the good. Slowly I began to realize that some of the qualities I value about myself—that I feel things strongly, that I’m sensitive, that I care about doing well and about things being right, for myself and in the world—were precisely the things that made it possible for me to get cast down. But at the same time, these were the qualities that allowed me, on a good day, to be empathetic, warm, observant. A good friend, a hard worker. Some people find comfort in thinking about depression as a kind of disease, but for me, recognizing it as a potential nested deep inside me, intertwined with the traits that made me strong, made me hate my depression less, and made me hate myself less too. Depression is pretty hard to love, but I did learn to regard at least my tendency toward it with a little fondness and a little humor that, I like to think, took the edge off.

 

Our lives are made up of moments, brief interactions strung together into a whole. In a sense, the quality of a life is the aggregate quality of those moments; it is hard to be right in the entire picture of your life if you aren’t right in the details. Big questions can feel unanswerable because they often are. My fantasy of an equally big solution, he was saying, was never going to work. He wanted me to start by letting go of my dream of a top-down approach, and taking a clear look at the things that were right in front of me.

 

In CBT, it doesn’t matter so much why you jump to a given conclusion, just that you notice yourself doing it; in psychodynamic therapy, understanding why would be seen as essential to creating change. Which approach will work best for any given person probably depends on what kind of investigation appeals most. Are they more comfortable isolating and zooming in on the problem, or would they rather start by taking a slow, meandering walk to get the whole lay of the land?

 

(Commenting on the inappropriateness of talk therapy to achieve “an immediate transformation of general mood,” Andrew Solomon wrote, “When I hear of psychoanalysis being used to ameliorate depression, I think of someone standing on a sandbar and firing a machine gun at the

 

incoming tide.”24) Antidepressants, the reasoning goes, may be able to blast somebody out of an entrenched depression and put them in a place where they’ll be able to properly do the work and absorb the benefits of therapy. Therapy, in turn, can help that person cope with symptoms that remain. It can make them better able to take care of themselves and recognize their triggers, so that they become less likely to get depressed again, or quicker to seek help when they do.

 

One thing that the cultural representations of therapy hadn’t led me to expect was how much mental energy it takes up. Especially in the first months, therapy was always there, like a program that runs silently in the background, hogging RAM. I began to watch myself in the world with a new kind of attention, and bring to John any detail that seemed like it might help.

 

While psychiatrists used to provide psychotherapy along with medication, now prescriptions come from the doctor, and talk therapy, if it’s wanted, from a different practitioner altogether. The situation leaves psychiatrists less able to monitor their patients’ progress, because they see their patients less frequently and talk to them less extensively. It has also contributed to a shift in which psychotherapy, because it’s generally no longer provided by medical doctors, has come to seem increasingly less like a medical ser-vice. The issue isn’t quality—nonpsychiatrists can be excellent psychotherapists. But pushing therapy to the periphery of medicine strengthens the rationale for insurance companies not to fully cover it. Talk therapy joins the ranks of other “nice but not necessary” ser-vices, like acupuncture or massage, that can seem vaguely alternative and that consumers often expect to have to pay for themselves, while medical care for emotional problems becomes increasingly synonymous with pharmaceuticals.