Two main characters in the Silver Lining Playbook are suffering from bipolar disorder (BD). One of the most important changes compared to the previous version of DSM 5 concerned the diagnostic criteria for manic and hypomanic episodes (Bach & Sellbom, 2016). Currently, the diagnosis of an episode of mania and hypomania requires the patient to not only be in high spirits constantly or irritable but also an abnormally increased activity aimed at achieving a specific goal. Such limitations can lead to overdiagnosis of BD. Meanwhile, more stringent criteria can reduce the likelihood of false-positive diagnoses and help avoid unnecessary psychopharmacological interventions (Bassett et al., 2016).
The main character is obsessed with his ex-wife, which a sign of mania. Another important point is the change in exclusion criteria for the diagnosis of BD I and BD II7.8. The earlier appearance of the symptoms of mania or hypomania in the treatment of a depressive episode with drugs, electroconvulsive therapy, or bright light therapy, which was previously referred to as exclusion criteria, currently serves as a diagnostic criterion for the diagnosis of BD I or II (Bassett et al., 2016). These personality shifts can be observed in both main characters’ behavior. This change was supported by a wide range of psychiatrists, since the inclusion of (hypo-) manic symptoms in the treatment of depression, according to many experts, is indeed a sign of bipolarity (Bach & Sellbom, 2016).
Finally, the change that concerns the inclusion of specific diagnostic conditions in the category of other specified bipolar and related disorders deserves attention. It allows specialists to better categorize the health of patients with symptoms that do not fully meet the criteria for the diagnosis of BD. Thus, it is critical to be able to identify and specify the various intricacies of the given issue.
References
Bach, B., & Sellbom, M. (2016). Continuity between DSM-5 categorical criteria and traits criteria for borderline personality disorder. The Canadian Journal of Psychiatry, 61(8), 489-494.
Bassett, D., Bear, N., Nutt, D., Hood, S., Bassett, S., & Hans, D. (2016). Reduced heart rate variability in remitted bipolar disorder and recurrent depression. Australian & New Zealand Journal of Psychiatry, 50(8), 793-804.