2.1. Review of the Previous Study
In conducting a research, to strengthen our statement during analyzing the target research, we need to provide previous study from other researchers that also discuss the same issue with our study. Therefore, as to meet the need of the readers, the researcher would like to give the review towards several study that focus on the issue of mental illness, especially in bipolar disorder that is suffered by the main character that involves in the story written by the author to be analyzed.
The first previous study comes from An Analysis of Bipolar Disorders as Portrayed in Matthew Quick’s The Silver Linings Playbook written by Maria Hana Sari in 2018. There are two points focused by Maria in objective of the study part, they are: (1) To describe Pat’s bipolar disorders as portrayed in Matthew Quick’s novel The Silver Linings Playbook, and (2) To describe Tiffany’s bipolar disorders as portrayed in Matthew Quick’s novel The Silver Linings Playbook.
According to the title of her thesis, the researcher only focused on the current issue which exists in the novel that is bipolar disorder suffered by the characters in the story; Pat and Tiffany. This is done to limit the discussion about the issue in order to hinder the scope of the study being discussed is too general or too narrow. The discussion must be criticized obviously and concisely.
To start the discussion, the researcher opened it with the history of bipolar disorder itself. She quoted the statement stated by Physician in ancient Greece, Aretaeus of
Cappadocia. Aretaeus was considered as the first physician that use the term
“mania” and “melancholia”, the episode of bipolar disorders. The researcher also quoted some other statements from some of physicians. The researcher believes that it is done because the researcher wanted to strengthen the study as the supporting theory to be provided for the readers. After providing the theory, the researcher gave a brief explanation about bipolar disorder; what is the definition of bipolar disorders according to experts, bipolar disorders episodes, criteria for major depressive episode, criteria for manic episode, and also the three main categories of bipolar disorders. These explanations are good enough for me as the reader who needs the information about bipolar disorder deeper and also as the researcher who wants to use this research as the reference for my current study.
In the finding’s part, the researcher explained the cause of why Pat and Tiffany were diagnosed as bipolar disorders sufferer. The researcher provided the theory and quotation picked from the fragment of conversation or scene inside the novel and she fit it with the theory by the experts that she used during conducting the study. After that she began to decide in what episode the character suffered bipolar disorder. This is a common way to analyze the issue exists in the novel because, it will make the study is reliable to be referenced and published. Therefore, by looking at some aspects available, this research really helps me in conducting the research about the same issue as the researcher discussed. It makes the reader know deeper about bipolar disorder and the reader also can get the complete information so that, this research is good to be used as the reference for the researcher.
Secondly, the thesis taken as the previous study is a thesis which entitled Bipolar Disorder in Josh Trank’s Film “Chronicle”
State Islamic University who took English and Literature Department Adab and Humanities
Faculty, Makassar. This thesis was first published on December 15th, 2014. Because this thesis was discussing the same issue as the researcher’s study, the researcher would like to review this and use it as the reference for my study. The review itself is conducted to measure is the thesis is good or reliable to be reference for my study, since it was discussing the same issue.
After formulating the problem of the study, the researcher decides the objective of her study to become the main focus of her study. So, the researcher has three main focuses of the study which are: (1) To describe how the episode of bipolar disorder experienced by Andrew in the film Chronicle by using the National Alliance of Mental Illness (NAMI) theory, (2) To find out the types of bipolar disorder that happened in the film Chronicle, and (3) To find out the cause of bipolar disorder that happened in the film Chronicle. As the researcher reviewed the first thesis, the second thesis seems have the same objective that is both of them are finding out the cause and the types, as well as describing how the character in the film can experience bipolar disorder.
As what has stated by the researcher in the Objective of Research part, the researcher uses NAMI as the theory of current issue. By using this theory, the researcher can provide the symptoms or cause of bipolar disorder and subtypes of bipolar disorder. The researcher also provides the statement from experts that mentioned the symptoms of bipolar disorder.
In the discussion part, the researcher provides the definition, screen capture of the scene that related to the evidence that the character in the film is suffering bipolar disorder. The researcher also provides the conversation in each scene she provided.
After finding out the main issue, the researcher fit the theory and the evidences existed in the film and then decide the compatibility of bipolar disorder issue.
The next work is a thesis entitled Bipolar Disorder in Jennifer Niven’sAll The Bright Places (2015) : A Bipolarist Perspective. The reason why the third article becomes the previous study is that because the writer analyzed the same novel in which the declaration of bipolar disorder suffered by the main character in this novel is stated obviously. In analyzing this novel, the researcher found characteristic of bipolar disorder describe by what the character say about himself.
Theodore Finch has the characteristic of a person diagnosed with bipolar disorder.
It can be seen from the habits he does.
Secondly, the researcher found the causes of bipolar disorder reflected in the All the Bright Places (2015) novel by through what the character says about his life.
Theodore Finch experience bipolar disorder because there is a contribution from problems in his family. The greatest cause is from his father. His father often doing physical violence and ignore him, likewise with his mother. This can be concluded that the cause of bipolar disorder suffered by Finch is because of biological factors, which is from his father. Finch gets neglect from his father since he was ten years old. It’s already affecting his emotional feeling toward his father. All of divorce, neglect, and violence are causes he suffers from bipolar disorder. In addition, bullying and indifference people around made the worse situation.
The 4th thesis that is going to be reviewed by the researcher is written by Loren Thomas from The University of Waikato entitled Lifting the Silence: Ethical Representation of Mental Illness in Contemporary Young Adult Fiction. The researcher was a Master of Arts in English department student. The thesis was first published in 2017. This study focuses on ‘Finding Audrey fiction and how important understanding of mental illness in the age of young adult. Teenagers have a huge opportunity to suffer mental illness because they are in the emotional age in which they will run away from home, drug abuse, sex, and so on rather than tell their story to their closers or their parents (Smith, 8). That is why, introducing and explaining about how importance mental illness in current situation can help people and societies from all ages and genders is an important thing.
In addition, the writer also gives the explanation about the medication that must be had by the sufferers of mental illness. The reason why it is also become important is because most of the sufferers know that they know they need a medication, but they do not want to consume it. In fact This inner turmoil fuelled in part by stigma can be incredibly dangerous as avoidance of treatments can often cause the illness to become more severe, or lead the sufferer to suicide in extreme cases, which is not unfounded as schizophrenia, especially untreated, has an increased risk of suicide (Mueser and McGurk 2064.
2.2 Psychological Approach
A strategy for analyzing works of literature is required in order to properly examine and comprehend them. According to Rohrberger and Woods (1971),
"Psychological Approach is an approach that concerns the efforts to discover and
demonstrate certain recurrent patterns" on page 15, "Psychological Approach is an approach that concerns the efforts to discover and demonstrate certain recurrent patterns." It entails using psychological theory to comprehend literary works.
Guerin, Labor, Morgan, and Willingham (1979) also suggest that a psychological perspective can help us understand the thematic and symbolic secrets of a work.
This method aids the writer in comprehending and clarifying the lines written on page 121 of the literary work. This approach is concerned with analyzing the motivations that underpin human action (p. 155). However, this approach is limited by its aesthetic inadequacies and neglects the appreciation of literary work (p. 121).
The writer uses this method to try to figure out and interpret the meaning of each sentence in the text. The psychological technique is also thought to expose and understand the character analysis here.
2.3 Theory of Bipolar Disorder
The theory that is used by the researcher is Emil Kraeplin’s. At the end of the 19th century, the draught of bipolar disorder developed by the term classified by Emil Kraeplin as ‘manic depressive insanity’. In 1957, Leonhard invented the term
"bipolar" to describe patients who had both depression and mania, or mood swings that were polar opposites. Angst and Perris independently stated in 1966 that the clinical appearance, evolution, family history, and therapeutic reaction of unipolar depression and bipolar disorder could be distinguished. Their theories were incorporated into both the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association (American Psychiatric Association, 2013) and the World Health Organization's International
Classification of Disease (ICD) published by the World Health Organization in 2010. The DSM theory then developed until its fifth revision. The development of the theory goes along the time goes by in this modern era. DSM-V is the fittest theory that can be related to bipolar disorder especially in depressive episode.
According to the DSM-V, a major depressive episode, which results in a depressed mood or a lack of interest or joy in life, characterizes the depressive side of bipolar disorder. To be diagnosed with a major depressive episode, a person must have five or more of the following symptoms in two weeks: 1) Depressed mood most of the day, nearly every day, 2) Loss of interest or pleasure in all, or almost all, activities, 3) Significant weight loss or decrease or increase in appetite, 4) Engaging in purposeless movements, such as pacing the room, 5) Fatigue or loss of energy, 6) Feelings of worthlessness or guilt, 7) Diminished ability to think or concentrate, or indecisiveness, 8) Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt. For the diagnosis of bipolar disorder, it is necessary to meet the following criteria: During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms have persisted are present to a significant degree and represent a noticeable change from usual behavior: 1) Increased or excessive self-esteem, 2) Decreased need for sleep (feels rested after only 3 hours of sleep), 3) Talking more than usual or pressure to keep talking, 4) The idea and the subjective experience in the mind is racing 5) Distractibility (attention too easily drawn to unimportant or irrelevant external stimuli). 6)Increased goal-directed activities, 7) Excessive involvement in potential activities high painful consequences. The criteria a-d constitute a manic episode, at least one mania episode a lifetime is required for the diagnosis of bipolar disorder.
The Hypomanic Episode is a distinct period of abnormal and persistently increasing, expansive, or easily recognizable mood and activity and abnormal and constantly increasing energy, lasts most not 4 days in a row and most days.
Basically, Hypomanic is quite same with manic episode, but the bipolar person still can doing their activity in their daily life and it is not as bad as the manic episode.
It can be conclude that Hypomanic is a better version of manic episode since it not as worse as manic episode.
2.4 The Types of Bipolar Disorder
Since ancient times, people’s understanding about bipolar disorder has undoubtedly progressed. In just the last century, huge strides have been made in education and care. But still, there are many people don’t know either about the issue of mental illness specifically bipolar disorder Bipolar disorder itself is formerly known as manic depression or manic-depression illness. This illness attacks the mental health of person which causes unexpected mood swings, activity levels, energy, concentration, and ability of carrying out daily activities. According to National Institute of Mental Health in January, 2020 there are four types of bipolar disorder which are: (1) Bipolar I Disorder, this types of bipolar disorder defined by manic episodes which last at least 7 days, or by manic symptoms that are so severe that the sufferer needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features or having depressive symptoms and manic symptoms at the same time are also possible, (2) Bipolar II Disorder, the second type defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes
which are typical of Bipolar I Disorder,. The one who suffered Bipolar II Disorder still can doing their daily activity. and (3) Cyclothymic Disorder (also called Cyclothymia which defined by periods of hypomanic symptoms as well as periods of depressive symptoms lasting for at least 2 years, but for children and adolescent it will last for 1 year. However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode, (4) Other Specified and Unspecified Bipolar and Related Disorders is a type that different from the three of types that already mentioned bipolar disorder because the symptoms that showed by the sufferer do not match any of the recognized categories. All the four types, except type number four involve obvious switches in energy, mood, and activity levels. Bipolar has a lifelong impact towards sufferers overall quality of life, health status, and functioning (Saeed Khalil Saeed bin Jabal, Khalid Ibrahim S Albulushi, Mohammad Ehsan M Shokri, Maan Ahmed Alsaaid, Abdulrahman Mohammed M Aloufi, Rawan Abdullah Alsaedi, Fatimah Radi Slais, Hasan Sharif H Bukhari, Abdulaziz Khalid MAddas, Turki Ali Abdullah., 2018).
Assault usually occurs in early adulthood or adolescent, notwithstanding later on it is possible to assault in life and it can cause disability. Bipolar also can occur with distinctive beginnings and ends, but may appear together (Zandy, 2015).
This mental illness represents a complex interplay of genes and environmentally (Uher, 2014). It is considered that life expectancy of the sufferers is shortened by 10 to 15 years. It is not only because of the number of suicidal urge rate but also the presence of medical comorbidities such as cardiovascular disease, obesity, diabetes, and other kind of metabolic conditions (Laursen, 2011); (Fagiolini, 2012);
(Merikangas, 2007). The particular reason for circumstance medication and
therapy, not a little people with bipolar disorder are now able to control their symptoms and deal with their condition. Even so, there is much more work to be done because many more people are not receiving the care they needed to live happier and easier lives. There was a report confirmed that bipolar disorder chronically undertreated in many developing countries due to the less understanding of the society.
2.5 The Factors of Bipolar Disorder
Bipolar disorder can be caused by specific interaction happened between environmental events and the genetic predisposition. There are several factors that can caused someone suffers bipolar disorder, which are: Psychological Factors, Biological Factors, and Environmental Factors.
a. Psychological Factors
According to Psychoanalysts Karl Abraham (1911) and Sigmund Freud (1917/1957) believed that early traumatic losses or rejections create vulnerability for later depression by triggering a grieving and rage process that becomes part of the individual’s personality. Subsequent losses and rejection reactive the original loss and cause a reaction not only to the current event but also to the unresolved loss from the past. Besides that Brown and Harris in (Smith P. a., 2007) interviewed women in London and found that the rate of depression among women who had lost their mothers before age 11 and who had also experienced a severe recent loss was almost 3 times higher than that among women who had experienced a similar recent loss but had not lost their mothers before age 11. According to (Beck, 1976),
defective, worthless and inadequate. They also believe that whatever happens to them is bad and that negative things will continue happening because of their personal defects.
b. Biological Factors
Biological factor refers to genetic factor. It is inherited from parents whether father or mother. Not only from parents, it can be also from other member of family. To bipolar disorder, genetic is also studied as the main causal factor to both men and women as Young & Joffe in (Smith P. a., 2007) stated that bipolar disorder, in which depression alternates with less frequent periods of mania, has been studied primarily at the biological level because it appears to have a stronger genetic basis than does unipolar depression. Among both men and women, the lifetime risk of developing a bipolar disorder is just below one percent. Yet about fifty percent of patients with bipolar disorder have a parent, grandparent or child with the disorder (Barondes, 1999). The concordance rate for bipolar disorder is five times higher in identical twins than in fraternal twins, suggesting a genetic link. Manic disorder may stem from an overproduction or the same neurotransmitters that are underactive and depression. This might explain the symptom picture that is quite the opposite of that seen in depression (Smith P. a., 2007).
c. Environmental Factors
According to Martell et al., in (Smith P. a., 2007) behavioral theorists believe that to begin feeling better, depressed people must break this vicious cycle by initially forcing themselves to engage in behaviors that are likely to produce some degree of pleasure. Eventually, positive reinforcement produced by this process of
behavioral activation will begin to counteract the depressive affect, undermine the sense of hopelessness that characterizes depression, and increase feelings of personal control over the environment.
2.6 The Effects of Bipolar Disorder
After finding out the type of bipolar disorder suffered by Finch, the researcher wants to show the effect of bipolar shown by Finch as depicted obviously in the novel.
The effect of bipolar disorder as seen in the novel is bipolar disorder II or depressive episode. According to the episode experience by Finch, The following factors can raise the risk of developing bipolar disorder or function as a trigger for the first episode: Having a first-degree relative of bipolar disorder, such as a parent or a sibling, periods of heavy stress, such as when a loved one dies or when some stressful incident occurs, abuse of some kind of drug or alcohol. By looking at the effects that can be raised by the sufferer, the things people surrounded by the sufferer must know how to treat someone who suffers bipolar disorder if left untreated, it can lead to serious problems that affect every aspect of life, including:
Addiction of drugs and alcohol causes a slew of issues, suicide or attempted suicide, financial or legal issues, relationships that have been damaged, and performing poorly at work or in school, Mayo Foundation for Medical Education and Research ((MFMER)-1998-2021).
