If you don't have plans to see this movie, you can check the spoilers here and then come back.
While I've never come close to the experiences of somebody who suffers from bipolar disorder like Pat, the lead character of Silver Linings Playbook portrayed by Bradley Cooper, my track record with anxiety and panic meant this would be a movie that had the potential to hit me hard emotionally and also one I'd be discerning on when it came to its accuracy. It definitely got to me at some points, particularly the scenes where Pat has blow-ups with his parents or raves about how much he "hates the ugly sick part" of him, but if anything that enhanced my appreciation of the film rather than stunting my enjoyment. As far as the realism, that may have been more of a sticking point, but I'll come back to it. The story follows Pat after his release from a mental facility into his parents' custody as he tries to put his life back together with the long term and unlikely goal of reconciliation with the wife who cheated and then put out a restraining order on him after he nearly beat her lover to death during a bipolar episode. As Pat is readjusting, Tiffany, the recently widowed sister-in-law of his buddy who has her own mental hangups with her sexuality and social graces--her mental state is never officially classified other than that she's off--played by Jennifer Lawrence, enters his life and they form a bizarre, ultimately endearing bond. Cooper is pretty tremendous in allowing the movie to be emotionally raw while still entertaining through his character as he plays the quirkiness of Pat with slightly uncomfortable humor but never takes it so far that you don't feel for him during the serious and sad moments. Really the big accomplishment of Silver Linings Playbook for me, much of which I'd attribute to David O. Russell since he both wrote and directed it, is that it veers between addressing some really tough subject matter that I personally take very seriously head on and then having a laugh with it pretty seamlessly. Lawrence gives the type of explosive performance she's becoming known for and that make you wonder how the hell she's only 22 as she dominates scenes with Hollywood heavyweights seemingly without effort and has an uncanny weariness and knowledge in her eyes and the way she carries herself. The film has my favorite turn by Robert De Niro in years as Pat's OCD-suffering father who has tied up all his fortunes--financially and otherwise--in the success or failure of the Philadelphia Eagles and who struggles with guilt over never realizing there was something wrong with his son until it was too late (there's one scene between just the two of them that is heart wrenching). Jacki Weaver holds the family scenes together as Pat's mom while Chris Tucker steps into surprisingly mature shoes far removed from his classic characters as his buddy Danny from the hospital. Russell also does a great job on the directing end, staging every scene perfectly, making the right choices on shots (like focusing on Pat's nervous hands during a therapy session rather than he or his doctor talking). If the film slips--and I think it does--it's that after building up goodwill over the first two acts in creating the serious/funny balance I described earlier, the final half hour plus veers a bit too far into the surrealism of a romantic comedy; it stumbles in trying to tie up the story and the characters begin acting differently without explanation, the narrative suffering. Still, I would see this movie again and think it deserves consideration come awards season; you will likely either love it or hate it, but I dug it. Terrible title though.