Shutter Island: Teddy Daniels In the 2010 film Shutter Island directed by Martin Scorsese, Andrew Laeddis, referred to through much of the movie as “Teddy” (Edward Daniels) is suffering from delusional disorder. Through the course of this paper we will discuss who he is, why he gets the diagnosis of delusional disorder, why he does not get the diagnosis of schizophrenic, amongst other things relating to his delusional disorder and possible treatments he could have gone through as opposed to being lobotomized. Teddy is a veteran that fought in WWII, and believes himself to be a US marshal going to the asylum island called Shutter Island to investigate the disappearance of a missing patient of ward B. He also, as revealed later in the movie, is particularly interested in investigating this asylum because he believes that the man who burnt down the apartment building he was living in subsequently killing his wife is being treated on the island. Teddy is shown to be an unreliable narrator over the course of the film as we see the events of the movie solely through his perspective and witness many cues pointing to this in the form of deliberate continuity errors. According to the DSM-5, delusional disorder is primarily characterized by “at least one month of delusions but no other psychotic symptoms.” This primary characterization fits Teddy because he has one delusion that we are aware has lasted 24 months at the time of the movie, (more than the criteria of one month) but displays no other psychotic symptoms. This differs from schizophrenia because he is shown not to have difficulty functioning outside of the anxiety that he feels because of the delusion, nor does he exhibit flat/ inappropriate affect or disorganized speech or thought. He also does not withdraw from Chuck and in fact trusts Chuck a lot with his thoughts and perceptions through the entire movie. His type of delusional disorder is mixed, with him having grandiose delusions of being a US marshal that should be listened to and obeyed, persecutory delusions that there is a conspiracy on the island against him and Chuck, and finally somatic delusions that he is being poisoned through the aspirin that the main doctor is giving him, as well as all of the cigarettes he is getting from other because he does not have his own. Currently there is no way to prevent or cure this disorder, but in Teddy’s case there is an explanation as to what may have brought it on. There are two main risk factors, his trauma as a veteran, and his trauma from killing his wife. We do not get Teddy’s family history so we have no way of knowing if delusional disorder is something that he is genetically predisposed to, but we do know that he suffered an extremely traumatic event. Teddy killed his wife after fishing the bodies of his three children out of the lake behind their house. He committed this murder because his wife killed their children, and then asked him to set her free. As the movie wraps up, he acknowledges that he made up the story of Teddy and is actually Andrew, but could not live with the reality of what he had done. He is shown to smoke through the movie, but his delusions do not seem to be caused by his smoking. There is also the fact that this delusion developed later in life that points to it being delusional disorder and not schizophrenia, because schizophrenia tends to occur early on in men, and Teddy is shown to be in his mid-thirties. To have a diagnosis of delusional disorder, the DSM-5 states that one must not meet criterion A for schizophrenia, nor have met it in the past. These criteria are “1) delusions, 2) hallucinations, 3) disorganized speech, 4) disorganized or catatonic behavior, and 5) negative symptoms.” (Diagnostic and statistical manual of mental disorders: DSM-5 2017) Teddy displays delusions, but it is not made clear if he has hallucinations. His speech and behavior is normal within the realm of his delusion, and he experiences no negative symptoms because of the delusions. He also has not displayed manic or depressive episodes within the course of the film. What the movie did wrong with this mental disorder is something even the characters within it recognize as controversial; an extremely long and intricate role play. The lead psychiatrist, John Cawley, came up with this idea as a way to try and “bring back Andrew” through making him see how improbable the entire situation was. Apparently, this works, but only for a few minutes of the movie, as the scene after Teddy recognizing that he is Andrew happens a scene of him fully reverting back to Teddy ends the movie. We are told that Teddy has actually had a breakthrough like this once before, but that he regressed immediately then as well. The have been giving him an antipsychotic for the past two years as well, and for the experiment they stop, causing him to have withdraw symptoms even though stopping medication like that is also extremely dangerous and is shown to have physical effects on Teddy, causing him to shake and have migraines. The character Teddy Daniels is presumed to ultimately have been lobotomized at the end of the movie, a practice that was unfortunately on the rise in the 1940’s and 1950’s. The movie tells us that the Shutter Island treatment facility is one of a kind, and prefers to treat its patients with respect, but Teddy is also said to be the most dangerous man there and thus delt with in an extreme manner. Delusional disorder can be difficult to treat as people with it may refuse medications and professional help because they may think that the person trying to help them is actually conspiring against them the way the Teddy did in the movie. Chuck has been Teddy’s psychiatrist, and psychotherapy is said to be the most helpful means of treatment for people suffering from delusional disorder. Chuck is shown to do what is typical, not challenge the delusion but instead reward the positive behavior of Teddy and push him in a healthier direction, although the methods that he uses are questionable at best. Over all, Shudder island shows a highly dramatized version of a very real mental disorder, along with a tragic ending to the character’s narrative when Chuck shakes his head no at John Crawley at the end of the film, signifying that Teddy has regressed yet again. This cyclical representation of delusional disorder is correct in some aspects, but the anagram names and film noir style of the movie reminds us that that is what Shudder Island is, a mystery movie.