Shutter Island: The psychological issues exhibited in this film

One major psychological issue exhibited in this film by the character of Andrew is Delusional
Disorder. According to DSM-IV-TR, in order for someone to be diagnosed with Delusional
Disorder, they must (1) have nonbizarre delusions, (2) not have schizophrenia, (3) be able
to function normally with relatively normal behaviors, (4) have short, if any, mood episodes,
and (5) not be taking any substance which causes the direct physiological effects of a
delusion. Delusions are false beliefs, often of persecution or grandeur, that may accompany
psychotic disorders (Myers, 590). Andrews delusion is that he is U.S. Marshal Teddy
Daniels, investigating a disappearance on Shutter Island, and this is viable because he is
actually a former marshal. Andrew also meets people on Shutter Island who are not real, like
Dr. Rachel Solando. However, Andrew is not schizophrenic because his hallucinations are
directly tied to his delusions, he functions normally and efficiently as any marshal would, and
his anger flare-ups are short and isolated. Andrew is not on any drugs during the movie, but
has some symptoms of withdrawal, like shakiness, from Thorazine, which was used
previously to suppress his psychosis. Andrew has a mixed type of Delusional Disorder, both
grandiose and persecutory. The grandiose type includes delusions of inflated worth, power,
knowledge, identity, or special relationship to a deity or famous person (DSM-IV-TR, 329).
Andrew experiences grandiose delusions because he believes he is a U.S. Marshal with a
special mission: first, to find a missing woman, and second, to uncover a secret government
operation. The persecutory type of Delusional Disorder includes delusions that the person
(or someone to whom the person is close) is being malevolently treated in some way (DSM-
IV-TR, 329). Andrew experiences persecutory delusions when he believes that the doctors at
Ashecliffe are lying to him and experimenting on patients, and when he believes that the
doctors have taken Chuck away to the lighthouse to operate on him.
Andrew also exhibits symptoms of Post-Traumatic Stress Disorder throughout the film. Post-
Traumatic Stress Disorder is an anxiety disorder characterized by haunting memories,
nightmares, social withdrawal, jumpy anxiety, and/or insomnia that lingers for four weeks or
more after a traumatic experience (Myers, 573). Andrew has memories of his time at
Dachau, the bodies he uncovered there, and the execution of the guards in which he
participated. His memories haunt him while he is awake, but he also dreams of his time at
war, incorporating the murder of his children by his wife into the memories as he sees his
daughter Rachel in the snow with other bodies at Dachau. Andrew has had such memories
and nightmares for much more than four weeks because he had them at least two years before
when his wife was alive, as revealed by his drinking problem. Andrew does experience some
social withdrawal as he works all the time, neglecting his wife, who needs serious psychiatric
help.
Andrews wife, Dolores Chanal, has Bipolar Disorder, referred to in the movie by Dr. Cawley
as manic depression. Although the audience is introduced to Dolores at the beginning of the
film, her mental state is not truly known until the end because throughout the film, she is seen
only through Andrews eyes. Bipolar Disorder is a mood disorder in which the person
alternates between the hopelessness and lethargy of depression and the overexcited state of
mania (Myers, 581). At the end of the movie, Dolores is slouching on the porch swing as if
in a blue funk, but when Andrew comes out to talk to her, Dolores becomes very excited,
happy that her husband is home, and completely ignores the fact that she just killed their kids.
Dolores romantically greets Andrew, and after he discovers the children in the lake, Dolores
comforts him, saying things like lets put them at the table and dry them off, theyll be our
living dolls, and tomorrow, well take them on a picnic. Dolores had previously set the
apartment where she and Andrew lived on fire, so her condition has been long-lasting.
According to Dr. Cawley, Dolores was suicidal manic-depressive, and after Andrew killed
her, he could not handle the cruel facts of what he had done; in order to avoid the truth,
Andrew repressed this memory and made up a new memory that Dolores died in a fire, along
with a new life as a marshal investigating on Shutter Island.