Howard Hughes Bipolar Diagnosis and Treatment in The Aviator
This paper applies clinical psychology concepts to the portrayal of Howard Hughes in the film The Aviator, arguing that Hughes's behavior is most consistent with a Bipolar I disorder diagnosis under the DSM-5. The paper evaluates differential diagnoses of obsessive-compulsive disorder (OCD) and agoraphobia, explaining why these conditions are better understood as secondary symptoms rather than primary diagnoses. Four treatment modalities are then assessed — psychopharmacological, psychological (with an emphasis on cognitive behavioral therapy), family therapy, and biomedical approaches — with recommendations tailored to Hughes's personality and the stage of illness depicted in the film.
- Primary Diagnosis: Bipolar I Disorder: DSM-5 criteria applied to Hughes's behavior
- Differential Diagnoses: OCD and Agoraphobia: OCD and agoraphobia assessed as secondary conditions
- Psychopharmacological and Psychological Treatment Options: CBT recommended over drug-based treatment
- Family Therapy and Biomedical Treatments: Family and biomedical approaches weighed and critiqued
- Combining Therapies and Stage-Specific Interventions: Combined therapy strategies by illness stage
- Conclusion: Treatment timing determines optimal intervention choice
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What makes this paper effective
- Grounds clinical claims directly in DSM-5 diagnostic criteria, giving the analysis academic credibility rather than relying on informal observation alone.
- Clearly distinguishes between primary and differential diagnoses, explaining why OCD and agoraphobia are secondary rather than simply listing them.
- Connects Hughes's personality strengths (goal-orientation, determination) to the recommended treatment (CBT), demonstrating person-centered clinical reasoning.
Key academic technique demonstrated
The paper uses a film-based case study as a vehicle for applied clinical reasoning. By treating the character as a patient, the writer demonstrates the ability to move from observable behaviors to diagnostic criteria, rule out competing diagnoses, and build a graduated treatment plan — all core skills in clinical psychology coursework.
Structure breakdown
The paper opens with the primary diagnosis supported by DSM-5 criteria, moves through differential diagnoses with specific justifications for their secondary status, then systematically addresses four treatment categories. The final section synthesizes these options by considering how treatment timing affects outcomes, and a reference list in APA format closes the paper. The structure mirrors a clinical case report format common at the undergraduate level.
Primary Diagnosis: Bipolar I Disorder
Howard Hughes would be diagnosed with Bipolar I disorder, with differential diagnoses consisting of obsessive-compulsive disorder (OCD) and agoraphobia. As the DSM-5 (2013) states, the diagnostic criteria for Bipolar I disorder are as follows: "For a diagnosis of bipolar I disorder, it is necessary to meet the following criteria for a manic episode. The manic episode may have been preceded by and may be followed by hypomanic or major depressive episodes" (p. 123).
This diagnosis applies well to Howard Hughes as portrayed in the film The Aviator. Throughout the film, he demonstrates an impulsive personality and is not averse to taking enormous risks, placing his entire fortune and even his life on the line. He alternates between manic-depressive episodes — shutting himself away for months at a time — and moments where he emerges as a commanding, triumphant figure, as in the courtroom scene near the end of the film when he defends himself. These behaviors are indicative of Bipolar I disorder according to the DSM-5, as Hughes exhibits both hypomanic episodes and major depressive episodes.
References
Campbell, G. (2001, May). The anxious client reconsidered: Getting beyond the symptoms to deeper change. Retrieved from
Chouinard, V. (2012). Mapping bipolar worlds: Lived geographies of 'madness' in autobiographical accounts. Health & Place, 18(2): 144–151.
Connolly, K., & Thase, M. (2011). The clinical management of bipolar disorder: A review of evidence-based guidelines. Primary Care Companion for CNS Disorders, 13(4): 1–4.
Steketee, G. (2003). Clinical update: Obsessive compulsive disorder.
Upthegrove, R., Chard, C., Jones, L., Gordon-Smith, K., et al. (2015). Adverse childhood events and psychosis in bipolar affective disorder. British Journal of Psychiatry, 206(3): 191–197.
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