Descent: Mental Health Awareness Week

by Linda Duncan McLaughlin

descent

I was lucky enough to receive a New Playwrights Award from Playwrights' Studio Scotland in 2013, and one of the pieces I submitted for the award was Safe, a (very) short play, centred around two characters who are barricaded in a room, worrying about an un-named threat outside it.  One of the characters wants to open the doors and/or go outside, and the other one refuses absolutely to allow this, because they are only safe inside.  I didn't actually know who these two characters were, or what their situation was, or what the threat was - I did that classic writer cop-out of claiming that they were whoever the audience wanted them to be - but I liked the piece, and always intended vaguely to develop it further.  What I didn't realise at the time was that this short piece would eventually become the lynchpin of Descent, the play that is on tour around Scotland throughout May.

The play deals with what happens when one of its characters (Rob) is pitched headlong into early onset dementia in his mid-50s and, when I was asked to write about how it might connect with Mental Health Awareness Week, I puzzled at first to think how to approach it.  Dementia isn't often thought of as something that is a manifestation of poor mental health - it's sometimes seen as just an 'absence', a gradual wiping out of the individual, rather than something that actively affects that person's mental state. 

But looking at the Mental Health Foundation's definition of what makes 'good mental health':

... characterised by a person's ability to fulfil a number of key functions and activities, including:

- the ability to learn
- the ability to feel, express and manage a range of positive and negative emotions
- the ability to form and maintain good relationships with others
- the ability to cope with and manage change and uncertainty

I realise that the story Descent is trying to tell, about Rob and the difficulties he and his family face in trying to deal with the effects of early onset dementia, falls squarely into this territory. 

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A lot of my writing is concerned with themes of identity, relationships, isolation -  and before starting to write the play I had been working (as an actor) with Tricky Hat Theatre Company on a project with carers who were experiencing a loss of intimacy/connection with the person they cared for, because of loss, ageing and/or illness.  Dementia and its effects featured frequently, (though it was just one of the difficulties experienced); but some of the people who took part in the project were younger, and the specific situation of those people - both those living with dementia and those who cared for them - was something that resonated very strongly with me.  Some of my own family members had experience of early onset dementia, and I had seen its effects at fairly close hand; I knew therefore about the isolation that it can bring and, often, the fear and shame surrounding the disease that might prevent someone seeking help and support almost until it was too late.  I recognised the instinct to retreat, to close the doors: if you don't tell anyone about this, then no-one will know, and no-one will interfere, and (biggest fear of all) your husband/wife/mother/father/ sister/brother/child will not be taken away from you.

So I was particularly concerned that the characters I created would be recognised as both truthful and respectful of that experience.  I undertook a lot of research, speaking to and reading about carers and people living with the disease, consulting academic authorities... and almost all of them talked about effects which tallied exactly with the Mental Health Foundation's definitions.  I read stories of what appeared to be personality change: a person who had always been friendly, mild-mannered, calm would suddenly be aggressive or morose or uncommunicative - or vice versa.  Stories about people becoming isolated from their loved ones, or suddenly becoming completely uncaring about them.  About people becoming fearful or suspicious of those around them, paranoid, accusing carers of theft, or abuse.  About people losing the ability to connect to those around them, to remember the details of long-held loving relationships.  About people seemingly cast adrift on unfamiliar seas of loss: of memory, personality, and relationship.  I wanted to write about these stories: about what makes you 'you' and what happens if you lose that.  About what makes you love someone, and what happens if they change so much they no longer seem to be that someone.

Rob and Cathy (his wife) have busy professional lives (Rob is an architect, Cathy a book-editor) and they are young enough to be looking forward to a new, more independent phase in their lives now that Nicola (their daughter) is grown-up and making her own way.  So the invasion of dementia has an extra effect on them: not only do they have to face the destruction that it brings, they are both concerned to cover its effects up so that they will not lead to the loss of their working identities as well as their personal ones.   People around them might be able to see the effects, but don't suspect the cause: if Rob is suddenly more tetchy, or more aggressive, it's not necessarily recognised as something he has no control over, he's just becoming a classic Grumpy Old Man; if Cathy is more stressed, and coping less well, it's easy enough to put it down to something hormonal, rather than because she's frantically trying to keep everything on an even keel.   And although they may be admitting privately to themselves that something is wrong, they aren't admitting it to anyone else, even Nicola - and that has an equally hard effect upon her, as she feels shut out and unable to help her parents.

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Dementia is a terrible disease.  There is currently no cure.  So any play which features it could be unrelentingly bleak and dark.  But the way I've always described Descent is that it's 'A play about love.  And dementia.  But mostly about love.'   And that is because, in talking to people affected by it, the overwhelming impression that emerges is how hard people - particularly carers - fight to keep themselves and their relationships together in spite of it.  Almost without exception, they refuse to give in and they carry on fighting to maintain that when others around them expect them to give up in despair. 

Descent is a celebration of that love.   Cathy does retreat into what she sees as a 'safe' place, trying to protect Rob against the invasion both of outside forces and dementia itself.  But eventually she accepts that she can't cope on her own, and allows Nicola in.  Between them they agree to find a solution that works for everyone in which Rob can be cared for properly, but which will allow them as a family to go on.  Different, certainly, diminished possibly, but in essence still the same: a loving family who care for each other deeply and will continue to do so, in whatever form they take from now on.   And that's where the real safety lies.

Just as with other mental health problems, the effects of dementia need to be brought out into the open so that the stigma, the shame, the fear can be addressed and - hopefully - dissipated.  The more we talk about and share our experiences, the more we support each other.  Although it's not an 'issues' play, Descent does come with a message: that with the right support, sought early enough, the effects of dementia - even if they can't be halted - can at least be mitigated.  If even one person who's been worrying about this situation recognises that message, and seeks help, then that would be an achievement.   And if, in addition, Descent reaches out and touches people and gives them a little more understanding of how it feels to be caught in dementia's clutches, then it's an achievement of which I would be very proud.

Mental Health Awareness Week 8-14 May 2017

 Linda McLaughlin
Linda Duncan McLaughlin

Production images: Mihaela Bodlovic

Written by Linda Duncan McLaughlin at 00:00

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