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Home , Brian Yorkey, Michael Greif, Next to Normal, Tom Kitt (musician)

study guide

contents The Play Now Playing in Crystal City Meet the Writers November 21, 2008 - January 18, 2009 Characters at a Glance music by Female Hysteria book & lyrics by directed by Two Sides to Prescription Medication Additional Resources

the play

As the musical Next to Normal opens, middle -aged mother Diana “Do you know what it’s like to die alive?” seems to have it all: a -Diana, Next to Normal handsome, loving husband and two talented, teenage children. It is soon obvious, however, that life for Diana is far more difficult than it seems. She has been dealing with severe and delusions since tragedy struck her marriage nearly 16 years earlier. As she continues to seek countless treatments, medications and therapies to help her return to a normal life, her family begins to unravel around her, finding their own desperate ways to deal with her illness and their own loss. characters at a glance meet the Diana is a middle-aged wife and mother, afflicted with bipolar depression and delusions for nearly 16 years. Dan is Diana’s husband, who tries to be supportive writers and optimistic despite his wife’s crippling and Brian Yorkey & Tom Kitt seemingly permanent illness. Gabe is Dan and Diana’s 18-year-old son; a bright, talented young man who serves as a narrator of his mother’s problems throughout the play. Natalie, Dan and Diana’s 16-year- ollaborators Brian Yorkey old daughter, tries to do well in C(bookwriter and lyricist – school, but finds the stress of dealing writes the words) & Tom Kitt with her mother’s illness is too much (composer – writes the music) to handle. met when they were students Henry, Natalie’s musician boyfriend, at in the tries to be supportive as Natalie 1990s. tries to cope with her family. Kitt began playing piano at age Dr. Madden, Diana’s 3 and writing music at age 8. He unconventional new doctor, became involved in musicals at attempts a number of unusual treatments to alleviate Diana’s age 19 in college. Yorkey also depression. started young, penning mystery plays for his fourth grade class. some renderings or drawings of Diana’s costumes by designer Jeff Mahshie. He was actively involved in his hometown’s theater from a young age and became its asso- ciate artistic director. hy do people suddenly start singing in musicals? After graduation, Kitt and Yorkey W Characters feel an emotion were invited to attend the BMI break so deeply that it can only Lehman Engel into be expressed in song and, Workshop. In 1998, a 10-minute song when it grows beyond song, musical about shock therapy, the emotion is compelled Feeling Electric, was their final to become dance. While project at BMI. In 2006/2007, “What has always heightening emotion and propelling the plot, music can after workshops, readings and attracted me to Next have a powerful, bodily affect revisions, the now full-length to Normal was how on the audience. Toes tap; musical was renamed Next to I felt the music—and lines of music get stuck in Normal. It opened Off-Broadway how each character’s people’s head; people leave l in January 2008. individual musicality— the theater singing. perfectly expressed Independent of their rich Activity: Music allows us to feel collaboration, Yorkey is a their emotional state.” – Michael Greif, director deeply and express playwright, director and ourselves when screenwriter on the East and words are not enough. What West coasts; Kitt is a Broadway is an issue you have a hard music director and composer. l time talking about? If the issue were a music genre, meet the director what would it be? Write lyrics – Michael Greif, director of Next for a song about this issue to Normal, is best known for directing the and imagine the music original Broadway production of . behind the lyrics. female hysteria emale hysteria – the idea that mental instability in a Fwoman is connected to her gender – dates back to ancient Greece.

Hysteria derives from the Greek word hystera, meaning literally “wandering of the womb.” Ancient Greek physician Hippocrates (the father of medicine) defined the condition, claiming that a woman’s womb traveled through her body and strangled her as it reached her chest.

Female hysteria has appeared in works of drama for thousands of years. In the ancient Greek play Medea, the title character murders her own children in a fit of rage after being betrayed by their father. Shakespeare incorporated the idea into Hamlet through Ophelia, who goes mad after all The idea of hysteria became symptoms included faintness, the men in her life attempt to use and control her in different popular in the Victorian era. nervousness, insomnia, heaviness ways. Modern playwright took the concept Physicians did not define its cause, in the abdomen, muscle spasms, further in his play Who’s Afraid of Virginia Woolf? His leading vaguely claiming it was a ‘womb shortness of breath, irritability and female character, Martha, deludes herself into believing that disease’ having to do with pent-up a loss of appetite. Since hysteria fluids in the female body. In 1859, was a chronic condition that could she has a son when she has never given birth, connecting it was claimed that 25 percent only be treated but not cured, her insanity directly to her gender and her womb. of women suffered from hysteria, it was suspected that doctors undoubtedly due to the 75-page diagnosed women merely to In Next to Normal, Diana’s mental problems are strongly catalog of symptoms, which make money from the continued associated with her identity as a wife and a mother. l was seen as incomplete. These treatment.

Despite its effectiveness, lectroconvulsive therapy remains bipolardisorder controversial. This is likely due to early, brutal treatments, in which n Next to Normal Diana is a seemingly normal wife and high doses of electricity were Imother, but she is privately battling bipolar disorder, a disease administered without anesthesia, that affects between 2 to 3 percent of the population. Bipolar leading to memory loss and death. disorder – also known as manic depression – is a mental illness Today, ECT can still cause side characterized by serious, even disabling, mood instability. effects, like memory loss, but uses precisely calculated electrical currents given in a controlled People who suffer from the disorder swing back and forth setting to achieve the most benefit between two extreme and opposite phases of moods: and with the fewest possible risks. depression. Mania can be identified by extreme optimism, rapid ECT speech and activity, risky behavior and inability to concentrate. hile medication and therapy are most commonly Its opposite, depression, is marked by sadness, hopelessness, Wused to treat bipolar disorder, some cases are suicidal thoughts, fatigue and chronic pain. The mood swings so severe that such treatments make no difference. may last for weeks or months, and sometimes a patient will swing In these cases, electroconvulsive therapy (ECT) is back and forth between the two moods several times in an hour. sometimes used. ECT is a procedure in which electric currents are passed through the patient’s brain, Severe episodes of either mania or depression may result in deliberately triggering a brief seizure. The treatment (sigh-co-sis), or a detachment from reality. Symptoms of is usually given three times a week and for up to 15 psychosis may include hearing or seeing things that aren’t there sessions. According to the American Psychiatric () and false but strongly held beliefs (delusions). Association, its success rate is 80 percent, considerably higher than the 50 – 60 percent success rate of most The cause of bipolar disorder is unknown, but connections have medications. Doctors are unsure why been made to biochemical factors and genetics. While there is no ECT works, though it is known that many chemical cure for bipolar disorder, a combination of medication and therapy aspects of brain function are altered during and after can often control the disease enough for the patient to lead a normal seizure activity. Researchers theorize that when ECT life. Mood stabilizers, like , can regulate mood and keep the is administered on a regular basis, these chemical swings from occurring, while therapy can help the patient recognize changes build upon one another, somehow reducing and control their mood swings. l symptoms of bipolar disorder. l Helpful Hints for Theater Audiences two sides As an audience member at the theater, YOU are part of the show! to prescription medication Just as you see and hear the actors “Who’s crazy? onstage, they can see and hear you in the audience. To help the performers The one who’s half-gone? do their best, please remember the Or maybe following: The one who holds on?” Arrive at least 30 minutes early. -Dan, Next to Normal Visit the restroom before the show Next to Normal tells the stories of two very different battles with prescription starts. medication. While Diana struggles with how her prescribed medication makes her Before the show begins, turn off your feel, her daughter Natalie begins taking pills recreationally. cell phone, watch alarms, pagers, and other electronic devices. If (Not) Adjusting Addiction anything rings by accident, shut it off Many patients find it difficult to stay More teens are beginning to take immediately. on medication for psychological prescription drugs recreationally. In Save food and drinks for the lobby. conditions. While medication may help 2006, nearly one in five teenagers There is no eating or drinking inside lessen depression or stabilize mood, it reported abusing prescription drugs the theater. also can cause side effects that many not prescribed to them, and more Walk to and from your seat - no find unpleasant. Some patients feel than 29 percent of teens in treatment running in the theater! that their personalities are clouded for this abuse were dependent on Do not talk, whisper, sing, or hum. over or their creativity is dulled. As the drugs. Legal medication can be Keep your feet on the floor, not on the one patient described it, “There was a easier to get than illegal drugs – half seat in front of you. perpetual mental fog…The emotional of teens using these drugs got them blunting left me without real for free from family or friends – but it Avoid getting up during a show for much of anything, while deep inside is no less dangerous. In the past 10 because it distracts your neighbors and the performers. If you must leave, the real me was screaming nonstop.” years the number of teens going into wait for a scene change, then exit Twenty-eight percent of patients taking treatment for addiction to prescription quietly and quickly. go off the drug within medication increased 300 percent, the first month of use. Patients should and emergency room visits have Performers appreciate enthusiastic applause rather than whistling or not go off medication without speaking increased 21 percent. l shouting. to their doctor. Often medication takes getting used to, and patients will Activity: Life confronts people Cameras and videotape are eventually be able to function better with a measure of loss and prohibited because they are distracting to the performers. than they would otherwise. sadness. How do different people deal with the pain? Enjoy the show! Research techniques and resources available to people living through difficult emotional situations. Additional Resources Books/Plays: Mind Race: Young, Bipolar and Thriving - A Personal Memoir by Patrick Jamieson, Ph.D. and Moira Rynn, M.D. 1101 Sixth Street, SW “The Yellow Wallpaper” by Charlotte Perkins Gilman Washington, DC 20024 On the Web: National Institute of Mental Health: www.nimh.nih.gov/ Phone: (202) 554-9066 Musicals 101: www.musicals101.com Fax: (202) 488-4056 Broadway: The American Musical: www.pbs.org/wnet/broadway/ Film: Broadway: The American Musical – PBS Community Engagement Rent – Sony Pictures Phone: (202) 234-5782 Fax: (202) 797-1043

Sub/Text Written by Laurie Ascoli For links and research related to productions, compiled by Contributions from Mitch Mattson & Arena Stage dramaturgs, please visit Sub/Text: Your Virtual Dramaturg at Dr. Korey Rothman, Ph.D. www.arenastage.org/season/08-09/sub-text/. Edited by Rebecca Campana Illustration by Matt Mahurin dramaturg– a theater specialist who does research for productions and represents the intentions of the playwright Visit www.arenastage.org for more information on Arena Stage produc- tions and educational opportunities.