The Almighty Sometimes @ The Royal Exchange Theatre

With the publicity surrounding Johann Hari’s new book Lost Connections and the subsequent headlines citing high rates of antidepressant prescriptions in the UK, questions concerning the widespread use of medication to treat mental health disorders are at the forefront of current public consciousness. This discussion is furthered by Kendall Feaver’s prizewinning play The Almighty Sometimes, which effectively captures the frustrations of eighteen year old Anna as she navigates the transition between child and adult mental health services.

“I’ve been on these pills so long, I don’t know who I am without them,” Anna tells her therapist Vivienne, reigniting the tension between the ‘true’ and the medicated self that is explored in Lucy Prebble’s 2012 play The Effect. Only this time, rather than confined to the temporary realm of the medical trial, the long-term effects of pharmaceutical drugs are explored as Anna attempts to come off the medication she has been on since her pre-teen years. Although Anna’s diagnosis is not specified, and is instead referred to euphemistically as ‘the illness’, the delusions of grandeur she exhibits intermittently alongside periods of depression hint at bipolar disorder. Often overlooked or misrepresented in mainstream depictions of mental illness, these symptoms are portrayed brilliantly by Norah Lopez Holden whose vibrant energy and dynamic physicality illustrate well the severity of the manic episode that Anna experiences.

Despite the centrality of the medication debate to the piece, the distinction between Anna on her meds and off them is not entirely clear-cut. Even in the beginning when she is still taking them, the high energy levels and inflated sense of self-importance are still present, and the exact moment in which she decides to stop taking the pills is unclear. This ambiguity serves to mirror Anna’s own troubled sense of identity, as well as highlighting the uncertainties surrounding psychiatric medication. Where do we draw the line between the ‘true’ and the medicated self? What is a ‘true’ self anyway? Is medication necessarily a departure from this if it enables someone to reach their full potential? And how can we tell exactly what that full potential would have been? Feaver’s play does not decisively answer any of these questions, but considering the contention surrounding these issues, this is arguably a wise move. Instead of a clear-cut argument for or against medication, The Almighty Sometimes instead gives a more nuanced exploration of the of the drugs and of the idiosyncrasies of the UK mental health system as a whole. By chronicling the varying side effects of each drug – “the pill that made my hands shake, and then you swapped that for something that made me nauseous for the whole four months it took me to adjust to it, and then my vision started blurring so you lowered that one” – Feaver artfully demonstrates that the issues surrounding medication are more than simply an abstract, philosophical debate. For Anna, this is a lived reality in which she must weigh up the relative merits and drawbacks in order to make any kind of meaningful progress.

Director Katy Rudd’s staging of the play in the Royal Exchange’s theatre in the rounds heightens the sense of scrutiny: with the characters being observed by the audience from all angles, they are left with nowhere to hide. The giant swings oscillating gently from the ceiling, and the ethereal, rippling pieces of fabric skilfully reflect the precarity of Anna’s interpersonal relationships and the tumultuous nature of her mind. Although at times this imagery feels a little heavy-handed, these elements are worked into the naturalistic dialogue of the piece with ease, creating a stunning visual spectacle that allows fleeting moments of space from the cloistered, tense atmosphere of the characters’ interactions.

The awkward yet tender relationship between Julie Hesmondhalgh and Mike Noble as Anna’s mother Renee and her boyfriend Oliver is another highlight of the performance. This was made all the more poignant by the sense they are both making up for what they mutually lack in familial figures. Despite Feaver’s generally strong characterisation, some elements of it seem a little misjudged, such as Renee’s retort to Anna’s creative block stopping her from writing: “Well, maybe you never could!”, suggesting her writing is “a childhood habit” in which she indulges. The cruelty of this comment, especially at this early, harmonious point in the drama is jarring and could be more effectively deployed later on in the action. Perhaps, for example, when Anna’s behaviour pushes her mother to her absolute limits. Although Sharon Duncan-Brewster does well in conveying Vivienne’s struggle between compassion and professionalism, the character seems slightly underdeveloped and could benefit from more time on stage for this conflict to fully come to fruition. However, regardless of these minor issues, the overall depth of the relationships created by Feaver, as well as the whole-hearted and committed performances of the actors, bring warmth and light into a story with a bleak subject matter. The Almighty Sometimes paves the way for more rigorous and nuanced representation of mental health within drama.