Explore Themes of Mental Health on Stage Thumbnail

Musicals have never shied away from difficult topics - physical abuse, addiction, alcoholism, serious mental illness, and suicide are strewn throughout the catalog.

Mental Health on Stage

People often think of musicals as an escape - an opportunity to sit in a darkened theatre and shut out the noise permeating their daily lives. But the truth is that musicals have never shied away from difficult topics - physical abuse, addiction, alcoholism, serious mental illness, and suicide are strewn throughout the catalog. However, those more serious subjects are often camouflaged by choreography, show tunes, incredible set designs, and costumes. But here’s the thing. There is a strong argument to be made that musicals are the perfect art form for exploring mental health, as they have an innate ability to elucidate and educate. 

Theatre allows the audience to gain insight into the character's inner lives through dialogue and song. To me, the best part of a musical is that when words alone are simply insufficient, a song begins. It is the combination of words and melody that provide a deeper understanding of the people who inhabit the world depicted on the stage, and frankly, provide a mirror to better understand ourselves. In this space, mental health is displayed as either a secondary theme in a play, or it is prominently featured. 

Let’s first jump in and look at a few musicals that address mental illness in a secondary or tertiary manner. 

Wicked (one of my favorite musicals of all time) portrays themes of disability, internalized and externalized prejudice, and classism (amongst other things). The Phantom of the Opera deals with disfigurement and stigma. RENT (my favorite musical of all time) incorporates trauma, grief, loss, depression, suicide, and external stigma/prejudice. Guys and Dolls addresses gambling addiction. Tommy focuses on abuse, reactions to trauma, mutism, and stereotypes. Spring Awakening centers around themes of abuse, rape, suicide, depression, emerging sexuality, and how this impacts one’s psyche. Jagged Little Pill utilizes the music of Alanis Morissette as its starting point, but is not a jukebox musical. Whether or not you enjoy her music (and I am more than happy to discuss your musical taste offline), this show deftly tackles sexual assault, trauma, and opioid addiction through the lens of a seemingly perfect family, who struggle with these very real problems.   

Separate from those are the themes of madness and delusion that have been inherent in the theatre for decades and decades (they are woven throughout the greatest operas of all time). One such nonoperative musical is Man of LaMancha. This play follows the trials and tribulations of Don Quixote and his happy companion, Sancho Panza. Don Quixote is delusional (through which lens he nobly lusts after his quest and The Impossible Dream) - windmills become great dragons or human foes, and a fallen woman becomes a damsel in distress. He is only able to pull back and gain self-awareness when he is confronted with a mirror that reflects his true self-image - which, one might argue, is an apt metaphor for how one can gain insight and self-awareness in therapy.

These types of shows have paved the way for there to be space for the discourse of mental health in the theatre, but now, I’d like to spend a moment addressing shows that confront mental illness head-on.

Next to Normal is a unique show in that it directly addresses mental illness. The rock musical centers on Diana, a woman struggling with Bipolar Disorder, and its impact on her family. Her family is a fairly typical, suburban family - mom, dad, two kids, and, of course, a white picket fence. This play showcases themes of grief (and trauma after losing her son), depression, suicide, drug abuse, and psychiatric ethics. While not your traditional rock opera, you are left with a feeling that mental health matters, or at least, I was (if you have seen the show, I would love to hear your experience!). The show explores more than the symptoms of mental illness, it also explores her relationships, how her illness impacted her family, and how she navigated psychiatric treatment (medications, hospitalizations, and lots of ECT). 

Dear Evan Hansen is a profound play that touches on, and frankly, tugs on, every possible emotion imaginable. Here’s the skinny: Evan Hansen is a senior in high school who contends with depression and social anxiety daily, which prevents him from connecting with his family and others. Yes, he is in therapy, and this is a prominent thread throughout the play! Evan’s therapist assigns him homework of writing letters to himself, a pivotal piece of the story. Through this, he is thrust into navigating a complicated situation in which a classmate struggles with addiction, mental illness, and eventual suicide. Evan fabricates a story that brings him closer to the deceased classmate’s family. This new relationship gives him the courage to make friends, learn to connect, and gain a sense of security on his own. The show integrates the struggle to make lasting, meaningful connections with others in the age of cyber-communication and how that can impact one’s ability to recognize the relationships (or lack thereof) in their life. Through his therapy and experience, Evan becomes more emotionally resilient and healthy enough to speak his truth in the end.

For those of you who have seen Dear Evan Hansen, I agree with you - that paragraph is a paltry and simplistic overview that does nothing to speak of the nuances, and the complexities of such an emotionally charged, roller coaster ride of a show, that has you laughing at one moment, bawling your eyes out at the next, and renders you unsure if you like or hate the show. (no? Just me? I doubt it). If you have seen it, I would love to hear your perspective on the show!

So, that is the audience's experience. But, what about the actors who are playing these roles on stage, numerous times a week? 

Good actors will tell you that they research, study, and practice until they understand and can become their characters. That means constantly stepping into the shoes of someone who navigates the serious symptoms, and heaviness, of contending with a mental illness - what an emotional toll these actors feel simply by playing these characters. They experience physical reactions- elevated heart rate and disrupted sleep, as well as emotional reactions - increased tearfulness, uncontrollable crying spells, and exacerbated startle responses. That said, credit where credit is due - Kudos to Broadway! The powers that be have recognized these potential negative effects that arise from immersion in these productions! Many theater companies have incorporated behavioral health consultants and mental health professionals to attend rehearsals, provide education for company members about the mental health concerns depicted in the shows, and hold space to talk through any physical and emotional reactions triggered by these productions. 

There is an old adage - “The show must go on!” An outdated phrase, it emphasizes putting the production first but it is now shifting. In the past, if someone broke their leg onstage, they would be told to suffer through it because “the show must go on.” Now, it would be okay for the show to be paused, have someone else go on for them, and allow the broken leg to be wrapped and cared for. The cultural conversation in the musical theatre world around mental illness is changing. It has become increasingly cognizant of the emotional and physical toll that mental illness has on those witnessing the show, as well as the actors portraying the characters. 

Speaking of changing the cultural discourse… “Break a leg” is a theatrical way of wishing someone luck…but, perhaps the orthopedic specialists of the world can work on changing that vernacular next!

Dr. Joy Nadler Frankel is the Chief Clinical Officer of CHE. She has been part of the CHE family for 14.5 years. In her spare time, she enjoys being with her family, long walks on the beach, cooking, baking bread, singing too loudly, and playing the piano.