Awake // Miranda Colmans

Sleep: we all need it and most of us probably think we don’t get enough. But what is it like to get a bad night of sleep, day after day, week after week, month after month? Awake, by Miranda Colmans, explores this. Told through a series of characters who find themselves awake in the middle of the night and come together in an online chat room, Colmans highlights the difficulties experienced by people with chronic insomnia.

Around 6-10% of the adult population will meet the clinical criteria for insomnia disorder, which requires at least 3 nights a week of poor sleep, for at least 3 months, causing significant distress or impairment to daytime functioning. Colmans portrays not just the exhaustion that is experienced by successive nights of little sleep, but also the frustration and loneliness that people experience being awake while everyone else is asleep.  Starting off with the at times comical side of the often conflicting advice and strategies offered to get to sleep, like trying to relax for the third time that night. 

Colmans leads us down a path of the increasing frustration and loneliness her character’s experience to the onset of mental health problems. Insomnia is a recognised risk factor for the development of depression and commonly occurs alongside many mental health conditions.  Colmans’ portrayal of a single mum as she tries to cope with a new baby on little or no sleep, eloquently demonstrates how things can quickly unravel. The onset of insomnia is not uncommon during or shortly after pregnancy and can be linked with the development or exacerbation of post-partum depression. This is a very vulnerable time for many new mothers and fathers, especially for those with little or no support. Sleep is often low on the list of priorities but more needs to be done to ensure that we give sleep the time it deserves. Work like Colmans’ bring sleep to centre stage, recognising the importance of sleep in all of our lives. 

- Kate Porcheret

Links relevant to this diagnosis:

Awake - Miranda Colmans

Scientific Review of Chronic Insomnia - The Lancet

Why Do We Sleep? - Russell Foster (TED Talk)

Having Trouble With Your Sleep? - Nuffield Department of Clinical Neurosciences

ELEPHANT OF MY HEART // Prospero Theatre

There’s a long and rich interplay between meditation and the arts, including music and artworks including the ancient Indian tradition of mandalas. 

But bringing meditation into conventional theatre is a little more unusual. Elephant of my Heart is a stage adaptation of Jessica Clements’ book of the same name: Clements herself even performs in the show’s chorus. It’s a memoir of her time in hospital recovering from a brain haemorrhage as a nine year old child. She believes that the inner travels she went on, guided by an elephant, triggered her healing process. 

Prospero Theatre adapt her story using familiar techniques of children’s theatre: puppets, songs, games, and audience participation. But there’s an emphasis on the body, and on creating a new language to talk about illness and recovery. Jess is taught that the scars covering her head are sewn up by a black panther’s whisker, and kept safe by invisible dragonflies. Medicalised terms are demystified by being paired with analogies from the natural world, in a holistic approach designed to lead Jess towards a new comfort with her recovering body.

At the close of the performance, Clements leads us on a simple visualisation, designed to help the audience find their own inner animals. It highlights the closeness between mindfulness exercises and the kind of imaginative games that children often play - their careful focus during  the visualisation suggests that perhaps children’s comfort with their own imaginations makes them more receptive to techniques that adults feel too inhibited to try.

Little is known about whether healing can be accelerated by meditation, but recent studies tentatively suggest that the stress-reducing properties of meditation can strengthen the immune system. Certainly, there are clear links between meditation and the state of mental wellbeing needed for a full recovery. But perhaps the strongest message of Elephant of My Heart is the importance of developing a language and story that enables people in recovery to understand their illness, whether or not that means cultivating an inner jungle.

- Alice Saville

Elephant of My Heart was on at the Edinburgh Fringe, Greenside, from 5-16th August. More information: http://prosperotheatre.com/prospero-community-company/elephant-of-my-heart/

The role of mandalas in meditation: http://www.chopra.com/mandalas-sri-yantras

More information on Jessica Clements’ book: https://www.amazon.co.uk/Elephant-My-Heart-Jessica-Clements/dp/1452585725

Studies which tentatively suggest the positive impact of meditation on the immune system: http://www.ncbi.nlm.nih.gov/pubmed/26799456

MONOLOGUES OF A TIRED NURSE // Theatre for Thought

Stress-related mental health problems affect one in five primary care workers. Four in five have trouble sleeping. These are the realities of working in today’s NHS, according to mental health research by Mind, and they form the backdrop to Monologues of a Tired Nurse.

Two nurses step onto the stage, one an optimistic new recruit, Emily, and the other a battle-hardened and exhausted nurse-in-charge called Sally. Among the paraphernalia and body fluids of a normal day, a harrowing story unfolds, the characters’ interconnecting soliloquies showing how the most compassionate individuals can become casualties of an undoable job.

Sally says she came into nursing with a Superman complex, but soon realised there was no time to care. She feels broken – that she isn’t good or worthy, and is angry with people who say nurses are saints.

Emily is hopeful, almost angelic, but struggles to gain professional confidence. Sally’s attempts to toughen her up only seems to make things worse. Emily blames herself for the mistakes she makes under pressure, and sees the coping mechanisms she develops as inevitable.

Monologues is written by Stephanie Silver, who worked for eight years as a paediatric nurse and plays the hardbitten Sally. Her insider’s perspective shows a health service in which shortages have a direct impact on both patients and carers, and where the scrutiny of box-ticking bosses takes priority over the humanity of staff.

It's the issue of putting a brave face on things, and continuing under grinding levels of stress, that this play really addresses. Emily, lost in issues of her past and present, eventually leaves a note for Sally and takes her own life.

Mind’s research shows that one in three healthcare workers would never talk about their stress for fear of being seen as less capable - less able to take the heat of an NHS essentially on fire. Monologues starkly shows us the future we are facing if we are not prepared to care for those who work on the frontline of caring for us.

- Rebecca Mileham

Monologues of a Tired Nurse ran at theSpace @ Surgeon's Hall until August 27th - https://tickets.edfringe.com/whats-on/monologues-of-a-tired-nurse

Mind’s 2016 survey into mental health in caring professions: http://www.mind.org.uk/news-campaigns/news/mind-finds-worrying-levels-of-stress-among-primary-care-staff/#.V8b8vqI9p8o

NHS staff cuts and reduction in care quality ‘inevitable’, say King’s Fund: https://inews.co.uk/essentials/news/health/kings-fund-nhs-staffing-cuts-care-quality/

Student bursary cut 'may worsen NHS staff shortages': http://www.bbc.co.uk/news/health-36336830

Nursing Times article on a nurse's suicide being linked to work pressures: https://www.nursingtimes.net/walsall-nurses-suicide-linked-to-work-pressures-rules-coroner/1/5076937.article?sm=5076937

(I COULD GO ON SINGING) SOMEWHERE OVER THE RAINBOW // FK Alexander

The volume of this work is at the level of trembling clothes. An affective noise that moves bodies and governs the internal rhythms of an audience to match its ritual of dialogue balladry. The singer is standing in a washed-out strobe aurora with a mic lead coiled in her punk rock grip, hand-in-hand with one from the crowd. The crowd let it lull them into a meditative state.

Noise is often a subtle charming of our unconscious reactions, whether the drip-drip of an irritating tap or the hollow roar of a train-journey tunnel. It holds and releases insides and surface, quivering and dimpling and pushing you back, fading into the background with time but rearranging you as you stand. It bathes and heals and envelops your stresses, leeching it back through vibrations that heal. FK Alexander enters into eye-contracts of healing interaction flanked by the two noisy sentinels of her co-performers. For an hour after entering you stand, sit or shuffle in the space at the limit of aural endurance, until leaving into the shocking quiet. It’s sound as a weapon targeting isolation, and sound as a healing force, bridging bodies in the room.

The work is a cover version of a performance moment, a reinterpretation of a numbingly repeated song to convey the hurt and poignance of the final performance of an aging star. Clattering drums and odd discordance augment the familiar Hollywood build to a transcendent moment of cathartic release. The formality of dressing, undressing, and holding hands acts out a serenade as an engagement. When Judy Garland died of an overdose of barbiturates in 1969 it was an overstimulation to the point of limit. The noise here is an overstimulation, but one that heals as much as that other destroyed. (LC)

(I Could Go On Singing) Over The Rainbow ran at Summerhall Basement until August 28th - https://tickets.edfringe.com/whats-on/i-could-go-on-singing-over-the-rainbow

FK Alexander: https://www.artsadmin.co.uk/artists/fk-alexander

A History of Using Sound as a Weapon: http://motherboard.vice.com/read/a-history-of-using-sound-as-a-weapon

Sound Healing: http://qz.com/595315/turns-out-sound-healing-can-be-actually-well-healing/

Come On, Feel the Noise (Paul Hegarty): https://www.theguardian.com/music/2008/nov/10/squarepusher-paul-hegarty-noise

Clip of Judy Garland’s Final Television Performance: https://www.youtube.com/watch?v=CJhHPTBjzac

The Second Summer of Hate: Noise Rock Now (The Quietus): http://thequietus.com/articles/19966-noise-rock-2016-reviews

Okishima Island Tourist Association Shoot: http://www.kovoroxsound.com/OKISHIMA%20ISLAND%20TOURIST%20ASSOCIATION%20-%20SHOOT.html

DON'T PANIC! IT'S CHALLENGE ANNEKA // on the button

A solo comedy show in which writer and performer Sophie Winter plays all the parts, including her boss, her mum, her best friend and 90s TV star Anneka Rice, Don't Panic! It's Challenge Anneka is all about anxiety. It uses humour and silliness to demystify and start conversations about a serious subject.

Sophie worries to a debilitating extent, making daily life incredibly difficult. The people around her don't understand the panic she regularly feels, advising that what she really needs to do is pull herself together and get on with it. Sophie even berates herself – she's a privileged young woman from Hampshire who has suffered no traumas of note. She has a job, a decent income and a roof over her head, what has she got to be so anxious about? Her guilt only makes her feel worse.

Anxiety disorders, which often manifest as excessive worry, fear and a tendency to avoid potentially stressful situations, are some of the most common mental health problems we experience. Modern life is anxiety inducing, but the fight or flight response is ancient. When a human believes they are in danger, their breath shortens, their heart beats faster, they sweat – all symptoms of a panic attack.

After Edinburgh, Don't Panic! It's Challenge Anneka will tour secondary schools, running workshops exploring mental health for students in Year 9 and above. This makes sense, as young people are most likely to experience anxiety. A global review of existing scientific literature by the University of Cambridge published in June this year found that four in every 100 people experience anxiety disorders, with women and people under 35 affected the most.

The literature review highlighted the need for more research, especially into how anxiety affects marginalised groups. Dr Louise Lafortune, Senior Research Associate at the Cambridge Institute of Public Health, says: 'Anxiety disorders affect a lot of people and can lead to impairment, disability, and risk of suicide. Although many groups have examined this important topic, significant gaps in research remain.' (HB)

Don't Panic! It's Challenge Anneka is on at Summerhall (venue 26) until 28 August (not 22nd). See venue for accessibility information - https://tickets.edfringe.com/whats-on/don-t-panic-it-s-challenge-anneka

Anxiety UK: https://www.anxietyuk.org.uk

'Women and people under the age of 35 at greatest risk of anxiety': http://www.cam.ac.uk/research/news/women-and-people-under-the-age-of-35-at-greatest-risk-of-anxiety

'Living with anxiety: Britain's silent epidemic': https://www.theguardian.com/society/2013/sep/15/anxiety-epidemic-gripping-britain

'Anxiety: the epidemic sweeping through Generation Y': http://www.telegraph.co.uk/women/health/anxiety-the-epidemic-sweeping-through-generation-y/

'How It Actually Feels to Live with Severe Anxiety': http://www.vice.com/en_uk/read/anxiety-and-me-189

It Affects Me: http://www.itaffectsme.co.uk