How to Write a Screenplay Dealing with Mental Illness

By February 28, 2015Screenwriting 101

Conflict consistently makes for interesting stories in screenplays. But how does one convey conflict within a person’s mental capacities?

With a lot of tact.

It’s very easy to tackle a topic in narrative fiction, whether or not it’s based on a true story, and insensitively muddle facts or come off as insensitive when dealing with a touchy subject like mental health. So if you’re looking to feature a character whose main conflict is in their head, look to the screenplay for Still Alice and these tips:

Establish The Lead Character and What Their Struggle Is Early

In Richard Glatzer and Wash Westmoreland’s screenplay, we follow Alice Howland as she discovers and copes with early onset Alzheimer’s along with maintaining her ties with her family members. The first scenes in the script show Alice misspeaking and forgetting words. The scenes effectively show her mental health deteriorating while showing the audience what her relationships are like with her husband and children. As the disease grows more intense, their relationships are taken through the ringer. As the audience, though, we have a good base of where these relationships started.

When writing a screenplay wherein a character struggles with a disease or something only they explicitly suffer from, be sure to show them figuring out what it is, how they suffer from it, and how or if they come to terms with their condition. Can they? Do they want to? Ask these kinds of questions.

Clearly Define Their Internal & External Obstacles

Alice mistakes herself with her daughter. She forgets the word “lexicon” while giving a speech about linguistics. She gets lost jogging near her home, where she has jogged many times before. Having these scenes play out in addition to a scene where a doctor spells out her condition help drive the severity of her situation home for audiences. Be sure to clearly and creatively illustrate the struggles your lead character faces. Have them speak dialogue with themselves. Write in scenes with slug lines where they pause and wonder. Action blocks are priority though.

There is a scene where Alice is doing memory exercises while making dinner and welcoming her family members. She does well at the exercise, but has forgotten how to make bread pudding, which she had been making for her family for years. This scene plays powerfully to show how she tries to battle her condition and retain normalcy, but can’t and loses parts of her that have been there for years, like knowledge of things her family loves and, eventually, her family as one.

Show The Grave Stakes They Face & How They Face Them

Alice’s Alzheimer’s gets worse and worse, eventually leaving her barely able to speak full sentences. Before getting to that point, she creates a terrible way out for herself should her mental state get too severe. She also looses her career and her familial relationships become strained as the plot progresses. When penning your screenplay, have the individual scenes show how your character does or doesn’t cope with their situation as it goes from bad to worse to worst. Definitely utilize the Eight Sequence framework to help chart your screenplay and use the scenes that show your screenplay moving forward to do it.



The scenes in the screenplay show Alice trying to do well in the condition she’s in, and it also shows her mental stake push her to the brink of giving up. The stakes are surely life and death for Alice and we see her try to do both. In your screenplay, be sure to include harsh realities of people grappling with terrifying odds and situations.

Still Alice isn’t the first screenplay I thought of to use for examples of great storytelling with such a grim subject matter. One Flew Over The Cuckoo’s NestOne Hour Photo, and Psycho came to mind. All of those critically acclaimed films feature a main character or characters with mental illness, but they are all men (too far often) and they didn’t have the main character deal with their condition in a touching, sensitive, hyper-realistic way like Still Alice does, in my opinion (feel free to comment on this below). And when writing your screenplay where a character has mental issues, be sure to keep some of what makes them affable and likable in tact, even if their struggles try to rid them of those characteristics.

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