The Film
We first meet Ian Curtis (Sam Riley) at school, as
a day dreamer interested in poetry. He falls for his close friend’s
girlfriend, Debbie (Samantha Morton), and they soon become engaged.
In 1975, they marry when Ian is just 19 and Debbie is 18. However,
Ian struggles to share in domestic life and prefers to write poetry
alone in a room of the house. At this time, he is working as an
employment agent at the local job centre, where he deals with a
young woman, called Corrine, who suffers from epilepsy. She attends
the appointment wearing a protective helmet and Ian witnesses her
having a seizure at his desk. By 1977, Ian and fellow band members
Peter Hook, Bernard Sumner and Stephen Morris formally debut as Joy
Division and Ian & Debbie provide the finance for the band’s
first record.
As the band’s success grows, their manager gets
them their first gig in London in 1978, and it is after this event,
on the way back home that Ian experiences his first grand mal
seizure. The diagnosis of epilepsy is followed by a recommendation
to take several antiepileptic drugs, which cause significant
drowsiness and soon threaten his ability to work at the employment
agency. It is at this time that he hears of the sudden death from
epilepsy of Corinne. Giving up his job just after the birth of
their daughter Natalie in 1979, Ian chooses to focus on his career
in Joy Division, leaving Debbie to look after their daughter and
earn some money whilst he goes on tour. In a gloomy mood, feeling
that his marriage was a mistake, he starts an affair with a Belgian
journalist, called Annik, who is reporting on Joy Division’s 1980
European tour. On his return home, Ian tells Debbie that he
probably doesn’t love her anymore and not long after this she finds
evidence of his affair and confronts him. Telling Debbie that the
affair is finished, he continues to see Annik, who is present at a
concert when he has a seizure on stage, and so is able to comfort
him as he regains consciousness, whilst telling him she loves
him.
Once he gets back home, Ian makes a suicide attempt
by taking an overdose of his medication, leaving a note for Debbie,
but also telling her before collapsing. A brief scene in hospital,
just before his discharge, shows no psychiatric assessment or
intervention despite it being very clear that his mood is
significantly depressed. As the band prepare for their first tour
in the USA, they perform at a small local venue, where Ian finds
himself unable to perform onstage, walking off after only one verse
of a song. Racked with guilt, he expresses the view that he has
lost control of his life. As the affair with Annik continues,
Debbie asks him for a divorce, and asks him to leave. He first
moves in with band member Bernard, who offers him help using
hypnotherapy tapes, and then with his parents. He writes to Annik
of his fear that epilepsy will kill him and that he loves her. But
nothing relieves his distress and he returns home to Debbie,
pleading for her not to divorce him. When she refuses, he becomes
angry, asking her to leave and he sits alone drinking until he has
a seizure. On waking from the floor the next morning he hangs
himself in the kitchen.
Relevance to the field of Mental Health
Control offers the opportunity to consider an important
mental health issue, namely the relationship between depression,
suicidal behaviour and epilepsy.
An article published in 2011, in Advances in
Psychiatric Treatment entitled Epilepsy and neuropsychiatric
comorbidities by Niruj Agrawal & Suren Govender (2011, vol
17, 44-53), provides an excellent introduction to epilepsy in its
various forms and discusses its association with depression,
anxiety and psychosis. The abstract makes
clear that the wide range of neuropsychiatric comorbidities has
only recently been truly appreciated and the full article provides
a thorough consideration of the relationship between epilepsy and
depression. The article states that there is also a strong
association between the risk of suicide and the onset of epilepsy
at an early age, especially during adolescence.
A population based case-control study by
Christensen et al in 2007 (Lancet Neurology 6:693-8)
suggested that the risk of suicide is 32 times higher in those with
epilepsy and depression than in the general population, as opposed
to 2.4 times higher in those with epilepsy alone (link to the
abstract). Antiepileptic medications can also have depressive
effects as well as having a possible influence on suicidal
behaviour. In the recently revised book entitled The
Neuropsychiatry of Epilepsy, edited by Michael R. Trimble and
Bettina Schmitz, published by Cambridge University Press 2011,
there is a chapter on
Antiepileptic drugs and suicide by Trimble, which is
accessible online at Google Books, in which the author discusses
the neurochemistry of affective disorders, suicidal behaviour and
antiepileptic medications.
A viewing of Control, alongside a
reading of these articles and the chapter, would form the basis of
an excellent introduction to the psychiatric aspects of epilepsy
for mental health professionals. But this film can also give all
viewers some understanding of the personal and social implications
of suffering from recurrent seizures.
To quote from a review of this film on the
Disability Now website:
Control is of huge benefit to people with
epilepsy. As a hidden disability, it has little profile. People who
have seizures on the street continue to terrify the population.
Control gets the issue out there.
Written by Clair Chapwell, who has had epilepsy
since she was 14.
This film would be especially beneficial to medical
students and psychiatric trainees and I strongly recommend it.
• More information about Control can be found
at IMDB as can a
short trailer
• The DVD can be purchased at
amazon.co.uk
• Minds on Film is written by Consultant
Psychiatrist, Dr Joyce Almeida.
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