Laughing Through the Darkness: Improv and Mental Health

(PHILADELPHIA) – With the strident shriek of his whistle, a referee in black pants and striped polo shirt bursts onto the stage and circles it several times. The audience crowded into 100 theater seats, initially responding with hesitant claps that grew louder as they realized the show had begun.

Each weekend for over 30 years, this is how ComedySportz Philadelphia at 2030 Sansom Street has opened the longest-running improv show in the city. Improv, short for improvisation, is a form of live theater in which actors, often together with the audience, create scenes on the fly without scripts to guide their performance. According to Chicago News, improv as a theatrical form has roots going back centuries. But, the modern form of improv emerged in the ‘50s at the University of Chicago and, since then, has spread to major cities across the world.

The ComedySportz theater is divided into four sections separated by a narrow corridor, with two smaller sections facing the stage from the sides and two larger ones directly in front of the stage. The ambiance is semi-dark, with the only illumination coming from the stage. Faces are hard to make out, but voices ring through the theater hall. From the youthful tones and goofy comments of teenagers to the deeper voices that pack years of wisdom, the audience mirrors the diverse human fabric of Philadelphia.

With a breathy voice, as if he just finished a 10K, the referee explains the show’s rules and provides detailed instructions for how the audience will participate. This, he says, is a “fierce sports match” between the blue team representing Philadelphia — which elicits a loud cheer from the crowd, forcing the referee to wait a few minutes until the loud applause and whistling subside — and the New Jersey red team, who are met with boos as they step onto the stage.

The 45 minutes that follow are packed with interactive, high-paced improv games, such as the adverb game, in which the referee throws out an adverb for each team to incorporate into their lines, or the reverse game, in which players go back and forth between their lines per the referee’s instructions.

The show ends with the tallying of votes earned from the different games, and to everyone’s surprise, the red team defeats the hometown blue team by five points. Despite the outcome, the audience’s excitement remains high, evident from their applause and whistles as both teams exit the stage.

People come to ComedySportz for various reasons — whether to escape a boring Tuesday night or to try to be the next SNL star. Kelly Jennings, 56, a ComedySportz veteran with over 30 years of improv experience, knows better than anyone else. “That’s why I have fallen in love with my profession,” she said.

The benefits of improv extend beyond entertainment. According to an article posted by WorkLife online magazine in February 2024, major companies like McKesson and Pepsi have relied on improvisation techniques for decades, leading to increased team collaboration and creativity. But when it comes to managing anxiety, improv has also shown promise. The brain is active during improv and entirely absorbed with the game, forcing feelings of fear to take a back seat. At the same time, the mantra of “Yes, and…” which is at the core of improv, as opposed to “no” or “yes, but” sets a more positive and creative mindset, both when faced with issues at work or in private life.

During the height of the pandemic, Dr. Adam Taupin, a psychotherapist with a clinical practice in Philadelphia, met Jennings during one of her online improv workshops. When he learned that Jennings was moving to Philadelphia Improv Theater (PIT), he emailed her to pitch an improv class geared toward mental health. Jennings was thrilled, and Taupin couldn’t have been happier about joining PIT to work on this new class exploring the connection between improv techniques and mental health. “This was a wonderful opportunity for me,” Taupin said during a telephone interview.

Taupin’s journey with improv began over a decade ago when, as a psychology graduate student, he recognized the need to deal with his own social anxiety.  “For anxiety, the best way is exposure therapy — that is just to be around other people — and that for me was improv, which became a huge, huge way to overcome my anxiety, and I want to pave the way for others,” Taupin said.

This class that Jennings and Taupin created quickly filled up with about 12 students, ranging from a first-year college student looking for ways to connect with fellow students to a retiree trying to refresh his social skills and everything in between. Thanks to the success of this first class, Taupin is teaching another round this spring and plans to introduce a third in the fall. “The hope is that, gradually, more people start making the connection between mental illness and improv, and the class takes off, becomes more popular, and becomes part of the PIT standard curriculum,” he said.

For Jennings, the most important thing is for participants to leave an improv class or show feeling as if they have learned something valuable and can see themselves reflected in the diverse audience drawn to this art form. “This is something I can personally attest to since I have been taking improv classes on and off for over 15 years,” she said. She is not alone. I have learned to be more creative at work, more accepting of others, and more assured of myself.

My Journey: From Depression to Stage

In 2010, I was diagnosed with depression — it felt like a life sentence. Growing up in a small rural area in Portugal, where everyone knew each other by name, being diagnosed with any mental illness often meant being sent to a mental institution. To this day, when I recall the whole ordeal of sitting alone in a small doctor’s room on one of the floors of the Hospital of the University of Pennsylvania, filling out a lengthy questionnaire that felt more like an exam I had barely prepared for, the sweat and the burning sensation still show up. I remember how difficult it was to read the words as they seemed all mashed up together. I could barely distinguish those words, let alone comprehend and answer the questions.

While filling out that questionnaire, I could feel the overwhelming tension in my brain and body, how my hands barely held the pen, and the sweat dripping into my eyes. Looking back, I wish I had cried. Then, there was the terrifying moment when I felt my jaw freezing, unable to articulate words or make sounds. The nurse came by and took the questionnaire. By the time the doctor knocked on the door, I had regained some control over my body and my mind. He pushed his stool next to me and reassured me that, despite the severity of my depression, with medication and therapy, I would recover within a few months.

As devastated as I was, when I left the doctor’s office, I was holding what felt like a life-saving prescription, and I finally had a name for the terrifying thoughts and feelings that plagued me for years: depression.

I went through years of slow and painful progress. My medication needed constant adjustments, and therapy sessions did not progress as quickly as I hoped. The highs and lows of dealing with my illness were excruciating, and it seemed that each low was worse than the last.

One afternoon, while heading to Rittenhouse Square in Philadelphia, I stumbled upon ComedySportz. The venue had a large poster in the window depicting two teams in an intense standoff with vibrant colors that caught my eye. I decided to give it a try, feeling desperate for change after years of medication with slight improvement. That decision marked a turning point in my life. After my first class, I vividly remember standing in front of the building, taking deep breaths as the therapist had taught me, feeling a sense of lightness and brightness. Though these positive feelings didn’t last long, they were the first of many such moments on my recovery journey. The journey was tough and arduous, but it gradually helped me grow back into myself, teaching me to be more spontaneous, to embrace and learn from mistakes, and to live in the present moment.

At that time, I was in my early 40s, living in Philadelphia, a city I barely knew, with no family nearby, and caring for two young children. Yet, the circumstances of being away in a foreign country turned out to be a blessing. It relaxed me because I controlled when or if I would share it. I never shared the outcome of that doctor’s visit with my husband or anyone else, but he, like those around me, understood the reality and what that would likely mean for them and me for the next few months if not years. Today, after 12 years of therapy, I still take a low dose of Wellbutrin to manage my disease.

Mental Health in the Wake of the Pandemic

In the years following the initial wave of the pandemic, scientists have extensively studied connections between COVID-19 and depression, particularly in vulnerable populations. The forced isolation, the rising number of deaths, and the mounted uncertainty surrounding COVID-19 exploded formed the perfect storm for depression and anxiety. According to Neuroscience Insights, depression can come directly from the virus itself or as a by-product of forced isolation and the consequent feelings of loneliness and hopefulness.

According to the World Health Organization, the COVID-19 pandemic led to an estimated 25% increase in depression, especially among young people and women. While physicians were initially concerned with the physical implications of COVID-19, such as shortness of breath, muscle pain, and loss of smell, today their concerns have shifted to the long-term effects of COVID-19, which also include changes in the brain, leading to a greater propensity for anxiety, fatigue, loneliness, symptoms that can lead to depression.

The levels of stress, insomnia, anxiety, and depression are still higher today than before the pandemic, according to the Mayo Clinic. Still, the silver lining is that people are also more open to and accepting of depression and other mental illnesses.

Dr. Jody Foster, chair of the Department of Psychiatry at the Pennsylvania Hospital of the University of Pennsylvania, notes that while stress, insomnia, anxiety, and depression surged during the pandemic and remain higher today than before the pandemic, she also notices a shift in how people perceive mental health issues. “The idea of isolation, loneliness, and sadness — symptoms that can lead to depression or profound anxiety — became more acceptable as side effects of the pandemic,” she says. This growing awareness has led more people to seek help, reducing some of the stigma associated with mental illness. “We see it with our young people. Therapy is no longer such a problem as it used to be. It’s becoming much more acceptable than ever, certainly over my career.”

Exploring Improv as a Therapeutic Tool

Taupin is not alone in his belief in exploring improv techniques to help manage mental health issues. Dr. Peter Felsman, an assistant professor in the Social Work Department at Northern Michigan University, has studied the impact of improvisational theater on mental health. He published a study in 2023 on whether participation in improv classes could help young people handle uncertainty differently, potentially reducing social anxiety.  Through the Improv Project, hundreds of Detroit students participated in a 10-week improv course. Students completed surveys during the first and last weeks to measure their ability to handle uncertainty and social anxiety, and the results were encouraging. Felsman’s work shows how improv promotes divergent thinking, tolerance of uncertainty, and overall well-being.

Felsman, who grew up learning about psychotherapy from two close relatives early on in his life, began experimenting with improvisation while learning music. But most people engage in improv “because it draws on the language of our day-to-day lives, as opposed to music that may require some technical expertise.”

Felsman credits improv with helping him feel more comfortable with not knowing. “It is something that shows up in my life a lot,” he says. “I think sometimes that is really useful to slow the urge to problem-solve and instead stay present.”

In my case, practicing improv helped me feel more comfortable with the unknowable. Slowly, I stopped worrying about my depression and the future. The unbearable feelings of being crushed every day became less frequent, less painful, and more manageable. My sense of hope returned, and I slowly started believing I could control my feelings. That was liberating.

In the Spring of 2023, I went back and enrolled in two of the practice group classes where we played games like “I Am an Object,” where participants form a circle, and one enters the circle and assumes the shape of an object, announces it like “I am a Tree,” And the next participant joins in as another object, like a flower. A third participant joins in as a leaf. The first participant then decides which of the other two objects (flower or leaf) to keep in the circle while the two others go, and the next round starts. The key to this game is speed so that no one can overthink. The result is spectacular as participants play both roles as actors and spectators. This game fosters creativity and teamwork and spurs an extraordinary willingness and ability to accept others as they are.

Felsman recognizes that the connection between improv and the healing and therapeutic process to overcome anxiety “is definitely not mainstream. I think people are increasingly more aware.”

Foster, in her role as head of the Psychiatry Department at the University of Pennsylvania, with over 30 years of experience treating patients suffering from depression and other mental illnesses, always reminds patients that  “If you do not give your mind different opportunities to do different things or think different things so you can get it out of that loop of thinking negative things all the time, it is going to be much harder to break that cycle and to feel well.”  She highlights that over the last few years, evidenced-based treatment has become much more prominent and that cognitive behavior is a “tried and true and data-driven evidence” based treatment of depression and anxiety. What seems to happen is that these activities reroute negative thoughts, showing our brain’s power to heal itself. This is similar to my experience with improv’s power to ease negative thoughts.

Medications take one to two months to work, and that is after the trial-and-error period to identify the correct dose, which might take weeks. However, according to Foster, the average stay is about five to six days when a patient requires hospitalization. “It is not the medication that makes people feel better,” Foster says. What helps patients recover faster is regular, predictable sleeping patterns, eating healthy, and keeping their brains busy through exercise or other activities that support brain rest.  “I would say that, at least on the inpatient side, that is probably 85% of the treatment,” Foster says.

As someone who ran a secure adult psychiatric unit for decades, Foster believes there is no substitute for getting enough sleep, eating well, and maintaining structured activities to stay engaged and healthy. While the medical community often focuses on treating acute illnesses and therapists address patients’ conflicts, the complete picture of recovery should also include Activities of Daily Living (ADLs), like eating, bathing, and dressing, skills required to manage one’s basic physical needs, and activities to foster social connectivity like spending time with friends and family.

It’s important to note that Foster is not referring to those with a genetic predisposition to major depression or anxiety, as their conditions may require different treatments. However, for preventable depression, like what many experienced during and after the pandemic, the stewardship of sleeping, eating, exercising, and fostering connections with others is critical to promoting good mental health.

Foster recognizes that the medical community focuses on treating acute illnesses, and therapists tend to address the conflicts patients deal with. Rarely does either one provide the complete picture of what it takes to feel well again, which must include ADLs.

It is important to note that Foster is not referring to those with a genetic predisposition to major depression or anxiety because no matter how well they take care of themselves, their genetics might cause depression episodes, forms of depression that are also treatable today. But for preventive depression, like what many people experience during and after the pandemic, the stewardship of sleeping, eating, exercising, and fostering connections with other people are critical components to promoting good mental health and preventing depression.

Although my depression and anxiety have been under control for a few years now, I still keep an eye on my mood and feelings. Recently, during a stressful time at work and school, I enrolled in an improv class, “Emotions and Character POV.” In this class, we paired up to play different characters and explore our emotions in various situations. Whether we played a brother and sister having a discussion, a mother and son visiting a zoo, or a couple dealing with their house on fire, the experience was liberating. We immersed ourselves in each scenario without fear of judgment, offering a refreshing escape from our daily stresses and a safe place for self-expression.

Improv has helped Felsman approach challenging conversations confidently and trust himself more to see things through. “Improv makes us more likely to try things we’re on the fence about, which enriches our lives tremendously,” Felsman says. “Oh, my God! I’m so happy that I went into this world.” And I agree.

Editor’s note:  The original version of this story incorrectly described Jody Foster as the “head of the Psychiatry Department at the University of Pennsylvania .” Her title was corrected to  “chair of the Department of Psychiatry at the Pennsylvania Hospital of the University of Pennsylvania” on Dec. 11, 2024.