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The Last of Us showrunners discuss Joel's mental health

"You have to go deeper into the emotional action."

Please note, there are spoilers for The Last of Us episode six and the game series it is based on in the article below.

The Last of Us episode six preview.Watch on YouTube

The most recent episode of The Last of Us gave us a closer look at the mental impact Joel's situation is having on him. On two occasions, Joel can be seen clutching his chest as the camera pulls in close and the noise around him distorts. He is having panic attacks.

In the first instance of this happening, Joel assures Ellie that it was just the cold air taking him by surprise. The second time, however, Joel is on his own, and is only 'calmed' by the sight of a young woman who for a moment Joel imagines to be his daughter, Sarah.

Images of Joel in this moment have been widely shared online in a meme format, but there's a lot to this moment than that.

Joel's first panic attack happens after meeting Marlon and Florence. Image HBO.

According to series co-creators Craig Mazin and Neil Druckmann, these moments are a way to show viewers Joel is "coming to terms with how terrified he is that [Ellie] is going to die and it's going to be his fault".

As Mazin explained in the show's accompanying podcast, Joel is having these panic attacks and he doesn't understand why, but ultimately it is because he is scared he is going to let Ellie down.

"If you've been paying attention along the way, what you will see is for as many times Joel has helped her, he's also failed her. And those are the things he dwells on," the creator stated.

"Like a lot of us, if you have core shame or core trauma the way Joel does, the things you do well are discounted but.. you will magnify your failures and tragedies until they threaten to subsume you."

Joel acknowledges these feelings later in the episode when talking to his younger brother, Tommy. He recalls how Ellie had to save him from a rebel in Kansas City, how Henry had to shoot Sam to save Ellie, and how when he and Ellie were being sniffed by a dog trained to detect if someone is infected, he froze.

Druckmann added that Joel is trying to convince himself that letting Ellie go is what is best for her (in both the game and the TV show, Joel asks his younger brother Tommy to take Ellie to the Fireflies) but in fact it is because he is trying to protect himself.

"In the game, the camera is quite far back," Druckmann stated. "You swing it around the character, there's no way to see what's going on in the faces so a lot of it has to be conveyed with dialogue. We just made Joel distant, like their relationship has gone backwards."

However, in the show, there is the option to have more "intimate moments" with the characters, making scenes such as Joel's panic attacks a more viable storytelling option.

When discussing the second of Joel's panic attacks in episode six, Mazin also noted that the lack of gameplay sections to break up scenes meant the crew had to "go deeper into the emotional action" of the characters.

Joel has a panic attack in Jackson. Image HBO.

While Joel does not experience these panic attacks in the game, there are hints at his underlying anxiety even before the outbreak begins.

At the very start of The Last of Us Part 1, players can take a stroll around Joel's house as Sarah. While not immediately obvious, should players choose to delve deeper into Joel's bits and bobs at this point in the game, they will come across a variety of medications. This includes medication for blood pressure and gastric ulcers. In addition to these bottles, players will also be able to find anti-anxiety medication on Joel's side table.

Joel's anxiety medication in the game. Image Naughty Dog.

There are three episodes left of series one of The Last of Us, with the next episode airing this Sunday evening/Monday morning - depending on what side of the pond you are.

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