Is Sundowning Real? 'The Visit' Has Some Roots In Real Neuropsychology

Before I begin, I would like to make one thing deeply clear: I would not recommend looking to horror films as a tool to learn more about the intricacies of neuropsychology. M. Night Shyamalan's new film The Visit is no exception. That said, the film does reference the very real neurodegenerative disease "sundowning," and for that, it deserves some attention. So, what is sundowning, and is it anything like we see in the film?

If you don't recall, here's how sundowning is referenced in the film: When 15-year-old Becca and eight-year-old Tyler go to visit their elderly grandparents, whom they've never met, they become acutely aware that their grandmother, Doris, begins to act rather erratically when night falls. After Becca witnesses Doris projectile vomiting one night and clawing at the walls in the nude, her grandfather reveals that Doris suffers from "sundowning." Becca looks into the disease online, and shares with her brother that, yes, it is a legit condition that can affect the elderly due to "chemical reactions" in the brain that are triggered by the lack of sunlight. Doris' increasingly violent behavior — laughing to herself, asking Becca to get inside the oven to "clean it," grabbing a knife to stab the children — is explained away by the disease for much of the film. 

But, how does sundowning affect sufferers in real life?

This is likely obvious, but it's hardly like what's seen in the film. According to WebMD, sundowning is actually a side effect for those suffering from a form of dementia, likely Alzheimer's Disease. It causes the sufferer to be increasingly confused and agitated in the later hours of the night, and those who have witnessed the condition in loved ones often report sufferers exhibiting symptoms of frustration, irritation, disorientation, suspicion, hallucinations, yelling, and exhaustion, amongst other things. Violent outbursts — which Doris suffered from — are not listed as a symptom.  

This is all seen in the film — but the parts where Doris is crawling around the house as if she were possessed by a demon are not at all typical of the disease. As the Mayo Clinic reports, symptoms of the phenomenon are actually set off by "fatigue, low lighting, increased shadows, disruption of the body's "internal clock," [and] difficulty separating reality from dreams." Episodes can last hours into the night, which causes the sufferer to feel greatly fatigued and restless — both feelings that can unfortunately worsen the symptoms of sundowning, leading to a rather vicious circle.

According to informational videos from the Alzheimer Society of Ontario, strategies to lessen the severity of episodes range from no napping — which encourages the sufferer to actually sleep at night — to avoiding caffeine, increasing lighting, and partaking in calming activities.

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In some senses, the portrayal of "sundowning" in The Visit is rather accurate — Doris is often increasingly confused at nights, and prone to erratic behavior in low lighting (remember when she chased Becca and Tyler as they were playing hide-and-seek under the house?). However, I'm fairly certain that her increasingly violent behavior, as well as her psychopathic tendencies, can actually be chocked up to a different disorder. As the film reveals (spoiler alert!), Doris and John aren't actually Doris and John — instead, they are escaped patients from the mental hospital that the real Doris and John used to volunteer at every Tuesday and Thursday. When fake Doris and John heard how excited the real Doris and John were to finally meet their grandkids, they escaped and killed the couple so that they could spend a picturesque week together like a real family (the reason for this, as fake John later explains to Becca, is because fake Doris killed her own children years ago, so she "deserved" a week to feel like a real grandmother). 

Based off of this explanation, it's not out of the realm of possibility that fake Doris suffered from other mental disorders in addition to dementia.

Once again, taking any actual scientific information from a film that was created with the intent to scare audiences is not something I would recommend — but learning more about a real life disease that affects many elderly patients as a result of seeing the film is definitely not a bad move. 

The Visit hits theaters Sept. 11.

Image: Universal Pictures

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