The game is set in a dystopian alternate 1960s England, where the face-painted inhabitants of the fictional town of Wellington Wells are kept under control with a drug called Joy. The player takes the role of a "Downer," a person who refrains from taking Joy. The Downers comprise an underground resistance movement that is trying to escape from Wellington Wells. However, the town's citizens do not take kindly to Downers, so players have to act like they are high on Joy in order to blend in. They must scavenge for food and supplies as they try to survive in this procedurally generated world.