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During the dance, Alicent starts forgetting. It's trivial, most days; she wouldn't attend a council meeting, citing she didn't remember it was going to happen then. It's normal enough, people think. Forgetfulness is a common thing for a widowed wife and grandmother still in grief.
It's only when she starts going to the sept everyday, saying that she hadn't yet gone that week, that she starts worrying people. Criston, her sworn protector, is the first to notice, as he accompanies her basically everywhere. Once, in a conversation, she mentions going to see Helaena and her grandchildren after visiting the sept. He doesn't object, not mentioning the fact that she only had one grandchild left, but he makes a mental note of it, deeming it worthy of a conversation with Aemond.
Helaena is the second person to realize something is wrong with her mother. On a rather uneventful afternoon, Alicent enters her room, asking if she knew where Aegon had been. "He's bound to his bed, mother. Unconcious." Helaena reminds. The dowager queen's face morphs into confusion, before she turns around, leaving the room.
She has her first hallucination in the sept, only two or three septas around to witness; Alicent, who's always quiet and discret with her prayers, starts talking, tone barely above a whisper, to someone who isn't there. "It looks like she's arguing with someone else", one of the septas points out. She leaves in a fast pace, irritated and confused. The women inside the religious temple don't comment on their queen any further.
One day, she enters Criston's chambers. "What are you doing here?", she had asked, impatient. "Where's my father? And what is your business in his room?", she finished before he could get a word out. "I'm hand of the king now, your grace." the answer came plainly; "Your father's back in Oldtown, with your son Daeron", he complemented. Alicent had only scoffed and whispered something akin to "I'll take this up with Aegon" to herself only, leaving the room annoyed. Cole had thought to run after her, to show her the state her son was in; state she seemed to forget about time and time again, but ultimately decided against it.
It's not until she shows up to a council meeting late and starts questioning why Aemond is taking his brother's place that they start to really worry for the dowager queen's mental capacities. She had yelled at Aemond's lack of answer, demanding to know where they had taken her eldest son. Her father, who had recently returned from Oldtown with her youngest child, was called to calm her down, taking her to her chambers alongside Maester Orwyle, so he could access Alicent's condition. "I fear she may have gone mad, my lord, but we'll keep a close eye on her." Otto had only nodded, taking himself and the maester out of her room. She wasn't able to sleep that night, worried of what might have happened to her son.
Her conciousness returns to her from time to time; a fortnight after the council incident, she shows up in time for their usual meeting, having seemingly forgotten the episodes from a few weeks before. She appears clear headed and objective, still giving her input in important matters, unbothered by the fact that Aemond sat at the end of the table rather than her eldest son.
The second time someone finds her hallucinating, she's in the Red Keep godswood, sat under the Weirwood there. She has a book in her hands, the contents unknown to the mostly illiterate castle servants. Alicent talks and laughs, like someone is at her side, reading it with her. "She looked happy, almost peaceful. I don't think I have seen her like this before", said one of the workers when questioned by Larys about the queen's doings. One even dared to say that Alicent had been pretending to talk to her estranged childhood companion, Rhaenyra.
The day King's Landing falls, Alicent's mind is as clear as it could be. She knows why Rhaenyra is there, why she beheaded her father and brother in front of her, why her and Helaena were held captive. She understands her hatred.
That much is not true for their next encounter; Alicent had woken up that day decided to visit her children, only to be stopped by the guards at her door, at the queen's orders. "I am the queen! My husband is king, and if you don't let me through at this instant I will have your heads!", she had yelled histerically. The whole of the castle had heard, including the now queen Rhaenyra, who took pity in the woman, going up to her chambers with Helaena. Alicent became immediately defensive; she held her daughter behind herself, looking terrified at Rhaenyra's presence. "Why are you here? Where are my children, Rhaenyra? Where's your father? Why is no one letting me out of this goddamn room!" the dowager queen kept yelling, exasperated. Rhaenyra became confused in an instant, the part of her that held affection for the younger queen growing worried. "Viserys is dead, Alicent. Has been, for more than a year now." and Alicent's expression became a mixture of fear and confusion. Soon enough she began crying, and Rhaenyra ordered everyone out of the room. Helaena had come out a few minutes later, indifferent to the situation. The queen didn't leave until way past midday the following day.
Alicent's mind came and went, each time worsened, more debilitated. In her three months rulling in the Keep, Rhaenyra began visiting her with increased frequency. She would always order the servants to leave them, keeping guards at the door. Sometimes they would fight, Rhaenyra leaving the room in tears. Some days, they would leave the dowager queen's chambers, Alicent apparently reverted to her younger self, reading books or just laying underneath the weirwood, or only walking through the castle. Rhaenyra held a private funeral cerimony for her sister the day she had died, Alicent attending by her side. No one seemed to know why the queen kept going back to the woman who had once been her only friend, even in the days Alicent hurt her the most. Maybe it's out of pity, some inquered. Or maybe Rhaenyra never really got over the love they had shared for each other.
Rhaenyra tried to bring Alicent alongside her and her son when she flees King's Landing, but she's stopped by the guards and Alicent's own unfit mind, as she seems quite angry at Rhaenyra's presence the day she escapes. After that, the dowager queen became self isolated, spending most of her days confined to her chambers. Her handmaidens described her as souless; like she had lost all will to live, everything that made her Alicent. She often wept; her servants and the guards couldn't understand why, if it had been the loss of her friend, of her children, a combination of all or simply nothing at all. They avoided bringing up Rhaenyra's death around her, fearing she would end up having the same fate as her daughter.
Most of her last days were spent on an almost vegetative state; she barely moved, and all she did was cry, forcing what food she could down her throat, her muscles in an apparent state of atrophy. She didn't speak for more than a year before her passing, despite a few servants claiming she had proclaimed Rhaenyra's name every once in a while. When the news of her son's poisoning were delivered to her, she didn't react. Alicent had, in the end, become a cold, lifeless reflection of the queen she had once been, a story to be forgotten.