Just reading the table of contents in Marya Hornbacher's book, Madness: A Bipolar Life, offers the reader some insight into the world of bipolar illness—"Depression," "Meltdown," "Escapes," "Hypomania," "The Diagnosis," "Losing It," "Hospitalization #1," "Hospitalization #6," "Release." The nature of bipolar disorder and schizophrenia makes the illness worse by the vicious cycle of paranoia, pain, and insanity that cause the suffering person to do everything to sabotage her treatment, or as Hornbacher says, "...how to make sure that you'll be getting crazier by the day." So when her psychiatrist says, don't drink alcoholic beverages, keep a routine, eat healthy, take the meds and so on, Hornbacher does just the opposite. Not because she's intentionally trying to disregard her doctor's advice, but because her manic episodes and the voices in her head tell her that she's okay, while the depressive episodes prevent her from taking any action at all.
Confounding all this confusion, the quality of care also takes its toll on her mental state as the emergency room doctors sometimes make medical decisions that oppose her doctor's treatment plan. In a sad but amusing account, Hornbacher patiently explains to the hospital psychiatrist that she's not depressed, but coming off a manic episode. The psychiatrist decides to increase her antidepressant medication and sleeping pills. When Hornbacher argues that she's an addict and can't take the medication the doctor prescribes, the doctor says, "I'm sure you won't start abusing it." Nothing Hornbacher says can convince the doctor to follow the regimen prescribed by her own doctor.
The author's account of her heroic struggles to escape the insanity of bipolar disorder, and her honesty and insight into her bizarre behaviors, make a fast-paced, gut-wrenching story. One that causes the reader to not only better understand those who suffer from this illness, but to cheer with the hope that Hornbacher expresses in experiencing good results as she strives to take her medications, exercise, use light therapy, participate in group therapy sessions, and listen to her therapist. Her ability to maintain this tenuous balance depends upon whether she can keep her swinging moods under control.
Hornbacher chronicles the often humorous though sad episodes of a person with bipolar disorder. In her manic episodes, she's a university teacher, a writer, and a lecturer doing a hundred and one different things all at once while drunk, on medication, and with little or no sleep. With insight, she says, "That I have made it all this way without dying or killing myself or someone else is a miracle, or a joke." It's no joke that she has successfully chronicled an illness that has contributed to her brilliance as well as to her suffering, in a way that allows the reader to understand and feel compassion for people afflicted with bipolar disorder. And she offers direction to those who might help.
Marya Hornbacher is the author of the Pulitzer Prize-nominated bestseller, Wasted: A Memoir of Anorexia and Bulimia, a book that remains a classic, and of the acclaimed novel, The Center of Winter. The award-winning journalist lectures nationally on writing and mental health and lives with her husband in Minneapolis, Minnesota. Visit her website.
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