Book: Madness by Marya Hornbacher

Reviewer: Jeriann

Age/Genre: Adult Memoir

Preferred Reading Environment: The Bathtub

Reading Accoutrements: A Lavender bath bomb, or your choice of soothing scent.

Content Notes: Eating Disorders, Addiction, Suicide Attempts, Medical Professionals not believing people about their symptoms

It’s Mental Health Awareness month, and when I was thinking about what books I might want to review, my mind immediately went to the memoir class I took in college. You see, this was a general memoir class, theoretically with no specific subject matter focus, but the first three books just happened to be about women with experiences in mental institutions. We read Girl, Interrupted, which I’ll review later this month, The Bell Jar (which wasn’t even a memoir, though it was highly inspired by Sylvia Plath’s personal experiences), and Madness, which follows Marya Hornbacher’s personal experiences with bipolar disorder. I’m not sure why the beginning of this course focused so heavily on mental illness when other books we read throughout the semester varied in subject and author identity, but I do know that by the 2-week drop deadline, there was only one male student left in the class.

Anyway, I didn’t remember Madness very well, so when I started it again, I was a little shocked by the intensity. The prologue depicts Marya hospitalized after a semi-accidental suicide attempt in her twenties. Then the first section shows her childhood, starting in the 70s, long before bipolar disorder was on the mind of pediatric mental health professionals. This section was really hard to read, mostly because it’s so obvious how little control Marya has over both her mind and her surroundings. She learns at the age of ten that alcohol helps her ride her mood swings, which quickly leads to her abuse of alcohol, cocaine, and other substances.

The book is told in present tense, which I think adds a lot to the experience. You know that adult Hornbacher is relaying these stories about her childhood, but you’re seeing it from the perspective of young Marya. So when she says things about trying to avoid being seen as crazy, it reads as the emotions she is feeling as a teenager, not as the analysis of her adult self. Hornbacher describes bipolar disorder as it has affected her – she clarifies several times that many people experience different symptoms, have different triggers, and that her experiences are not universal to bipolar disorder; they are simply hers. This in-the-moment picture added a personalization to the stories that triggered both empathy and sympathy in me as I read.

Madness is a great book for Mental Health Awareness month not only because it shows personal experience with mental illness (which should be a bare minimum for any book on the subject, in my opinion), but because it shows how frustrating and flawed mental health treatment is. Hornbacher makes clear that research on mental illnesses is ever-evolving, and it wasn’t necessarily any particular doctor’s failing that led to the lack of a diagnosis until she was 24 years old. But, at the same time, throughout her life, many psychiatrists and other medical providers told her that she probably had depression, because she had an eating disorder. When Prozac didn’t work, they prescribed her more. Even after she had been diagnosed for many years, a psychiatrist treating her for an eating disorder relapse refused to listen when Marya told her that she wasn’t depressed and that the medicine she was trying to prescribe would be harmful and against her regular doctor’s orders. Marya then was asked if she was refusing treatment.

Hornbacher also relays a story of a psychiatrist in California who basically ignored Marya’s concerns about her own alcohol abuse, saying that it was common for people to drink every day, and that Marya’s recent binge of more than four bottles in a day was of no great concern. This dismissal led to Marya downplaying her alcohol issues, and taking longer to get the treatment she needed. Warning, this scene will make you angry.

Speaking of California, Hornbacher painted a great picture of San Francisco in the 90s. The tech boom and party culture provided the perfect backdrop for Marya’s unregulated manic states, and I thought this juxtaposition really illustrated how much our surroundings can affect us without us noticing or realizing.

One of the things I really appreciated about Madness is how straightforward it is. This book is just relaying Hornbacher’s life experience. It’s not overdramatized; there are no epiphanies or tragic events that give her sudden perspective – even after her suicide attempt. About that semi-accidental suicide attempt I mentioned earlier – Hornbacher includes statistics about how many bipolar suicide attempts occur not from a desire to die, but rather accidentally going too far. In Marya’s mind, she was harmlessly cutting herself, but she slipped and hit the artery. This is a sad but important fact that gives the reader a concrete image of one of the many dangers that people with bipolar disorder live with.

Marya learns to manage her illness by failing to do so for a long time, and eventually learning from her mistakes. Her life never snaps into place. The book ends on a hopeful, but serious note. Her life will never be as easy as it would if she did not have bipolar disorder. She’s come to terms with that, but that doesn’t make the effects that being bipolar has on her life any less severe.

This is a great book to get some insight into one person’s experience with mental illness, and a small picture of the how the medical system works regarding mental health. Do you have any book suggestions for Mental Health Awareness Month? Share in the comments!