Madness

Marya Hohnbacher is bipolar, and her memoir of her life with it, Madness, is amazing. If you have an interest in mental health memoirs, which can be rare in terms of this kind of quality and attention to details, please read it.

There are so many passages when she describes what it feels like to be manic, or depressed, with such directness as to put me right there (squirming) with her. I'll share some of those.

But first, some of her more universal, process-oriented passages, which show her wisdom and whiz with words:

How do we know who we are or what we can become? We tell ourselves stories. The stories we tell are what we know of ourselves. We are a creation, a product of our own minds, a pastiche of memory, dream, fear, desire. My memory looks like a child's collage, or a ransom note, incomplete and full of holes. All I have is today, this moment, to work with. I am writing my story as I go. I am inventing myself one moment, one experience, at a time. 

And that's all right. It means I can choose who I become. It means I can write my future. I can create a person, write a story, full of hope.

Her narrative alternates from scenes and vivid descriptions of the exact sensations, thought patterns and dialogues of madness (her word) to more reflective, now-voice passages with a bit of space and perspective. This kind of alternating is powerful in any memoir, but essential in a memoir where the narrator's memory - by her own admission - can be somewhat unreliable, and the intensity of her suffering so knock-you-over-the-head that in order to keep reading, you need some sense of hope.

Here's a dreadfully accurate, slightly comical but also poignant description of madness itself, as a character:

...no matter what you do, no matter how tightly you batten the hatches, madness can get in.You wake up one morning and there it is, sitting in an old plaid bathrobe in your kitchen, unpleasant and unshaved. You look at it, heart sinking. Madness is a rotten guest. You can tell it to leave till you're blue in the face. You follow it around the house, explaining that it's come at a bad time, and could it come another day. Eventually you give up and go back to bed, shutting the door.But of course it barges in and demands to be entertained. Before you know it, it has strewn its stuff all over the house, and there are sticky plates in its bed, and it refuses to change its sheets, Madness lounges all day in front of the TV, watching Oprah andmunching on a bag of chips, drinking milk from the carton, getting crumbs between the cushions of the couch.

One of Hornbacher's incredible skills is describing when mania - which often actually feels good, normal, better than normal, even - hits the skids and becomes too intense in negative ways. This ordinary scene, with language matching the tone and speed of the mania, gives us a glimpse in:

I am feeling my way through the little market in town. I am near the mustard, and I search the shelves for something to keep me alive, for I have to hide away from the world, and I need food in case of fires, bombs, or acts of God. The aisles seem to lean over me, threatening to collapse, and the bright white lights in the buzzing dairy case confuse me. I keep to the back of the store, not wanting to go out front, where the clerk might see me and suspect me, or someone might open the jingling door, coming in for their morning coffee and the paper — when I came in it was just barely getting light, the purple sky reeling overhead — and I can't have anyone see me, for they might see how crazy I am, they might know. I need to get out of here before I am seen. I hurry through the market, dropping things into my basket, anything in a can, sardines, soup, peas and carrots, beans, tuna, smoked oysters. I need to stock up, I need to fill the shelves at the beach house with food, like a bunker, keeping me locked away from the world for a while, condensed milk, pickled beets, my hand grabs things off the shelf and drops them in the basket, it doesn't matter what they are.

Another extra-special aspect is her depiction of visitors, staff, and other patients in all of her hospital visits. She maintains a steady line of compassion for all involved in this split world - part outside hospital, part inside - and for her former selves who have inhabited them. At the same time, she holds outsiders, folks who don't have such compassion, accountable:

The outside world — "real" people — might treat me as if I'm a lost cause, hopeless, but the staff treats me as if I'm still human, still conscious, and that makes an enormous difference. I'm not completely removed from the world that you and I agree is real. My perspective is off, certainly, but I'm not totally gone. I'm not off the planet. I know what the world would think if they came onto the unit, what they would think if they saw me. The staff simply refuses to make those sorts of judgments.

I have worked with quite a few survivors of the mental health system, and hands down, the presence of others' compassion is essential. In one quick line, in the middle of describing the different kinds of other patients as well as visitors, Hornbacher makes the importance of visitors totally clear:

The people who have visitors have not yet lost everything.    

Whether it is because their visitors haven't given up yet, or because the patient hasn't, that suspension, as tense and difficult as it is for all, is crucial. Luckily, Hornbacher has loving friends and husband - not everyone has so much support.

I look forward to reading memoirs from survivors who did it mostly alone - especially those by some of the sole survivors I work with. While acknowledging others' support is crucial, noticing how others can make it even without such support is also helpful. It's inhuman - it shouldn't have to be that way - but even when people are actually dehumanized in institutional settings and have no or few intimates in their lives, they can make it. One day that end of the mental health memoir spectrum will fill in.