next to normal: Not Quite Normal Enough

I recently had the opportunity to attend next to normal, dubbed the “feel everything” Broadway musical by the New York Times. The play hit home for me, as the plot is centered around a character who has bipolar disorder, a woman who lives in an upper middle class home with her husband, Dan, and teenage daughter, Natalie.

The play won both a Tony and the Pulitzer.

Most commendable about the play is its willingness to tackle such a delicate subject as mental illness and bring a discussion of its many dimensions to the country. Less commendable is its actual message.

Contrary to the New York Times, I can’t say I felt “everything,” but the play certain conjured a range of reactions for me. My predominant emotion was pain, as I watched this character, Diana, go through struggles that were all too familiar to me, including bizarre behavior, alienation from family members, and battles with medication.

In one of the first scenes, Diana helps the family by making sandwiches-- on the floor. I thought this was realistic; it reminded me of a time when I sautéed the foam from a pillow cushion with eggs and proceeded to serve it to my neighbor, who looked askance at the concoction.

I also related to Diana when she would stay up late at night, classic manic behavior, full of projects and plans. I was reminded of the days that I spent awake “creating,” in truth, destroying property, even one time, my piano.

The play also depicts fractured family dynamics. Husband Dan is perpetually trying to help, to connect, to do the right thing, be the right man. His efforts are continually frustrated by his alienating wife. The daughter, Natalie, is estranged from the family, isolated by the lack of love from her mother.

These kinds of relationships are all too typical when an individual has a mental illness. I hearken back to the days when my illness was in full force, and I had tough-and-go relationships with my mother and brother. Thankfully, I have had the opportunity to stabilize and strengthen these ties in my recovery.

Another piece that resonated with me was Diana’s song, “I Miss the Mountains,” where she sings about the struggle of taking medication that numbs her senses.

In the third verse, Diana sings:

But I miss the mountains
I miss the dizzy heights
All the manic magic days
And the dark depressing nights
I miss the mountains
I miss the highs and lows
All the climbing, all the falling
All the while the wild wind blows
Stinging you with snow
And soaking you with rain
I miss the mountains
I miss the pain

Here, I think the song captures a true predicament of the bipolar person adjusting to medication. I know from experience that medications sometimes feel like one is covered in latex. Diana’s struggles here are understandable and certainly realistic, but she abandons the belief that medications can bring relief—also sadly realistic--and shortly thereafter, slits her wrists and is admitted to the hospital for ECT (electro-convulsive therapy.)

It is here that the play takes a turn towards One Flew Over the Cuckoo’s Nest in terms of its power in generating fear and stigma regarding treatment. Here, ECT is depicted with a mannequin on a gurney with a doctor overhead holding baton-shaped “shockers,” accompanied by flashing lights mimicking electrical pulses. The stage becomes a cacophony of “music” and color. The effect is gruesome and traumatic. From this experience, Diana loses her memory en masse. She can’t even recognize her husband or her daughter.

Then the song “Aftershocks” is sung by her dead son, Gabriel, who is an ongoing vision and trigger in Diana’s psychosis.

ECT, electric chair, we shock who we can't save
They've cleared you of my memory and many more as well
You may have wanted some of them but who can ever tell
Your brainwaves are more regular, the chemistry more pure
The headaches and the nausea will pass and you'll endure
You son is gone forever though, of that the doctor's sure
The memories will wane, the aftershocks remain
You wonder which is worse, the symptom or the cure

I found the sensational depiction of ECT to be stigmatizing, and this greatly saddened me. My experience of ECT was benign. The procedure is safe and painless. The patient is put under anesthesia, feels nothing, and wakes up to orange juice and a doughnut. For me, the memory loss was negligible. I know for others, ECT does have significant memory loss, but I have never heard of a case where the patient can’t recognize loved ones or forgets huge swaths of long term memory. For most, it is quite clear which is worse: the symptoms of depression or mania.

Of course, there is artistic license. The play’s second act hinged on a plot line dependent on Diana remembering virtually nothing of her life with her husband and daughter, which led to the resolution of the play, where Diana leaves her immediate family, sick and untreated, to go live with her parents.

Perhaps I am conditioned to the Hollywood ending instead of a Broadway one (after all, I am from Los Angeles,) but in my fantasy, I would have liked to see the main character find a positive solution, using medication productively and mending the relationships with her family, where she could resume “normal” life. Instead, in next to normal, Diana walks out on Dan and Natalie, and the ending is painful and less than hopeful.

Alice Ripley, the star who plays Diana, in the Q&A after the show, thought that Diana was empowered and experienced “liberation.” My interpretation is that Diana simply stayed in her symptoms, demonstrated deterioration with her illness, and made a rash decision which negatively affected her loved ones.

I think that the accolades for next to normal are valid for its dramatic and musical quality; however, its message is disturbing to someone who promotes the idea that recovery from mental illness is possible, that people with mental illness can live “normal” lives. Rather, deterioration from mental illness and ineffective treatment became the focus of the musical.

I think my positive resolution is not a very sexy resolution, but it is one that does happen in the real world. It would have been nice to have a role model on Broadway instead of a bipolar woman trapped by her illness who thinks that one can be freed by packing a suitcase and walking out the door.

Maybe the final scene of my version of the play would have Diana, Dan, and Natalie sitting on the couch watching TV, laughing at a dumb commercial.

Maybe Diana takes lithium, lamictal, abilify, clorazapam, wellbutrin, metformin, and synthroid. She feels a little tired, but fine.

The name of my version of the musical would be really close to normal.

The last number, sung by Diana, would go like this:

Really Close To Normal

This mellow life doesn’t fit me.
Life should flow like lava, hot and free.
I still miss the mountains
Its torrents of rain.
Something vital
Something I can’t tame.
But I’ve learned to love the pasture.
I know that I can last here.
The pasture’s a place I can grow
Even when I miss the world I know.
I miss the world I know.
But I can spend my life here
With the people that I love.
I may never have another exploit.
But I was spoiled anyway.
I was spoiled anyway.
I’ve learned to love the pasture.
I can last here.
I can last here.