Madness: A Bipolar Life

By Marya Hornbacher, New York: Houghton Mifflin Company, 2008, 299 pages

Reviewed by Rich Blake, B.A., Loyola College in Maryland

Madness: A Bipolar Life is a biographical account of a lifelong struggle with bipolar disorder. Author Marya Hornbacher’s previous work Wasted: A Memoir of Anorexia and Bulimia received numerous accolades including a Pulitzer Prize nomination.  Madness: A Bipolar Life is greatly entertaining, shocking, and informative. Readers are left with a vivid glimpse into the life of woman suffering from serious mental illness.

The book is organized chronologically and divided into detailed events each titled and dated. It is immediately apparent in the prologue that this book is not for those sensitive to gruesome details or intolerant of profanity. This intense introduction gives the reader a look at a dramatic occurrence of wrist cutting and hospitalization. It is written in the moment, giving the reader the feeling of being inside the author’s head. This style is maintained throughout the book and this is far from the first look at her self-injurious behavior. From the frantic thoughts of a restless four year old, hospitalization after hospitalization throughout early adulthood, and innumerous setbacks, to an epilogue that leaves the reader hopeful, it is difficult to put the book down.

The most significant strength of the book is the writing style. The author’s tremendous insight combined with superb communication skills allows the reader to actually see and experience the thoughts of someone with bipolar disorder. Her detailed accounts are raw and uninhibited. Another strength is the inclusion of actual dialogue that enhances the reader’s view of what it is like for her to interact with others.

This book undoubtedly has utility in bibliotherapy. However, it should be used thoughtfully and with great caution. The greatest therapeutic value may come from the instillation of hope. After reading dreadful account after dreadful account, the author perseveres and remains productive, successful, and glad to be alive. Clients could possibly find comfort in knowing that someone so successful has similar experiences. Clinicians can greatly benefit from hearing about the bipolar mind from someone who has a canny ability to express what it means to be bipolar.

The greatest drawback of the book is that the intensity with which the author describes events has the potential to cause the patient distress or activate self-injurious behavior or panic. Great consideration should be given to the current state of the patient before using the book in bibliotherapy. This is an important work that should be read by all clinicians who work with clients that suffer from bipolar disorder. It is equally as important for those suffering; however, timing is an essential consideration.