Madness

One of the most dramatic clues to a new cycle of the highs and lows of bipolar disorder is the shift in the pace of the sufferer's internal dialogue, which soon leads to erratic behavior and actions. Narrator Tavia Gilbert uses this shift in pace to construct a framework for her narration of this memoir. It's a powerful technique for personalizing the experiences of Hornbacher, and the people whose lives are profoundly affected by her illness: rapid-cycling bipolar disorder, the worst form of the condition. During each cycle Gilbert's initial shifts in pace begin subtly and then intensify as the cycle progresses and ultimately ends, only to begin again. Through this technique, she effectively foreshadows changes, heightens the impact of Hornbacher's brutal honesty and self-revelation, and provides a glimpse of the dramatic mood shifts characteristic of this disorder. J.E.M. (c) AudioFile 2008, Portland, Maine

January 28, 2008
Hornbacher, who detailed her struggle with bulimia and anorexia in Wasted
, now shares the story of her lifelong battle with mental illness, finally diagnosed as rapid cycling type 1 bipolar disorder. Even as a toddler, Hornbacher couldn't sleep at night and jabbered endlessly, trying to talk her parents into going outside to play in the dark. Other schoolchildren called her crazy. When she was just 10, she discovered alcohol was a good “mood stabilizer”; by age 14, she was trading sex for pills. In her late teens, her eating disorder landed her in the hospital, followed by another body obsession, cutting. An alcoholic by this point, she was alternating between mania and depression, with frequent hospitalizations. Her doctor explained that not only did the alcohol block her medications, it was up to her to control her mental illness, which would always be with her. This truth didn't sink in for a long, long time, but when it did, she had a chance for a life outside her local hospital's psychiatric unit. Hornbacher ends on a cautiously optimistic note—she knows she'll never lead a “normal life,” but maybe she could live with the life she does have. Although painfully self-absorbed, Hornbacher will touch a nerve with readers struggling to cope with mental illness.