Genova Hopes Latest Novel Demystifies Biopolar Disorder

Bestselling author Lisa Genova of Chatham has a knack for finding the most fitting professional occupations for her protagonists as they are challenged by dire illness.

In “Every Note Played,” her main character is a concert pianist who loses the use of a finger, a hand, then an arm after he is diagnosed with ALS.

 In her new novel, “More or Less Maddy,” Genova gives her protagonist, an undergraduate at NYU recently diagnosed with bipolar disorder, a career in the fascinating world of stand-up comedy. It turns out this is a brilliant choice.

 When a stand-up comedian is “killing it, it is the biggest high — almost addictive,” Genova said during a telephone interview last week. “When they’re bombing, when no one’s laughing, it is the most low feeling. The worst feeling ever. Almost like depression.”

 Also, stand-up comedians are “very exposed and vulnerable. They can swing from moment to moment. It mirrors what can happen with bipolar disorder.”

Genova has a doctorate degree in neuroscience from Harvard University. Her debut novel, “Still Alice,” about a professor with early-onset Alzheimer’s Disease, stayed on the New York Times bestseller list for 59 weeks.

 In researching her latest novel, her sixth, Genova got to know nine people who have bipolar disorder along with their families. She also took a comedy improv class through Laughing Buddha Comedy in New York. She interviewed several stand-up comedians including Amy Schumer and Matt Pavich, who talks in podcasts about his bipolar episodes.

 Stand-up comedy also served “to give the book some levity,” she says. “The story could be heavy.”

 Roughly seven million people — or 2 to 3 percent of the U.S. population — have bipolar disorder, which has now been classified as mental illness. The period of onset is often in one’s late teens or early 20s.

 The novel opens with Maddy waking in a hotel room in Las Vegas after a manic episode. Contributing to the episode might be jetlag, a lack of sleep, overindulgence in alcohol and a “bump of coke.” Also, she left her medication at home — partly because, as Genova says, the medication can have unpleasant side effects that “wear a person down.”

 The previous night, in her manic state, Maddy believed she was writing Grammy award-winning music. Her scribbling is all over the wall in the hotel suite equipped with a piano.

 Manic events can be “big, wild, quite destructive,” Genova says. “People end up in jail or mental institutions.”

 The novel then moves back 18 months. At home in Connecticut are Maddy’s mother and stepfather, both devotees of the local country club where Maddy doesn’t fit in. “It all feels so pointless to her.” Maddy’s relations with her boyfriend are “a carnival ride.”

 At 19, Maddy appears to be “feeling a little blue,” and as she visits various medical specialists, she is given treatments such as a contraceptive “arm bar” that feeds her hormones. A doctor at the university health center prescribes an antidepressant.

 Both the hormone (progestin) and the antidepressant probably helped induce her initial manic episode at school. Among other out-of-control behaviors, Maddy spends over $20,000 on clothes and becomes convinced that she is ghost-writing Taylor Swift’s memoir. It’s not giving too much of the plot away to say that Maddy ends up in a private mental institution where she is finally diagnosed as she exhibits “textbook” bipolar symptoms. As the doctor tells Maddy and her mother, “this is a disease of instability.” The answer is lithium.

 “There is no blood test or scan — you’re diagnosed on the basis of a conversation,” Genova says. Generally, the proper diagnosis is given only after visits to several physicians.

 Maddy had trouble accepting that she would from now on be living with a chronic illness. The disease “chose her. Without her consent, like an arranged marriage, till death do they part. She wants an annulment, a divorce… Some way out of this,” Genova writes.

 Throughout the next few months Maddy has ups and downs — including another manic episode in an airport — as she copes with her illness. Her mother, while supportive, also serves as the voice of shame. One day when she learns Maddy is in a Starbucks, she texts, “I hope you’re not reading the book on bipolar I sent you... You don’t want to advertise your condition to the world.” Yet Genova notes that Maddy’s mother “comes from a well-meaning place, and a place of fear.”

Genova hopes that Maddy’s story will humanize bipolar disorder and allow others to be compassionate. “It’s not that they are the condition,” she says. “We don’t reduce the person to an illness they didn’t choose.”

 The novel ends on a note of hope. Maddy has found a way to cope and to pursue comedy in a safe way. And her illness “shook her out of that cookie cutter kind of life,” Genova says. Instead, she is propelled into the wide world of stand-up comedy.

 Genova opened her international book tour in Sandwich on the publication day of “More or Less Maddy,” Jan. 14. To follow her book signing schedule through the coming months, visit www.lisagenova.com.