The complications On going insane in America

In this raw debut memoir, essayist Rensin interweaves an account of his struggles with schizoaffective bipolar disorder with a cutting examination of American attitudes toward mental health. Most chapters are rooted in Rensin's own experiences, describing, for example, the year he visited four different psychiatrists, his various periods of institutionalization, and his experiments with going off such medications as Seroquel and Abilify. Rensin expounds on these episodes with incisive critiques of the way Americans discuss mental illness, pulling in sources ranging from Roman history and ancient Chinese medicine to track shifting attitudes toward mental health across several centuries. Provocative ideas abound, including Rensin's argument that the current tendency to reduce stigma around mental illness undermines meaningful discussions of the actual experiences of mental illnesses: "Everywhere, the shame and embarrassment and stigma of lunacy is held up like a scarecrow, while every actual discussion of madness insists that it is trying to liberate us from that straw man's repressive gaze." Such strident takes might alienate some readers, but Rensin's points are trenchant and well argued, and the harrowing details of his own struggles lend him credibility. While the unremitting darkness can be tough to stomach, it's a rousing rebuke to more placid treatments of similar subject matter. (Apr.)

A firsthand look at schizoaffective and bipolar disorder. In an absorbing debut memoir, journalist Rensin recounts in chilling detail his "superior and specific epistemological access to the lived experience of being mad." Distinguishing his own psychosis from a popularized conception of mental illness as "diffuse unhappiness and attendant social struggles," he describes the violent episodes and "agitated emptiness" that led to repeated hospitalizations and often frustrating encounters with "nearly two dozen therapists"; the multiple medications (four different pills, twice a day) that keep his symptoms in check; and, most emphatically, his "particular way of being in the world." Although he sees psychosis as "a medical problem and a social problem and a personal problem, a problem of health-care policy and criminal justice and housing and labor," Rensin does not intend his memoir "to educate or enlighten." Rather, he began writing because he believed "in a magical way, that by doing so, I could consign going mad to the past; turn it into an area of my expertise but not an area of my experience." That goal, he has come to realize, is unrealistic: Even though medication has helped him to function, he is cognizant always of the possibility of a breakdown, a fear "very near but out of sight, like something waiting to attack." A bipolar mood episode, he reveals, does not rise up suddenly, and "psychosis comes and goes without warning." He constantly worries that he is getting worse: unusually sensitive, prone to tantrums, "rude, unable to read tone, and impulsive and forgetful and disorganized." While he claims not to want "to change anything," his historical overview of psychiatry, examination of the vagaries of diagnosis and therapy, and stark depiction of his own visceral experiences offer unique insight into the meaning of madness. An intimate look at a tormented mind. Copyright (c) Kirkus Reviews, used with permission.