Even social workers may have difficulty digesting books about severe mental health issues. More or Less Maddy is a novel that describes the journey of Maddy, a young college student who experiences first depressive symptoms and then mania before a formal bipolar diagnosis. With a mother who desperately, and often ineptly, tries to salvage an out-of-control situation, Maddy is both resistant to and dependent on her mother on her mental health journey.
Although a fictionalized account of bipolar disorder may seem out of order when there are publications of those with lived experiences, More or Less Maddy allows the reader the freedom to follow the emotional journey of the characters without focus on the verifiability of the story. As the novel progresses, details emerge and puzzle pieces develop related to the likely mental health issues of Maddy’s absent father, with whom there has not been contact since Maddy was a small child, and about whom Maddy’s only significant memory is related to the collection of boats (yes, boats) in the front yard of her childhood home. Maddy’s non-traditional goal of becoming a stand-up comedian adds layers to the planned college and professional path.
Author Lisa Genova does an excellent job of articulating the intersection between creativity and mania, and how before there is crisis, there can be periods of concentrated productivity, which can be intoxicating.
Before the hypermania ripened to rotten, there was a delicious sweetness to her thoughts and life. She had a massive amount of unearned confidence in her ability to do anything that struck her fancy.… It embarrasses her now to think of herself this way, but her amped up swagger gave her the absolute freedom to do whatever the fuck she wanted, without permission or second guessing herself, without worrying what anyone else would think, whether it was good or bad. And it felt so good. (p. 162)
Social workers will be familiar with the cyclical nature of bipolar disorder, the often-alternating nature of medication adherence and non-adherence, and the struggle of families to support a situation that may be both difficult to understand and emotionally overwhelming. More or Less Maddy allows the reader to lean in to understanding the person at the center of a condition that requires growth from all.
Reviewed by Lisa Eible, DSW, MSW, LCSW, a consultant, writer, and educator with more than 33 years of social work experience. Lisa has advanced certificates in cultural competence and trauma. Professional interests include social work in healthcare, administration, leadership, supervision, Relational-Cultural Theory, and diversity issues. Lisa is a member of The Relational-Cultural Theory Collective.