October 13, 2012

Crazy: A Psychtember Review

Patient: Crazy by Amy Reed

Presentation (from Goodreads):   "He’s falling in love—and she’s falling over the edge of sanity. From the author of Beautiful and Clean, a heartwrenching exploration of a romance marred by mental illness.Connor knows that Izzy will never fall in love with him the way he’s fallen for her. But somehow he’s been let into her crazy, exhilarating world and become her closest confidante. But the closer they get, the more Connor realizes that Izzy’s highs are too high and her lows are too low. And the frenetic energy that makes her shine is starting to push her into a much darker place.

     As Izzy’s behavior gets increasingly erratic and self-destructive, Connor gets increasingly desperate to stop her from plummeting. He knows he can’t save her from her pain...but what if no one else can?"


Axis 1. Characters

I didn't particularly like either Connor or Isabel, especially for the first half. Isabel was very annoying in some ways — she's quite self-centered and melodramatic. I suspect that these are aspects of her personality regardless, but that her bipolar disorder intensifies them. She's also creative, and there appears to be some connection between creativity and manic episodes. I thought the difference between "normal" creativity and manic-inspired creativity was actually illustrated quite well here in comparing Connor and Isabel. Connor can be poetic and a bit dramatic when he wants to be, but he doesn't succumb to it the way Isabel does. She throws herself into these fantasies and her imagination just goes wild with it. Still, it's tough to know how much of Isabel's character is just pure Isabel and how much is an effect of the bipolar, especially as she is struggling with the disorder for so much of the book.

Ultimately, Isabel is both self-destructive and destructive of her relationships with others. This is probably mostly due to her disorder, but she actually says at one point that she can blame it on the bipolar, but it's partly herself as well. Indeed, there's at least one cognitive hurdle Isabel needs to get over — that of feeling not good enough for everyone's love and attention, and thinking that she needs to be punished. We don't really see how this attitude has developed, although we're given some indicators in her home life. Her family has ignored her and focused instead on her drug-using brother, and so Isabel has looked for attention in the wrong places (like with Trevor).

I was surprised Connor puts up with Isabel's behaviour for so long, that he keeps trying to help her and be her friend. I didn't really see what he sees in Isabel; maybe back in camp when they first met she acted differently because the bipolar disorder hadn't been triggered yet? Obviously he's not perfect, though, and he does get mad at her quite a bit — not that I blame him, because she says some really out-of-line stuff. It's like she feels she has the right to take things out on anybody.

Also, I didn't find Connor that authentic as a teen guy. He's unusually thoughtful and sensitive (which is pointed out a few times), and while I got used to his voice I never ended up liking him much.

Axis 2. Premise/plot

I wasn't that into it for the first half, but then later as Isabel's bipolar started to worsen, things got more emotionally intense and I became more interested. Crazy is a fantastic portrayal of someone's downward spiral into serious bipolar disorder. Isabel begins oscillating, first just a little, and then more and more as her highs and lows start getting really high and really low.

After the climactic scene there's a fair bit of denouement where not that much actually happens, but it was neat that the author offers a glimpse of the beginning of recovery for her, and we see her start to gain a perspective of "normality".

Axis 3. Writing Style

The writing was quite good, especially once things got going. Isabel's sections come off as overly dramatic, yes, but that's because Isabel is overly dramatic, so the writing is merely reflecting her personality/mood. In fact, this quality of the writing is particularly well-illustrated in one of her e-mails, which is just one long run-on sentence, like there are all these words bubbling over that she has to get out. This "stream-of-consciousness" kind of style works well to portray what's going through her head, and also functions as a written version of the pressure of speech symptom some individuals with bipolar experience.

Axis 4. Psychological Accuracy
"Fast Facts" about bipolar disorder: Did You Know?
  • For a long time, nobody knew why lithium worked as a medication for bipolar disorder. We still don't know for sure, but recent research is suggesting that it could be due to a link with circadian rhythms.

Crazy does an exceptional job of showing what a person with bipolar disorder is going through mentally and emotionally. In fact, I don't think I've read a better portrayal of the perspective of someone who has bipolar disorder.

Mania is often associated (by the general public) with being really happy, but with Isabel, this isn't often the case. She's happy for very brief moments at the beginning of a manic episode, but this quickly turns to anger/bitterness — but still with all the energy a manic episode brings. Then this progresses downhill into depression. It's good to see the portrayal in Crazy doesn't fall prey to stereotype, as I suspect what happens with Isabel is a much more likely scenario for many individuals with bipolar, rather than a black-and-white, "happy" or "unhappy" sort of divide. It's better to think of bipolar as alternating between energy levels. Also, it's possible that Isabel sometimes experiences a mixed state — either mania with some depressive symptoms, or depression with some manic symptoms.

While I wish we'd seen a little more of Isabel's manic episodes, bipolar disorder cannot be neatly separated 50-50 into depression and mania; the frequency of each type of episode depends on the individual. During her manic episodes, though, she definitely "acts out" in ways one might expect (spoilers, highlight to read: for example, having sex with a random guy, burning stuff, and shredding her mom's records). She's also obsessed with sex at some points, and hypersexuality can occur with manic episodes. And we see elements of psychosis in Isabel at times — she hears voices and holds what could be interpreted as a delusion about her "evil twin". Psychosis certainly can be present in some individuals with bipolar, particularly in a manic episode. Overall, I'd diagnose Isabel with Bipolar I disorder, rapid cycling (since the book doesn't take place over a very long period of time, and by the end she's already shown a few episodes of both mania and depression).

I thought it was very realistic that Isabel resists treatment for such a long, long time. She really digs her heels in, turning against everyone who tries to help her, thinking they're the enemy. Indeed, she almost starts acting a little paranoid schizophrenic (perhaps part of this is her psychotic symptoms?). We're not told exactly why she doesn't want to get help, though — whether it's the stigma of having a mental disorder, that she's in denial, that she's naturally stubborn, that it's an effect of the bipolar disorder itself, that she's worried she'll lose part of herself, or a combination of these factors.

As for Connor, he didn't strike me as being really codependent — a term brought up briefly in Crazy — but he certainly lets her take center stage in the relationship. It's all about her, and he doesn't put his foot down very much in terms of making her pay attention to him. It's a one-way relationship — he's trying to save her and she's not giving him anything in return, which she acknowledges at one point.

Validity Score: How psychologically accurate was Crazy?

Patient shares symptoms with: A Note of Madness by Tabitha Suzuma, The Unquiet by Jeannine Garsee

Patient's statement:

I am a parasite on this world. I suck the life out of the things I love. I multiply and spread until I've consumed you. And even when you're gone, even after I've licked up every last crumb of you, I'm still hungry. I'm starving, Connor. I'm empty and lonely and lost and I'm starving, and there isn't enough in the whole wide world that could make me feel whole.

Diagnosis: 4 shooting stars.


For more information about bipolar disorder, see here.

Note: this book contains some coarse language and mature content.

This book counts toward my goal for the Just Contemporary reading challenge.

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