Lisa Genova
Allen & Unwin
Otago Daily Times, March 29th 2025
Neuroscientist Lisa Genova’s novels are intended to promote empathy for and understanding of people whose cognitive differences render them marginalised or excluded from mainstream society. In More or Less Maddy she turns her attention to bipolar disorder, a diagnosis that comes with “massive and unnecessary burdens…secrecy, stigma, shame, judgement, fear, alienation, desperation, and misinformation.”
The story’s titular narrator, Maddy Banks, hopes college will help her decide what to do with her life, but it has provided little clarity. Struggling with coursework, and an on-again-off-again relationship with her high school boyfriend, she starts on antidepressants, and within weeks feels “not only like herself again, but the best version of it”. Not only is she ahead on her studies, a short but exhilarating performance at a comedy club open night has revealed her true calling as a stand-up comedian. Then there’s the authorised biography of Taylor Swift she is working on…
Thus begins an episode of mania ending in involuntary hospitalisation and a diagnosis of bipolar disorder. The subsequent account of Maddy and her family’s struggle to come to terms with this new reality is vivid and detailed, and includes descriptions of clinical depression, self-harm and suicidality which some readers may find triggering.
Although I don’t subscribe to the view that authors should write only what they know, I am uncomfortable about people describing the internality of mental conditions they have not experienced, and there are many excellent novels and autobiographies from writers with bipolar disorder, including Sylvia Plath’s The Bell Jar and Kay Redfield Jamison’s An Unquiet Mind that provide this perspective. That said, Genova has extensively researched every aspect of the story and Maddy’s experiences feel real and tangible. Her experiences match those of people I know with the condition, and the novel successfully captures the challenges of adjusting to a psychiatric diagnosis, particularly the way it undermines one’s identity. It might seem like a trivial distinction, but the question of whether one has or is their condition is a profound one: “…it’s not just that her diagnosis is scary and unacceptable. If she not only has bipolar but also is bipolar, then she herself is scary and unacceptable”. How much of oneself is real, and how much the condition? “Does feeling bad mean she is depressed? Does feeling good mean she’s manic?” And are the are her love of Taylor Swift and stand-up symptoms of mania, or merely normal interests caught up by their temporal proximity to events?
Where I do think the novel stumbles is in its resolution. Six months after her third cycle we rejoin Maddy to find her stable and comfortable with her personal ‘normal, and she her mother reconciled to her about her life and career choices. I understand the importance of showing that equilibrium is not just possible but usual, but the abruptness and brevity of the transition feels artificial. Overall, however, Genova successfully presents her central character not as a frightening ‘other’ but as someone in whom we can feel a shared humanity.