From the author of the best-selling "Wasted", an astonishing dispatch from inside the belly of bipolar disease, reflecting major new insights.When Marya Hornbacher published her first book,"Wasted: AMemoir of Anorexia and Bulimia", she did not yet know thereason for her all-but-shattered young life. At age twenty-four, Hornbacher was diagnosed with Type 1 rapid-cycle bipolar, the most severe form of bipolar disease there is.In "Madness", in her trademark wry and utterly self-revealing voice, Hornbacher tells her new story. Through scenes of astonishing visceral and emotional power, she takes us inside her own desperate attempts to control violently careening mood swings by self-starvation, substance abuse, numbing sex, and self-mutilation. How Hornbacher fights her way up from a madness that all but destroys her, and what it is like to live in a difficult and sometimes beautiful life and marriage-wherebipolar always beckons-is at the heart of this brave and heart-stopping memoir."Madness" delivers the revelation that Hornbacher is not alone: there are millions of people in America struggling with a variety of disorders that may mask their true diagnosis of bipolar. Also, Hornbacher's fiercely self-aware portrait of her own bipolar as early as age four will powerfully change the current debate on whether bipolar in children exists.Ten years after Kay Redfield Jamison's "An Unquiet Mind", this storm of a memoir will provoke, educate, and move.

Marya Hornbacher is the author of the Pulitzer Prize-nominated national bestseller Wasted: A Memoir of Anorexia and Bulimia, a book that remains an intensely read classic, and the acclaimed novel The Center of Winter. An award-winning journalist, she lectures nationally on writing and mental health and lives in Minneapolis, Minnesota.

Prologue: The Cut: November 5, 1994	p. 1
The Goatman: 1978	p. 11
What They Know: 1979	p. 14
Depression: 1981	p. 19
Prayer: 1983	p. 20
Food: 1984	p. 22
The Booze under the Stove: 1985	p. 23
Meltdown: 1988	p. 26
Escapes: Michigan, 1989	p. 35
Minneapolis: 1990	p. 37
California: 1990	p. 39
Minneapolis: 1991	p. 41
Washington, D.C.: 1992	p. 44
1993 45 1994	p. 45
Full Onset: 1995	p. 47
The New Life: 1996	p. 53
The Diagnosis: April 1997	p. 59
The Break: July 1997, Nine A.M.	p. 71
Unit 47: Same Day	p. 73
Tour: January 1998	p. 82
Hypomania: July 1998	p. 88
Jeremy: Later That Summer	p. 93
Therapy: 1999	p. 106
Losing It: Winter 1999	p. 112
Crazy Sean: June 2000	p. 114
Oregon: August 2000	p. 121
Day Treatment: Late August 2000	p. 133
Attic, Basement: Fall 2000	p. 141
Valentine's Day: 2001	p. 149
Coming to Life: Summer 2001	p. 152
Jeff: Fall 2001	p. 155
The Good Life: Summer 2002	p. 159
The Magazine: November 2002	p. 163
Fall 2003	p. 168
The Missing Years	p. 175
Hospitalization #1: January 2004	p. 175
Hospitalization #2: April 2004	p. 181
Hospitalization #3: July 2004	p. 186
Hospitalization #4: October 2004	p. 189
Hospitalization #5: January 2005	p. 192
Hospitalization #6: April 2005	p. 196
Hospitalization #7: July 2005	p. 202
Release: August 2005	p. 207
Fall 2006	p. 221
Winter 2006	p. 242
Spring 2007	p. 248
Summer 2007	p. 258
Epilogue	p. 273
Bipolar Facts	p. 281
My bipolar facts	p. 284
Useful Websites	p. 285
Useful Contacts	p. 291
Research Resources	p. 293
Bibliography	p. 294
Acknowledgments
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The Goatman 1978

I will not go to sleep. I won’t. My parents, who are always going to bed, tell me that I can stay up if I want, but for God’s sake, don’t come out of my room. I am four years old and I like to stay up all night. I sing my songs, very quietly. I keep watch. Nothing can get me if I am awake.
I sleep during the day like a bat with the blinds closed, and then they come home. I hear them open the door, and I fling on the lights and gallop through the house shrieking to wake the dead all evening, all night. Let’s have a play! I shout. Let’s have a ballet! A reading! A race! Don’t tell me what to do, get away from me, I hate you, you’re never any fun, you never let me do anything, I want to go to the opera! I want opera glasses! I’m going to be an explorer! I don’t care if I track mud all over the house, let’s get another dog! I want an Irish setter, I want a camel! I want an Easter dress! I’m going ice-skating! Right now, yes! Where are the car keys? Of course I can drive! Fine, go to bed! See if I care!
And I slam into my room, dive onto the bed, kick and scream, get bored, read a book, shouting at the top of my lungs, “I don’t care,” says Pierre! And the lion says, “Then I will eat you, if I may.” “I don’t care, says Pierre!” It is my favorite Maurice Sendak book. I jabber to my imaginary friends Susie and Sackie and Savvy and Cindy, who tell me secrets and stay with me all night while I am keeping watch, while I am guarding the castle, and there are horrible creatures waiting to kill me so I talk to myself all night, writing a play and acting it out with a thousand little porcelain figures that I dust every day, twice a day, I must keep things neat, in their magic positions, or something terrible will happen. The shah of Iran, who is under my bed, will leap out and carry me away under his arm.
I have to get dressed. So what if it’s black as pitch outside. I go to the closet, I take out a jumper and a white shirt, and from the dresser I get white socks and white underwear and a white undershirt, and I get my favorite saddle shoes, and I suit up completely. I must be very quiet or my parents will hear. I tie my shoes in double knots so I won’t fall out of them. I get on my hands and knees and crawl all over the room, smoothing out the carpet. Finally I make myself stop. I lie down in the center of the floor, facing the door in case of emergency. I cross my ankles and fold my hands across my middle. I close my eyes. I fall asleep, or die.

“Mom,” I whisper loudly, pushing on her shoulder. It’s dark, I’m in my parents’ bedroom, a ghost in my white nightie. “Mom,” I say again, shaking her. I bounce up and down on my toes and lean over her, my mouth near her ear. “Mom, I have to tell you something.” “What is it?” she mumbles, opening one eye.
“The goatman,” I whisper, agitated. “He’s in my room. He came while I was sleeping. You have to make him leave. I can’t sleep. Will you read to me?” I hop about, crashing into the nightstand. “Can we make a cake? I want to make a cake, I can’t go to school tomorrow, I’m scared of Teacher Jackie, she yells at us, she doesn’t like me, Mom, the goatman, do you have to go to work tomorrow? Will you read to me?” “Marya, it’s the middle of the night,” she says, hoisting herself up with her elbow. Next to her, the mountain of my father snores. “Can we read tomorrow?” “I can’t go back in there!” I shriek, running around in a tiny circle. “The goatman will get me! We could make cookies instead! I want to buy a horse, a gray one! And I want to go to the beach and collect seashells, can’t we go to the beach, I promise I’ll sleep —” My mother swings her legs off the edge of the bed and holds me by the shoulders. “Honey, can you slow down? Just slow down.” Out of breath, I stand there, my head spinning. “What did you want to tell me?” she asks. “One thing. Tell me the most important thing you want to tell me.” “The goatman,” I say, and burst into tears. “But Mom, I can’t—” “Shhh,” she says, picking me up. She carries me down the hall. This is how she fixes it. She holds me very tight and things slow down a little. But I’m too upset. I set my chin on her shoulder and sob and babble. Everyone’s going to leave, you’ll forget to come get me, I’ll get lost, I’ll get stuck in the grocery store and they’ll lock me in. What if there are snakes in my bedroom? Why won’t the goatman go away? What if it isn’t perfect? What if it’s scary? What if you and Daddy die? Who will take care of me? What if you give me away? I don’t want you to give me away, I want to be a policeman, why do policemen wear hats — “Marya, hush. It’s all right. Everything’s going to be all right.” I want to see Grandma, let’s go see Grrandma, I want to go outside and play in the yard, why can’t I play in the yard when it’s dark, I want to look at the moon — We pace up anddddd down the hall. I get more and more agitated, swinging moment by moment from terror to elation to utter despair, until finally I wiggle my way free and start to run. I race around the house, my mother trailing me, until I stumble on my nightgown and sprawl out on the floor, sobbing, beating my fists on the ground. “I’m here,” she says. “Honey, I’m here.” I snuffle and drag a hiccupping breath and heave a sigh. She is here. She is right here. She picks me up. She carries me into the bathroom and turns on the bathtub. While it runs, I squirm on her lap, kicking my legs, shrieking, laughing, crying, I can’t ever go back in my room, the goatman, I want to have a party, when is it Christmas, I want to live in a tree house, what if I fall in the ocean and drown, where do I go when I die — She pulls my nightgown over my head and sets me in the tub. I am suddenly quiet. Water makes it better. In the water, I am safe. She kneels next to me where I sit, only my head sticking out of the water. She tells me a story. Things are slowing down. I am contained. I bob in the water, warm, enclosed. My limbs float. The noise and racing of my thoughts wind down until they yawn in my head as if they are in slow motion. My head is filled with white cotton, and I hear a low humming, and my skull is heavy. I am aware only of the water and my mother’s voice.
Back in bed, she wraps me tight in my quilt, my arms and legs and feet and hands all covered, kept in so they won’t fly off. The goatman has gone away for the night. She sits on the edge of my bed, smoothing my hair. I am wrapped up like a package. I am a caterpillar in my cocoon. I am an egg.
She stays with me until, near dawn, I fall asleep.

What They Know 1979

They know I am different. They say that I live in my head. They are just being kind. I’m crazy. The other kids say it, twirl their fingers next to their heads, Cuckoo! Cuckoo! they say, and I laugh with them, and roll my eyes to imitate a crazy person, and fling my arms and legs around to show them that I get the joke, I’m in on it, I’m not really crazy at all. They do it after one of my outbursts at school or in daycare, when I’ve been running around like a maniac, laughing like crazy, or while I get lost in my words, my mouth running off ahead of me, spilling the wild, lit-up stories that race through my head, or when I burst out in raging fits that end with me sobbing hysterically and beating my fists on my head or my desk or my knees. Then I look up suddenly, and everyone’s staring. And I brighten up, laugh my happiest laugh, to show them I was just kidding, I’m really not like that, and everyone laughs along.

I am lying on the bed. I am listening to my parents scream at each other in the other room. That’s what they do. They scream or throw things or both. You son of a bitch! [crash]. You’re trying to ruin my life! [crash, shatter, crash]. When they are not screaming, we are all cozy and happy and laughing, the little bear family, we love each other, we have the all-a-buddy hug. It’s hard to tell which is going to come next. Between the screaming and the crazies, it is very loud in my head.
And so I am feeling numb. It’s a curious feeling, and I get it all the time. My attention to the world around me disappears, and something starts to hum inside my head. Far off, voices try to bump up against me, but I repel them. My ears fill up with water and I focus on the humming in my head.
I am inside my skull. It is a little cave, and I curl up inside it. Below it, my body hovers, unattached. I have that feeling of falling, and I imagine my soul is being pulled upward, and I close my eyes and let go.
My feet are flying. I hate it when my feet are flying. I sit up and grab them with both hands. It’s dark, and I stare at the little line of light that sneaks in under the door.
The light begins to move. It begins to pulse and blur. I try to make it stop. I scowl and stare at it. My heart beats faster. I am frozen in my bed, gripping my feet. The light has crawled across the floor. It’s headed for the bed. I want it to hold still, so I press my brain against it, expecting it to stop, but it doesn’t. The line crosses the purple carpet. I want to scream. I open my mouth and hear myself say something, but I don’t know what it is or who said it. The little man in my mind said it, I decide, suddenly aware that there is a little man in my mind.
The line is crawling up the side of the bed. I tell it to go away. Holding my feet, I scootch back toward the wall. My brain is feeling the pressure. I let go of my feet and cover my ears, pressing in to calm my mind. The line crests the edge of the bed and starts across the flowered quilt. I throw myself off the bed. I watch the line turn toward me, slide off the bed, follow me into the corner of my room.
I want to go under the bed but I know it will follow me. I jump up on the bed, jump down, run into the closet and out again, the humming in my head is excruciatingly loud. The light is going to hurt me. I can’t escape it. It catches up with me, wraps around me, grips my body. I am paralyzed, I can’t scream. So I close my eyes and feel it come up my spine and creep into my brain. I watch it explode like the sun.
I drift off into my head. I have visions of the goatman, with his horrible hooves. He comes to kill me every night. They say it is a nightmare. But he is real. When he comes, I feel his fur.
I don’t come out of my room for days. I tell them I’m sick, and pull the blinds against the light. Even the glow of the moon is too piercing. The world outside presses in at the walls, trying to reach me, trying to eat me alive. I must stay here in bed, in the hollow of my sheets, trying to block the racing, maniac thoughts.
I turn over and burrow into the bed headfirst.

I have these crazy spells sometimes. Often. More and more. But I never tell. I laugh and pretend I am a real girl, not a fake one, a figment of my own imagination, a mistake. I never let on, or they will know that I am crazy for sure, and they will send me away.
This being the 1970s, the idea of a child with bipolar is unheard of, and it’s still controversial today. No psychiatrist would have diagnosed it then — they didn’t know it was possible. And so children with bipolar were seen as wild, troubled, out of control — but not in the grips of a serious illness.
My father is having one of his rages. He screams and sobs, lurching after me, trying to grab me and pick me up, keep me from going away with my mother, but I make myself small and hide behind her legs. We are trying to leave for my grandmother’s house. We are taking a train. I have a small plaid suitcase. I come around and stand suspended between my parents, looking back and forth at each one. My mother is calm and mean. The calmer she gets, the more I know she is angry and hates him. She hisses, Jay, for Christ’s sake, stop it. Stop it. You’re crazy, stop screaming, calm down, we’re leaving, you can’t stop us. My father is out of control, yelling, coming at my mother, grabbing at her clothes as she tries to move away from him. Don’t leave me, he cries out as if he’s being tortured, choking on his words, don’t leave me, I can’t live without you, you are the reason I even bother to stay alive, without you I’m nothing. His face is twisted and red and wet from tears. He throws himself on the floor and curls up and cries and screams. I go over to him and pat him on the head. He grabs me and clutches me in his arms and I get scared and try to push away from him but I’m not strong enough. I finally get free and he stands up again, and I stand between them, my head at hip level, trying to push them apart. He kneels and grabs my arms, Baby, I love you, do you love me? Say you love me — and I pat his wet cheeks and say I love him, wanting to get away from him and his rages and black sadness and his lying-on-the-couch-crying days when I get home from preschool, and his sucking need, and I close my eyes and scream at the top of my lungs and tell them both to stop it.
My father calms down and takes us to the train station, but halfway there he starts up again and we nearly crash the car. We leave him standing on the platform, sobbing.
“Why does he get like that?” I ask my mother. I sit in the window seat swinging my legs, watching the trees go by, listening to the clatter of the wheels. I look at my mother. She stares straight ahead.
“I don’t know,” she says. I picture my father back at home, walking through the empty house to the couch, lying down on his side, staring out the window like he does some afternoons, even though I tell him over and over I love him. Over and over, I tell him I love him and that everything will be okay. He never believes me. I can never make him well. crazy is nothing out of the ordinary in my family. It’s what we are, part of the family identity, sort of a running joke — the crazy things somebody did, the great-grandfather who took off with the circus from time to time, the uncle who painted the horse, Uncle Frank in general, my father, me. In the 1970s, psychiatry knows very little about bipolar disorder. It wasn’t even called that until the 1980s, and the term didn’t catch on for another several years. Most people with bipolar were misdiagnosed with schizophrenia in the 1970s (in the 1990s, most bipolar people were misdiagnosed with unipolar depression).We didn’t talk about “mental illness.” The adults knew Uncle Joe had manic depression, but they didn’t mind or worry about it — just one more funny thing about us all, a little bit of crazy, fodder for a good story.
This is my favorite one: Uncle Joe used to spend a fair amount of time in the loony bin. My family wasn’t bothered by his regular trips to and from “the facility” — they’d shrug and say, There goes Joe, and they’d put him in the car and take him in. One day Uncle Frank (who everybody knows is crazy — my cousins and I hide from him under the bed at Christmas) was driving Uncle Joe to the crazy place. When they got there, Joe asked Frank to drop him off at the door while Frank went and parked the car. Frank didn’t think much of it, and dropped him off.
Joe went inside, smiled at the nurse, and said, “Hi. I’m Frank Hornbacher. I’m here to drop off Joe. He likes to park the car, so I let him do that. He’ll be right in.” The nurse nodded knowingly. The real Frank walked in. The nurse took his arm and guided him away, murmuring the way nurses always do, while Frank hollered in protest, insisting that he was Frank, not Joe. Joe, quite pleased with himself, gave Frank a wave and left.

Excerpted from Madness: A Bipolar Life by Marya Hornbacher
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