Lisa Genova, the bestselling author of STILL ALICE and EVERY NOTE PLAYED, returns with yet another poignant, meticulously researched and emotionally resonant exploration of a misunderstood disease. Moving on from Alzheimer's and ALS, this time Genova turns her keen eye to bipolar disorder.

Maddy Banks has never quite lived up to the expectations of her mother, who is laser-focused on perfection. While her older siblings are well on their way to their mother’s dreams --- her sister engaged to a financial analyst and her golden-boy brother having everything handed to him --- Maddy is experiencing a bit of a failure to launch. Although she was accepted to prestigious NYU, she has not yet determined her major. And despite her boyfriend’s proximity at Columbia, he has unceremoniously dumped her.

Freshman year passes by in a depressed haze as Maddy struggles to get out of bed, attend her classes and live up to the rigorous academic program for which she has signed up. A quick visit to the university’s health facility lands her on an antidepressant. Before long, it is as if she is seeing colors again for the first time.

"As with any Lisa Genova novel, you are sure to fall in love with the protagonist, but you also will walk away with a new compassion and empathy for everyone around you…and maybe even yourself."

As a reader, you want to be delighted for Maddy, who is now acing her classes, but the warning signs slowly start to creep in. Maddy often stays up late completing essays that her professors haven’t even assigned yet, and she still wakes up by 5am to exercise and do more work. When she is approached by a hustler trying to sell comedy show tickets, she doesn’t just accept, she practically leaps at the chance. This fervor is typically reserved for her favorite musician, Taylor Swift, not a random, probably not-funny man outside of a club.

But then a dream is born: Maddy will be a stand-up comic. That’s not all, though. She’s also going to write Taylor’s authorized biography. No, wait, what if she could combine her two passions and perform a bit before Taylor takes the stage every night? After all, she can’t write the book without getting close to her. Then there are the signs that Taylor has been sending her all over New York City.

Regardless of your experience with mental illness, it is immediately clear that Maddy is not just feeling better. She’s manic. Hypermanic. Long accustomed to softening her harsh edges when around her WASPy family, Maddy has no trouble hiding her mania…until she doesn’t. One argument, a tipped-over wine glass, two smashed cars and one wielded knife later, she finds herself in a psychiatric hospital with a diagnosis: bipolar disorder. Maddy’s family is quick to adapt to their new normal, but her mother’s well-intentioned yet misguided attempts to protect her smother and stifle rather than support and uplift. First she removes all sharp items from the house, and then she takes away Maddy’s bathroom door.

As Maddy adjusts to her medications and therapy appointments, she starts to bristle at her mother’s control, and the two reach an agreement. While she cannot yet return to NYU --- with its lack of routine and abundance of temptation --- she can stay with her sister in the city and work at the local Starbucks. Desperate for freedom, Maddy agrees but with her own secret caveat. She has revisited the jokes she wrote when she was manic, and while the later pages are composed of wild, mean ramblings, a more stable Maddy can see the value in her earliest writings.

As Maddy adapts to her new routine, she continues to return to these pages, polishing and rewriting them, her enjoyment of her new life growing with every joke. However, there’s no way that any member of her perfect family will ever see a desire to perform comedy as anything other than insane, regardless of Maddy’s mental state. So when she begins to do her stand-up, she does so in private. This is a dangerous place for someone struggling mentally, especially someone who is unable to self-evaluate when she needs it most.

As a narrator, Maddy is unreliable to say the least, but this is not your drunken GIRL ON THE TRAIN or AMERICAN PSYCHO. Lisa Genova is unflinching in her exploration of Maddy’s disease but is never exploitative. The way she writes her highs and lows is incredibly immersive, almost terrifying in its easy slide into madness. But what is clear throughout is how deeply she is rooting for Maddy. And you are too. By combining Maddy’s diagnosis --- which she is always careful to frame as just that, even when Maddy herself labels it as an identity --- with her desire to perform comedy, Genova demonstrates how flimsy the idea of “normal” is. After all, millions of people enjoy comedy, and that must mean that at least thousands dedicate their lives to performing it. But to Maddy’s family, this trait is just as insane as attacking your mother with a knife.

Genova cleverly constructs a narrative that educates you even as it entertains and horrifies you. We all will be diagnosed with something at one point or another, so why should Maddy’s illness outshine her or force her to live strictly within its bounds, never enjoying a normal day again? This is a true and hopeful message, but Genova’s exploration of Maddy’s stops and starts reminds readers what a journey it is to get to “normal” --- whatever that is --- and why people with mental illnesses deserve so much grace and respect.

As with any Lisa Genova novel, you are sure to fall in love with the protagonist, but you also will walk away with a new compassion and empathy for everyone around you…and maybe even yourself. As our understanding and acceptance of these illnesses grow, it is novels like MORE OR LESS MADDY that will make these conversations more open and accessible for all. This one reads like an instant classic for the genre.