This article first appeared in the St. Louis Beacon, April 11, 2011 - Alice Curran of St. Louis used to dread Thanksgiving. Every year, she planned the meal for her extended family under a cloud of worry: Would her husband, Steve, show up at the table or would she have to make an excuse -- again -- for his sleeping through the entire holiday?
"I was like, 'What's wrong with him? This isn't fair,'" Curran said.
But a decade later, Curran understands that her husband is doing the best he can to manage his severe depression.
"I talk to friends, and they have issues in their marriages that I wouldn't put up with," Curran said. "Everybody has something, and this is just what we have."
That kind of acceptance is at the heart of "Next to Normal," a Tony- and Pulitzer Prize-winning rock musical about the unlikely topic of mental illness, whose touring production comes to the Fox Theatre April 12 through 24.
Bipolar Is Main Character's Normal
Diana, the main character in "Next to Normal" -- played by Alice Ripley, who originated the role on Broadway -- is diagnosed with bipolar disorder. According to the National Alliance on Mental Illness, bipolar is a medical illness once known as manic depression that triggers significant swings in mood, energy and ability to function in subtle or dramatic ways.
During a manic phase, someone with bipolar may espouse grandiose plans or take extreme risks. In a depressive stage, they may be restless, irritable and/or suicidal. A combination of medications can control both extremes but finding the right mix with the fewest side effects can take years.
The medication rollercoaster may include weight gain, tremors and a feeling of emotional numbness, about which Diana laments in "I Miss the Mountains."
"She is a wild creature in a cage. To Diana, she is in her natural state," Ripley said in an email. "It is only in others' eyes that she becomes limited by her actions."
Even though "Next to Normal" focuses on Diana's bipolar disorder and its impact on her husband and teenage children, its themes are broader than any single issue. Book author and lyricist Brian Yorkey said he and composer Tom Kitt sought to create a musical in which bipolar could be replaced with another number of topics -- alcoholism, drug abuse or any other mental illness -- and the play would still stand.
According to Yorkey, no matter what the concern, nearly every real-life family includes a member for whom the others have to make sacrifices.
"Producer David stone puts it really well," Yorkey said. "He says that in every family, there is one person who sucks all the air out of the room."
Tv Special Sparked Idea
Back in 1999 when Yorkey and Kitt were trying to come up with an idea for a 10-minute musical for a songwriter's workshop, Yorkey didn't have to look far for inspiration. He simply turned on the TV, where he happened upon a "Dateline" episode about electroconvulsive shock therapy.
After Yorkey and Kitt composed and staged the project, an unexpected response informed them they had a big idea on their hands.
"We found that many people had had a mother or a grandmother who had had shock therapy, and many people had depression in their families," Yorkey said. "The very fact of seeing this written about and set to music made people want to share their own personal stories; it felt like something pretty powerful."
While mental illness is certainly a serious topic, Yorkey took some humorous liberties with the script and lyrics. For example, the medications maze to which many of us can relate is a source of mirth as Diana's doctor delivers very specific directions about which pill is to be taken when, and how.
"The round blue ones with food, but not with the oblong white ones. The white ones with the round yellow ones, but not with the trapezoidal green ones. Split the green ones into thirds with a tiny chisel, use a mortar and pestle to grind..." the doctor instructs.
"There are moments in life when you have no choice but to laugh," Yorkey said.
Bemused by her own antics, Diana is "incredibly bright and witty, not just a downer of a person," according to Yorkey, something that may surprise some theater-goers. As he wrote the play, his own beliefs about mental illness, formed during an Omaha, Neb., farming-area upbringing, began to crumble.
"I confess that I used to feel that many people who said they suffered from depression probably needed to pull themselves up by their bootstraps and get back to work and get back to school and get over it," Yorkey said. "To learn how depression is not just imagined and how devastating it can be was quite a shock to me."
Half-price Tickets, Discussion On Nami Night
"Next to Normal" has the potential to erode at least some of the misconceptions about mental illness, according to Arlen Chaleff, vice president of NAMI St. Louis. Even conditions like schizophrenia can now be successfully treated, she said, and families really can live next-to-normal lives.
"Most people hear about the horror of mental illness like in 'One Flew Over the Cuckoo's Nest' or see it through the eyes of a psychotic killer," Chaleff said. "In the play, people can see a family living with this, and it might not be what people consider normal but it is relatively normal."
Thursday, April 21, is NAMI night at the Fox. Anyone ordering tickets for that performance can enter the code "NAMI" to get half off the ticket prices That evening, Barnes-Jewish Hospital psychiatrist Luis Giuffra will be on hand for a question-and-answer session before the play begins.
According to Giuffra, the more severe form of bipolar affects 1 percent of the population, with another 2 to 3 percent affected by the less-severe bipolar II.
"Altogether, one out of every 25 or 30 people suffers from a form of bipolar disorder, which is a lifelong illness," Giuffra said. "It's one of the leading causes of disability, work-wise, and in the U.S. the cost of bipolar in financial terms is in the tens of billions of dollars a year."
One in four families is affected by some kind of mental illness. But the stigma persists.
"This play helps people realize how real mental illnesses are," Giuffra said. "I am sure that for many families, it will hit very close to home."