The Complications : On Going Insane in America

Enhanced descriptions from Syndetics:

An unflinching, rare account of living with severe mental illness that is also a bold commentary on how we misunderstand this often debilitating disease.

The Complications is an intimate portrait of what it's like to live with schizoaffective disorder of the bipolar type as well as a biting, revelatory critique of America's mental health culture. Emmett Rensin has written and edited articles for major national media outlets, and taught writing and literature at prestigious schools. But he has also lost jobs and friends, been hospitalized and institutionalized, and cycled through a daunting combination of medications. With scorching honesty, he reflects on his messy, fragile attempt to live his life, his periods of grace, and his near misses with disaster and death.

Going beyond the usual peans against "stigma" and for "understanding", Rensin confronts the dysfunction in current mental health narratives, contrasting what he calls mental illness "high culture"--in which we affirm the prevalence of anxiety and encourage regular therapy, insisting that the "mentally ill" aren't dangerous or even weird--with even progressive society's inability to contend with people with more severe forms of mental illness: those people we pass on the street talking to themselves, those caught in a loop between hospitals and prisons, or even those who we cannot tolerate in our own schools, offices, and lives, including himself.

With raw honesty, Rensin invites us into every aspect of his life, from what it's like see four different psychiatrists in one year and the nature of psychotic breaks to a harrowing diary that logs exactly what happens when he stops taking his medication and the unexpected kinship he discovers with an incarcerated spree killer with schizophrenia. Going beyond pure memoir, he reflects on the uncertain "science" of diagnosis, the nature of art about and by the insane, political activism, and the history of madness, from the asylum to the academy.

A compelling, often devastating, blend of memoir, cultural commentary, and history, The Complications elevates the conversation around mental illness and challenges us to reexamine what we think we know about what is to go insane.

Reviews provided by Syndetics

Publishers Weekly Review

In this raw debut memoir, essayist Rensin interweaves an account of his struggles with schizoaffective bipolar disorder with a cutting examination of American attitudes toward mental health. Most chapters are rooted in Rensin's own experiences, describing, for example, the year he visited four different psychiatrists, his various periods of institutionalization, and his experiments with going off such medications as Seroquel and Abilify. Rensin expounds on these episodes with incisive critiques of the way Americans discuss mental illness, pulling in sources ranging from Roman history and ancient Chinese medicine to track shifting attitudes toward mental health across several centuries. Provocative ideas abound, including Rensin's argument that the current tendency to reduce stigma around mental illness undermines meaningful discussions of the actual experiences of mental illnesses: "Everywhere, the shame and embarrassment and stigma of lunacy is held up like a scarecrow, while every actual discussion of madness insists that it is trying to liberate us from that straw man's repressive gaze." Such strident takes might alienate some readers, but Rensin's points are trenchant and well argued, and the harrowing details of his own struggles lend him credibility. While the unremitting darkness can be tough to stomach, it's a rousing rebuke to more placid treatments of similar subject matter. (Apr.)

Kirkus Book Review

A firsthand look at schizoaffective and bipolar disorder. In an absorbing debut memoir, journalist Rensin recounts in chilling detail his "superior and specific epistemological access to the lived experience of being mad." Distinguishing his own psychosis from a popularized conception of mental illness as "diffuse unhappiness and attendant social struggles," he describes the violent episodes and "agitated emptiness" that led to repeated hospitalizations and often frustrating encounters with "nearly two dozen therapists"; the multiple medications (four different pills, twice a day) that keep his symptoms in check; and, most emphatically, his "particular way of being in the world." Although he sees psychosis as "a medical problem and a social problem and a personal problem, a problem of health-care policy and criminal justice and housing and labor," Rensin does not intend his memoir "to educate or enlighten." Rather, he began writing because he believed "in a magical way, that by doing so, I could consign going mad to the past; turn it into an area of my expertise but not an area of my experience." That goal, he has come to realize, is unrealistic: Even though medication has helped him to function, he is cognizant always of the possibility of a breakdown, a fear "very near but out of sight, like something waiting to attack." A bipolar mood episode, he reveals, does not rise up suddenly, and "psychosis comes and goes without warning." He constantly worries that he is getting worse: unusually sensitive, prone to tantrums, "rude, unable to read tone, and impulsive and forgetful and disorganized." While he claims not to want "to change anything," his historical overview of psychiatry, examination of the vagaries of diagnosis and therapy, and stark depiction of his own visceral experiences offer unique insight into the meaning of madness. An intimate look at a tormented mind. Copyright (c) Kirkus Reviews, used with permission.