February 27, 2025 • 48 mins
Lisa Genova is back at Lisa's Book Club! The two Lisa's sat down at Joss and Main to discuss Genova's new novel More Or Less Maddie. Lisa gave amazing insight to bipolar disorder and answered multiple questions from the crowd. You wont want to miss this one!
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Episode Transcript
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Speaker 1 (00:04):
Hey, Welcome to Lisa's Book Club, a podcast where I
interview best selling authors from the New England area, pulling
back the curtain on what it's really like being a
best selling author. They're guilty pleasures, latest projects, and so
much more. Lisa's Book Club a meeting last night and
we had author Lisa Genova. She's actually back for a
second time. The first time we talked about her book, Remember,
(00:26):
which is nonfiction. This time she wrote a novel. It's
called More or Less Maddie. We were back at Johnson,
Maine at the Burlington Mall. And a little side note,
Lisa Genova grew up in Waltham and she used to
go to the Burlington Mall and a lot of her
classmates from her high school were there last night, which
(00:46):
is really really fun. So we had a great discussion
talking about the book. It's a heavy topic, is about
mental health and bipolar disorder, but Lisa always attempts to
give good and information in such a compassionate way, so
I hope you enjoy this podcast.
Speaker 2 (01:04):
Welcome.
Speaker 1 (01:04):
We are here to talk about your new novel, More
or Less Maddie. But I want to sort of cycle
back to where we first met because Lisa joined the
book club. Lisa is a graduate of Waltham High School.
Get some.
Speaker 2 (01:22):
She said that this is her mall. Right, this was
my mall growing up.
Speaker 3 (01:26):
It was Kiss Went Away and the Burlington Mall.
Speaker 2 (01:30):
It makes perfect sense.
Speaker 1 (01:31):
And I think there's like a whole group here from
Wallfale High School. You are like, go hooks, You're all
still friends.
Speaker 2 (01:40):
This is amazing. That makes me so happy.
Speaker 1 (01:44):
So you're a Harbor trained neuroscientist. You've written many novels,
many stories. You joined us for a non fiction book,
remember the first time around? And I want to remind
everyone that Lisa's first book, your self published book, was
Still Alice, which won an OSCAR.
Speaker 2 (02:06):
Yeah. Like that's like right out of the box. I know,
I know. It's hard to live up to that, right,
Like the bar said, so high.
Speaker 1 (02:14):
I didn't realize I was actually talking to a couple
of the people in our group tonight, and I had
I thought that Still Alice was.
Speaker 2 (02:22):
A true story. Oh no, no, no, And I come
to find out that it's not at all.
Speaker 3 (02:28):
Yeah. No, none of my novels are true stories. I
try to tell the truth under the imagined circumstance. Right,
But I thought it was based on a true story.
I was inspired by my grandmother who had Alzheimer's, but
she was older, she was in her eighties, and was
the inspiration for me wanting to understand more about what
it feels like to live with it. And so I've
read everything I could about Alzheimer's, but those books they
(02:49):
were medical texts, and research are scientific research articles.
Speaker 2 (02:54):
And it was the thirty six Hour Day, which was.
Speaker 3 (02:56):
Really helpful, but also from the point of view of
someone else, a caregiver, a scientist, a clinician, they're all
very sort of like homework and heavy and technical, and
so I learned a lot, but I didn't learn what
does it feel like to be her? And the AHA
was like, Oh, isn't that interesting. Fiction is the place
where you have the chance to walk in someone else's
(03:17):
shoes and imagine what it feels like to be them.
So I need a novel about someone with Alzheimer's, and
it didn't exist at the time.
Speaker 2 (03:24):
So I was like, all right, well, I guess I'll
write it. Yeah, that's how that happened.
Speaker 1 (03:28):
So stories create empathy and people feel like they have
a window inside of what's really happening with people.
Speaker 2 (03:34):
And families and relationships, right.
Speaker 3 (03:37):
Yeah, and you know what, I just want to mention
at the topic. So I'm just I've been on book
tour for this book now.
Speaker 2 (03:41):
For a little over a month, and this is very typical.
Speaker 3 (03:45):
It's there's a couple of men here, It's almost all
women everywhere I go.
Speaker 2 (03:51):
And I'm not unique in this.
Speaker 3 (03:53):
If it's Jodi Pico, if it's Elean Orldebrand, if it
doesn't matter the book, if.
Speaker 2 (03:57):
It's fiction, the audience is women.
Speaker 3 (04:00):
And if reading fiction is like going to the empathy gym,
like fiction is the place where we get chance to
try on the experience of someone who's different than us
and maybe understand what it's like to be someone different
from us.
Speaker 2 (04:13):
And women are the ones throughout life who are.
Speaker 3 (04:16):
Getting practiced in this through reading story, and men aren't
as a whole, Like we got to invite men to
start reading fiction.
Speaker 2 (04:23):
I think it would help.
Speaker 1 (04:24):
I agree, Just say and go home and tell your guys, Yeah,
give them more or less, Maddie. So okay, so we're
here to talk about more or less Maddie. You have
written books about neurological diseases. You've written about als, you've
written about Alzheimer's Huntington's disease. And why did you choose
(04:46):
to write a book about mental health and then bipolar disorder?
Speaker 2 (04:53):
Yeah, so, I.
Speaker 3 (04:55):
Mean I kind of see anything that's going on from
the neck up as my domain. So I hadn't yet
tackled anything that's categorized as mental illness.
Speaker 2 (05:05):
Right I do.
Speaker 3 (05:06):
I want to write about people who are living with
some kind of condition, disease, illness, something's going on inside
their brains that causes them to be ignored, feared, or
misunderstood by the public, like, oh, I don't understand what's
going on with you.
Speaker 2 (05:20):
I'm uncomfortable. I'm just going to look away, and so.
Speaker 3 (05:22):
People get kicked out of belonging for what's going on
inside their brains.
Speaker 2 (05:26):
I hadn't done mental illness yet.
Speaker 3 (05:28):
And interestingly, that term mental illness is entirely made up,
So there's no neuro anatomical, neurobiological reason to carve oute
things like depression, schizophrenia, bipolar disorder, anxiety disorders and call
them mental illness.
Speaker 2 (05:44):
But we do.
Speaker 3 (05:46):
And I think there's a lot of unnecessary baggage and
burden that comes with that. So I did want to
go there next and I chose bipolar disorder because I mean,
I think that we have a lot more stories and
under standing about depression now than we did, say, like
back in the eighties.
Speaker 2 (06:03):
Like nobody talked about depression in the eighties, but we're
a little more comfortable with that now.
Speaker 3 (06:07):
I think bipolar disorder is hiding in plain sight everywhere.
So and so I was like, this is going to
be a chance for us to talk openly about it,
to have that open conversation that helps us humanize what
this is rather than there's a lot of judgment. There's
a lot of stigma and shame attached to this, and
so I thought that like a humanizing story could really help.
Speaker 1 (06:28):
So Maddie is a central character, and she is a
young girl starting her freshman year at NYU. And what
is the age the typical age range of someone you
know when they get bipolar disorder?
Speaker 3 (06:43):
Yeah, So, in doing the research for this book, I
talked to a lot of people who have it, their
loved ones, and then the people who treat it and
research it, so psychiatrists and psychologists, And the average age
of onset is late teens to early twenties. So knowing
that informed my character I'm like, okay, so I'll make
her nineteen years old twenty years old when the story begins.
Speaker 2 (07:03):
Yeah, and so she's.
Speaker 3 (07:04):
Got one like can you think back to the age,
Like you've got one foot in adult adulthood, right, You're
just starting to figure out your identity and who you
might be beyond the house you grew up in, Like.
Speaker 2 (07:15):
What do I want to major in? What do I
want to do? Who am I? What do I think
about things?
Speaker 3 (07:20):
And imagine then getting this diagnosis that swoops in at
that age and interrupts everything, really because it's so overwhelming
and so chaotic, and it's basically saying to you, here.
Speaker 2 (07:31):
This is who you are. You are bipolar.
Speaker 3 (07:35):
And so I think a lot of this book is
Maddie wrestling with what is the distinction between I am
bipolar and I have bipolar?
Speaker 1 (07:42):
I thought it was really interesting that she presented as
a depressed person and was given an antidepressant and then
that tripped her manic episode. And I never realized that
that that could happen.
Speaker 2 (07:57):
And that's what does happen.
Speaker 3 (07:59):
So all right, so until you have that first manic episode,
no one would know that that's what's hiding inside your
brain if that's.
Speaker 2 (08:06):
What you've got. So there's no blood test, there's.
Speaker 3 (08:08):
No brain scan for bipolar disorder, and people usually do
have maybe a series of depressions first before they ever
have that first manic episode. So you'll either be undiagnosed
as depressed and just dealing with the depression without being
treated as a lot of young people do. They sort
of try to muscle through and oh, it's not happening,
or just go along. But eventually, if you get seen
(08:30):
and they're like, well, you've been experiencing depression, let's try
you on an antidepressant, it's reasonable. If what's going on
in your brain is unipolar depression, then that antidepressant could
be helpful. But if what you've got is bipolar, that
antidepressant medication is actually going to catapult you into your
first manic episode.
Speaker 1 (08:49):
Now, the manic episode in the book, I have to say,
when I was reading it, I was so anxious, like
really it made me really uncomfortable because she was so unhinged,
she was delusional. What was that like for you writing
that scene?
Speaker 2 (09:04):
And how many people did you talk to? Is that
sort of a you pulled from a lot.
Speaker 1 (09:08):
Of different experiences from families to create that scene.
Speaker 3 (09:12):
Yeah, so I interviewed twelve people who have bipolar disorder,
and all of those folks shared with me there are
examples of manic episodes, and then a lot of the
reading I did, so I read a lot of memoir
and there were a lot of manic episodes described there too,
so I had a sense of the lived felt experience,
and so then I had to go there. And in
(09:32):
writing it, it really is you're trying to slow things down.
Even though I'm writing this is a very fast scene,
it should feel very breathless. So I'm really just trying
to be in that the sensory moment to moment details
of like what is like what is she experiencing?
Speaker 2 (09:49):
And it did. It felt very like breathless.
Speaker 3 (09:52):
I wrote that scene with a pen and I was
like just trying to keep up with what was happening,
writing as fast.
Speaker 2 (09:58):
As I could.
Speaker 1 (10:00):
You talk to you because you do a lot of
references to Taylor Swift a lot of her music Who
did you talk to your kids? From?
Speaker 2 (10:07):
About? You know, who did you talk to? So interestingly?
Speaker 3 (10:10):
So I started this book a while back and then
I paused to hit pause on it to right remember
for you, because I was like, all right, people need
to understand how their memory works because so many of
you are freaking out and you're fine, but you don't
think you're fine, So.
Speaker 2 (10:24):
Like, let me help. So I yes.
Speaker 3 (10:28):
So when you're manic, So for those of you who
may not know, so mania is your So bipolar is
an your brain is impaired in its ability to regulate
things like mood, energy, emotion, sleep, and thought. So when
you're manic, when you swing in that direction, you have
an excess of energy. You are might not be sleeping
(10:51):
at all or maybe just a couple of hours a night,
and you are not tired. You're talking really fast, you're
interrupting everybody. You've got tons of ideas. It's called a
flight of idea as. You might quit your job because
now I'm going to go start a fashion label, and
then I'm going to open a furniture store, and then oh,
I'm going to become an artist, and oh I'm going
to be a rock star. And then you might have
You're acting recklessly and you're taking risks, you're spending thousands
(11:13):
of dollars you don't have. You're having sex with multiple
partners even though you're married, there's no consequences to anything.
Speaker 2 (11:19):
And you might also believe things that aren't real.
Speaker 3 (11:22):
So the things you believe that aren't real usually are
that you're very special in some way, you're gifted, or
God has called upon you to do something, or you
know really famous people, because you are also very famous.
So she, being a nineteen twenty year old, I was like, well,
she knows Taylor Swift and she's going to be writing
her memoirs the first belief. Later on she believes she's
(11:44):
opening for her as a comedian. But yeah, so I
have a twenty four year old daughter who lives in
New York, and I have two twenty one year old
nieces and my youngest daughter's fourteen, and all of them
are swifties.
Speaker 2 (11:57):
I am now a swifty as well. Go did you
see her?
Speaker 3 (12:01):
Oh yeah, yeah, yeah. So we saw her at Gillette,
my two daughters and I. And then as things moved along,
because this errors tour went on and on, the Tortured
Poet's Department came out, and now she's got new songs
on the tour. So my oldest is like, mom, let's
go see her in Europe. Okay, So but we it.
Speaker 2 (12:18):
Was Austria, so it got canceled. No, so then we
went to Toronto. Okay, so yeah, but all you had
to go to Toronto.
Speaker 3 (12:26):
I know. So yeah, the young people really helped me
with the texting that's in the book because like how
like mom, Like I'm fifty four, Like I don't know
how to text like they text. So yeah, they helped
me with that and with like anything Taylor related.
Speaker 1 (12:41):
How did you choose stand up comedy as Maddie's you know,
career choice.
Speaker 2 (12:47):
Yeah, so and then I want to ask you, I.
Speaker 1 (12:50):
Did I know, so Lisa like really did a research.
Speaker 2 (12:54):
You actually did stand up in New York. I know
we're going to talk about that.
Speaker 1 (12:57):
Why did you choose comedy for Maddie? So there's a
number of reasons that I really liked comedy for her.
So one is like this book is a lot about
like what is normal? Like who gets to decide that?
Speaker 3 (13:07):
Right, Because now she's got this condition that she's being
labeled as not normal and that that needs to be medicated.
So she stays within the range of normal and there's
obviously some validity to that when she's manic or when
she's depressed, and the depression is brutal and awful and scary.
There's a high risk of suicide with bipolar disorder, so
(13:28):
staying contained within that range of.
Speaker 2 (13:30):
Normal is is vital.
Speaker 3 (13:33):
But also like who gets to say and like as
a woman, right, especially as a woman, like culture deciding
what's normal for you, and you better not step outside
of that or you're crazy, right, right, So I wanted
her to pick a career that wasn't normal that that
culture and her family would be like, wait, there's not
enough structure to that. There's not enough stability in that decision,
(13:55):
Like that's not a nine to five job, there's no like, well,
if you do a and see then you'll be a
successful stand up comic, So that there's no rules to it.
Speaker 1 (14:06):
And maddening and you're going to be at its maddening
and you're going to be at bars right at night,
and there's going to be a lot of like drinking
and substances there. And it's like when you're when you
have bipolar disorder, if you've got this delicate.
Speaker 2 (14:18):
Balance now of keeping you I could.
Speaker 3 (14:20):
Use some water, If someone has, we'll get you them.
You've got this delicate balance of trying to stay regulated.
You don't want to be drinking alcohol, taking stimulants, anything
that's going to push you in one way or the other,
because that could mess things up for you. So they're like,
we don't want you in this in these night clubs.
So that's another reason.
Speaker 2 (14:41):
I love that.
Speaker 3 (14:41):
Humor is just a way that humans use to connect
and bridge uncomfortable, awkward subjects.
Speaker 2 (14:47):
So I like that, and then, oh, thank you so much,
thanks Jordan. I also loved the metaphor of it.
Speaker 3 (14:57):
So if you're a stand up comic on any given night,
from minute to minute, you can be experiencing mania or depression.
Speaker 2 (15:05):
So if I'm killing it and.
Speaker 3 (15:07):
You're all laughing and we're in on it together and
we're connected and you get it, it's the best feeling.
Speaker 2 (15:12):
I want to I want to stay there. It's you
for work. I want to chase that and get that
again and again. Mania.
Speaker 3 (15:17):
If I'm bombing and you guys just are silent and
arms crossed and stone faced, and oh my god, I
just this is the worst feeling.
Speaker 2 (15:26):
I'm miserable. It's torture. I just want to crawl into
a hole and die. So I love the metaphor of it.
Speaker 1 (15:32):
Yeah, I totally agree with you. So, what was your
experience in New York? What club did you do a
stand up set to? And was it terrifying?
Speaker 3 (15:40):
Yeah, so it's so so it was, it was out
of New York.
Speaker 2 (15:44):
It's laughing Buddha comedy.
Speaker 3 (15:46):
I took a stand up comedy writing class because I
knew I had to write stand up comedy in this
book now with this decision, and I needed to start
in a place where she wasn't very good, but there's
like the glimmer of hope of it all, and then
she knows the little tailorism so and that she would
get better, and that the book would end with what
would essentially be her five minute set, and she'd be
(16:09):
communicating something about her relationship to having bipolar disorder, inviting
you to be okay with it as well, and it
maybe even laugh a bit about some of the absurdity
that can happen with it.
Speaker 2 (16:21):
So I took the.
Speaker 3 (16:22):
Stand up writing class, and I told the teacher right away,
I'm like, okay, so I'm taking this to write it
as my character, who's only twenty years old. I want
to be writing all of my jokes as if I'm
my character. And he immediately said no, you are not
doing that. You're writing it as you you fifty something
year old lady.
Speaker 2 (16:42):
I was like, oh crap, So I had to do that,
and so what were your jokes? So you have to
tell us one of your jokes? So I will say
the five minutes.
Speaker 3 (16:52):
It's a little bit of a cheap because it was
at the end of the pandemic and so we couldn't
do it in the club.
Speaker 2 (16:57):
It was assumed and so I know, which, on the.
Speaker 3 (17:01):
One hand, is way not as scary, but also like,
you don't have the feedback of the real people. They
were just little squares. My friend Kim is here somewhere.
She was one of the squares. She saw me do it.
Speaker 2 (17:10):
How did she do it? I know, I don't know
where she went. She's shopping for furniture.
Speaker 1 (17:15):
Good.
Speaker 2 (17:17):
So okay, so I'll tell you.
Speaker 3 (17:18):
I gave Maddie exactly one of my jokes from my
five minute set, and it's the joke about the thongs.
Speaker 2 (17:24):
Ah, that was good, thank you. Yeah, I like that one.
Speaker 1 (17:30):
So did you make Maddie's mother as perfect as pot like,
like obnoxiously perfect on purpose? Right?
Speaker 2 (17:40):
Just because well I wanted her to really care about appearances? Right,
and she did.
Speaker 3 (17:47):
Yeah, you know, so yes, in some sense, yes, because
again there's so much shame and stigma attached to this.
But I also I hope over the course of the book.
I mean, it's not told in mom's point of view.
It's told in's point of view, and if your teenager
is telling her version of the story, she's not really
getting right, Like your teenager's not telling the story with
(18:10):
the benefit of what you're thinking and feeling. Mom right,
of course, but so I hope you develop more empathy
for Mom as the story goes on.
Speaker 2 (18:18):
But Mom is coming from a place a lot of fear.
Speaker 3 (18:23):
So her first husband, Mattie's dad, had undiagnosed bipolar disorder
and put her through hell, and we got glimpses.
Speaker 2 (18:32):
Of what went on.
Speaker 3 (18:33):
Mattie doesn't really remember because she was four when he left,
and they don't know where he is. They've not seen
him since, so she's very scared of what can happen
to her daughter, having lived with it before. So yeah,
she's I think that Mom. Like, there's this comment Maddie
makes very early on where she's just trying to figure
out her mom and Phil. She's like, what is Mom
seeing this guy, he's twenty years older. Like he's like
(18:55):
the grandfather in this story. Like, why where the passion?
Speaker 2 (18:59):
I don't see it? She says.
Speaker 3 (19:02):
It seems to her that my mom has traded an
awful lot for a stable life. And I think that
after the chaos and the heartbreak of the first marriage,
that she decided that she was going to make everything
as perfect as possible because she would find safety in that. Okay, Yeah,
and so what she's projecting on to Maddie is if
(19:22):
I can just keep you perfect, you'll find safety there.
Speaker 2 (19:27):
Right, it makes sense.
Speaker 1 (19:28):
Yeah, when you were talking and interviewing all of the families,
was that a common thread? I mean, was that sort
of did you find common threads with some of the stories?
Speaker 2 (19:37):
For sure?
Speaker 3 (19:38):
Yeah, there's lots of fear for the parents, and there's
no you know, it's not like if you're diagnosed, say
with diabetes, it's life changing, it's difficult, and we know
what to do for you, right, like here's your medication,
here's your prescription, and we know what's going to work.
Speaker 2 (19:55):
Right.
Speaker 1 (19:55):
And with bipolar, you said that there's really the drugs
that are out there actually not made for bipolar, right.
Speaker 3 (20:01):
They're not so the drugs for bipolar disorder aren't designed
for it. We don't know what causes bipolar disorder in
your brain, We don't know the neuroscience of bipolar disorder,
and so the drugs that are used to treat it
are drugs that just were serendipitously discovered that happened to
work for bipolar. That's lithium, and then the others are
(20:23):
drugs that are used for other illnesses like epilepsy and
being applied to bipolar disorder, which means that they're acting
on all kinds of.
Speaker 2 (20:31):
Receptors that aren't actually bipolar in your brain. So you
get a ton of side effects.
Speaker 3 (20:36):
Right WEA gain, wakeained hand, tremor, nausea, foggy thinking, constant thirst.
Speaker 2 (20:44):
It's brutal.
Speaker 3 (20:45):
It's really tough a lot of these side effects to
deal with.
Speaker 1 (20:48):
I thought that you dealt with it so well in
the book be As you really could feel the struggle
that the family was having and trying to balance and
trying to find the right combination of drug that wouldn't
make her doo low so she didn't feel like she
didn't want to get out of bed.
Speaker 2 (21:05):
And then yeah, yeah.
Speaker 3 (21:07):
The medications will have like a break like depressive lever
or break on the mania lever, right, So it's like, Okay,
we don't want you to swing manneck. So some of
the drugs might be really good at keeping you out
of mania, but they push too hard on the depression
and so you're like just sedated and leaning that way.
So we don't want you to live like that. So
it's a tricky. It's it's more of an art than science,
(21:29):
like just trying to figure out the combination. So the doctors,
if any of your family members have this, it should
be a collaboration. It should be you're in communication like
where you can raise your hand at any point and say,
this isn't working for me right now, what can we
do to change it? Rather than just try to bear
it until you can't bear it.
Speaker 1 (21:48):
Right and then things get go very very bad. Can
anyone can you be diagnosed with bipolar in your forties
and fifties?
Speaker 2 (21:56):
Absolutely? Yeah, Yeah.
Speaker 3 (21:58):
There's there's a couple of people who I interviewed who's
we're talking about parents who were recently diagnosed. Somebody that
told me tonight that a parent was diagnosed.
Speaker 1 (22:07):
So what were they inhibiting throughout their entire life though
that they wouldn't have been diagnosed earlier.
Speaker 3 (22:12):
Oh A, that might not have shown up yet, or
B it's been there all along and now everyone's going, oh,
oh I get it now. So yeah, that just a
lot of like chaotic behavior, reckless behavior like hypomania. So
bipolar two you don't actually reach a full blown manic episode,
(22:34):
so you're not having got delusions or yeah, or hallucinations.
So and if you're talented in some way and you're
just go to hypomania, so think of it as like
mania light.
Speaker 2 (22:46):
You just have a lot of excess energy.
Speaker 3 (22:49):
You're probably talking too much and you're posting to Instagram
all night long or interrupting everybody.
Speaker 2 (22:54):
You've got tons of ideas.
Speaker 3 (22:55):
But like say you're a songwriter and you're now you
don't need any sleep really and you've got and all
of your inhibitions are dropped, like you don't have any
guardrails anymore. So now you can just pour yourself into something.
You might be really productive in these phases. There's a
price to pay. You will have a depression at some point,
and that's not going to be fun for you or anybody.
(23:15):
That can be very scary, but there could be moments
of creative versts so wonderful.
Speaker 2 (23:20):
If you're not talented, you're writing songs.
Speaker 3 (23:23):
That are crap, which is what Maddie does. If you
have the very first scene in the book, she thinks
she's a songwriter now and she's written all these songs
on the walls of the plots of hotel in Vegas,
and she at the time she thought she's gonna win
a Grammy. But after the manic episode's over, she's like,
oh my god, like, none of that makes any sense.
Speaker 1 (23:42):
Is there a connection between people in creative fields and
bipolar disorders?
Speaker 3 (23:48):
So there have been a lot of people who are
creative who who in retrospect or at the time, do
have bipolar disorder.
Speaker 2 (23:55):
You mentioned Selena Gomez.
Speaker 3 (23:57):
Selena Gomez, Yeah, Taylor Tomlinson, Yeah, Carrie Fisher had it.
Speaker 2 (24:03):
So they think Van Go had it. They're Ernest Hemingway.
But it's right.
Speaker 3 (24:11):
So the numbers out there are anywhere from two to
four percent of the population. So at the minimum, it's
one in fifty people. How many people are here tonight,
So and it's hard to get a diagnosis.
Speaker 2 (24:23):
You have to come from a place of privilege.
Speaker 3 (24:25):
To navigate the US healthcare system to get to that diagnosis.
Speaker 2 (24:29):
So it's got to be more than that.
Speaker 3 (24:31):
So I think we know about creative people because we
know about the work they produced, because they're famous to
some extent. I'm like, there are just as many accountants
who have bipolar disorder. They're just not You're not aware
of it because they're not telling you about it on
a comedy stage or on in a documentary on Apple TV.
Speaker 1 (24:49):
Wow, So what can we do with the healthcare system?
Is your book trying to.
Speaker 2 (24:57):
Vote? That's a big question, Lisa.
Speaker 3 (25:01):
I know, well, I mean, honestly, some of this is
like no, like like still Alice has been for a
lot of folks who've navigated Alzheimer's in their family. Read
the story. You know what the conversations should sound like.
So one of the things I do in all of
my books. It's fiction. I've made it up, but I've
done tons of research. And so every time there's a
(25:21):
conversation with a medical professional, whether it's an occupational therapist,
a psychiatrist, a neurologist, I am giving you what should
the gold standard compassionate practice, Like, this is what it
should sound like, This is what it should look like.
So if this is happening in your family, you should
at least know like some of what you should look
(25:44):
for in your psychiatrists.
Speaker 2 (25:46):
Like, so use this book more or less, Mattie as
a manual. It's a resource.
Speaker 3 (25:50):
Yeah, understand like a sense of what that conversation should
sound like, what you can expect.
Speaker 2 (25:56):
Yeah.
Speaker 3 (25:56):
In fact, so doctor Andy Nuremberg, who runs the Polar
Center at mass General Hospital. I talked to him quite
a bit and when I finished the first draft, I
sent it to him and asked him to read it
for accuracy. And his biggest note to me is can
you make the doctor more collaborative?
Speaker 2 (26:14):
And I was like, yes, let's do that. Yeah.
Speaker 3 (26:18):
Yeah, it's a big because it's not diabetes. It's not
like here's your prescription.
Speaker 2 (26:22):
That's well. They have to play you do no matter
where you are.
Speaker 3 (26:25):
If you were diagnosed with bipolar disorder in Los Angeles, Boston, Chicago,
and Atlanta, you could be getting four different prescriptions.
Speaker 1 (26:34):
Absolutely, So it's you really laid that out in the book.
Can we shift gears just a little bit and sort
of talk about the mechanics of writing? And because I noticed,
I mean we mentioned that Selena Gomez used her quote.
Speaker 2 (26:49):
But I want to talk a little bit about.
Speaker 1 (26:53):
Quotes that are used on the covers of books. Jody
Peacole is on your cover.
Speaker 2 (27:00):
How does this? How does this happen? How do the
quotes happen? So the quotes are a.
Speaker 3 (27:05):
Bit of a pain if you're an author, Okay, it's
it's like an imprint of Simon and Schuster that's doing
away with them, which every.
Speaker 2 (27:13):
Author I know, we're like, oh, thank god.
Speaker 3 (27:17):
So it's not you know, if you're a musician, you
don't have to get quotes from musicians for your new album. Like,
if you're an actor with a movie out, you're not
asking other actors to like write a quote to promote
your movie.
Speaker 2 (27:29):
But authors, we are.
Speaker 3 (27:31):
Asked to go out and get quotes from other authors
who are very busy writing their own books and doing
their own things. And now I'm like, it's so awkward, like, Hi,
will you please read my book? And what if it's
not good?
Speaker 2 (27:42):
They I didn't really have I asked them out. The
publisher did that for you. They might have done it
in the nineties. They definitely don't do it anymore. The
authors do it. So yeah, those are all my friends.
We have some very powerful friends. Yeah, yeah, yeah, JODI's great.
Do you think that the quotes help sell the book?
(28:03):
I don't know. Does it help you? I don't think
it matters. This is where, yeah, we're getting to like,
can we please just stop doing this? I love your quotes.
Speaker 3 (28:12):
Like when you guys leave a gup or view a
good Reads, or are somewhere publicly, or if you DM
me on Instagram or or leave a note like I
will often turn that into something that I share that
because that's I mean, that's what.
Speaker 2 (28:25):
Matters the people reading.
Speaker 1 (28:26):
I'm glad you mentioned social media because I wanted to
touch on this, and we spoke about this.
Speaker 2 (28:30):
A few days ago.
Speaker 1 (28:32):
It seems like, especially on TikTok the last couple of
years with a lot of you know, gen z ers,
even millennials, that a lot of people are sharing their
struggles with mental illness. It's become something that people feel
more comfortable talking about. But I know that on TikTok
and I know social media, there's a lot of great
things that can happen, and there's a lot of misinformation
(28:53):
out there, So can you talk about that?
Speaker 2 (28:56):
Yeah, this is a big, big it's not black and white.
Speaker 3 (29:00):
So on the plus side, community is so important, right, So,
like one of the tough things about being diagnosed with
any mental illness is that it does it kicks you
out of belonging people. You become authorized, people become afraid
of you. They don't invite you to things, they don't
know how to look you in the eye. There's a
lot of you become outcast in a lot of ways.
(29:22):
And so and maybe you don't live, you know, amongst
a lot of people. Maybe you live in rural Oklahoma
and you've got something and you don't know anybody else
who has this. It's just you because nobody's talking about it.
So social media can be a way that you find support,
you find others who are like you, and you can
it's educational. I mean, I'm on there with a lot
(29:43):
of bipolar communities right now and how I did some
of my research, and it's how I continue to be
part of the conversation. So it can be education and
community belonging.
Speaker 2 (29:55):
So that's huge.
Speaker 3 (29:56):
But the misinformation part is really frustrating. I battle this
a lot, especially with respect to Alzheimer's and memory. There's
a lot of snake oil salesmen out there. There's a
lot of misinformation even while meaning people will read something
and take like, you know, a snippet from it, a
SoundBite that isn't accurate, out of context, and they run
(30:17):
with it.
Speaker 2 (30:18):
Now people believe something that isn't true, and then you're
trying to unravel It's really tough.
Speaker 3 (30:23):
So you know, when you're on social media and you're
looking for information about something health related, a make sure
it's someone that you trust to begin with, or research
what they're saying, like get out of the get out
of Instagram and google what they're saying and see if
like credible sources.
Speaker 2 (30:43):
And I'm just trying to think like it, like.
Speaker 3 (30:46):
Like if there's research papers that that support it. If
someone's selling you, if they're telling you something and they're
selling you something, they're selling you supplements. Don't believe them
like they Some of what they're saying is probably true,
but they might be exaggerating a whole lot.
Speaker 1 (31:05):
Right, Did you talk to any of the doctors about
the role of social media right now and how it's
making their job either easier or more difficult.
Speaker 3 (31:12):
I know I didn't go there with them, but then
the there's so much more to right there's the you know,
the fear of missing out and the bullying and the
living up to and it can like how many hours
dare we glued to this rather than being with each other.
That can contribute to depression and feeling isolated.
Speaker 2 (31:31):
So it's it's so tricky. It depends on how you
use it.
Speaker 1 (31:36):
I felt like how you ended the book with Maddie.
I felt very hopeful for her.
Speaker 2 (31:42):
I did. Do you guys agree with that? I'm so
glad that.
Speaker 1 (31:45):
She was finding her place, she was settling in, she
was being okay with who she is, right, yeah, yeah,
and we all struggle with that. So I really I
really liked the ending of this book.
Speaker 2 (31:56):
Thank you.
Speaker 1 (31:57):
Yeah, yeah, did you struggle with the ending? Did you
have like different ending? Now?
Speaker 2 (32:00):
I knew where I was going from the beginning.
Speaker 3 (32:02):
I knew that I wanted to get to her five
minute set, So I was going to basically write her
five minute set, and that it had to be in
a place where she's not cured.
Speaker 2 (32:11):
There's no guarantee for her.
Speaker 3 (32:13):
But she's now in a place where she feels supported,
that she's got you know, she's agreed to be on medication.
So every all of the doctors I talked to you
said it takes most people three times going off the
meds before they decide, Okay, I'm done with that experiment
and I'm going to stick to stick to it in
some way. And then you also have a village of
(32:35):
people around you who are also your eyes and ears,
because if you start to swing one way or the other,
your brain starts to lie to you, you know, whether
it's depression and you're just like, I'm a piece of
shit and I'm you know, worthless and it's hopeless and
like you start believing that, or you're manic and you're like,
I'm amazing in every way. Like, so you need other
(32:55):
people who you become unreliable as a narrator, So you
need other people to be like, I'm noticing something like,
so will you agree on what your triggers are? Like, Oh,
if I start, I've only slept five hours last night
and I'm not tired.
Speaker 2 (33:08):
Uh oh, Like that could.
Speaker 3 (33:09):
Be a sign that you're drifting into a manic episode. Ye,
So you have your toolkit and your your medication. So
I knew she would have that in place, and that, yes,
that she would come to she would come to her
place in the distinction of I have bipolar disorder and
so I am polar and that was a big, like
(33:31):
aha moment for her, like, oh, if I can live
with it as something I have, not as the sum
total of who I am, right that I can handle this,
then it's not so big, right that it's part of me,
but it's all of me?
Speaker 1 (33:43):
Right. Yeah, it was a very very like powerful distinction
at the end. Do you guys have any questions for Lisa?
Speaker 2 (33:52):
Yeah? Here, do you want to you know what? Do
you want me to you know what? Yeah?
Speaker 1 (33:57):
Yell and I'll repeat it so people in this stream
can hear it.
Speaker 2 (34:03):
The future.
Speaker 1 (34:03):
I've been watching.
Speaker 3 (34:08):
You ever, things like.
Speaker 1 (34:14):
I don't know really that do you see things on
social media like Tourett's And is that something that you
would want to tackle next?
Speaker 2 (34:29):
Yeah?
Speaker 3 (34:29):
So you're also asking, like you get my ideas, like
is it it could be from there, It could be
from social media. It hasn't been yet, so still Alice
was the experience with my grandmother. Left neglected was from
reading The Man who Mistook His Wife for a Hat
by Oliver Sacks, because there's a three page story in
there about left side neglects, and I was like, what
(34:51):
how does someone walk through the world only aware of
half of it? Autism was my cousin, Tracy's son has
a severe form of autism. U Huntington's was my first
job out of college, and I was working as a
lab assist a lab tech at mass General East in
the Charlestown Navy Yard. The lab down the hall, these
(35:11):
neuroscientists start screaming and celebrating and hugging, and neuroscientists don't
do that, so everybody is quiet, like what's happening? And
they had just isolated the genetic mutation that causes Huntington's.
It's the only thing that causes it, I know, right,
so goosebumps, Oh my God. And I immediately thought, well,
they're going to cure this disease. It's the only thing
that causes it. And we're all these years later and
(35:32):
we still don't have a treatment or a cure. So
I wrote that book to raise some awareness about Huntington's ALS.
I wrote about because our co writer of the script
and our co director of Still Alice was diagnosed with
ALS just before he started writing that script. He died
two weeks after Julian Moore won her Oscar I know,
and then this one was I wanted to write about
(35:54):
mental illness, and bipolar just seemed the place to go.
Speaker 2 (35:58):
I am writing a movie.
Speaker 3 (35:59):
Next, straight to film, not a book.
Speaker 1 (36:03):
Can we talk about this at all? She's got like
two major projects, two books?
Speaker 2 (36:08):
Sorry sorry, no four? Okay, but you only told me
about it. I know, I know which are huge. I
know like they're huge, and she won't tell us. I'll
tell you. I would love to. When can you tell us?
Will you call it at the Billion in the Morning
show the second I can? I would love to. Whn
do you think that will happen?
Speaker 3 (36:26):
Oh my god, if I had that crystal ball, believe
me so. But so I wrote the script for Inside
the O'Brien's. We have a director for that finally, but
the producers for that, who also did still ellis. When
I finished writing that script, heat another producer asked me
if I would write a dramaedy about menopause.
Speaker 2 (36:48):
I said yes, So.
Speaker 3 (36:50):
I'm working on that now. And then my next novel
is going to be about alcohol addiction and corsicoff syndrome.
Speaker 1 (36:57):
Okay, but the moral us Maddie has, so the ones
that are filmed, something going on with.
Speaker 2 (37:04):
More or less.
Speaker 3 (37:04):
Maddie has already been optioned for a film. We have
our we have matt Our, actress for Maddie.
Speaker 2 (37:11):
I can't say, but you're gonna like love who it is.
And then every note played.
Speaker 3 (37:15):
We're almost fully cast for that and so hopefully you'll
hear about that one any minute.
Speaker 2 (37:19):
And Left Neglected is also underway, so you.
Speaker 1 (37:23):
Will call in and tell us I would love to do.
I'm holding you too, Okay, do you have any other questions?
Speaker 3 (37:36):
Yeah?
Speaker 2 (37:45):
Yeah, So how do you know?
Speaker 3 (37:46):
The question is, how do you know if what you're
dealing with with your teenage son or daughter is a
normal mood swing because they're teenagers and their frontal lobes
aren't fully developed yet and they're making terrible decisions and
their migdalas are firing much. Yeah, how do you know
if it's just no moodiness versus something that is like
a clinical illness, because it's because it's very different. So yeah,
(38:10):
I mean, so if it's a if it's a clinical depression,
it's not just you know, really bummed out some And
this is something that's difficult with the disorder, by the way,
like how do I trust my own emotions now, like,
am I allowed to feel bummed out and disappointed and
upset about something if something bad happened? Or is that
now a sign of illness?
Speaker 2 (38:31):
Right?
Speaker 3 (38:32):
Because we do have moodiness, we do feel, we're human beings,
we feel so it's tricky, but the depressions will be
it will last for more than the day or the week.
Speaker 2 (38:45):
It's going to last a while.
Speaker 3 (38:47):
And it's gonna be heavier than just a like a
daughter who's like, doesn't want to talk to you today,
is like storming around or won't come out of a room.
It is It's a more than just a psychogenic it's
a physical pain, Like you won't want to get dressed,
you won't want to take a shower, You have trouble
focusing on what anyone's saying. You don't enjoy anything that
(39:09):
you used to enjoy. It's a very it's very different
than just a moodiness. And then on the on the upside,
you also don't trust if you have bipolar disorder, how
do I trust when I'm in a really good mood,
I'm so excited about something, Oh my god, I'm like,
are you fall in love or you're just lit up
by I want to go into comedy.
Speaker 2 (39:27):
This is so exciting.
Speaker 3 (39:29):
So what happens to Matty in the book, She's like,
she's like sort of floundering. I don't know what my
major is gonna be. I don't know what I'm interested in.
School's not really doing it for me. What's wrong with me?
I must be doing this wrong. Everybody told me this
would be the best four years of my life. It's
just not happening for me. And then she discovers comedy
and she's so lit up. But by now she's been
diagnosed with bipolar disorder. So it's like, is that okay
(39:51):
for me to feel excited? Or does this mean that
I'm it's a sign of mania, So it what you're
talking about is a tricky distinction. Families who live with
us are like, what's normal, what's okay?
Speaker 2 (40:04):
But there are distinct signs.
Speaker 3 (40:06):
If it's mania, you're going to be not sleeping very much,
and you're not tired.
Speaker 2 (40:10):
That's a hallmark sign. You are.
Speaker 3 (40:13):
Your thoughts are racing, they're so fast, and if you're
talking at the same time that you're thinking, you are
talking a million miles an hour and nobody can interrupt you.
If this is someone you know and love and they're
on social media. You'll wake up in the morning and
you'll click on their profile and you'll see, like, you know,
the Instagram stories, like the lines get really thin. If
they've posted like a hundred stories, that will be happening.
(40:34):
So that's not just like, oh, I'm excited about comedy.
That's like a little too much. So you'll you'll get
the feel for the distinction for sure.
Speaker 2 (40:43):
Yeah, yep. Yeah.
Speaker 3 (40:55):
So we don't one hundred percent know the causes of this,
but there are some correlations of events and then things
that ride alongside this, so they may be causal, but
we don't know for sure. So we do know that
there is a genetic component. It's not one hundred percent genetic,
but a family history of bipolar disorder will make it
more likely that you can develop it. So if I
(41:16):
have bipolar, every one of my children has a ten
percent chance of developing it in their lifetime, and that's
higher than the general public of two percent.
Speaker 2 (41:26):
Things.
Speaker 3 (41:26):
There are three things that we know are correlated with it,
adolescent substance abuse, head injury, and concussion, and there was
one more, what is it, oh, in childhood trauma. So yeah, yeah,
(41:49):
that's tough.
Speaker 2 (41:51):
Yeah, yeah, oh good, I'm glad, Patty. Can you outgrow it?
Speaker 3 (42:04):
So no, they say that this is a lifelong illness
and so but also I take that with yes, that's
what we know as of now. We are not in
the stage of enlightenment when it comes to bipolar disorder, right,
so we're not like we know everything about this, and
this is a lifelong illness as of right now. That
is what every every psychiatrist will tell you. And you
(42:26):
go presuming that. In fact, I'm going to be a
little bit long in this answer, so everyone who goes
off their meds totally reasonable. I think for people to
try that. Okay, So I want you all to think
about for a second, because this was one of my
misconceptions going into this. I had a lot of judgment
around if I had heard of someone who spiraled off
(42:46):
into a manic episode, ended up in jail, ended up hospitalized,
and then the person would say, well, he went off
his meds, and I'd be like, well, that's what happens, right,
If he's going to go off his meds, then like
what was he thinking?
Speaker 2 (43:02):
A lot of judgment there.
Speaker 3 (43:03):
And so what I've learned is because these side effects
are so brutal, right, They're just really tough to deal with.
Let's say I was diagnosed six months ago, I had
my very first manic episode. I'm diagnosed by a psychiatrist.
Speaker 2 (43:15):
I've never met before.
Speaker 3 (43:16):
There's no blood test, there's no brain scan. It's six
months later. I haven't had a depression of romania since,
which might be because the meds are working.
Speaker 2 (43:24):
But I'm miserable.
Speaker 3 (43:26):
Like the every person I spoke with said at some
point they wondered if the symptoms of the side effects
were worse than the symptoms of the illness the drug
is treating. So it's six months later, I'm feeling like crap.
I'm like, well, wait a minute.
Speaker 2 (43:40):
Are we sure that I have this?
Speaker 3 (43:43):
Like and by the way, when your manic, your brain
doesn't lay down memories very well, so your memory of
that episode is going to be spotty to begin with.
It's going to be like, did everybody kind of overreact? Like, Yeah,
I wasn't sleeping much. Maybe I just had insomnia and
I was really overwhelmed and stressed, And yeah I had
like a bit of a breakdown, But maybe that was
a one time thing. I outgrew it. I'm not in
(44:05):
that situation. Now, I'm gonna try going off the meds
and see how I do. Seems really reasonable. So, but
what happens is they end up with a manic episode
or they end up depressed again. And so I don't
know of anyone who has outgrown it. That said, I
don't think we know a lot about this yet. We
haven't studied it to know about someone over the course
(44:27):
of a lifetime with this, Kim, I mean one hundred.
Speaker 2 (44:30):
Two hundred years ago, they treated this with leeches.
Speaker 3 (44:33):
Two hundred years before that, they drilled a hole in
your skull, gave you a craniotomy to let the evil
spirits out.
Speaker 2 (44:39):
They called you a witch and hung you.
Speaker 1 (44:42):
In the book, you talk about lifestyle choices and how
Maddie needed to get sleep, she needed to not travel,
she needed to be in the same time zone. Can
any of those if you really work on those lifestyle
choices and you really make a commitment, can that really
lesson yes, a lot to where you don't have to take.
Speaker 2 (45:00):
I would say possibly. Yeah.
Speaker 3 (45:02):
Oh again, it's a collaboration with your physician, your village
of family and friends who are keeping eyes and ears
on you. If you're like, hey, I want to try
tapering off this or would it be what do you
think of me? Like I've been on these three meds.
What if I lose this one? So see how we do.
And it's like, yes, if you're going to travel and
(45:24):
switch time zones, like it's all hands on deck, Like,
let's see if we can get and make sure.
Speaker 2 (45:28):
You get some sleep to bolster that.
Speaker 3 (45:30):
Like if you start, you know, if your sleep starts
moving around, that's going to be a problem. That's the
number one predictor that something's gonna swing. But yes, it's
like when Maddie comes home to her the family home
in Connecticut after first year of school. She was depressed
that whole first year, but she chalked it up to
the boyfriend breakup and school's hard and all that she's
(45:51):
home and she feels better. That's in part because everything
is now in place. Mom's making three meals a day,
she's riding her bike to work at Starbucks.
Speaker 2 (46:01):
Every day, so she's getting exercise.
Speaker 3 (46:02):
She's going to sleep at the same time, getting up
at the same time.
Speaker 2 (46:06):
Like so routine. She's got the routine, she's got the
healthy eating, she's got the sleep.
Speaker 3 (46:11):
So that that that is probably as effective as any
medication we have.
Speaker 1 (46:16):
In some ways, it seemed like it we have time
for one more question, anyone else, does menopause bring bipolar
out more?
Speaker 2 (46:32):
I don't know that that's been studied. I would bet
that it's not because we haven't.
Speaker 3 (46:37):
Studied women very much, and we certainly haven't studied menopause
very much. That is changing and I'm loving it, but
I would imagine that it does to some extent, right,
because again, anything that moves you, I told you, like,
if you drink alcohol, that's a depressant, you know, if
you're taking stimulants, if it's adderall, if it's cocaine and fat,
I mean even maybe caffeine. To some folks, like if
(46:58):
you're swinging in either direction, then you're gonna get you know,
maybe that's going to.
Speaker 2 (47:03):
Knock you out of out of balance.
Speaker 3 (47:06):
So menopause, right, your moods are being you're swinging all
over the place, and so that could be are you're
not sleeping, Oh my god, right, so the night sweats
and the hot flashes and you're, oh my gosh, so
your sleep is going to get disrupted.
Speaker 2 (47:20):
I would bet if we.
Speaker 3 (47:21):
Studied this and you had a propensity if you were
living with bipolar, this would exacerbate it.
Speaker 2 (47:26):
That would make sense.
Speaker 1 (47:27):
I have to say that reading several of your books,
the one common thread in a lot is getting enough sleep,
Like really for your Bradley, getting enough sleep.
Speaker 3 (47:38):
So every neuroscientist I know makes sleep a priority.
Speaker 1 (47:41):
And I grew up at a time. I'm going to leave
with that. Yeah, sleep more, Yeah, take care of take
care of you.
Speaker 2 (47:47):
Sleep more. And it's a simple thing that we can
all do.
Speaker 1 (47:50):
Yeah, right, turn your phone off, read a book, right, yeah, yeah, Well.
Speaker 2 (47:55):
This sounds amazing. Lisa is the best. Right, thank you everyone,
Thank you, Thank you, Lisa.
Speaker 1 (48:01):
Thank you, And I'm going to hold you to that
big news it's coming. So next week we will have
Aaron Gates. She is a Boston based interior designer. She's
written several books. We had such a fun discussion talking
about design, what works, what doesn't work, her love of
Taylor Swift. She traveled the world to follow Taylor Swift
(48:23):
with her daughter. So check that out next week. And
you can always join Lisa's book club. Just go to
kiss one Away dot com slash Lisa's book Club to
join and you'll get alerts on our next event, so
hope to see you soon.
Hey, Welcome to Lisa's Book Club, a podcast where I
interview best selling authors from the New England area, pulling
back the curtain on what it's really like being a
best selling author. They're guilty pleasures, latest projects, and so
much more. Lisa's Book Club a meeting last night and
we had author Lisa Genova. She's actually back for a
second time. The first time we talked about her book, Remember,
(00:26):
which is nonfiction. This time she wrote a novel. It's
called More or Less Maddie. We were back at Johnson,
Maine at the Burlington Mall. And a little side note,
Lisa Genova grew up in Waltham and she used to
go to the Burlington Mall and a lot of her
classmates from her high school were there last night, which
(00:46):
is really really fun. So we had a great discussion
talking about the book. It's a heavy topic, is about
mental health and bipolar disorder, but Lisa always attempts to
give good and information in such a compassionate way, so
I hope you enjoy this podcast.
Speaker 2 (01:04):
Welcome.
Speaker 1 (01:04):
We are here to talk about your new novel, More
or Less Maddie. But I want to sort of cycle
back to where we first met because Lisa joined the
book club. Lisa is a graduate of Waltham High School.
Get some.
Speaker 2 (01:22):
She said that this is her mall. Right, this was
my mall growing up.
Speaker 3 (01:26):
It was Kiss Went Away and the Burlington Mall.
Speaker 2 (01:30):
It makes perfect sense.
Speaker 1 (01:31):
And I think there's like a whole group here from
Wallfale High School. You are like, go hooks, You're all
still friends.
Speaker 2 (01:40):
This is amazing. That makes me so happy.
Speaker 1 (01:44):
So you're a Harbor trained neuroscientist. You've written many novels,
many stories. You joined us for a non fiction book,
remember the first time around? And I want to remind
everyone that Lisa's first book, your self published book, was
Still Alice, which won an OSCAR.
Speaker 2 (02:06):
Yeah. Like that's like right out of the box. I know,
I know. It's hard to live up to that, right,
Like the bar said, so high.
Speaker 1 (02:14):
I didn't realize I was actually talking to a couple
of the people in our group tonight, and I had
I thought that Still Alice was.
Speaker 2 (02:22):
A true story. Oh no, no, no, And I come
to find out that it's not at all.
Speaker 3 (02:28):
Yeah. No, none of my novels are true stories. I
try to tell the truth under the imagined circumstance. Right,
But I thought it was based on a true story.
I was inspired by my grandmother who had Alzheimer's, but
she was older, she was in her eighties, and was
the inspiration for me wanting to understand more about what
it feels like to live with it. And so I've
read everything I could about Alzheimer's, but those books they
(02:49):
were medical texts, and research are scientific research articles.
Speaker 2 (02:54):
And it was the thirty six Hour Day, which was.
Speaker 3 (02:56):
Really helpful, but also from the point of view of
someone else, a caregiver, a scientist, a clinician, they're all
very sort of like homework and heavy and technical, and
so I learned a lot, but I didn't learn what
does it feel like to be her? And the AHA
was like, Oh, isn't that interesting. Fiction is the place
where you have the chance to walk in someone else's
(03:17):
shoes and imagine what it feels like to be them.
So I need a novel about someone with Alzheimer's, and
it didn't exist at the time.
Speaker 2 (03:24):
So I was like, all right, well, I guess I'll
write it. Yeah, that's how that happened.
Speaker 1 (03:28):
So stories create empathy and people feel like they have
a window inside of what's really happening with people.
Speaker 2 (03:34):
And families and relationships, right.
Speaker 3 (03:37):
Yeah, and you know what, I just want to mention
at the topic. So I'm just I've been on book
tour for this book now.
Speaker 2 (03:41):
For a little over a month, and this is very typical.
Speaker 3 (03:45):
It's there's a couple of men here, It's almost all
women everywhere I go.
Speaker 2 (03:51):
And I'm not unique in this.
Speaker 3 (03:53):
If it's Jodi Pico, if it's Elean Orldebrand, if it
doesn't matter the book, if.
Speaker 2 (03:57):
It's fiction, the audience is women.
Speaker 3 (04:00):
And if reading fiction is like going to the empathy gym,
like fiction is the place where we get chance to
try on the experience of someone who's different than us
and maybe understand what it's like to be someone different
from us.
Speaker 2 (04:13):
And women are the ones throughout life who are.
Speaker 3 (04:16):
Getting practiced in this through reading story, and men aren't
as a whole, Like we got to invite men to
start reading fiction.
Speaker 2 (04:23):
I think it would help.
Speaker 1 (04:24):
I agree, Just say and go home and tell your guys, Yeah,
give them more or less, Maddie. So okay, so we're
here to talk about more or less Maddie. You have
written books about neurological diseases. You've written about als, you've
written about Alzheimer's Huntington's disease. And why did you choose
(04:46):
to write a book about mental health and then bipolar disorder?
Speaker 2 (04:53):
Yeah, so, I.
Speaker 3 (04:55):
Mean I kind of see anything that's going on from
the neck up as my domain. So I hadn't yet
tackled anything that's categorized as mental illness.
Speaker 2 (05:05):
Right I do.
Speaker 3 (05:06):
I want to write about people who are living with
some kind of condition, disease, illness, something's going on inside
their brains that causes them to be ignored, feared, or
misunderstood by the public, like, oh, I don't understand what's
going on with you.
Speaker 2 (05:20):
I'm uncomfortable. I'm just going to look away, and so.
Speaker 3 (05:22):
People get kicked out of belonging for what's going on
inside their brains.
Speaker 2 (05:26):
I hadn't done mental illness yet.
Speaker 3 (05:28):
And interestingly, that term mental illness is entirely made up,
So there's no neuro anatomical, neurobiological reason to carve oute
things like depression, schizophrenia, bipolar disorder, anxiety disorders and call
them mental illness.
Speaker 2 (05:44):
But we do.
Speaker 3 (05:46):
And I think there's a lot of unnecessary baggage and
burden that comes with that. So I did want to
go there next and I chose bipolar disorder because I mean,
I think that we have a lot more stories and
under standing about depression now than we did, say, like
back in the eighties.
Speaker 2 (06:03):
Like nobody talked about depression in the eighties, but we're
a little more comfortable with that now.
Speaker 3 (06:07):
I think bipolar disorder is hiding in plain sight everywhere.
So and so I was like, this is going to
be a chance for us to talk openly about it,
to have that open conversation that helps us humanize what
this is rather than there's a lot of judgment. There's
a lot of stigma and shame attached to this, and
so I thought that like a humanizing story could really help.
Speaker 1 (06:28):
So Maddie is a central character, and she is a
young girl starting her freshman year at NYU. And what
is the age the typical age range of someone you
know when they get bipolar disorder?
Speaker 3 (06:43):
Yeah, So, in doing the research for this book, I
talked to a lot of people who have it, their
loved ones, and then the people who treat it and
research it, so psychiatrists and psychologists, And the average age
of onset is late teens to early twenties. So knowing
that informed my character I'm like, okay, so I'll make
her nineteen years old twenty years old when the story begins.
Speaker 2 (07:03):
Yeah, and so she's.
Speaker 3 (07:04):
Got one like can you think back to the age,
Like you've got one foot in adult adulthood, right, You're
just starting to figure out your identity and who you
might be beyond the house you grew up in, Like.
Speaker 2 (07:15):
What do I want to major in? What do I
want to do? Who am I? What do I think
about things?
Speaker 3 (07:20):
And imagine then getting this diagnosis that swoops in at
that age and interrupts everything, really because it's so overwhelming
and so chaotic, and it's basically saying to you, here.
Speaker 2 (07:31):
This is who you are. You are bipolar.
Speaker 3 (07:35):
And so I think a lot of this book is
Maddie wrestling with what is the distinction between I am
bipolar and I have bipolar?
Speaker 1 (07:42):
I thought it was really interesting that she presented as
a depressed person and was given an antidepressant and then
that tripped her manic episode. And I never realized that
that that could happen.
Speaker 2 (07:57):
And that's what does happen.
Speaker 3 (07:59):
So all right, so until you have that first manic episode,
no one would know that that's what's hiding inside your
brain if that's.
Speaker 2 (08:06):
What you've got. So there's no blood test, there's.
Speaker 3 (08:08):
No brain scan for bipolar disorder, and people usually do
have maybe a series of depressions first before they ever
have that first manic episode. So you'll either be undiagnosed
as depressed and just dealing with the depression without being
treated as a lot of young people do. They sort
of try to muscle through and oh, it's not happening,
or just go along. But eventually, if you get seen
(08:30):
and they're like, well, you've been experiencing depression, let's try
you on an antidepressant, it's reasonable. If what's going on
in your brain is unipolar depression, then that antidepressant could
be helpful. But if what you've got is bipolar, that
antidepressant medication is actually going to catapult you into your
first manic episode.
Speaker 1 (08:49):
Now, the manic episode in the book, I have to say,
when I was reading it, I was so anxious, like
really it made me really uncomfortable because she was so unhinged,
she was delusional. What was that like for you writing
that scene?
Speaker 2 (09:04):
And how many people did you talk to? Is that
sort of a you pulled from a lot.
Speaker 1 (09:08):
Of different experiences from families to create that scene.
Speaker 3 (09:12):
Yeah, so I interviewed twelve people who have bipolar disorder,
and all of those folks shared with me there are
examples of manic episodes, and then a lot of the
reading I did, so I read a lot of memoir
and there were a lot of manic episodes described there too,
so I had a sense of the lived felt experience,
and so then I had to go there. And in
(09:32):
writing it, it really is you're trying to slow things down.
Even though I'm writing this is a very fast scene,
it should feel very breathless. So I'm really just trying
to be in that the sensory moment to moment details
of like what is like what is she experiencing?
Speaker 2 (09:49):
And it did. It felt very like breathless.
Speaker 3 (09:52):
I wrote that scene with a pen and I was
like just trying to keep up with what was happening,
writing as fast.
Speaker 2 (09:58):
As I could.
Speaker 1 (10:00):
You talk to you because you do a lot of
references to Taylor Swift a lot of her music Who
did you talk to your kids? From?
Speaker 2 (10:07):
About? You know, who did you talk to? So interestingly?
Speaker 3 (10:10):
So I started this book a while back and then
I paused to hit pause on it to right remember
for you, because I was like, all right, people need
to understand how their memory works because so many of
you are freaking out and you're fine, but you don't
think you're fine, So.
Speaker 2 (10:24):
Like, let me help. So I yes.
Speaker 3 (10:28):
So when you're manic, So for those of you who
may not know, so mania is your So bipolar is
an your brain is impaired in its ability to regulate
things like mood, energy, emotion, sleep, and thought. So when
you're manic, when you swing in that direction, you have
an excess of energy. You are might not be sleeping
(10:51):
at all or maybe just a couple of hours a night,
and you are not tired. You're talking really fast, you're
interrupting everybody. You've got tons of ideas. It's called a
flight of idea as. You might quit your job because
now I'm going to go start a fashion label, and
then I'm going to open a furniture store, and then oh,
I'm going to become an artist, and oh I'm going
to be a rock star. And then you might have
You're acting recklessly and you're taking risks, you're spending thousands
(11:13):
of dollars you don't have. You're having sex with multiple
partners even though you're married, there's no consequences to anything.
Speaker 2 (11:19):
And you might also believe things that aren't real.
Speaker 3 (11:22):
So the things you believe that aren't real usually are
that you're very special in some way, you're gifted, or
God has called upon you to do something, or you
know really famous people, because you are also very famous.
So she, being a nineteen twenty year old, I was like, well,
she knows Taylor Swift and she's going to be writing
her memoirs the first belief. Later on she believes she's
(11:44):
opening for her as a comedian. But yeah, so I
have a twenty four year old daughter who lives in
New York, and I have two twenty one year old
nieces and my youngest daughter's fourteen, and all of them
are swifties.
Speaker 2 (11:57):
I am now a swifty as well. Go did you
see her?
Speaker 3 (12:01):
Oh yeah, yeah, yeah. So we saw her at Gillette,
my two daughters and I. And then as things moved along,
because this errors tour went on and on, the Tortured
Poet's Department came out, and now she's got new songs
on the tour. So my oldest is like, mom, let's
go see her in Europe. Okay, So but we it.
Speaker 2 (12:18):
Was Austria, so it got canceled. No, so then we
went to Toronto. Okay, so yeah, but all you had
to go to Toronto.
Speaker 3 (12:26):
I know. So yeah, the young people really helped me
with the texting that's in the book because like how
like mom, Like I'm fifty four, Like I don't know
how to text like they text. So yeah, they helped
me with that and with like anything Taylor related.
Speaker 1 (12:41):
How did you choose stand up comedy as Maddie's you know,
career choice.
Speaker 2 (12:47):
Yeah, so and then I want to ask you, I.
Speaker 1 (12:50):
Did I know, so Lisa like really did a research.
Speaker 2 (12:54):
You actually did stand up in New York. I know
we're going to talk about that.
Speaker 1 (12:57):
Why did you choose comedy for Maddie? So there's a
number of reasons that I really liked comedy for her.
So one is like this book is a lot about
like what is normal? Like who gets to decide that?
Speaker 3 (13:07):
Right, Because now she's got this condition that she's being
labeled as not normal and that that needs to be medicated.
So she stays within the range of normal and there's
obviously some validity to that when she's manic or when
she's depressed, and the depression is brutal and awful and scary.
There's a high risk of suicide with bipolar disorder, so
(13:28):
staying contained within that range of.
Speaker 2 (13:30):
Normal is is vital.
Speaker 3 (13:33):
But also like who gets to say and like as
a woman, right, especially as a woman, like culture deciding
what's normal for you, and you better not step outside
of that or you're crazy, right, right, So I wanted
her to pick a career that wasn't normal that that
culture and her family would be like, wait, there's not
enough structure to that. There's not enough stability in that decision,
(13:55):
Like that's not a nine to five job, there's no like, well,
if you do a and see then you'll be a
successful stand up comic, So that there's no rules to it.
Speaker 1 (14:06):
And maddening and you're going to be at its maddening
and you're going to be at bars right at night,
and there's going to be a lot of like drinking
and substances there. And it's like when you're when you
have bipolar disorder, if you've got this delicate.
Speaker 2 (14:18):
Balance now of keeping you I could.
Speaker 3 (14:20):
Use some water, If someone has, we'll get you them.
You've got this delicate balance of trying to stay regulated.
You don't want to be drinking alcohol, taking stimulants, anything
that's going to push you in one way or the other,
because that could mess things up for you. So they're like,
we don't want you in this in these night clubs.
So that's another reason.
Speaker 2 (14:41):
I love that.
Speaker 3 (14:41):
Humor is just a way that humans use to connect
and bridge uncomfortable, awkward subjects.
Speaker 2 (14:47):
So I like that, and then, oh, thank you so much,
thanks Jordan. I also loved the metaphor of it.
Speaker 3 (14:57):
So if you're a stand up comic on any given night,
from minute to minute, you can be experiencing mania or depression.
Speaker 2 (15:05):
So if I'm killing it and.
Speaker 3 (15:07):
You're all laughing and we're in on it together and
we're connected and you get it, it's the best feeling.
Speaker 2 (15:12):
I want to I want to stay there. It's you
for work. I want to chase that and get that
again and again. Mania.
Speaker 3 (15:17):
If I'm bombing and you guys just are silent and
arms crossed and stone faced, and oh my god, I
just this is the worst feeling.
Speaker 2 (15:26):
I'm miserable. It's torture. I just want to crawl into
a hole and die. So I love the metaphor of it.
Speaker 1 (15:32):
Yeah, I totally agree with you. So, what was your
experience in New York? What club did you do a
stand up set to? And was it terrifying?
Speaker 3 (15:40):
Yeah, so it's so so it was, it was out
of New York.
Speaker 2 (15:44):
It's laughing Buddha comedy.
Speaker 3 (15:46):
I took a stand up comedy writing class because I
knew I had to write stand up comedy in this
book now with this decision, and I needed to start
in a place where she wasn't very good, but there's
like the glimmer of hope of it all, and then
she knows the little tailorism so and that she would
get better, and that the book would end with what
would essentially be her five minute set, and she'd be
(16:09):
communicating something about her relationship to having bipolar disorder, inviting
you to be okay with it as well, and it
maybe even laugh a bit about some of the absurdity
that can happen with it.
Speaker 2 (16:21):
So I took the.
Speaker 3 (16:22):
Stand up writing class, and I told the teacher right away,
I'm like, okay, so I'm taking this to write it
as my character, who's only twenty years old. I want
to be writing all of my jokes as if I'm
my character. And he immediately said no, you are not
doing that. You're writing it as you you fifty something
year old lady.
Speaker 2 (16:42):
I was like, oh crap, So I had to do that,
and so what were your jokes? So you have to
tell us one of your jokes? So I will say
the five minutes.
Speaker 3 (16:52):
It's a little bit of a cheap because it was
at the end of the pandemic and so we couldn't
do it in the club.
Speaker 2 (16:57):
It was assumed and so I know, which, on the.
Speaker 3 (17:01):
One hand, is way not as scary, but also like,
you don't have the feedback of the real people. They
were just little squares. My friend Kim is here somewhere.
She was one of the squares. She saw me do it.
Speaker 2 (17:10):
How did she do it? I know, I don't know
where she went. She's shopping for furniture.
Speaker 1 (17:15):
Good.
Speaker 2 (17:17):
So okay, so I'll tell you.
Speaker 3 (17:18):
I gave Maddie exactly one of my jokes from my
five minute set, and it's the joke about the thongs.
Speaker 2 (17:24):
Ah, that was good, thank you. Yeah, I like that one.
Speaker 1 (17:30):
So did you make Maddie's mother as perfect as pot like,
like obnoxiously perfect on purpose? Right?
Speaker 2 (17:40):
Just because well I wanted her to really care about appearances? Right,
and she did.
Speaker 3 (17:47):
Yeah, you know, so yes, in some sense, yes, because
again there's so much shame and stigma attached to this.
But I also I hope over the course of the book.
I mean, it's not told in mom's point of view.
It's told in's point of view, and if your teenager
is telling her version of the story, she's not really
getting right, Like your teenager's not telling the story with
(18:10):
the benefit of what you're thinking and feeling. Mom right,
of course, but so I hope you develop more empathy
for Mom as the story goes on.
Speaker 2 (18:18):
But Mom is coming from a place a lot of fear.
Speaker 3 (18:23):
So her first husband, Mattie's dad, had undiagnosed bipolar disorder
and put her through hell, and we got glimpses.
Speaker 2 (18:32):
Of what went on.
Speaker 3 (18:33):
Mattie doesn't really remember because she was four when he left,
and they don't know where he is. They've not seen
him since, so she's very scared of what can happen
to her daughter, having lived with it before. So yeah,
she's I think that Mom. Like, there's this comment Maddie
makes very early on where she's just trying to figure
out her mom and Phil. She's like, what is Mom
seeing this guy, he's twenty years older. Like he's like
(18:55):
the grandfather in this story. Like, why where the passion?
Speaker 2 (18:59):
I don't see it? She says.
Speaker 3 (19:02):
It seems to her that my mom has traded an
awful lot for a stable life. And I think that
after the chaos and the heartbreak of the first marriage,
that she decided that she was going to make everything
as perfect as possible because she would find safety in that. Okay, Yeah,
and so what she's projecting on to Maddie is if
(19:22):
I can just keep you perfect, you'll find safety there.
Speaker 2 (19:27):
Right, it makes sense.
Speaker 1 (19:28):
Yeah, when you were talking and interviewing all of the families,
was that a common thread? I mean, was that sort
of did you find common threads with some of the stories?
Speaker 2 (19:37):
For sure?
Speaker 3 (19:38):
Yeah, there's lots of fear for the parents, and there's
no you know, it's not like if you're diagnosed, say
with diabetes, it's life changing, it's difficult, and we know
what to do for you, right, like here's your medication,
here's your prescription, and we know what's going to work.
Speaker 2 (19:55):
Right.
Speaker 1 (19:55):
And with bipolar, you said that there's really the drugs
that are out there actually not made for bipolar, right.
Speaker 3 (20:01):
They're not so the drugs for bipolar disorder aren't designed
for it. We don't know what causes bipolar disorder in
your brain, We don't know the neuroscience of bipolar disorder,
and so the drugs that are used to treat it
are drugs that just were serendipitously discovered that happened to
work for bipolar. That's lithium, and then the others are
(20:23):
drugs that are used for other illnesses like epilepsy and
being applied to bipolar disorder, which means that they're acting
on all kinds of.
Speaker 2 (20:31):
Receptors that aren't actually bipolar in your brain. So you
get a ton of side effects.
Speaker 3 (20:36):
Right WEA gain, wakeained hand, tremor, nausea, foggy thinking, constant thirst.
Speaker 2 (20:44):
It's brutal.
Speaker 3 (20:45):
It's really tough a lot of these side effects to
deal with.
Speaker 1 (20:48):
I thought that you dealt with it so well in
the book be As you really could feel the struggle
that the family was having and trying to balance and
trying to find the right combination of drug that wouldn't
make her doo low so she didn't feel like she
didn't want to get out of bed.
Speaker 2 (21:05):
And then yeah, yeah.
Speaker 3 (21:07):
The medications will have like a break like depressive lever
or break on the mania lever, right, So it's like, Okay,
we don't want you to swing manneck. So some of
the drugs might be really good at keeping you out
of mania, but they push too hard on the depression
and so you're like just sedated and leaning that way.
So we don't want you to live like that. So
it's a tricky. It's it's more of an art than science,
(21:29):
like just trying to figure out the combination. So the doctors,
if any of your family members have this, it should
be a collaboration. It should be you're in communication like
where you can raise your hand at any point and say,
this isn't working for me right now, what can we
do to change it? Rather than just try to bear
it until you can't bear it.
Speaker 1 (21:48):
Right and then things get go very very bad. Can
anyone can you be diagnosed with bipolar in your forties
and fifties?
Speaker 2 (21:56):
Absolutely? Yeah, Yeah.
Speaker 3 (21:58):
There's there's a couple of people who I interviewed who's
we're talking about parents who were recently diagnosed. Somebody that
told me tonight that a parent was diagnosed.
Speaker 1 (22:07):
So what were they inhibiting throughout their entire life though
that they wouldn't have been diagnosed earlier.
Speaker 3 (22:12):
Oh A, that might not have shown up yet, or
B it's been there all along and now everyone's going, oh,
oh I get it now. So yeah, that just a
lot of like chaotic behavior, reckless behavior like hypomania. So
bipolar two you don't actually reach a full blown manic episode,
(22:34):
so you're not having got delusions or yeah, or hallucinations.
So and if you're talented in some way and you're
just go to hypomania, so think of it as like
mania light.
Speaker 2 (22:46):
You just have a lot of excess energy.
Speaker 3 (22:49):
You're probably talking too much and you're posting to Instagram
all night long or interrupting everybody.
Speaker 2 (22:54):
You've got tons of ideas.
Speaker 3 (22:55):
But like say you're a songwriter and you're now you
don't need any sleep really and you've got and all
of your inhibitions are dropped, like you don't have any
guardrails anymore. So now you can just pour yourself into something.
You might be really productive in these phases. There's a
price to pay. You will have a depression at some point,
and that's not going to be fun for you or anybody.
(23:15):
That can be very scary, but there could be moments
of creative versts so wonderful.
Speaker 2 (23:20):
If you're not talented, you're writing songs.
Speaker 3 (23:23):
That are crap, which is what Maddie does. If you
have the very first scene in the book, she thinks
she's a songwriter now and she's written all these songs
on the walls of the plots of hotel in Vegas,
and she at the time she thought she's gonna win
a Grammy. But after the manic episode's over, she's like,
oh my god, like, none of that makes any sense.
Speaker 1 (23:42):
Is there a connection between people in creative fields and
bipolar disorders?
Speaker 3 (23:48):
So there have been a lot of people who are
creative who who in retrospect or at the time, do
have bipolar disorder.
Speaker 2 (23:55):
You mentioned Selena Gomez.
Speaker 3 (23:57):
Selena Gomez, Yeah, Taylor Tomlinson, Yeah, Carrie Fisher had it.
Speaker 2 (24:03):
So they think Van Go had it. They're Ernest Hemingway.
But it's right.
Speaker 3 (24:11):
So the numbers out there are anywhere from two to
four percent of the population. So at the minimum, it's
one in fifty people. How many people are here tonight,
So and it's hard to get a diagnosis.
Speaker 2 (24:23):
You have to come from a place of privilege.
Speaker 3 (24:25):
To navigate the US healthcare system to get to that diagnosis.
Speaker 2 (24:29):
So it's got to be more than that.
Speaker 3 (24:31):
So I think we know about creative people because we
know about the work they produced, because they're famous to
some extent. I'm like, there are just as many accountants
who have bipolar disorder. They're just not You're not aware
of it because they're not telling you about it on
a comedy stage or on in a documentary on Apple TV.
Speaker 1 (24:49):
Wow, So what can we do with the healthcare system?
Is your book trying to.
Speaker 2 (24:57):
Vote? That's a big question, Lisa.
Speaker 3 (25:01):
I know, well, I mean, honestly, some of this is
like no, like like still Alice has been for a
lot of folks who've navigated Alzheimer's in their family. Read
the story. You know what the conversations should sound like.
So one of the things I do in all of
my books. It's fiction. I've made it up, but I've
done tons of research. And so every time there's a
(25:21):
conversation with a medical professional, whether it's an occupational therapist,
a psychiatrist, a neurologist, I am giving you what should
the gold standard compassionate practice, Like, this is what it
should sound like, This is what it should look like.
So if this is happening in your family, you should
at least know like some of what you should look
(25:44):
for in your psychiatrists.
Speaker 2 (25:46):
Like, so use this book more or less, Mattie as
a manual. It's a resource.
Speaker 3 (25:50):
Yeah, understand like a sense of what that conversation should
sound like, what you can expect.
Speaker 2 (25:56):
Yeah.
Speaker 3 (25:56):
In fact, so doctor Andy Nuremberg, who runs the Polar
Center at mass General Hospital. I talked to him quite
a bit and when I finished the first draft, I
sent it to him and asked him to read it
for accuracy. And his biggest note to me is can
you make the doctor more collaborative?
Speaker 2 (26:14):
And I was like, yes, let's do that. Yeah.
Speaker 3 (26:18):
Yeah, it's a big because it's not diabetes. It's not
like here's your prescription.
Speaker 2 (26:22):
That's well. They have to play you do no matter
where you are.
Speaker 3 (26:25):
If you were diagnosed with bipolar disorder in Los Angeles, Boston, Chicago,
and Atlanta, you could be getting four different prescriptions.
Speaker 1 (26:34):
Absolutely, So it's you really laid that out in the book.
Can we shift gears just a little bit and sort
of talk about the mechanics of writing? And because I noticed,
I mean we mentioned that Selena Gomez used her quote.
Speaker 2 (26:49):
But I want to talk a little bit about.
Speaker 1 (26:53):
Quotes that are used on the covers of books. Jody
Peacole is on your cover.
Speaker 2 (27:00):
How does this? How does this happen? How do the
quotes happen? So the quotes are a.
Speaker 3 (27:05):
Bit of a pain if you're an author, Okay, it's
it's like an imprint of Simon and Schuster that's doing
away with them, which every.
Speaker 2 (27:13):
Author I know, we're like, oh, thank god.
Speaker 3 (27:17):
So it's not you know, if you're a musician, you
don't have to get quotes from musicians for your new album. Like,
if you're an actor with a movie out, you're not
asking other actors to like write a quote to promote
your movie.
Speaker 2 (27:29):
But authors, we are.
Speaker 3 (27:31):
Asked to go out and get quotes from other authors
who are very busy writing their own books and doing
their own things. And now I'm like, it's so awkward, like, Hi,
will you please read my book? And what if it's
not good?
Speaker 2 (27:42):
They I didn't really have I asked them out. The
publisher did that for you. They might have done it
in the nineties. They definitely don't do it anymore. The
authors do it. So yeah, those are all my friends.
We have some very powerful friends. Yeah, yeah, yeah, JODI's great.
Do you think that the quotes help sell the book?
(28:03):
I don't know. Does it help you? I don't think
it matters. This is where, yeah, we're getting to like,
can we please just stop doing this? I love your quotes.
Speaker 3 (28:12):
Like when you guys leave a gup or view a
good Reads, or are somewhere publicly, or if you DM
me on Instagram or or leave a note like I
will often turn that into something that I share that
because that's I mean, that's what.
Speaker 2 (28:25):
Matters the people reading.
Speaker 1 (28:26):
I'm glad you mentioned social media because I wanted to
touch on this, and we spoke about this.
Speaker 2 (28:30):
A few days ago.
Speaker 1 (28:32):
It seems like, especially on TikTok the last couple of
years with a lot of you know, gen z ers,
even millennials, that a lot of people are sharing their
struggles with mental illness. It's become something that people feel
more comfortable talking about. But I know that on TikTok
and I know social media, there's a lot of great
things that can happen, and there's a lot of misinformation
(28:53):
out there, So can you talk about that?
Speaker 2 (28:56):
Yeah, this is a big, big it's not black and white.
Speaker 3 (29:00):
So on the plus side, community is so important, right, So,
like one of the tough things about being diagnosed with
any mental illness is that it does it kicks you
out of belonging people. You become authorized, people become afraid
of you. They don't invite you to things, they don't
know how to look you in the eye. There's a
lot of you become outcast in a lot of ways.
(29:22):
And so and maybe you don't live, you know, amongst
a lot of people. Maybe you live in rural Oklahoma
and you've got something and you don't know anybody else
who has this. It's just you because nobody's talking about it.
So social media can be a way that you find support,
you find others who are like you, and you can
it's educational. I mean, I'm on there with a lot
(29:43):
of bipolar communities right now and how I did some
of my research, and it's how I continue to be
part of the conversation. So it can be education and
community belonging.
Speaker 2 (29:55):
So that's huge.
Speaker 3 (29:56):
But the misinformation part is really frustrating. I battle this
a lot, especially with respect to Alzheimer's and memory. There's
a lot of snake oil salesmen out there. There's a
lot of misinformation even while meaning people will read something
and take like, you know, a snippet from it, a
SoundBite that isn't accurate, out of context, and they run
(30:17):
with it.
Speaker 2 (30:18):
Now people believe something that isn't true, and then you're
trying to unravel It's really tough.
Speaker 3 (30:23):
So you know, when you're on social media and you're
looking for information about something health related, a make sure
it's someone that you trust to begin with, or research
what they're saying, like get out of the get out
of Instagram and google what they're saying and see if
like credible sources.
Speaker 2 (30:43):
And I'm just trying to think like it, like.
Speaker 3 (30:46):
Like if there's research papers that that support it. If
someone's selling you, if they're telling you something and they're
selling you something, they're selling you supplements. Don't believe them
like they Some of what they're saying is probably true,
but they might be exaggerating a whole lot.
Speaker 1 (31:05):
Right, Did you talk to any of the doctors about
the role of social media right now and how it's
making their job either easier or more difficult.
Speaker 3 (31:12):
I know I didn't go there with them, but then
the there's so much more to right there's the you know,
the fear of missing out and the bullying and the
living up to and it can like how many hours
dare we glued to this rather than being with each other.
That can contribute to depression and feeling isolated.
Speaker 2 (31:31):
So it's it's so tricky. It depends on how you
use it.
Speaker 1 (31:36):
I felt like how you ended the book with Maddie.
I felt very hopeful for her.
Speaker 2 (31:42):
I did. Do you guys agree with that? I'm so
glad that.
Speaker 1 (31:45):
She was finding her place, she was settling in, she
was being okay with who she is, right, yeah, yeah,
and we all struggle with that. So I really I
really liked the ending of this book.
Speaker 2 (31:56):
Thank you.
Speaker 1 (31:57):
Yeah, yeah, did you struggle with the ending? Did you
have like different ending? Now?
Speaker 2 (32:00):
I knew where I was going from the beginning.
Speaker 3 (32:02):
I knew that I wanted to get to her five
minute set, So I was going to basically write her
five minute set, and that it had to be in
a place where she's not cured.
Speaker 2 (32:11):
There's no guarantee for her.
Speaker 3 (32:13):
But she's now in a place where she feels supported,
that she's got you know, she's agreed to be on medication.
So every all of the doctors I talked to you
said it takes most people three times going off the
meds before they decide, Okay, I'm done with that experiment
and I'm going to stick to stick to it in
some way. And then you also have a village of
(32:35):
people around you who are also your eyes and ears,
because if you start to swing one way or the other,
your brain starts to lie to you, you know, whether
it's depression and you're just like, I'm a piece of
shit and I'm you know, worthless and it's hopeless and
like you start believing that, or you're manic and you're like,
I'm amazing in every way. Like, so you need other
(32:55):
people who you become unreliable as a narrator, So you
need other people to be like, I'm noticing something like,
so will you agree on what your triggers are? Like, Oh,
if I start, I've only slept five hours last night
and I'm not tired.
Speaker 2 (33:08):
Uh oh, Like that could.
Speaker 3 (33:09):
Be a sign that you're drifting into a manic episode. Ye,
So you have your toolkit and your your medication. So
I knew she would have that in place, and that, yes,
that she would come to she would come to her
place in the distinction of I have bipolar disorder and
so I am polar and that was a big, like
(33:31):
aha moment for her, like, oh, if I can live
with it as something I have, not as the sum
total of who I am, right that I can handle this,
then it's not so big, right that it's part of me,
but it's all of me?
Speaker 1 (33:43):
Right. Yeah, it was a very very like powerful distinction
at the end. Do you guys have any questions for Lisa?
Speaker 2 (33:52):
Yeah? Here, do you want to you know what? Do
you want me to you know what? Yeah?
Speaker 1 (33:57):
Yell and I'll repeat it so people in this stream
can hear it.
Speaker 2 (34:03):
The future.
Speaker 1 (34:03):
I've been watching.
Speaker 3 (34:08):
You ever, things like.
Speaker 1 (34:14):
I don't know really that do you see things on
social media like Tourett's And is that something that you
would want to tackle next?
Speaker 2 (34:29):
Yeah?
Speaker 3 (34:29):
So you're also asking, like you get my ideas, like
is it it could be from there, It could be
from social media. It hasn't been yet, so still Alice
was the experience with my grandmother. Left neglected was from
reading The Man who Mistook His Wife for a Hat
by Oliver Sacks, because there's a three page story in
there about left side neglects, and I was like, what
(34:51):
how does someone walk through the world only aware of
half of it? Autism was my cousin, Tracy's son has
a severe form of autism. U Huntington's was my first
job out of college, and I was working as a
lab assist a lab tech at mass General East in
the Charlestown Navy Yard. The lab down the hall, these
(35:11):
neuroscientists start screaming and celebrating and hugging, and neuroscientists don't
do that, so everybody is quiet, like what's happening? And
they had just isolated the genetic mutation that causes Huntington's.
It's the only thing that causes it, I know, right,
so goosebumps, Oh my God. And I immediately thought, well,
they're going to cure this disease. It's the only thing
that causes it. And we're all these years later and
(35:32):
we still don't have a treatment or a cure. So
I wrote that book to raise some awareness about Huntington's ALS.
I wrote about because our co writer of the script
and our co director of Still Alice was diagnosed with
ALS just before he started writing that script. He died
two weeks after Julian Moore won her Oscar I know,
and then this one was I wanted to write about
(35:54):
mental illness, and bipolar just seemed the place to go.
Speaker 2 (35:58):
I am writing a movie.
Speaker 3 (35:59):
Next, straight to film, not a book.
Speaker 1 (36:03):
Can we talk about this at all? She's got like
two major projects, two books?
Speaker 2 (36:08):
Sorry sorry, no four? Okay, but you only told me
about it. I know, I know which are huge. I
know like they're huge, and she won't tell us. I'll
tell you. I would love to. When can you tell us?
Will you call it at the Billion in the Morning
show the second I can? I would love to. Whn
do you think that will happen?
Speaker 3 (36:26):
Oh my god, if I had that crystal ball, believe
me so. But so I wrote the script for Inside
the O'Brien's. We have a director for that finally, but
the producers for that, who also did still ellis. When
I finished writing that script, heat another producer asked me
if I would write a dramaedy about menopause.
Speaker 2 (36:48):
I said yes, So.
Speaker 3 (36:50):
I'm working on that now. And then my next novel
is going to be about alcohol addiction and corsicoff syndrome.
Speaker 1 (36:57):
Okay, but the moral us Maddie has, so the ones
that are filmed, something going on with.
Speaker 2 (37:04):
More or less.
Speaker 3 (37:04):
Maddie has already been optioned for a film. We have
our we have matt Our, actress for Maddie.
Speaker 2 (37:11):
I can't say, but you're gonna like love who it is.
And then every note played.
Speaker 3 (37:15):
We're almost fully cast for that and so hopefully you'll
hear about that one any minute.
Speaker 2 (37:19):
And Left Neglected is also underway, so you.
Speaker 1 (37:23):
Will call in and tell us I would love to do.
I'm holding you too, Okay, do you have any other questions?
Speaker 3 (37:36):
Yeah?
Speaker 2 (37:45):
Yeah, So how do you know?
Speaker 3 (37:46):
The question is, how do you know if what you're
dealing with with your teenage son or daughter is a
normal mood swing because they're teenagers and their frontal lobes
aren't fully developed yet and they're making terrible decisions and
their migdalas are firing much. Yeah, how do you know
if it's just no moodiness versus something that is like
a clinical illness, because it's because it's very different. So yeah,
(38:10):
I mean, so if it's a if it's a clinical depression,
it's not just you know, really bummed out some And
this is something that's difficult with the disorder, by the way,
like how do I trust my own emotions now, like,
am I allowed to feel bummed out and disappointed and
upset about something if something bad happened? Or is that
now a sign of illness?
Speaker 2 (38:31):
Right?
Speaker 3 (38:32):
Because we do have moodiness, we do feel, we're human beings,
we feel so it's tricky, but the depressions will be
it will last for more than the day or the week.
Speaker 2 (38:45):
It's going to last a while.
Speaker 3 (38:47):
And it's gonna be heavier than just a like a
daughter who's like, doesn't want to talk to you today,
is like storming around or won't come out of a room.
It is It's a more than just a psychogenic it's
a physical pain, Like you won't want to get dressed,
you won't want to take a shower, You have trouble
focusing on what anyone's saying. You don't enjoy anything that
(39:09):
you used to enjoy. It's a very it's very different
than just a moodiness. And then on the on the upside,
you also don't trust if you have bipolar disorder, how
do I trust when I'm in a really good mood,
I'm so excited about something, Oh my god, I'm like,
are you fall in love or you're just lit up
by I want to go into comedy.
Speaker 2 (39:27):
This is so exciting.
Speaker 3 (39:29):
So what happens to Matty in the book, She's like,
she's like sort of floundering. I don't know what my
major is gonna be. I don't know what I'm interested in.
School's not really doing it for me. What's wrong with me?
I must be doing this wrong. Everybody told me this
would be the best four years of my life. It's
just not happening for me. And then she discovers comedy
and she's so lit up. But by now she's been
diagnosed with bipolar disorder. So it's like, is that okay
(39:51):
for me to feel excited? Or does this mean that
I'm it's a sign of mania, So it what you're
talking about is a tricky distinction. Families who live with
us are like, what's normal, what's okay?
Speaker 2 (40:04):
But there are distinct signs.
Speaker 3 (40:06):
If it's mania, you're going to be not sleeping very much,
and you're not tired.
Speaker 2 (40:10):
That's a hallmark sign. You are.
Speaker 3 (40:13):
Your thoughts are racing, they're so fast, and if you're
talking at the same time that you're thinking, you are
talking a million miles an hour and nobody can interrupt you.
If this is someone you know and love and they're
on social media. You'll wake up in the morning and
you'll click on their profile and you'll see, like, you know,
the Instagram stories, like the lines get really thin. If
they've posted like a hundred stories, that will be happening.
(40:34):
So that's not just like, oh, I'm excited about comedy.
That's like a little too much. So you'll you'll get
the feel for the distinction for sure.
Speaker 2 (40:43):
Yeah, yep. Yeah.
Speaker 3 (40:55):
So we don't one hundred percent know the causes of this,
but there are some correlations of events and then things
that ride alongside this, so they may be causal, but
we don't know for sure. So we do know that
there is a genetic component. It's not one hundred percent genetic,
but a family history of bipolar disorder will make it
more likely that you can develop it. So if I
(41:16):
have bipolar, every one of my children has a ten
percent chance of developing it in their lifetime, and that's
higher than the general public of two percent.
Speaker 2 (41:26):
Things.
Speaker 3 (41:26):
There are three things that we know are correlated with it,
adolescent substance abuse, head injury, and concussion, and there was
one more, what is it, oh, in childhood trauma. So yeah, yeah,
(41:49):
that's tough.
Speaker 2 (41:51):
Yeah, yeah, oh good, I'm glad, Patty. Can you outgrow it?
Speaker 3 (42:04):
So no, they say that this is a lifelong illness
and so but also I take that with yes, that's
what we know as of now. We are not in
the stage of enlightenment when it comes to bipolar disorder, right,
so we're not like we know everything about this, and
this is a lifelong illness as of right now. That
is what every every psychiatrist will tell you. And you
(42:26):
go presuming that. In fact, I'm going to be a
little bit long in this answer, so everyone who goes
off their meds totally reasonable. I think for people to
try that. Okay, So I want you all to think
about for a second, because this was one of my
misconceptions going into this. I had a lot of judgment
around if I had heard of someone who spiraled off
(42:46):
into a manic episode, ended up in jail, ended up hospitalized,
and then the person would say, well, he went off
his meds, and I'd be like, well, that's what happens, right,
If he's going to go off his meds, then like
what was he thinking?
Speaker 2 (43:02):
A lot of judgment there.
Speaker 3 (43:03):
And so what I've learned is because these side effects
are so brutal, right, They're just really tough to deal with.
Let's say I was diagnosed six months ago, I had
my very first manic episode. I'm diagnosed by a psychiatrist.
Speaker 2 (43:15):
I've never met before.
Speaker 3 (43:16):
There's no blood test, there's no brain scan. It's six
months later. I haven't had a depression of romania since,
which might be because the meds are working.
Speaker 2 (43:24):
But I'm miserable.
Speaker 3 (43:26):
Like the every person I spoke with said at some
point they wondered if the symptoms of the side effects
were worse than the symptoms of the illness the drug
is treating. So it's six months later, I'm feeling like crap.
I'm like, well, wait a minute.
Speaker 2 (43:40):
Are we sure that I have this?
Speaker 3 (43:43):
Like and by the way, when your manic, your brain
doesn't lay down memories very well, so your memory of
that episode is going to be spotty to begin with.
It's going to be like, did everybody kind of overreact? Like, Yeah,
I wasn't sleeping much. Maybe I just had insomnia and
I was really overwhelmed and stressed, And yeah I had
like a bit of a breakdown, But maybe that was
a one time thing. I outgrew it. I'm not in
(44:05):
that situation. Now, I'm gonna try going off the meds
and see how I do. Seems really reasonable. So, but
what happens is they end up with a manic episode
or they end up depressed again. And so I don't
know of anyone who has outgrown it. That said, I
don't think we know a lot about this yet. We
haven't studied it to know about someone over the course
(44:27):
of a lifetime with this, Kim, I mean one hundred.
Speaker 2 (44:30):
Two hundred years ago, they treated this with leeches.
Speaker 3 (44:33):
Two hundred years before that, they drilled a hole in
your skull, gave you a craniotomy to let the evil
spirits out.
Speaker 2 (44:39):
They called you a witch and hung you.
Speaker 1 (44:42):
In the book, you talk about lifestyle choices and how
Maddie needed to get sleep, she needed to not travel,
she needed to be in the same time zone. Can
any of those if you really work on those lifestyle
choices and you really make a commitment, can that really
lesson yes, a lot to where you don't have to take.
Speaker 2 (45:00):
I would say possibly. Yeah.
Speaker 3 (45:02):
Oh again, it's a collaboration with your physician, your village
of family and friends who are keeping eyes and ears
on you. If you're like, hey, I want to try
tapering off this or would it be what do you
think of me? Like I've been on these three meds.
What if I lose this one? So see how we do.
And it's like, yes, if you're going to travel and
(45:24):
switch time zones, like it's all hands on deck, Like,
let's see if we can get and make sure.
Speaker 2 (45:28):
You get some sleep to bolster that.
Speaker 3 (45:30):
Like if you start, you know, if your sleep starts
moving around, that's going to be a problem. That's the
number one predictor that something's gonna swing. But yes, it's
like when Maddie comes home to her the family home
in Connecticut after first year of school. She was depressed
that whole first year, but she chalked it up to
the boyfriend breakup and school's hard and all that she's
(45:51):
home and she feels better. That's in part because everything
is now in place. Mom's making three meals a day,
she's riding her bike to work at Starbucks.
Speaker 2 (46:01):
Every day, so she's getting exercise.
Speaker 3 (46:02):
She's going to sleep at the same time, getting up
at the same time.
Speaker 2 (46:06):
Like so routine. She's got the routine, she's got the
healthy eating, she's got the sleep.
Speaker 3 (46:11):
So that that that is probably as effective as any
medication we have.
Speaker 1 (46:16):
In some ways, it seemed like it we have time
for one more question, anyone else, does menopause bring bipolar
out more?
Speaker 2 (46:32):
I don't know that that's been studied. I would bet
that it's not because we haven't.
Speaker 3 (46:37):
Studied women very much, and we certainly haven't studied menopause
very much. That is changing and I'm loving it, but
I would imagine that it does to some extent, right,
because again, anything that moves you, I told you, like,
if you drink alcohol, that's a depressant, you know, if
you're taking stimulants, if it's adderall, if it's cocaine and fat,
I mean even maybe caffeine. To some folks, like if
(46:58):
you're swinging in either direction, then you're gonna get you know,
maybe that's going to.
Speaker 2 (47:03):
Knock you out of out of balance.
Speaker 3 (47:06):
So menopause, right, your moods are being you're swinging all
over the place, and so that could be are you're
not sleeping, Oh my god, right, so the night sweats
and the hot flashes and you're, oh my gosh, so
your sleep is going to get disrupted.
Speaker 2 (47:20):
I would bet if we.
Speaker 3 (47:21):
Studied this and you had a propensity if you were
living with bipolar, this would exacerbate it.
Speaker 2 (47:26):
That would make sense.
Speaker 1 (47:27):
I have to say that reading several of your books,
the one common thread in a lot is getting enough sleep,
Like really for your Bradley, getting enough sleep.
Speaker 3 (47:38):
So every neuroscientist I know makes sleep a priority.
Speaker 1 (47:41):
And I grew up at a time. I'm going to leave
with that. Yeah, sleep more, Yeah, take care of take
care of you.
Speaker 2 (47:47):
Sleep more. And it's a simple thing that we can
all do.
Speaker 1 (47:50):
Yeah, right, turn your phone off, read a book, right, yeah, yeah, Well.
Speaker 2 (47:55):
This sounds amazing. Lisa is the best. Right, thank you everyone,
Thank you, Thank you, Lisa.
Speaker 1 (48:01):
Thank you, And I'm going to hold you to that
big news it's coming. So next week we will have
Aaron Gates. She is a Boston based interior designer. She's
written several books. We had such a fun discussion talking
about design, what works, what doesn't work, her love of
Taylor Swift. She traveled the world to follow Taylor Swift
(48:23):
with her daughter. So check that out next week. And
you can always join Lisa's book club. Just go to
kiss one Away dot com slash Lisa's book Club to
join and you'll get alerts on our next event, so
hope to see you soon.
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On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!