Accolades for (and one critique of) Renegade Theater Company’s Current Production: “Next to Normal”

Gary G. Kohls, MD

I was in the audience at Duluth’s Teatro Zuccone last Friday night and witnessed the inspired performances (and superb singing) of the cast of “Next to Normal.” The performance had to be delayed a bit to find seating for the sold-out crowd. (My advice: See this play! But reserve your tickets soon. And, for those who might not be able to get tickets to see it during either of the next two weekends’ offerings, consider lobbying the Renegade to offer it again soon or perhaps extend the run. Not only are the many messages important, the performances are just that good!)
In my opinion, the six Duluth-area actors/singers who portrayed the seven characters in this rock musical couldn’t have been out-performed by high-priced professionals if it had been done at the Guthrie Theater in Minneapolis.
“Next to Normal” is the Pulitzer Prize-winning and Emmy Award-winning 2005 rock musical that deals with the complex issue of mental ill health—not just from the perspective of the poorly understood, too often misdiagnosed/mislabeled and drug-intoxicated (or drug-withdrawing) main character, but also from the perspective of the patient’s secondarily afflicted family members, none of whom (in this case) had been offered proper “First Do No Harm” therapy for the serious psychological traumas they all had endured.
I only had one minor quibble with the play. The writers got the diagnostic label of the main character wrong! (She was diagnosed with “bipolar disorder.”) But that mistake is not uncommon for most of us brainwashed victims of the conventional wisdom (about mental “illnesses”) that was the norm at the turn of the century, when “bipolar disorder” (of unknown etiology) was being popularized.
Here’s why the diagnosis was wrong:
We are explicitly told at the beginning of the play that the main character—the now-middle-aged Diana—had been exposed to severe life-changing and brain-changing psychological trauma 16 years earlier with the traumatizing death of her infant son. Thus the more accurate diagnosis should have been “posttraumatic stress disorder” (of known cause) “with psychotic features.”
Thus, rather than having a diagnosis of “bipolar disorder” (of unknown cause and seemingly always treated with neurotoxic and psychotoxic drugs), she began, 16 years earlier, on a series of therapeutic misadventures mainly involving brain-altering psychotropic drugs (see list below), which led eventually (perhaps inevitably?) to a series of electroshock “therapy” sessions, with predictably worsening memory loss, IQ loss, probable (hard to measure until it is too late) brain damage , and secondarily worsening family dysfunction, rather than being given the more appropriate intensive individual, marital, group, and family psychotherapy with a compassionate, understanding therapist,  which could have led to a cure with no brain damage complications and an emotionally intact family.
Such psychologically damaged patients, like Diana, always experience normal sadness, normal grieving, insomnia, distressing dreams, re-traumatizing nightmares, re-traumatizing daytime flashbacks/delusions (usually misdiagnosed and mistreated as hallucinations) and—too often—the long-term use of combinations of psych drugs that have never been tested for safety long-term.
Patients like Diana frequently experience psychotropic drug-induced mania (from either psycho-stimulants or second-generation antidepressants), drug-induced memory loss, and drug-induced delusions and psychotic episodes. In addition, patients like Diana often suffer from a range of confusing drug withdrawal symptoms when they are being switched off their old, failed psychiatric drugs or when the dosages of the old drugs are simply being reduced. Drug withdrawal is commonly misdiagnosed as relapse.
In defense of the writers of this powerful musical (no matter what is the precise mental ill health diagnosis), the truths that are so brilliantly expressed in the lyrics are still deeply meaningful and would have been just as powerful if the more accurate diagnosis of PTSD had been written into the play.
For those people who have a little trouble catching the lyrics or the hidden deeper secret meanings of the songs, I offer below some excerpts of the more meaningful songs. The lyricists are to be congratulated on their psychological understanding of the subject matter (except for the initial misdiagnosis, of course) and their withering critique of modern-day psychiatry and the absurdity of modern medicine’s widespread reliance on synthetic brain-altering chemicals, otherwise known as psychotropic drugs.
In the excerpts below, the characters listed are Diane (the patient with PTSD), her husband Dan (who, in denial, has unsuccessfully tried to suppress the reality of the tragedy of what happened when he and Diane innocently, accidentally, and prematurely gave birth to a child while they were still ignorant, inept adolescents themselves), Dr. Fine and Dr. Madden, Diana’s well-meaning psychiatrists, and Natalie (Diane and Dan’s screwed-up, neglected only child, born soon after the tragic death of her infant brother).

Who’s Crazy / My Psychopharmacologist and I

Patient Diane’s Husband Dan:
Who’s crazy?
The husband or the wife?
Who’s crazy?
To live their whole life
believing that somehow things
aren’t as bizarre as they are

Who’s crazy?
The one who can’t cope
Or maybe the one who’ll still hope
The one who sees doctors
Or the one who just waits in the car

And I was a wild twenty-five
And I loved a wife so alive
But now I believe I would settle
For one who can drive

Psychopharmacologist Dr Fine:
The round blue ones with food
but not with the oblong white ones
The white ones with the round
yellow ones
but not the trapezoidal green ones
Split the green ones into thirds with
a tiny chisel
Use a mortar and pestal to grind...

Patient Diana:
My Psychopharmacologist and I
It’s like an odd romance
Intense and very intimate
We do our dance
My Psychopharmacologist and I
Call it a lovers’ game
He knows my deepest secrets
I know his... name!

And though he’ll never hold me
He’ll always take my calls
It’s truly like he told me
Without a little lift the ballerina falls

Dr Fine:
Goodman, Diana.
Bipolar depressive with delusional
16 year history of medication.
Adjustment after one week.

I’ve got less anxiety,
but I have headaches, blurry vision,
and I can’t feel my toes.
Not a very exact science, is it?

Zoloft and Paxil and Buspar and
Xanax Depakote, Klonopin, Ambien
and Prozac

Atavan calms me when I see the bills
These are a few of my favorite pills

Ooh. Thank you, Doctor.
Valium is my favorite color.
How’d ya know?

Dr Fine:
Goodman, Diana.
Delusions less frequent
but depressive state worse.

I’m nauseous and I’m constipated,
completely lost my appetite
and gained 6 pounds,
which ya know, is just not fair.

May cause the following side effects - one or more:

Dizziness, drowsiness, sexual
Headaches and tremors and
nightmares and seizures
Diarrhea, constipation, nervous
laughter, palpitations
Anxiousness, anger, exhaustion,
Nervousness, lethargy, nausea,
Odd and alarming sexual feelings

Oh and one last thing.
Use may be fatal

I now can’t feel my fingers or my
I sweat profusely for no reason.
Fortunately, I have absolutely no
desire for sex.
Although, whether that’s the
medicine or the marriage
is anybody’s guess.

Dr Fine:
I’m sure it’s the medicine

Oh, thank you, that’s very sweet.
But my husband’s waiting in the car

Who’s crazy?
The one who’s half gone?
Or maybe the one who holds on
Remembering when she was twenty,
and brilliant and bold
And I was so young and so dumb,
and now I’m old.

And she was wicked and wired
The sex was simply inspired
Now there’s no sex
She’s depressed
and me I’m just tired, tired,
tired, tired.

Who’s crazy?
The one who’s uncured
Or maybe the one who’s endured
The one who has treatments
or the one who just lives with
the pain

And though he’ll never hold me
He’ll always take my calls
It’s truly like he told me
Without a little lift the ballerina

My Psychopharmacologist and I
Together side by side
Without him I’d die
My Pyschopharmacologist and I

I don’t feel like myself. I mean,
I don’t feel anything.

Dr Fine:
Hmph. Patient stable.

Didn’t I See This Movie?

Didn’t I see this movie,
With McMurphy and the nurse?
That hospital was heavy
But this cuckoo’s nest is worse.
And isn’t this the one where
In the end the good guys fry?
Didn’t I see this movie
And didn’t I cry?

Dr Madden (Electroshock
The modern (ECT) procedure’s
clean and simple. The electricity
Required is barely enough to light
a hundred-watt bulb.

What makes you think
I’d lose my mind for you?
I’m no sociopath.
I’m no Sylvia Plath 
I ain’t no Frances Farmer
Kind of find for you...
So stay out of my brain
I’m no princess of pain.

Didn’t I see this movie
Where the doctor looked like you?
Where the patient got impatient
And said “sorry, doc, I’m through.”
I know where this is going,
And I know what you’re about
‘Cause I have seen this movie
And I walked out.
I walked out.
I’m walking
I Miss The Mountains

There was a time when I flew higher,
Was a time the wild girl running free
Would be me.
Now I see her feel the fire,
Now I know she needs me
There to share
I’m nowhere.

All these blank and tranquil years
Seems they’ve dried up all my tears.
And while she runs free and fast,
Seems my wild days are past.

But I miss the mountains.
I miss the dizzy heights.
All the manic, magic days,
And the dark, depressing nights.

I miss the mountains,
I miss the highs and lows,
All the climbing, all the falling,
All the while the wild wind blows,
Stinging you with snow
And soaking you with rain
I miss the mountains,
I miss the pain.

Mountains make you crazy
Here it’s safe and sound.
My mind is somewhere hazy
My feet are on the ground.

Everything is balanced here
And on an even keel.
Everything is perfect
Nothing’s real...

And I miss the mountains.
I miss the lonely climb.
Wand’ring through the wilderness.
And spending all my time
Where the air is clear
And cuts you like a knife
I miss the mountains...
I miss my life.

Wish I Were Here

In an instant lightning flashes and
the burst might leave me blind.
When the bolt of lightning crashes
and it burns right through my mind,
It’s like someone drained my brain
out, set my frozen mind to thaw,
Let the lethargy and pain out, while
I stood and watched in awe.

I am riding on the brightest buzz.
I am worlds away from who I was.
And they told me it would change
me, Though they don’t know how
it does.

I have lived a life of clouds and gray,
But this is crystal clear.
Wish I were here.

I imagine it’s remarkable,
Exuberant, austere.
Wish I were here.

It’s euphoria, it’s anger,
It’s the winter wind, it’s fire.
And it kills my deepest hunger
As it fills me with desire.

I’m the light and heat of every sun.
I’m a bullet from a magic gun.
And I’m trying to enjoy it,
But I’m missing all the fun.

Am I feeling what I think I’m feeling;
The hope, the heat, the fear?
Wish I were here.

Diana and Natalie:
Is this someone else’s head trick?
Do I just disappear?
Wish I were here.

Plug me in and turn me on,
And flip the switch, I’m good as
It slits my skin, and trips my brain
And feel the burn, when I don’t feel
the pain.

Is my brain reborn or is it wrecked,
In freedom or in fear?
Wish I were here.

Have I blown my mind forever?
Is cloudy my new clear?

Can I hide my stupid hunger,
Fake some confidence and cheer,
Wish I were here?