Next to Normal is a musical, composed in a rock idiom.  

Meet the Goodmans, (father Dan, mother Diana, daughter Natalie) who on the surface resemble a “perfect loving family” like any one of millions.  However, from the outset we see that they are, in fact, a hair’s breadth from collapse:  Diana’s long-term struggle with bipolar disorder leaves her suffering uncontrollable mood swings.  Her illness fuels the chronic tension in her relationships with husband and daughter.  In addition, we learn that a son (Gabe), whom we initially believe to be an active family member, actually died years ago and his appearances represent Diana’s hallucination. 

As the show begins, Diana is undergoing a hypomanic episode that is resistant to treatment by her psychopharmacologist.  Discouraged by side effects and egged on by her phantom son, Diana flushes her pills down the toilet.  As she deteriorates, she visits a new psychiatrist who agrees at first to treat her without medication.  As she begins in psychotherapy, for the first time, to accept the loss of her son, she descends to a new clinical low.  At the close of the first act, after making a suicide attempt, she is hospitalized and agrees to be treated with ECT.   

By Act II, the ECT has effected great clinical improvement, with stabilization of Diana’s mood and no further hallucinations.  All this, however, has come at the expense of her memory.  As it returns, she becomes aware that what she most needs to remember, and process, are her feelings about losing a child.  In fact, we learn that she was kept from expressing them at the time because of concerns she might decompensate.  She struggles to make sense of all of this while remaining stable.  When she confronts Dan about Gabe, it is he who appears unable to discuss their loss.  She suddenly becomes aware that Dan has been enabling her in an unhealthy way.  She reconciles with her daughter, but realizes that in order to move forward she needs to get out of her dysfunctional marriage.  However, the door is left open on this relationship, for at the recommendation of her psychiatrist Dan enters psychotherapy.


This is a musical written in an approachable, contemporary idiom, with at least one well-rounded, complex character.  It has an up-to-the-minute feel, well-crafted music and lyrics, and it correlates with public discourse about mental health.  As such, it has great potential as an educational tool, especially with regard to bioethical issues in psychiatry. 

It is well known that the show was revised extensively after an off-Broadway production.  Audiences were initially unsure of how to react because the tone veered toward satire.  Later it went on to become successful: however, the creators still found it necessary to go on record to say they were not against mental health treatment.  There are times when it still feels as if we are getting a mixed message.  The depiction of Diana’s first psychiatrist teeters on satire, as when the author falls back on a cliché by having him make an inappropriate romantic comment (p. 21) that seems otherwise out of character.  Likewise, the second psychiatrist is, at first, flippantly labeled a “rock star,” but later the tone changes and he really comes through for his patient.  It is to his credit that instead of bombarding her with more pills he initially agrees to see her for psychotherapy.  It is strange, then, that merely four weeks later he abandons this treatment for hypnosis.  Of course, a case might be made for saying that the ambiguity makes the show more interesting.  

Diana’s stated diagnosis, Bipolar Depressive Disorder with delusional episodes, would be revised, in the latest edition of the DSM, to Bipolar Type II with psychotic features. The dead son appears throughout the show as a full-fledged visual and auditory hallucination to a degree unusual for bipolar patients. On the other hand, the origin of the symptom in Diana’s unresolved grief calls attention to the underappreciated fact that delusions and hallucinations may serve a defensive function, being less random than they are sometimes given credit for.

In short, while it may not be perfect, Next to Normal penetrates beneath the surface more successfully than most musicals. It performs a real service by giving voice to the complex and contradictory emotions – love, hatred, duty, guilt, resentment- felt by family members of persons with mental illness.  


Next to Normal opened on Broadway in April 2009 where it ran for nearly two years, racking up close to 700 performances, and then toured.  It won three Tony Awards, as well as the Pulitzer Prize for Drama, becoming the first musical in fourteen years to do so.  The Pulitzer Board called it "a powerful rock musical that grapples with mental illness in a suburban family and expands the scope of subject matter for musicals."  The musical numbers are available in CD and MP3 format (the CD comes with a booklet containing a short synopsis and the lyrics, but not the whole book).  An unofficial, primitively filmed video of the Broadway production may be found on YouTube and is chiefly valuable as a memento of Alice Ripley’s truly extraordinary performance in the role of Diana.  At one may find articles and reviews of the show.


Theatre Communications Group

Place Published

New York



Page Count