As the pandemic surges in Los Angeles and across the United States, I am finding it's more important than ever to find ways to bolster my self-care. For me that's deepening my journaling practice, taking long walks by the beach, and staying connected with friends.

I had the opportunity to speak at length with author Terri Cheney, who is a mental health advocate. Her new book Modern Madness dives deeply into the complexities of mental illness and breaks it down in a way that is accessible, seeing it more clearly by unpacking the myths and realities. When I asked her what is most misunderstood about mental illness, she said, "how common it is." It may be challenging to release a book during COVID, but for Terri, the timing couldn't be better. It is not just for readers with a diagnosis but for anyone who is trying to better understand this issue and what we can do about it.

Terri Cheney is the author of the New York Times bestseller Manic: A Memoir. Terri's writings and commentary about bipolar disorder have also been featured in the New York Times, the Los Angeles Times, the Huffington Post, NPR, and countless articles and popular blogs, including her own ongoing blog for Psychology Today, which has over one million views.

Her new book, Modern Madness, exposes the complexities of the mental health issues currently confronting our nation. Using the familiar framework of an owner’s manual, Modern Madness brilliantly imposes order on a frightening and forbidding topic. Cheney’s juxtaposition of conventional clinical language with real, lived experience unpacks the myths and realities of mental illness.

Read People Magazine's feature story about Terri and her new book.

KARIN GUTMAN: You wrote about your experience with bipolar disorder in your first two books. How is this new book, Modern Madness, different?

TERRI CHENEY: This book is different because the first two were really strictly memoir. I wanted to take this beyond the confines of memoir because since Manic became a best seller, I have heard so many stories and met so many people and am much more aware of myself as being a member of a community of the mentally ill. So I really wanted to reach out beyond me for a change and incorporate family and loved ones of people with mental illness, really see if I could bring them into the conversation more. So it is my story but it's also lessons learned. I think this is the big difference.

We actually have to come up with a new genre to market it, because it's on the edge… it is memoir, but it's also somewhat prescriptive. So my agent and I ended up calling it prescriptive memoir and that seemed to work out okay.

KARIN: What about self-help memoir?

TERRI: I didn't want it to be self-help, it's not what it is. It's memoir. I mean, it's all my story.

KARIN: What’s the difference between prescriptive and self-help memoir?

TERRI: Well, I think prescriptive bounces more heavily into memoir. This is not an advice book. I actually have a story in here where I rail against advice. I think it shuts people down and it turns them off. I have a story in here about saying, “Tell me where it hurts.” Sit down with someone who's struggling and just say, “Tell me where it hurts.”

Five little words that just make a world of difference, rather than telling them what to do, how to do... get more exercise, eat more blueberries, that kind of thing.

It's so hard to be told what to do when you're depressed, because you can barely move or breathe. Being told to take a shower or exercise is almost a slap in the face.

KARIN: When you wrote Manic, weren’t you originally intending to educate your audience? Until you realized, “This is just not working.”

TERRI: That is neat to remember that.

KARIN: That really stuck with me.

TERRI: I was in the hospital at the time and did tons of research when on grand rounds with the doctors. I immersed myself in the science and the clinical aspect of it and was so bored. I just couldn't get into it. When I was trying to write, I just didn't feel that tug, that I need to tell this. I don't know if I was narcissistic or what it was, but my own story was really fascinating to me, and just wanted to be told. So I threw away everything, all the research. I mean, I still have it, but I did a total about face and dove into myself and my own story, my own experience, my feelings, what it felt like inside my body to have bipolar disorder.

To be where I had been as an entertainment lawyer and then to turn into a writer on mental health issues was not where I saw my life going until I wrote the book.

KARIN: Do you think Modern Madness is maybe a different version of the original intention you had with Manic?

TERRI: It could be that it's more expansive than Manic was. It's more all-encompassing and it does have the introductory sections describing for example what depression is or what mania is. It does have that clinical element that I had thrown away. So the research was not useless. It came in very handy to know all that. Never throw away research.

KARIN: Does the book focus on bipolar disorder or is it broader?

TERRI: Much broader. My stories are necessarily partly bipolar, but also as I said, they are part of the mental health community and the mentally ill. So, this definitely reaches beyond just bipolar.

KARIN: How are you doing today?

TERRI: I'm doing great. I waited for the other shoe to drop with COVID because isolation is one of the things I talk about in the book as being a bad coping skill. Isolation is very bad for you when you're depressed or have a mental health issue. But I've done great during COVID.

KARIN: Why do you think that is?

TERRI: First of all, because I'm used to being alone. I'm not married, I'm a writer. I'm used to feeling separate as a writer and as someone with mental illness. I think there is a separateness that is inherent in that. You watch a lot when you're a writer and you stand outside. So isolation kind of comes naturally. It's almost as if I've been practicing for COVID. I'm trained for it.

KARIN: Wow.

TERRI: Yeah. I'm quite surprised.

KARIN: Do you take medication for your illness?

TERRI: Yes, I've been a proponent of medication from the beginning. I've been on every medication there is practically. For me to accept having bipolar disorder, I had to have a story around it. My story is that it's chemically based or it has something to do with physicality, whether it's caused by inflammation (that's a recent theory) or by a chemical imbalance in the brain. That is easier for me to accept and then treat with medications. So, I've always believed that medication is necessary.

KARIN: I recall you sharing that you enjoy the experience of hypomania. Does the medication interfere with that?

TERRI: Kay Jamison writes a lot about this, about not wanting to take lithium because it would dull her writing ability. I certainly love hypomania, it is the best part of being bipolar. You feel so on top of your game and everything connects, everything clicks. The words just come pouring out of you. But the consequences of not taking medication are so great that it's just not worth it. The trade-off is just not worth it because the reactions are so bad. I'm one of those few people who is totally medication compliant.

KARIN: With three books under your belt, what have you learned about the creative writing process, about how to birth a book. Is there anything that is consistent?

TERRI: Yes. I've learned that you can't wait for inspiration to strike. That's been a huge lesson. I struggled for seven years to write Manic because I would just sort of sit there with my pen waiting for the metaphor to come, and trying to force the damn metaphor. And it just doesn't happen that way. You have to put yourself in a place to write and then write something—anything—so you have what I call playdough. Clay that you can sculpt. Because then the next day when you have to face the writing process, you're not facing an empty page, you're playing with words. And playing with words is great, I love doing that. I don't like the blank page.

KARIN: Many writers I work with struggle with finding the structure of their book.

TERRI: I've learned that I am not very good with structure, it's my bête noire. I work better with a short form format—the essay—than I do with a long form. So, in Manic and in Modern Madness I use the essay form to create a book with a narrative thread.

I tried to turn it to my advantage, because I know I have trouble with plotting a long chronological narrative. It's one thing I work at really hard, but I think some people are gifted in it and some people aren't. And I don't feel like I'm particularly gifted that way. I can see the arc of a short story very clearly, I feel it, but I don't feel the long ones.

KARIN: What about your second book, The Dark Side of Innocence?

TERRI: That one was more chronological. I don't think it worked as well. It told the story of my childhood. In a way, it was the idea of my editor to write about my childhood and I didn't have very strong feelings about it at the time. I sort of wish I had held back and waited for something that really felt more like it needed to be written the way that Manic and Modern Madness felt. These are stories that I've seriously wanted to tell and get out there.

KARIN: What was the urgency around this book? What were the stories you wanted to tell?

TERRI: I felt very strongly about incorporating relationship stories into a book because I was too wrapped up in my illness for too many years to see how it affected the people around me. I had watched how it affected men that I dated, friends that I had, my family. I had a little more perspective after all these years, and I felt very strongly that relationships were unexplored in my earlier work because it was mostly just about me.

KARIN: How does your mental illness affect or inform your creative process? Or is it hard to have perspective on it?

TERRI: No, I can see it. I can see it with some clarity. When I'm depressed I can't and don't write and that's something I've learned. It's been a really difficult lesson to learn, that there are simply times when I can't write and I have self-compassion for that, because you feel rotten when you don't write when you're a writer. You feel like you just haven't gotten anything done and you're just all clammy and stuck. I hate that feeling. And when I'm depressed I just don't have the inspiration or the desire really to tackle the words, so I let myself have those days off.

I try to make up for it when I'm in better places. I try to take advantage of the hypomanic moods. There's also normalcy in bipolar disorder. You have periods where you're just like everybody else, when you're not going through a mood state.

So I write as much as I can. When I’m manic I try to write because I think I've got the world's greatest ideas and I'm going to change the universe with them. I see the fabric of the universe, but unfortunately I write very badly when I'm manic. I write almost illegible to begin with, I like to do it in longhand.

KARIN: Do those episodes still happen even on medication?

TERRI: Not as much as they used to. I don't get as high and I don't get quite as low. I still get depressive episodes unfortunately, but they're fewer and for the most part they don't get as suicidal. So that's huge.

KARIN: How long do those depressive episodes typically last?

TERRI: I'm a rapid cycler. It's sort of a curse and a blessing because my episodes are very short, like four days depression followed by three days of mania. So the good part of that is that I know people who have episodes that last for months and I cannot imagine being severely depressed for months or years. But the problem is, it's very hard to treat because you're always chasing the symptoms. They're changing constantly. I think I write in Modern Madness, it's like chasing a comet's tail to try to get the last symptom that you had and medicate that, but then you're on to the next one.

KARIN: How much time typically passes in between?

TERRI: It varies. It can be weeks, months, generally weeks. I'm very aware of my moods and I don't know if that's because I'm bipolar and I've educated myself about it, or because I'm a writer. I'm just hyperaware of my emotions and my moods. I'm always thinking of it as material.

So it really does inform the universe for me. There's this big controversy that's saying, “I am bipolar” versus “I have bipolar disorder.” I get yelled at a lot by people for saying “I am bipolar,” which is part of the way I see the world. It's part of my mindset. It affects everything, so it doesn't feel weird to me to say that. But I understand it's not your whole identity. There are other parts of me.

KARIN: Since you’re so comfortable exposing yourself, is there any part of you that gets nervous to release your work into the world?

TERRI: I have a perfect example of that. I had this big lecture last night in front of 250 people, and it's on Zoom and I had to read a story from Modern Madness. I chose one that has me wondering where my panties went after an illicit interlude. And I'm thinking as I'm reading this, “There are doctors in this audience, there are people I know... what am I doing? Are you crazy?” And yet there's a certain thrill about doing it. Because there's a power to self-exposure as long as it's not too graphic and doesn't make people too uncomfortable. There's a great power to it. I spent so many years, as you know, hiding out and not telling anyone about my illness and just literally hiding under my desk when I was depressed as a lawyer. Lying all the time, pretending that something else was wrong with me and I couldn't go out because I had the flu or whatever. I would get so tired of the lies that telling the truth and being honest about what's going on can never feel as bad, I think, for me as it might feel for other people. I know how sick that made me to be lying all the time.

KARIN: Also, you have tended to expose yourself versus other people.

TERRI: Right. I worried about exposing my family when I wrote my second book. I was very careful with that. Both my parents are dead now, so I don't have to worry about that now and I probably have more to write about them. But exposing yourself... I feel like you're fair game. Who is the famous writing teacher who wrote, “If people want you to write warmly about them, they should have behaved better”?

KARIN: Anne Lamott.

TERRI: I love that. That has encouraged me many times.

KARIN: Has anything ever come back to bite you?

TERRI: I've tried not to make people too recognizable, but people that are recognizable have been absolutely thrilled to be in the book. I have an ex-boyfriend who does not come off very well. He brags about it all the time. He said to me, “I'd marry you in a minute if it weren't for your bipolar disorder.” I wrote that in Manic and I think that's a pretty damning statement. He joked about it all the time and loves that he was a character in the book. So that's been my experience. I know other people have had problems but I've been very lucky. And I don't let people read my writing before it goes out. I think that's a dangerous habit.

After years of working for other people, if I'm going to make the self-sacrifice to be a writer, I want to have the perks of it as well. And part of that is being able to say what you want. You're the writer. You live or die by your words.

KARIN: I love that.

TERRI: Yeah.

I miss the money of being a lawyer. Writing is so hard financially.

KARIN: Do you miss practicing law at all?

TERRI: Well pretty much money is the only part. There is a certain instant credibility that went with being a lawyer that I miss, that business card moment when people, men especially, started to take you very seriously all of a sudden. When you say you're a writer there's that pause, that uncomfortable pause like, oh, another one.

KARIN: Even though you're published?

TERRI: Well now I get to say what I've written. Then I get to do my killer line, “And I wrote a book that became a best seller.” That's great. I mean I'm so lucky. I just love being able to say that, because I never in a million years expected that would happen.

KARIN: Why do you think it hit so strongly? What were the forces behind that?

TERRI: I think one of the big things, just from a marketing standpoint, was that my Modern Love essay for the New York Times hit a week before Manic was due to come out. And it was a powerful essay. It got filmed and Anne Hathaway ended up playing me which was such a bizarre turn of events. But that really helped, getting that exposure in the New York Times was tremendous.

KARIN: Was the timing just by chance?

TERRI: Just fortuitous. Yeah.

The same way that Modern Madness has come out in the middle of a pandemic when everybody is struggling with their mental health. I mean, I've been lucky. And I certainly didn't time it that way, and I didn't realize the title would be so prescient.

KARIN: Who is Modern Madness for?

TERRI: Pretty much everybody, because I think one thing I've learned is that when I tell people I'm bipolar there's this... it's not even six degrees of separation. It's, “So am I” or ”my best friend is” or somebody I work with, or I have depression, I have anxiety. That really has surprised me how many people are affected by mental illness. And if you don't have it yourself, you love someone who does.

So when I was writing my proposal for the book, I realized if this goes out, this could be marketed to almost anybody. It's not just for those with a diagnosis.

KARIN: What do you think is most misunderstood about mental illness?

TERRI: How common it is. One in five Americans takes a psychiatric medication, and the suicide rate, even before COVID, has just been skyrocketing. There's one suicide in the world every 40 seconds. It's tremendous what's happening and I don't really understand why, particularly with young people, it's so prevalent. I think it's being talked about more, thank God.

KARIN: Why do you think it’s so prevalent?

TERRI: I think it's easy to say social media is contributing to it. When I look at the people, I don't read my comments anymore, although I hope everybody will leave me an Amazon review! I really try not to read anonymous comments anymore because they were so brutal.

I had one person say, “Terri Cheney writes about suicide so much, I wish she would just go ahead and do it already.” If you read something like that you're like, “Do they not think I'm a human being?” So that sort of cured me for a while. That was for an article I wrote in The Huffington Post.

KARIN: What is your life like now? How do you spend your days?

TERRI: Well, now that I don't go to the cafe anymore to write, I try to set aside time for productivity every day which I am trying to be kind to myself about. Right now I've been dealing so much with publicity. That's been the last few months. But I've started to plot my new book. You have to really be kind to yourself when you're a writer because it's so easy to find fault with not doing enough. There's always that feeling of “I didn't do enough today.” But I think any day that you face the page or you face the project is a day well spent. Because your brain is percolating, I call it.

KARIN: But don't you find a lot of the writing, or the ideas, come when you're not facing the page, too?

TERRI: Absolutely, yeah.

KARIN: So how do you balance that?

TERRI: I write down all my ideas because I have a terrible memory. And it's just getting worse. So I have post-it notes everywhere. I use the software program Ulysses that lets you organize your ideas. I'm very technophobic, so that's the best I can explain it.

KARIN: Can you say anything about your new book?

TERRI: Well, I can say what it feels like at the moment. I'd like to write about recovery from substance abuse and mental illness because that's called a 'dual diagnosis' when you have both.

There's a lot of addiction and recovery memoirs out there, so I'm a little nervous about that. But I don't think there's been enough about dual diagnosis. I facilitated a mental health support group for dual diagnosis for about 15 years at UCLA Neuropsychiatric Institute and heard a lot of stories. I'm still in a group. I just joined one in fact. And I think the issues are different when you have the combined forces attacking you. It's really a tough recovery and I'd like to write about that. It's funny, there are whole areas of my life that I haven't written about because I've been too ashamed, if you can believe that after reading everything that I've written already. But I heard if you have shame, it's probably a good thing to start writing about.

KARIN: It is pretty shocking that there are areas you haven't explored yet.

TERRI: I know. I didn't really want to go there. But I have used up a lot of my life in three books. So I think it's time to turn to the stuff that was very difficult. I felt like with alcohol there was more of a volitional aspect than with bipolar disorder, which feels to me like it was not within my control.

KARIN: I see. So, you relate personally to the dual diagnosis?

TERRI: Very much so. I'm 21 years sober, so I went through quite a journey.

KARIN: How have you become a better writer over the years? Have you always been a writer?

TERRI: Interesting question. I have written all my life since I was a little girl. My father would read to me and encouraged me to write poetry, and that was a huge bond between us. So I always wanted to write. The entertainment law, while it had its perks, was a major detour off my true passion. I was an English major and I always envisioned myself as a writer and never really let that dream go. But I've noticed my writing changing over the years, which is exciting and scary at the same time because I think I write more simply now than I used to. I don't know if that's because I've used up all the words already or if I really just have a clear thought process after writing so much.

KARIN: Are you more confident in some way?

TERRI: Well, I hear a pretty strong rhythm in my head and that guides me. I got that from, of all things, the Hudson Harlem line—the train from Poughkeepsie from Vassar College going into New York City—where I went every weekend to go play and go to the museums. I would hear that train sound and that's when I would do all my writing and my homework and it got into me. It got into my bones somehow and got in my head. So my writing has always been rhythmic, whether it's poetry or memoir. I haven't lost that sense of internal rhythm. That's why I can't write when like rock music is playing. I can only write if classical music is playing. Anything that disrupts that rhythm is going to disrupt my writing.

I don't know if that answers your question but It's just a very lovely memory of going on the train and writing to the wheels.

KARIN: What a great touchstone for you.

So, is the simplicity about less words, or more minimalist in sentence structure?

TERRI: Yes. Less metaphors. A little less flowery, I'd say.

I don't agonize over every image as much as I used to. So I wouldn't say it's easier. I don't think writing is ever easy, but it does flow more than it used to. I used to have terrible writer's block and I don't seem to have that. That's something I'd love to tell your readers. I went to see Dennis Palumbo, the writing coach, and he told me to “write one moment” and those three words have gotten me through so much. Just write one moment, because you get so overwhelmed by a lot of the story and characters. I've found when I write one moment and I focus on my internal sensations, something happens... something comes up.

It breaks through that ice.

Buy the book!

To learn more about Terri Cheney, visit her site.

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