Editor’s note: This article contains references to suicide that may be troubling to some readers.

“It feels like Silicon Valley is ready for this conversation,” Elisa Hofmeister ’18 said from the stage of a packed Pigott Theater. Hofmeister was prefacing “The Manic Monologues,” a play composed of stories of those who have been impacted by mental illness.

Hofmeister, an assistant clinical research coordinator at the Stanford Medical School’s Department of Psychiatry, co-founded “The Manic Monologues” with her boyfriend, Ph.D. candidate Zack Burton, after he was diagnosed with bipolar disorder. Struggling with rebuilding his confidence after his diagnosis and a psychotic episode that almost led him to attempt suicide, Burton brought the idea to Hofmeister with the aim of breaking down stigma surrounding mental illness.

After spending a year converting a collection of story submissions into a theatrical production, Burton and Hofmeister put on “The Manic Monologues” on May 1, 2 and 3. It sold out all three nights.

‘The Drop’: Zack’s experience

In the weeks leading up to Burton’s Ph.D. qualifying exams, Hofmeister could see him “spiraling.”

“It was really hard to tell what was going on with him,” she said. “It was like, maybe he’s sleep deprived, maybe he’s just never had anything this stressful before.”

But Burton, who had not yet been diagnosed, was experiencing what he later would find out was his first psychotic break. Driven by what he described as “an elevated sense of purpose,” he was “thinking a mile a minute, having tons of ideas.”

The hyper-organization that enabled Burton to do things like have “15 different windows each with like 30 tabs [open]” and still know “where every single tab was” came to a head the night before his exam. In the early hours of the morning, Burton left his building and ascended to the top of a five-story parking garage on campus, intending to jump.

“I had this very distinct memory when I was in that situation of my mom telling me to call her if I ever thought about harming myself, and so that, I think, in many ways saved my life,” he said.

Burton would spend the next 11 days in the psychiatric facility of Stanford Hospital, where he felt himself losing agency. People took care of him at the hospital, and he started to feel like he was no longer capable of taking care of himself.

What Burton said eventually progressed into a lack of confidence began as “a complete loss of identity.”

This feeling becomes the theme of his monologue, “The Drop,” in which Burton opens, “It was hard not to drop from the side of that five-story Stanford parking garage … But it was even harder not to drop out of school in the chaotic and confusing months that followed.”

“I had a lot of voices who I trusted and voices who cared about me who are like, you know, maybe it is best if you leave [Stanford], maybe just for a few months, a few quarters,” he told The Daily. “I think … that [leaving Stanford] would have made it harder for me personally, to recover my sense of confidence and self worth.”

For Burton, it was not the psychosis that defined his struggle with his mental illness, but the “crisis of confidence” that followed his diagnosis. Falling victim to what he describes as a common perception, Burton feared that medication might damper the effects of a mania he felt enabled him to be more productive. He also felt, in what he described as his own stigmas, that having bipolar disorder might mean “somehow, [he’s] less competent.”

Instead, Burton regained confidence by focusing on easing back into his work at Stanford. When he took his qualifying exams five months after he was supposed to — five months after his psychotic break — he felt more assured that he could “build back up [to his] previous capabilities.”

“It’s been this slow build of getting back up to confidence,” Burton said. “This is just another part of the human experience, mental illness. And in many ways, what I’ve found is that it’s not a hindrance, but it can actually be beneficial in some ways.”

To support Burton, Hofmeister had to shift her mindset as well.

“Seeing a loved one go through it obviously forced me to confront, very quickly, a lot of that stigma [surrounding mental illness] and to realize that, here’s someone who’s just in a place of pain, and it’s important to help him,” she said. But Hofmeister also learned that she shouldn’t hold him back or feel like he was incapable because he has a mental illness — “it’s important to recognize that he can go on and live a very full and successful life.”

Hofmeister has always been interested in medicine, but she describes her experience with Burton’s diagnosis as a “huge turning point” in her decision to work in psychiatry.

“I didn’t really have an appreciation for how important your brain chemistry is until this happened,” she said. “It gave me a lot more understanding and a lot more empathy for people with mental illness.”

Putting it on stage

The same increase in understanding and empathy is what Hofmeister and Burton hoped to bring to their community in producing “The Manic Monologues.”

When Burton came to Hofmeister with the name for “The Manic Monologues” — a play on title of the popular production “The Vagina Monologues,” which aims to destigmatize female sexuality — she knew it had to be performed for an audience, even though neither Hofmeister or Burton had theater experience.

“I really wanted to do it on stage in front of an audience, because I just know that unless you have someone looking you eye to eye, it’s really easy to distance yourself from these issues,” Hofmeister said. “Because some of them are heavy, and because people are afraid.”  

They spent the next year learning how to produce a play from the ground up. They solicited stories on and off campus, working with advisors and professional and student actors to put together the production. Burton and Hofmeister received the most submissions from advertising in Facebook groups geared toward bringing together individuals experiencing mental health challenges. The result was a collection of stories from as close as on campus to as far as Vancouver.

“It ranges from absolutely tragic, devastating, life-changing in negative ways to sometimes humorous, to powerful, to uplifting — these amazing stories of resilience and recovery,” Burton said.

The setup for “The Manic Monologues” is minimalist: characters — sometimes actors, sometimes individuals sharing their own stories — wear all black, are engulfed in a single spotlight and choose either to sit or walk around a black chair at the center of the stage as they tell their story. Monologues range from one to 10 minutes in length.

“My hope is just that our audience members they came and that they connected with at least one story,” Hofmeister said. “ I think as soon as you do that, and as soon as you feel that compassion [and] empathy go out for one person up on stage, it allows you to recognize [that] there are other people out there like that.”

Looking forward, Burton and Hofmeister hope to make the script of “The Manic Monologues” accessible so that the play can be performed in theaters across the country. They also hope to make it more adaptable, so the community that intends to put it on can add their own monologues.

“How we lose this stigma is normalizing the experience,” Burton said. “My own early stigma against mental illness has been shattered through this process.”

Contact Julia Ingram at jmingram ‘at’ stanford.edu.