[1] While generally categorised as fiction, the book draws heavily on Pinto's upbringing as a Goan Catholic in Bombay, and his family's struggle with his own mother's bipolar disorder.

An earlier version of the novel was written in the form of a memoir, but was rewritten as fiction after it began to take an emotional toll on Pinto.

[4] In a review for India Today, Anvar Alikhan said of the novel, "I don't know how much of this book is autobiographical, but I suspect a large part of it is: It's just too authentic, in its minutiae of mental illness, and its deliberately matter-of-fact narrative of pain, for it to be the fiction that it pretends to be.

"[7] In The Guardian, Scarlett Thomas wrote, "This book is most successful when the characters are allowed to speak for themselves, and Pinto is quite a genius with dialogue.

"[8] Peter Yeung of The Financial Times reported, "It is written with genuine compassion and sincerity, while a sprinkling of black humour ensures it is never overly sentimental.