In the book, she uses her training as a writer to make notes, and tells the story of the condition both from the inside and in terms of literary understanding: with etymology, metaphor, mythology, music, and poetry pressed into service to give the reader a picture of the events as she perceived them.

[2] In the book, Griffiths explores both intellectually and subjectively a year-long episode of manic depression that she experienced, something that she found at once terrifying and attractive, based on the notes she kept at the time.

[5] Griffiths briefly enumerates the causes—genetic vulnerability (having a combination of genes that predispose to the condition); long-term stress; a trigger, in her case a "mild" sexual assault.

She notes that hypomania and mania can appear as hyperacusis, sharply increased awareness "certainly an aspect of artistic sensitivity",[11] and compares the experience to flight—followed by "payback time".

[12] Griffiths tells how she felt, using metaphors, anecdotes, descriptive passages, narrative of how her doctor patiently helped her: "He listened, deeply.

[14] She examines the mythical figures associated with the condition, starting with Mercury-Hermes, "one of the Trickster gods"[15] and "the only shaman in the pantheon", "dynamic, quixotic, enigmatic".

Griffiths notes that many of Shakespeare's characters, too, have mania, depression, or both: Antonio, Jaques, Hamlet, Lear, Timon, Cleopatra; and wonders if he experienced it himself.

She explains the book's title as "the 18th-century word she prefers to capture the precise combination of mania and melancholy in a mixed-state bipolar episode ... a condition steeped in metaphorical significance."

"[29] The reviewer observed that Griffiths used her notebooks, "very precious to me ... footprints of my thoughts, tracks of journeys, curiosity-paths and desire-lines",[30] to make sense of her experience.

She praises Griffiths for the "difficult trick of taking you into the depths of her madness ("I could feel my mind on a slant, every day more off-kilter, every night sleeping less"[32]) while managing to remain a completely reliable guide."

Griffiths is a high-wire writer who performs the difficult trick of taking you into the depths of her madness while managing to remain a completely reliable guide.

Griffiths's subtle point is that in madness we live inside metaphors that offer a parallel understanding of what is real that is no less valid than any other, only less tenable.