Looking at a serenely beautiful portrait of Marya Hornbacher, I found it hard to believe that the author has been to hell and back not once but at least once a year since early childhood.

She has suffered every imaginable disorder: anorexia and bulimia (the subject of her first memoir, "Wasted"), alcoholism, drug addiction, hypersexuality, paranoia, cutting and last (and least!), the occasional financially ruinous shopping spree. And these are just the symptoms of the underlying malady, manic-depressive disease, which afflicts just 2 percent of the population, as Hornbacher notes in her useful and sobering appendix.

What ought to be a thoroughly depressing memoir is anything but. In staccato bursts of present tense she makes us inhabit her brain and experience the extremes of her highs and lows, which are not mood swings as much as all-engulfing tsunami waves. Hornbacher is so gifted a writer that I was more than willing to go along for the ride, even though it necessitates innumerable visits to Unit 47, the hospital psych ward. She finds precise and startling images for her mood states: " ... the shrieking has stopped, and my mind floats in a bath of sedatives, sunning itself on its back like a seal."

Madness, the hypermanic state, comes without warning for the hell of it:

"You wake up one morning and there it is, sitting in an old plaid bathrobe in your kitchen, unpleasant and unshaved. You look at it, heart sinking. Madness is a rotten guest. You can tell it to leave till you're blue in the face." Reality shatters into overbright chaos of incomprehensible shards. Even words scatter, the "whirlwind of words, beautiful strings of sentences, which I pictured as a net of letters, strands of words spun into a kind of silver sugar cone inside my head, whirl away from me, phrases and snatches of words now seething all over my brainpan like a pit of snakes."

Hornbacher's disease was misdiagnosed until she was 23. Misdiagnoses, she says, occur in 70 to 75 percent of its sufferers. The shrinks and doctors she consults tell her she's depressed and give her Prozac, which exacerbates the mania they somehow overlook. A Freudian therapist tells her she must deal with her "issues." Marya is savagely funny and justifiably angry with the experts. When she tells them one moment she's flying and the next she's unable to move from the floor, they tell her she's making "progress." She's finally "feeling her feelings." They yammer on about "tools": "mindful eating," "being in your body," "self-soothing" (as in tea, lotions, bubble baths, scented candles). After one of these ludicrous sessions, the 20-year-old Marya goes home and slashes her left arm with a razor so deeply that she cuts through an artery and hits bone.

Most of the manic scenes -- at least those she recalls -- are rendered in a tone of surreal high hilarity, like a demented "Saturday Night Live" skit on steroids. Comedy was a wise choice; without it I couldn't have gotten through the book (and perhaps Hornbacher couldn't have gotten through the writing).

There is the time, when "in a very good mood," that she buys nine Coach purses, 12 Coach scarves and six Coach hats, items she needs right now. "Though of course one can overaccessorize, and in certain regrettable moments one has in fact vastly overaccessorized, wearing for example more than one hat, a winter scarf around the neck, a silk head scarf, Gibson Girl short pants, black, bug-eyed sunglasses," etc.

During one psychotic break, husband Jeff hauls her to the emergency room for the umpteenth time. While waiting for the doctor, Marya climbs on top of a cabinet, perching like a crow and babbling a mile a minute. When the doctor arrives, Jeff translates Marya's behavior in a deadpan, nothing-out-of-the-ordinary voice. Why is she on the cabinet? Well, because she's crazy, Jeff informs the doctor affably.

And yet, by age 33 or so, Hornbacher has gotten through college, taught creative writing, created an arts section for a Twin Cities magazine, written articles and reviews, published three books, gone on tour, lectured around the country, all while tending a house and a marriage.

Hornbacher poses a fundamental question about authenticity and identity.

Is there a core self? From early childhood, she asks herself if she will ever be "real."

Hornbacher will never have it all together; the psych ward drill will come again. For the rest of her life she will have to learn, and relearn, how to make her selves cohere. But the constant need for vigilance also turns every ordinary moment into a gift.

Brigitte Frase of Minneapolis also reviews books for the Los Angeles Times.