Rachel Lindsay’s graphic memoir RX, published this month by Grand Central Publishing, is the story of an all-too-familiar struggle: Because she suffers from bipolar disorder, she’s had to set aside her creative ambitions and get a stable job with health insurance. The twist is that her new job was creating ads for antidepressants.

She understands that she is the target for these ads and a self-conscious victim of the revolving door of treatment and hospitalization that mental health patients endure. RX is her account of attempting to take control and live an independent life as an artist and of the consequences of that choice. For someone suffering from mood disorders, is quitting your job an act of courage or a symptom of the illness?

Lindsay uses a light, cartoony style and isn’t afraid to laugh at her situation, even when she is making a serious point. PW asked her to talk about how she transformed those emotional experiences into her first graphic memoir—and what her life has been like since the book was finished.

On the last page, you show the cover of the first incarnation of this book. How did you develop the story from there?

The version of the book you mention was written in the hospital. It’s very much a journal. There are some comics, but it was mostly writing, and there were also ads torn out of magazines and different papers the hospital gave me taped into it. It’s more of an art object than a narrative. I initially thought it would be interesting to include some of the original journal in the final book, but I ultimately decided I wanted the reader to know me as I am rendered on the page, and including portions of the journal would jolt them into some other dimension of my reality. But still, that journal remains the most important energetic tool for the creation of this book.

Why did you choose such a cartoony style for such a serious story?

The style of the drawings is just the way I draw, so there wasn’t much of a choice there, but I think it does serve the story really well in the end. The old-school, cartoony look of my work is something that people associate with humor and lighthearted subject matter, and the break of that expectation is pretty jarring and uncomfortable. It kind of sneaks up on you in the same way that mania does.

The first scene shows your intake interview in a mental hospital. This shows you as an unreliable narrator, since what we see in the panels is very different from what you are telling the medical staff. Why did you choose this as your opening sequence?

I’ve been living life as an unreliable narrator ever since my diagnosis! I opened the book with this scene because I wanted to share the way in which my hospitalization was determined, the swiftness and emotional tenor, and be upfront with the fact that there was a disconnect between my understanding of the appropriateness of my behavior and how it appeared at face value. It’s the most slapstick scene in the book, I think because this was the most unbelievable moment of my life and I can’t recount it with complete sobriety. This was a breakthrough scene for me and I am really happy with how it functions.

Why did you draw yourself as a wolf during the sequences at the ad agency?

The wolf character is based on the wolf-in-sheep’s-clothing metaphor—hence the cover of the chapter “Passing.” It’s more about being an imposter than an animal, though a more instinctual attitude is part of my manic behavior. I felt a very strong otherness in my role, holding this knowledge that I had a mental illness and was part of the machine that essentially controlled my life. It came from within myself and really weighed on me. It only intensified the shame and confusion I felt about my identity in relation to my diagnosis and I knew that I had to have a really distinct visual for that secret self.

How did you develop the visual vocabulary to show your changing condition?

I’ve always put a lot of energy into drawing facial expressions; they are essential to the way I draw emotion. One deliberate decision I made was with regards to how the eyes are drawn. Eyes are an indication of perception, and perception is a central variable for people who are experiencing mental illness. My stable self—and all the other characters that represent stable people—has simple dots for eyes. Then, when I become manic, my eyes turn into big googly eyes, which have a history of use for adding larger-than-life emotions in comics. Beyond that, when you do simple linework for long enough, you pick up on how subtle adjustments do a lot. I love to play with the shape and movement of my lines. Line is king.

You kept your bipolar disorder a secret for years. Now you are publishing a book about it. What changed your mind?

It’s funny because I still feel uncomfortable telling people about my illness – I can’t even look people in the eye when I do, usually. But I could never shake the instinct that I needed to tell this story, that it was bigger than me and that it could help other people who have felt what I’ve felt. That has overridden my previous desire for secrecy.

Now that RX is finished, what do you plan to do next?

I never imagined myself creating an auto-bio piece on this scale or with this level of honesty, and I don’t know that any other part of my life will strike me in this way, but who knows. I have several fiction projects that I’ve tabled during the writing of the book that I’d like to return to. Those are much more light-hearted!