Madness has been a prominent theme in drama as far back as the Greek tragedies, but the theater has rarely been in step with accurate, scientific and humane understandings of mental illness. One sign that this might be changing is Next to Normal, writer Brian Yorkey’s and composer Tom Kitt’s rock musical about one woman’s struggle with bipolar disorder and the toll it takes on her family.

San Jose Rep’s production (done in collaboration with Arizona Theatre Company), directed by David Ira Goldstein, begins on a seemingly banal note, with the song “Just Another Day” introducing neurotic stay-at-home mom Diana (Kendra Kassebaum), hard-working father Dan (Joe Cassidy), overly studious daughter Natalie (Andrea Ross) and golden-boy son Gabe (Jonathan Shew). It seems that we are in for the petty tribulations of the average white, middle-class suburban family—“living on a latte and a prayer,” as an almost cringe-worthy line from the opening number puts it.

In fact, Next to Normal has other plans for us. Diana is having hallucinations. She makes sandwiches on the floor, bakes a birthday cake for a long deceased brother and sees her doctor (Mark Farrell) as a flamboyant rock star. Attempts to treat her condition, first with pills and then with electroshock therapy (the play was originally titled Feeling Electric), only make things worse for her and her family.

This exploration of the family’s breakdown is a heartfelt exercise in anguish. Natalie, starved for attention, copes by turning to drugs, while Dan wonders, “Who’s crazy, the one who’s half gone/or, maybe, the one who holds on?” The bleak mood is softened by some well-timed humor, mostly surrounding Natalie’s relationship with amiable stoner boyfriend Henry (A.J. Holmes), and the six-piece band at the back of the stage keeps the action flowing at a splendid pace. Musically, there are a number of standout moments, such as Kassebaum’s touching rendition of “I Miss the Mountains” and Shew’s energetic romp through “I’m Alive,” where the pleasantly familiar tinge of ‘90s alt-rock clashes eerily with the song’s dark content.

The musical has received praise for its sensitive and nuanced take on mental illness. This praise is well deserved. Diana is not a stigmatized monster, as with so many disburbed stage characters (Sweeney Todd, for instance), nor is she a romanticized outsider like Alan Strang in Equus. She is simply a “next to normal” person whose condition is the understandable result of life in a world that doles out lots of tragedy and fosters every neurosis.

Next to Normal
Runs through Feb. 3; $35Ð$79
San Jose Repertory Theater