Next to Normal Music by Tom Kitt; Book and Lyrics by Brian Yorkey; Directed by Michael Greif At Arena Stage to Jan. 18 At Arena, a stunning musical about depression—and pills. Lots of pills.

World’s Sedatest Mom: Dr. Madden keeps Diana dosed.

I’m trying to think of the last time I was actually surprised by something in a musical not written by Stephen Sondheim. That echo song in Floyd Collins, maybe, where an electronic delay allowed a spelunker to sing a duet with himself in a cave, the echoes stretching and stretching in duration until they turned the melodic line into a round—him accompanied by a whole chorus of…him. That was startling.

But that was almost a decade ago. Musicals aren’t generally in the surprise business these days. Even the most anarchic of them seem determined to dispense comfort of one sort or another, perhaps because music soothes savage breasts even when what’s doing the soothing are crashing rock chords. Comfort, of course, is not unwelcome, especially at today’s ticket prices. Still, a decade is a long time to wait for something more bracing.

So it’s with no little joy that I am now resetting my own personal clock. I was surprised—jaw-droppingly so—by Next to Normal, a musical about the effects of manic depression that is, appropriately enough, leaving audiences both teary-eyed and elated at Arena Stage’s Crystal City theater. I’m going to have to tap-dance around the show’s more startling moments so that you can experience them too, but let me just say that if my description makes the vibrant work of composer Tom Kitt and writer Brian Yorkey sound either bipolar itself, or like some disease-of-the-week exercise, I’m doing them and it a disservice. Next to Normal is about smart people who deal with tricky issues of love and loss and who do so in soaring, searing melodies. And at Arena, it’s being sung to the rafters (and at several points, from the rafters) in ways that prove exhilarating and roundly affecting.

All of which counts as a surprise in itself, considering the show’s history. Directed by Michael (Rent) Greif, and featuring much of the original New York cast, Arena’s production qualifies as a sort of post-off-Broadway tryout. Earlier this year, the show got next-to-favorable reviews at Manhattan’s Second Stage—the New York Times opined that “one minute you’re rolling your eyes; the next, you’re wiping them”—and its creators decided not to settle for next-to-favorable but to send a reworked, sharpened version on the road. Crystal City is that new version’s first stop, and not having seen the original, I can’t vouch for the specifics of what’s different; I can only report that I wiped my eyes plenty, and I don’t recall rolling them.

Well, maybe once, but at an Act Two moment that quickly turned on itself in ways I shouldn’t really describe. Suffice it to say that the show does a lot of twisting, starting right at the top as it introduces a suburban nuclear family that seems no more radioactive than most. Dan (J. Robert Spencer) appears the dutiful provider, heading out to work with a puzzled smile after his wife Diana (Alice Ripley) surprises him by initiating a bit of unexpected pre-dawn sex. Their kids—18-year-old heartbreaker Gabe (Aaron Tveit), and overachieving 16-year-old Natalie (Jennifer Damiano)—seem pleasant teenagers. All, in fact, seems altogether conventional as they gather in the kitchen before heading out to school and work. Then they notice that Diana, in laying out slices of bread and cheese for lunches as if dealing out poker hands, has covered not just the table but also a chair and a big part of the floor. The kids stare. “This is just a blip, nothing to worry about,” Dan tells her. And the world shifts slightly.

In songs with titles like “My Psycho-Pharmacologist and I,” what soon becomes clear is that Diana has a few medication issues, and that fact alters—we’re perhaps 15 minutes in at this point—almost everything you think you know about these people. Dan now seems far more than the plodding dutiful hubby as he sings of marriage (“Who’s crazy?/The one who’s half gone/Or the one who hangs on”) and his off-kilter life with this unpredictable woman he loves. The kids’ behavior, too—that rebellious James Dean slouch of Gabe’s, those books Natalie clutches shieldlike to her chest—now glimmer with hints of the self-images they’ll later describe in the song “Superboy and the Invisible Girl.” And trust me, the re-evaluating you’ll be doing is just starting.

Greif’s sensitively supercharged staging sends the performers ricocheting around Mark Wendland’s three-story, metal-framed setting as panels slide this way and that, revealing musicians scattered around upper levels. The set, which initially seems more stage-filling than practical, proves startlingly flexible as Kevin Adams’ assertive, in-your-face lighting helps to transport the performers from suburban home, to raucous nightclub, to electro-shock ward, to deep inside Diana’s mind. Jeff Mahshie’s natural but intriguingly color-coded street clothes are also helpful, especially when the director wants to give visual weight to parallels in Yorkey’s script, letting us see, for instance, how a promise between young lovers plays out in present tense, and in retrospect.

The performers are as emotionally expressive and persuasive as they are full-voiced, including Adam Chandler-Berat as Natalie’s stoner boyfriend, who proves a Rock of Gibraltar when she starts popping her mom’s pills. Louis Hobson makes two of Diana’s many doctors into intriguingly faceted foils for her illness. Spencer and Damiano have a father/daughter dynamic that’s believable and ever more haunting as the evening progresses, and Tveit’s blistering vocals make Gabe a presence to reckon with, virtually every second he’s on stage.

But Next to Normal is, at its heart, Diana’s story, and Ripley claims the evening for the character, whether she’s in hilarious, hallucinating overdrive, or in an anguish that springs from the knowledge of what her illness is doing to her family. You ache for this woman when she’s down, soar with her when she’s savoring the highs, and understand when the doctors say she’s stable but she sings that she “misses the mountains, misses the highs and lows.”

It’s a harrowing ride, and she would be hell to live with, but damn, she’s amazing company onstage.

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