78 pages • 2 hours read
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Content Warning: This section of the guide includes discussion of bullying, sexual violence, rape, mental illness, child abuse, child sexual abuse, child death, self-harm, sexual content, and death.
Lizzie is a protagonist and point-of-view character whom the novel follows from 3 until 16 years old. Lizzie is diagnosed with early-onset bipolar disorder at a young age; she has selective mutism, lashes out at her peers, and reacts violently toward her father and her older sister, Caoimhe. When Lizzie is five years old, Caoimhe’s boyfriend Mark begins sexually abusing her, leading Lizzie to experience severe mania and depression. Throughout her childhood, abuse or bipolar disorder become mutually reinforcing, heightening Lizzie’s episodes of mood instability. Lizzie keeps Mark’s abuse a secret, because of a childlike inability to understand what Mark is doing, and because her parents and her doctors repeatedly insist that her assaults are imagined due to her diagnosis.
Lizzie’s character is defined by her need for autonomy. After Mark takes away her autonomy at a young age, she fights to gain control back despite the damage that it does to her. She feels trapped when speaking to therapists, whose interventions seem futile. When she stops taking her medication as a way of breaking free, she has rapid cycling episodes of mania and depression, causing her to feel euphoric and hypersexual, and to experience memory lapses.