My family has a grand tradition. After a woman gives birth, she goes mad. I thought that I would be the one to escape.

So begins Adrienne Martini's candid, compelling, and darkly humorous history of her family's and her own experiences with depression and postpartum syndrome.

Illuminating depression from the inside, Martini delves unflinchingly into her own breakdown and institutionalization and traces the multigenerational course of this devastating problem. Moving back and forth between characters and situations, she vividly portrays the isolation -- geographical and metaphorical -- of the Appalachia of her forebears and the Western Pennsylvania region where she grew up. She also weaves in the stories of other women, both contemporary and historic, who have dealt with postpartum depression in all its guises, from fleeting baby blues to full-blown psychosis.

Serious as her subject is, Martini's narrative is unfailingly engaging and filled with witty, wry observations on the complications of new motherhood: It's like getting the best Christmas gift ever, but Santa decided to kick the crap out of you before you unwrapped it. New mothers and those who have struggled with parenthood -- whether or not they dealt with depression -- will find affirmation in this story of triumph, of escape from a difficult legacy, of hope for others, and of the courage to have another baby.