Sorrow and Bliss centers on Martha’s mental health and experiences with mental illness. The author’s note at the end of the book clarifies that the portrayal of Martha’s illness is not consistent with any genuine mental illness; the treatment protocols and doctors’ advice featured in the story are fictionalized. Nevertheless, Mason draws on reality to flesh out these aspects of the story.
Martha begins experiencing symptoms of a mental health condition when she is 17, having her first episode the day before her French A Levels. While this is consistent with the age of onset of a majority of psychiatric illnesses, the onset is usually slower and more gradual than happens with Martha, who experiences a sudden break out of the blue. Martha receives multiple misdiagnoses throughout her life, until she finally receives a seemingly accurate, unnamed diagnosis when she is almost 40. This is a common occurrence for many people with mental illnesses due to a number of factors: an inability to secure a doctor’s appointment in time; an inaccurate medical history; multiple disorders having overlapping symptoms; and so on. In Martha’s case, her multiple misdiagnoses appear to be tied to overlapping symptoms. She, and multiple doctors over the course of her treatment, believe she has depression, and so she is often prescribed antidepressants.