ZACH Theatre's Next to Normal is not an easy pill to swallow.

From the sudden jolt of the musical's opening number and on through the very raw second act, the play is a jagged spectacle full of highs and lows that mirrors the harsh reality of its bipolar protagonist. It takes some getting used to, and it won't appeal to everyone, but the story and ZACH's production of it ring true to the constant cacophony associated with the disorder.

I was ready for the subject matter, having been familiar with the show's pedigree and soundtrack of the Pulitzer Prize-winning musical. Hailed as the next revolutionary rock musical, Next to Normal is one of the first of its kind to honestly and successfully stage the violent ups and downs that mental illness can have on an individual and her family.

Cast in the center of the maelstrom is ZACH veteran Meredith McCall, charged with the unenviable task of "playing crazy" on stage. While she has a few opportunities to flex her well-honed comic chops, McCall spends most of Next to Normal furrowing her brow and pleading for salvation from the universe.

Her highs and lows are all true to character, if at times a bit big for the intimate space of the Kleberg stage. But I found myself rooting for Diana largely because the high-stakes tension just never stops piling upon this poor woman throughout the show.

McCall's voice is crystal clear throughout, even in the hardest emotional turns. When her heart breaks for her son, her daughter and herself, it resonates throughout the theater. There were more than a few people audibly and inconsolably weeping from the middle of the second act on. The show takes turns brutalizing each of its characters, but it is Diana who feels the inescapable guilt of bringing it upon the others.

Andrew Cannata occupies a tricky role as Diana's son Gabe, who coaxes her further down the rabbit hole of her illness. Clearly comfortable in the context of the rock musical genre, Cannata really lets loose with his powerful vocals and nonstop energy. Taxed with the responsibility of moving the show along, both in plot and literally on the stage, he's like a high-spirited imp that constantly seduces and taunts the other characters. The relationship between Diana and Gabe is uncomfortable and wrong, and the explanation of why is pretty satisfying.

My favorite performance of the show, however, came from relative ZACH newcomer Kelli Schultz, who plays Diana's daughter, Natalie. Schultz captures the pressure and insecurity and fear of a high school senior living in a house ruled by despair and disease, scared she might turn into her mother. Her song, "Superman and the Invisible Girl," is a masterpiece of adolescent angst, and her dealings with her mother crystalize the struggle of a teenager forced to grow up too soon.

Lending key support to the struggles of the women who take the spotlight in this show are Diana's husband, Dan, and Natalie's new boyfriend, Henry. ZACH vet Jamie Goodwin plays the ideal patient yet put-upon husband, and remains steady in his walking-on-eggshells devotion to his already cracked wife. The overly-gentle approach of Dan is smartly foiled by Natalie's new beau who addresses the challenges head-on. "Crazy and fucked-up is perfect," he tells Natalie to assure her he's not going anywhere.

The musical's handling of its subject matter is intense and unflinching. Anyone who has known a loved one who suffers from bipolar disorder — or any chronic illness really — will struggle with seeing it so blatantly expressed on stage.

Brian Yorkey's book and lyrics correctly stage all of the ugly extremes that can feel impossible to cope with: the medications, the doctor visits, the loss of control and autonomy. This show will open those vulnerable doors right up if you're not prepared; so I think it's okay to offer fair warning.

My only significant criticism of this production was the stark vocabulary of the set and light design. Both were undoubtedly created to infer the jarring nature of Diana's disorder and the efforts to conceal the ugliness of what lurks beneath the surface; the effect is to leave the audience feeling uneasy and discomfited. However, even with that understanding, the immensity of the set in the intimate Kleberg stage left me feeling overwhelmed and exposed.

Harsh fluorescent lights zig-zag across the rear of the stage wall, implying both harsh medical lights and electrical impulses. Cold blue lighting permeates the show, only offset by the occasional hopeful yellows. The extremes match Diana's moods, and again, leave the audience feeling uneasy and defeated. It felt as if the entire second act were performed only in half light, overemphasizing the all-encompassing sorrow of the piece. Even when the sun returns in the final song, "Light," I still felt the (ahem) blues.

My biggest struggle, however, was with the set. Four giant wheeled screens rolled right and left in new combinations that formed new scenes in the family house, the doctor's office or the school. However, the screens themselves were partially see-through, so you could make out the forms of the actors and the stagehands constantly buzzing around the set. The primary reason for the screens to be translucent was to project back-lit silhouettes, an effect that proved a bit overwrought.

Overall, Next to Normal is a very necessary musical that I would recommend to most musical theater lovers. (If you already don't like musicals, you'll most especially dislike one calling itself a rock musical, no matter how great it is.) I can also imagine a show so entirely relatable and amazingly frank in its discussion of a disquieting subject matter would push some polite audience members past their comfort levels.

But if you're looking for some serious drama that exposes the roller coaster of real life with some honest performances from people who can really sing, give Next to Normal a shot. Just steel yourself and bring some tissues.

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Next to Normal plays on ZACH's Kleberg Stage until March 4. Tickets available at ZACH website.