Psychotic Mother Belts It Out, Wins Tony. It's Next to Normal.

Next to Normal, is a Broadway pop musical about Electroconvulsive Therapy and suicidal ideation. And you may ask: how in the world does one sing about psychopharmacology and major depressive disorder? With lyrics like this: “Zoloft and Paxil and Buspar and Xanex…These are a few of my favorite pills.”

Which is to say, it’s not your daddy’s Rodgers and Hammerstein hoe-down. Next to Normal, which opened on Broadway in 2009 and just arrived in San Francisco last week, uses sardonic wit and dark humor to lighten this heartbreaking story of a family desolated by mental illness.

At the center of this Pulitzer-Prize winning musical is Alice Ripley, who won a Tony for her performance as a wife and mother suffering from bi-polar disorder and psychotic delusions. Fortunately, Ripley has joined the touring cast of the show, because it’s hard to imagine anyone else in the role. For one thing, Ripley has an incredibly unique singing voice — low and throaty, which perfectly communicates her character Diana’s pain. It can sound a little bit like Marianne Faithful — just a few nerves away from a breakdown.

The musical numbers (Brian Yorkeyto won a Tony for the book and lyrics and Tom Kitt wrote the score) have a profundity and resonance that are startling in their plain truth.

As the revelations of the depth of Diana’s illness unfold, each member of her family expresses loss and longing. Many of the most affecting songs speak to each family member’s wish to be seen and acknowledged in a climate where reality sometimes takes a back seat. Songs like “Wish I Were Here” “He’s Not Here,” “I’m Alive” and “Superboy and the Invisible Girl” all achingly reflect a mother, father, sister and brother hungry to be present and known. It’s quite a feat of depth for musical theater to communicate a real understanding of the reverberations of mental illness within a family.

Emma Hunton plays Natalie, a hurt and angry teenager who sees herself as the “invisible girl” to her brother Gabe’s “superboy.” And Gabe (Kurt Hansen) does hold a unique power to capture his mother’s attention. As Gabe, Hansen is menacingly electric. Hunton is powerful as the strong but mortally wounded teen. Asa Somers is the dutiful husband, whose patience is waning, even while his devotion is undying. Somer’s Dan is something of a generic nice guy and a bit less defined.

The drama cannily illustrates the mixed-bag that is psychiatric health care. Jeremy Kushnier plays Diana’s psychiatrist, Dr. Fine, a name that is something of a misnomer; though he’s a quick draw with the prescription pad, he’s no Dr. Feelgood. In one of Ripley’s most haunting ballads, she sings of the downside to “feel better” drugs. In “I Miss the Mountains,” a particularly aching ballad, Diana pines for the time before her emotions were flattened by meds.

While there is much specificity in the drama, the set design is standard rock musical scenery — industrial hip scaffolding, blinding club lighting. Mark Wendland’s sets and Kevin Adams’ lighting give a chilly, rock and roll vibe to an otherwise engaging production.

While rock musicals like American Idiot or Rent revel in their hip flair and downtown (East Village) milieu, Next to Normal is not anchored in its time period. Current rock musicals (Spring Awakening), as well as classics like Tommy and Hair, focus on youth culture and youth alienation. Next to Normal focuses on family suffering and brings into play a second generation of casualties, which ups the ante and makes it more maturel. The score — it’s more an Adult Contemporary genre — is well-matched to this grown-up drama.

Next to Normal runs through February 20, 2011 at The Curran Theater in San Francisco. For tickets and information visit shnsf.com or call 888-SHN-1799.