How two Stanford students turned mental health struggles into art

A psychotic break inspired Stanford students Zack Burton and Elisa Hofmeister to create a stage play in an effort to destigmatize mental illness.

One night in the spring of 2017, geology PhD student Zack Burton’s graduate career was derailed after a series of delusions led him to the top of a campus parking garage, where he seriously considered hurting himself.

PhD student Zack Burton and Elisa Hofmeister, ’18, are the creators of The Manic Monologues. (Image credit: Dr. Matthew Malkowski)

The crisis, which sent him to the emergency department and into therapy, forced him to delay his academic and professional pursuits. It also tested his personal relationships, most notably with his girlfriend, Elisa Hofmeister, ’18. Perhaps the greatest challenge for Burton was his eventual diagnosis of bipolar disorder and having to come to terms with the shame and stigma associated with mental illness.

But on his road to recovery and acceptance, Burton would find an unlikely outlet to address his mental health struggles. With Hofmeister, he would produce The Manic Monologues, a stage play featuring a series of true stories about mental illness that, since its debut last year, has been making its way to audiences across the country, including an upcoming show in Los Angeles.

Although a dramatic departure from his day-to-day life as a Stanford doctoral student, Burton’s new role as a theater producer has helped him cope with his mental illness, combat stigma and encourage discussion about an aspect of many peoples’ lives that remains painfully taboo.

A psychotic break

On Monday, May 8, 2017, at 3 a.m., Burton was alone in his office in the Geology Corner on the Main Quad, where he was preparing for his PhD qualifying exams later that day. For weeks, he’d been operating on little sleep as he threw himself into his studies. But with a pivotal moment in his life and career just hours away, the mounting pressure began to implode inside him.

“I was in my office and was literally yelling out loud trying to motivate myself,” Burton said. “Then I began to have these paranoid and scattered thoughts that the world was out to get me and that I wasn’t intended to pass the qualifying exams.”

Around 3:30 a.m., Burton left the building and ran across campus to a parking garage near the Cantor Arts Center. He ran to the top floor, where he said he considered jumping. But in a moment of clarity, he thought about his mother.

“I remembered something my mom had told me many years before, which was that if I ever thought of hurting myself, I should pick up the phone and call her,” Burton said. He did. He also called his roommate, who drove to the garage and picked him up. Burton’s paranoid delusions continued for the next few hours as the two drove around the Bay Area, including to San Francisco.

They returned to campus to meet Hofmeister, then a Stanford junior. When they arrived, Burton was so deep in psychosis that he wouldn’t make eye contact with her and was fidgeting.

“I thought it was some sort of joke,” Hofmeister said. “It then became clear that something was deeply wrong, but I didn’t have the language to know what was happening.”

That’s when they took Burton to the emergency department.

Accepting the diagnosis

In the weeks following his manic episode, Burton stepped away from his schoolwork, postponed his qualifying exams and entered group therapy. An eventual diagnosis of Bipolar Type 1 was enormously challenging for Burton, who grappled with his own stigma about mental illness. But he said the hardest part of the experience was dealing with what he called a crisis of confidence.

“I started to question all of my apparent successes up to that point in my life,” he said. “For example, I became convinced that I was in this PhD program only because I was manic before and because my mania and creativity allowed me to be a high achiever.”

Burton and Hofmeister, center, debuted The Manic Monologues at Pigott Theater at Stanford. (Image credit: Frank Chen)

His relationship with Hofmeister also suffered.

“It was a terrible time,” she said. “It was such a crisis that the whole relationship and dating thing was a moot point.”

The two put their romantic relationship on hold for a few months as Burton managed his illness and Hofmeister juggled supporting him while pursuing her own career. By the fall, they resumed their relationship and Burton successfully passed his qualifying exams.

But during those incredibly difficult first few months, Burton and Hofmeister had a realization: As they struggled to find hope for their own situation, they were desperately unable to find relatable and uplifting stories of mental illness. Instead, everywhere they looked, they found horror stories and worst-case scenarios. And so, the two became captivated by a mission to help others through their own privileged and positive experience with mental illness.

About a year after Burton’s diagnosis, the couple landed on the idea of adapting stories of mental illness for a stage play called The Manic Monologues, which they hoped would do for mental illness what The Vagina Monologues did for female sexuality. It was an ambitious project for the couple, neither of whom had experience in theater production.

“We couldn’t sing, couldn’t dance, couldn’t act,” Burton said. “But we think theater is a unique and powerful means to force an audience to confront these stories.”

The Manic Monologues

Burton and Hofmeister spent the next several months writing a script, seeking out advisors in the theater and medical worlds, soliciting true stories about mental illness from the Stanford community and the general public and producing the play. On May 2, 2019, The Manic Monologues premiered at Pigott Theater at Stanford. Burton was one of 15 performers to share stories of mental illness before a sold-out crowd, which included his colleagues, professors and his PhD advisor. The experience, he said, was terrifying.

“Aside from facing strangers, the most terrifying part was having a room full of people I actually knew and was quite close to, but who didn’t really know what was going on and maybe would make a judgment or would stigmatize me moving forward,” he said. “Luckily that hasn’t been the experience or the reception at all.”

Hofmeister, who directed the play, said that seeing Burton perform was an emotional experience, especially given the sheer amount of “blood, sweat and tears” they had both put into the production. “I was very proud and I got a little teary-eyed,” she said.

The Manic Monologues played three nights at Stanford and received an overwhelmingly positive reception. The play has since been performed by a theater company in Des Moines, Iowa, and performances are planned at other college campuses, including the University of California, Los Angeles, on Feb. 9.

Burton has come a long way since his manic episode and diagnosis almost three years ago. He credits medication, plenty of sleep and a strong support network for helping him cope with his illness. Now a fifth-year doctoral student set to graduate in June, he is considering pursuing postdoctoral research or consulting work. Although Burton and Hofmeister are dedicated to their professions, they hope that their work on The Manic Monologues will continue to resonate with audiences for years to come.

“This will probably be one of the most important things we’ve ever done,” Burton said. “If not the most important.”