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Christina Patterson: Madness: a great metaphor, not such a great life

You can go bananas and be sidekick to one of the leaders of the Western world

It has, it's fair to say, been a bit of a mad week. By which I don't mean a bit hectic, a bit tiring, too many deadlines, too many late nights, too many stresses. By which I also don't mean too many headlines, or at least too many discombobulating headlines (black American president opens arms to Muslim world, UK economy in line for biggest collapse in developed world etc), too much evidence of a world turned upside down. What I mean is that it has been a week in which madness has featured prominently.

On Sunday night, women in white dresses swayed to ragtime, their faces obscured by a curtain of hair. They were, it soon became clear, semi-catatonic. They were, it soon became clear, in a loony bin. On Tuesday night, men in grey pyjamas swayed to the sounds of an orchestra. One of them played a triangle. They were, it soon became clear, in a loony bin. On Tuesday night, too, a packed hall in the city of London resonated with the voice of an old woman who had spent much of her life in silence, much of her life, it turned out, in a loony bin.

If you don't like the phrase "loony bin", perhaps you would prefer the one used on Sunday night. Idiot Colony. A place, it transpired, in which the women have spent pretty much their entire adult lives. At first, it's not clear, in this award-winning show by RedCape Theatre at the ICA – a show which relies entirely on the language of the body – what they're doing there. By the end, we know that these women gyrating to 1980s hits are there because, 40 years before, they had a baby out of wedlock, or made love to a woman, or a black man. They're there because they had, by the rules of their society, transgressed.

So, it turns out, has Roseanne McNulty, the 99-year-old co-narrator of Sebastian Barry's Costa Award-winning novel, The Secret Scripture, and so has Alexander Ivanov (or at least one of the two Alexander Ivanovs) in Stoppard's Every Good Boy Deserves Favour. Stoppard's play, written in 1977, focuses on the plight of two men with the same name, sharing a cell – or ward – in a mental hospital. One believes he is living in an orchestra. The other believes (in the time-honoured fashion of all political dissidents) that the symphonic structure of Soviet society is more discordant than any orchestra. You don't have to be mad here, etc.

In one sense, these three separate portrayals of transgression-as-madness (all culled, by the way, from real-life stories) seem a little anachronistic, a little R D Laing, a little yeah-but-who's-really-mad-here in a beardy, pot-smoking way. In another sense, they seem utterly, electrically alive. Certainly, a time when a former KGB officer can buy a bastion of the British media is a time when you might well wonder if the orchestra that haunts you is imaginary or (as on the stage of the National) real. (And a time when the judges of a literary prize acclaim an almost-masterwork with a major telling-off is a time when you can't help thinking there might, after all, be something to be said for incarceration.)

Madness, it's true, remains a potent metaphor for the ills of all societies, and the cray-zee shifts in ours, but madness is also madness. "Mental disease; insanity; mania," according to the dictionary, that thing that turns your brain, and psyche, and spirit, and life, and relationships, and work, upside down. "1 in 4 people, like me, have a mental health problem," says a poster of Stephen Fry on the Tube. "I said to Tony Blair," says another, of a scary-looking Alastair Campbell, "you do know about my breakdown, don't you?"

Fry and Campbell both loom out at commuters as part of Time to Change, a new campaign aiming to end discrimination faced by people with mental health problems. It's an extremely worthy aim, and an ambitious one. You too, it implies, can crack up and entertain a nation. You too can go bananas and be sidekick to one of the leaders of the Western world. And you can. You can, but you probably won't. And the reason you probably won't is not prejudice or persecution or because you've broken society's rules, but because the chemistry of the brain is a delicate thing and, once disrupted, extremely hard to fix. And the pills that fix it are not magic, but powerful drugs which affect the body's functioning, drugs which sometimes make you shake and swallow and sleep when you should be awake and awake when you should be asleep. And the doctors who give you the pills are often overworked, or not conversant with your case, or off with stress, or too keen on a certain drug, or not keen enough.

And the place to which you will be sent is not a big Victorian building, now probably loft apartments, but the psychiatric ward of your local hospital, a place, according to a leading NHS psychiatrist last year, which is quite likely to make you more ill.

You want transgression? Sure, it's terrible to be sane and locked away, but it's the way we treat our mad that bothers me.