Summary:
Hillbilly Gothic is a personal memoir that also tells the history of a family and of their roots in the Appalachian region. It's remarkable for the keen sense of emotional and geographic isolation it portrays. Adrienne Martini presents her own experiences with depression, postpartum syndrome, and institutionalization triggered by pregnancy and childbirth, and traces the multigenerational history of this devastating problem through the women in her family. Martini also weaves in the stories of other women, both contemporary and historic, who have dealt with postpartum depression, psychosis, and the "baby blues." Maintaining an indelible sense of humor throughout, Martini ultimately conveys a story of triumph, of escape from a difficult legacy, of hope for others, and of the courage to have another baby.

Questions for discussion:
1. Martini begins her book with two quotes:
"Left my home in the valley
put the mountains to my back
there's nothing wrong with where I come from
Sometimes it's meant to be just that."
-- Scott Miller, Cross the Line
"As for me, I've chosen to follow a simple course:
Come clean. And wherever possible, live your life
in a way that won't leave you tempted to lie. Failing
that, I'd rather be disliked for who I truly am than
loved for who I am not. So, I tell my story. I write
it down. I even publish it. Sometimes this is a
humbling experience. Sometimes it's embarrassing.
But I haul around no terrible secrets."
-- Joyce Maynard, "For Writers: Writing for Health"
What is the value of these to the text? Did you feel differently about them before reading the book as opposed to after? Why or why not? Did you find it helpful or interesting when a book begins with a quote or quotes like this? Why or why not?
2. Early in the book, Martini remarks that, "Once you stop wanting it to make sense, the way always becomes clear" (18). To what is she referring to specifically? In what way is this statement true? How do things become clear to her throughout the book?
3. Referring to her body, Martini wonders if, "everything will ever fall back into its previous location" (44). But what about her life? Does it ever "fall back into its previous location"? Can it? Should it? Is it depression that keeps her life from falling back into place, or is it simply the experience of having children?
4. What do you think Martini means, in both a literal and a figurative sense, when she says, "I will be doing this for the rest of my life, this pushing" (53)?
5. On page 61, Martini likens a thunderstorm to a car wash and says that, "Next would come the hot wax" (61). What is she foreshadowing with this comment? Does the metaphor seem apt? Why or why not? Does the text "make good" on the foreshadowing?
6. "I can navigate, sure, but I'm not linear enough to make my own charts" (83), Martini says. Before going back into the text to remind yourself, can you remember to what she is referring? Now look to the text and find the quote. Were you correct? If not, was your explanation just as appropriate? Why or why not? If you were correct, what was Martini saying through that particular metaphor and what made it stick with you? How does the quote "Once I'd been given a plan, I couldn't dream of deviating from it" (130) relate to the quote mentioned at the beginning of this question?
7. The idea of being outside of one's own body comes up numerous times throughout the novel both in reference to Martini herself and to others. "It's like she wasn't completely present, that some part of her was floating just above her head in a helium balloon" (173). What does this imply? Do you think everyone feels this way at some point?
8. Martini expresses a strong sense of needing to belong as evidenced by how often she attempts to "prove" that she does indeed belong, that people like her. "Even crazy, I still got it" (174). Why is that? What does that say about Martini and her personality? What does it mean both for the text and Martini's life? Is this too directly related to the postpartum, to having children, or simply to Martini's personality?
9. Martini feels there is a stigma around depression and the medications prescribed for treating it. Do you agree? Why do you think Martini feels so strongly that it exists? Does her feeling that way help her or hurt her in any way? What do her strong feelings say about her?
10. Martini battles with food and weight throughout the memoir. (See pages 22, 25, 26, 32, 33, 41, 47, 115, 156, and 202, for example.) By extension, she also deals with issues of appearance -- how she felt about herself as well as how others viewed her. In what ways do food, weight, and overall appearance play into Martini's experiences with postpartum depression?
11. When Martini says, "I love a plant that can thrive despite extreme neglect" (183), to what do you think she's referring? Herself? Family? Husband? Baby? Explain your response.
12. "I am always surprised by how kind people can be" (184). Throughout the book, Martini seems surprised by people's kindness -- bringing food, coming over to sit with her, watching Maddy. Why do you think that is? How does it make you feel about Martini and her self-image? What does it make you realize about postpartum depression? Point to other places in the text where Martini comments about being surprised by people's kindness.
13. Throughout the text, Martini talks about being a failure -- from breastfeeding to not loving Maddy enough to suffering from depression. (See pages 185, 188, and 190 for example.) What societal pressures contribute to such feelings of failure for many women?
14. Are you surprised at the end of the text to find out that Martini is again pregnant? What do you think of her decision?
15. Hillbilly Gothic is filled with fresh metaphors and analogies like, "Our lives now fit us like too-small pantyhose, uncomfortable and riding up in weird places" (205). What other examples of such language can you point to in the text? What purpose do such devices serve?
16. While reading Martini's story, did you see yourself or any of your family or friends? In what way(s)? Was this helpful to you? Painful? Neither?

Creative Tips:
Invite a therapist who specializes in postpartum depression to join your discussion.
Find an article or essay about postpartum depression either online or at the library. Compare and contrast the information and experiences you find in the article with the stories of the Martini family.
Check out Martini's website http://www.martinimade.com/ to learn more about her and her writing.