Next to Normal (stylized as next to normal) is a rock musical with book and lyrics by Brian Yorkey and music by Tom Kitt. Its story concerns a mother who struggles with worsening bipolar disorder and the effect that her illness has on her family. The musical also addresses such issues as grieving a loss, suicide, drug abuse, ethics in modern psychiatry, and suburban life. The musical won 2009 Tony Awards for Best Original Score for Tom Kitt (music) and Brian Yorkey (lyrics), Best Orchestration for Michael Starobin and Tom Kitt, and Best Performance by a Leading Actress in a Musical for Alice Ripley. The show was nominated for a total of 11 Tony Awards, including Best Musical. Next to Normal received several workshop performances before it debuted off-Broadway in 2008, winning the Outer Critics' Circle Award for Outstanding Score and receiving nominations for Drama Desk Awards for Outstanding Actress (Alice Ripley) and Outstanding Score. Next to Normal won the 2010 Pulitzer Prize for Drama, becoming just the eighth musical in history to receive the honor. The previous musical to win the Pulitzer was for Jonathan Larson's Rent in 1996, which was also directed by Michael Greif. In awarding the prize to Kitt and Yorkey, the Pulitzer Board called the show "a powerful rock musical that grapples with mental illness in a suburban family and expands the scope of subject matter for musicals." After an Off-Broadway run, the show then played at the Arena Stage in Crystal City, VA from November 2008 to January 2009 and opened on Broadway in April 2009.