It is hard to think of a better-titled film than “I Smile Back.” Ostensibly about the nervous breakdown of well-off housewife Laney Brooks (Sarah Silverman), it is also about the price we pay when we suppress our real responses – when we laugh at an unfunny joke, feign fascination when we’re bored to tears, repress our anger around a phony or a bully. When we smile back when we feel like screaming or crying.
Silverman, as it happens, possesses a wide variety of smiles in her arsenal. We’re well acquainted with many of them through her Emmy Award-winning stand-up: the lopsided smirk that precedes her best punch lines, the goofy grin she wears at her most salacious, the simpering that accompanies her nasal singsong. She employs all these and many more – leers, cry-smiles, heart-breaking beams – as Laney, who already is in the throes of a downward spiral when we are first introduced to her.
The mother of adorable elementary school-aged children Eli (Skylar Gaertner) and Janey (Shayne Coleman) and wife of insurance guru Bruce (Josh Charles), Laney lives in a sprawling New Jersey house that is too tasteful to be an outright McMansion and too sterile to be truly warm. She occupies it as gingerly as she occupies her fortysomething body, which she regards with great disappointment in the bathroom mirror right before she hoovers a line of cocaine, drives her kids to school in a shiny black SUV, and then has hot hotel room sex with someone else’s husband.
Laney seems a prime candidate for at least three twelve-step programs. She drinks, pops pills, and snorts coke all day long; beds male strangers; masturbates on a teddy bear in the room in which her daughter is sleeping; and eats nothing but the occasional lollipop. 
But she seems able to maintain appearances – perhaps because everyone around her, including her Slick Rick husband, is on automatic pilot – until she literally ends up curled in a fetal ball, awash in her own bodily fluids. She enters rehab, where, in sessions with her counselor (Terry Kinney, a long way from his turn on “Thirtysomething”), we learn Laney’s core problem: She is bipolar and has gone off her meds.
“I Smile Back” is adapted from the eponymous 2008 novel by Amy Koppelman, who co-wrote this screenplay with Paige Dylan (Bob’s daughter-in-law), and it is admirably free of the Lifetime-TV-style clichés that can saddle drug and mental illness dramas. But this strength is also a weakness, as the film’s restraint – its unwillingness to beat metaphorical pillows and issue primal screams – echoes Laney’s alienation without imparting much insight.
The very nature of depression, of course, is alienation – from oneself as well as the world. But in Koppelman’s novel, we live squarely within Laney’s perspective, which at least grants us an understanding of what has triggered her devolution from suburban maven to saboteuse. This film lacks any such breadcrumbs. With an almost ascetic economy, there are no “Diary of a Mad Housewife” moments here: no breakthroughs in therapy, no chest-thumping avowals, no expositional sharing with girlfriends. In fact, this is markedly not a women’s liberation fable. Laney may not be able to stand anyone in her keeping-up-with-the-Joneses lifestyle but she interacts almost solely with men – her husband, her sexual conquests, the son whom she fears is manifesting symptoms of the family illness, and the shadow of an absentee father (Chris Sarandon) who makes a real-life appearance late in the film that does not, God forbid, offer any closure. At an uncomfortable dinner party, she goes so far as to call the young, pretty wife of an older man a prostitute.
That Laney is an unlikeable lone wolf is not necessarily a problem; depression tends to create Mary Quite Contrarians, and Hollywood places far too much emphasis on the need for likeable female characters, anyway. 
But her inability to connect becomes our problem, as the film itself lacks any connective tissue. Even Adam Salky’s direction feels dissociative. Interiors and exteriors are generic and bleak, and time, which elapses without markers, drags, perhaps because Laney is afflicted with a morbid sense of mortality. Silverman, who has been open about her real-life struggles with depression, does an impressive job of embodying Laney’s many recoveries and relapses. But by this film’s stark ending, we can’t feel any more than she can.
This was originally published in Word and Film.