In a scene toward the end of the first season of Lady Dynamite, the Netflix comedy starring Maria Bamford, Maria shares her concern about her lack of friends with her life coach, Karen (played with perfectly vapid sincerity by Jenny Slate).  At first, Karen answers with well-worn therapy jargon, telling Maria, “The only friendship you need to be concerned with is the one with the gal in the mirror.” Maria presses her, saying, “I’m just worried, because the only two friends I have left who will still be friends with me are Dagmar and Larissa”—to which Karen cheerfully responds, “Yeah, because you’re bipolar and you’re incredibly hard to stay friends with. I mean, people are really just going to fall by the wayside. And that’s life … for you.”

What’s remarkable about this exchange is not Karen’s apparent callousness in the face of her client’s troubles. In fact, by the episode’s end, Maria abandons her goal of “no friend left behind,” realizing that not all friendships are worth the sacrifices required to keep them. What makes this scene, and Lady Dynamite as a whole, so refreshing, is that Karen is exactly right. Maria isn’t an easy person to be friends with. She is thoughtful and eager to please, but her good intentions don’t always make up for her bad decisions.  And her desire to help those around her can’t prevent her brain from turning stress into mania, or stop the destructive behavior mania incites.

Maria’s life coach is just one of the many voices of harsh truth throughout the show’s 12-episode season. Some of these truth-tellers are more tactful than others. In the blue-tinted scenes representing Maria’s time in Duluth, MN, taking part in psychiatric outpatient therapy after a severe manic episode, her parents are shown to be kind and patient, but also matter-of-fact about her illness. When her mom scolds her dad for going out just as Maria arrives home, he replies to them both, “I thought we weren’t going to treat her differently just because her frontal lobe went on the fritz.” Her obnoxious best friend from childhood adds her own insight, musing: “Isn’t that funny, all the fame and fortune of Hollywood can’t save ya, if your brain done broke.”

Many of the tone-deaf comments Maria hears regarding her life with Bipolar Disorder (“Actually, I’m Bipolar II,” she tells her life coach, to which her life coach replies, “Right, which means you’re twice as hard to stay friends with.”) are played for laughs. But the humor is that much sharper for its proximity to truth. One of the major themes of the season, and one of the most sincere and affecting elements of Maria’s character, is her struggle to honestly state her own feelings, especially when they are unpleasant or scary. Whether she’s agreeing to act in ad campaigns of increasing absurdity (the most memorable of the bunch being the Bamford Pepper Stepper Pepper-Bot, a backpack-sized robot that feeds whole bell peppers to the jogger wearing it) or buying a nicer house than she needs to please her childhood friend’s aggressive real estate agent (a convincingly intimidating June Diane Raphael), Maria’s inability to say what she really thinks threatens to destroy not only her career, but also her closest friendships and romantic relationships.

While the desire to avoid conflict clearly isn’t new for a TV character (pick almost any sitcom of the last several decades and you’ll clearly find plenty of storylines set into motion by one character withholding information from another), Maria’s fear of sharing her thoughts is based on more than a simple desire to be liked. The character of Maria, like the real Maria Bamford, has good reason to fear how other people might react to her true thoughts., She perceives the world through a lens that is hers alone. This unique view is what makes her such a great comic, and what has earned her such a respected perch within L.A.’s alternative comedy scene. Her albums and specials are full of jokes that range from absurdly hilarious to disturbingly dark, often told in a number of different voices (outside of stand-up, Bamford’s greatest success has been in doing voice work for commercials and animated programs). She is physically small and outwardly cheerful, which highlights by contrast her frequently grim comedic observations. This apparent contradiction is what makes Maria the character, and Lady Dynamite the series, feel so refreshing amid a wide range of half-hour shows featuring stand-up comedians. And it is also what singles out Lady Dynamite’s depiction of mental illness from every other show on television.

Depictions of mental illness on TV have generally grown increasingly nuanced and considered in recent decades, with prestige dramas from The Sopranos to Homeland, treating mentally ill protagonists with seriousness and respect. In the past year, comedies like You’re the Worst, and Crazy Ex Girlfriend have presented characters who are highly functional, frequently charming, and relatively successful, despite living with ongoing symptoms. But Lady Dynamite goes even further. Instead of treating mental illness as an obstacle for a character to overcome, or a device to explain otherwise nonsensical actions, Lady Dynamite builds it into the very fabric of its world. It mines tragedy for comedy, showing us a character who is herself struggling to find the humor within her own terrible pain. It’s the rare comedy that shows us that the reality of mental illness is that darkness can coexist with creativity and fun and hope.

Like Type 1 Diabetes, Crohn’s Disease, or fibromyalgia, Maria’s mental illness will never go away completely. Even after months of psychiatric care, Maria returns to Los Angeles knowing the risk of a manic episode or a suicidal depression isn’t entirely behind her. She actively tries to do the things she knows will help her stay healthy, but the dark realities have not changed, and neither has her desire to make people like her. (When her mother tells her not to look to others for approval, Maria replies, “But that’s literally what standup is, looking for approval from strangers.”).

The wisest advice Maria receives over the course of the first season comes from another comically blunt therapist. While taking part in an art-therapy group at the Duluth psych ward, Maria tries to stop two other patients who are arguing over the magazine cut-outs for their vision boards. Maria says, “Hey, we’re all here to get along.” Without missing a beat, the group therapist corrects her, saying, “No, Maria, we are not. We are all here to better ourselves and sometimes that means expressing your negative emotions in a constructive way.” Trying to set an example, the therapist goes on to tell her patients that they stress her out so much that she sometimes contemplates taking “all the pills” in her desk. She laughs as she says this, patting another patient on the shoulder.

Maria is generally realistic, but she is also an optimist. She believes that happiness, healthy relationships and basic human kindness are not only worth striving for, but are achievable. Her challenge, and the challenge of Lady Dynamite, is balancing that hope and desire for good with the realities of her suffering. The entire show is an exercise in following the art-therapy teacher’s advice: finding a way to use the fear and pain of mental illness to construct something that ultimately brings joy. Just as in life, the truth can be painful, but it can also be incredibly funny.