Ballad of the black and blue mind

"Estelle Berman is a distinguished psychiatrist who lives and practices on the Upper West Side. She observes her own decline with much the same acceptance with which she observes the idiosyncrasies of her patients, some of whom she likes more than others. Her patients are Justine, the movie star, and the daughter of a colleague; Edith Forman, who is very large and writes poems; and Anna, a college student whose parents are both well-published academics, who cuts herself ... And there is her own son Gerald, who has never been close to Estelle as he was to her late husband. And now there is his son Ryan, who is the first to understand that there is something wrong with the doctor herself--