Edinburgh Fringe comedy reviews: Josephine Lacey | Anna Akana | Sarah Roberts | Olivia Levine

Josephine Lacey: Autism Mama ★★★★

Pleasance Courtyard (Bunker Three) (Venue 33) until 25 August

Anna Akana: It Gets Darker ★★★★

Pleasance Courtyard (Upstairs) (Venue 33) until 24 August

Sarah Roberts: Silkworm ★★★

Assembly George Square (The Box) until 25 August

Olivia Levine: Unstuck ★★★

Just the Tonic at The Mash House (Just the Bottle Room) (Venue 288) until 25 August

If some of the more ardently personal stand-up at the Fringe can often feel like extended therapy sessions for all involved, there are also plenty of absorbing hours in which comics deliver uplifting accounts of coping with the most difficult, distressing and unusual circumstances that life can throw at them. And that's especially apparent when they're out to make an impact with their debut shows. One such excellent example is the singular festival bow of Josephine Lacey, a 56-year-old mother of three and new grandmother, mining considerable humour from the awkward topic of having to teach her autistic youngest son how to masturbate. Callum, 17, faces a number of challenges, including sensory processing disorder. And now, the ticking timebomb of his hormones have kicked in, giving him painful erections that he doesn't know how to expel. All the while, his desire to get naked and to tell women matter-of-factly that he likes their breasts has to be carefully regulated, with Lacey painstakingly outlining the patient processes that she's undertaken to help her son manage. The unending, sacrificial love of a mother for her child naturally underpins Autism Mama. But Lacey doesn't sugarcoat the often mortifying aspects of navigating Callum's nascent sexuality, appreciating that when pushing through the embarrassments and mental processes, there are still plenty of laughs to be found in the peculiarities of their tale. You'll come out of this wonderful hour with a better understanding of neurodiversity and a fond appreciation for Lacey's storytelling acumen.

Anna Akana both owes and lost her stand-up career to the tragedy in her life. And It Gets Darker is about the funniest show you can conceive about suicide and post-traumatic stress. In the wake of the Asian-American's sister taking her own life, it was the comedy of Margaret Cho that alleviated Akana's pain and inspired her to perform herself. Unfortunately, having built a career, she attracted her first (but not last) stalker, threatening to kill her and showing up at her home, prompting her to quit the business for a number of years. Although she capably conveys the impact of these traumas, and of writing your will at just 27, Akana has, perhaps understandably acquired an entertainingly ironic distance in her anecdotal style, frequently joking that even the bleakest aspects of her tale are “hot”. Indeed, after she comes out as bisexual and attracts her first female stalker, she weighs up the pros and cons of both sexes trying to hunt you down. Refraining from painting too full a picture of her late sister, Akana does gradually establish a profile of herself as a survivor. Yet also the ways in which the rest of her family have changed - most strikingly her ex-Marine father, whose shutting out of his loved ones and enlisting to fight for Ukraine against Russia the comic interprets as grief and guilt-induced suicide ideation. Despite the psychological suffering she conveys, the arch, sardonic Akana sustains a high gag rate and doesn't excessively seek for sympathy.

Similarly, Sarah Roberts has packaged up her insecurities about entering her thirties and disclosing the double jaw surgery she had for her big chin, into a jaunty, spirited and confident persona that trades in mild celebrity gossip and sexual assertiveness. Just about keeping the more troubling preoccupations of her mental health at bay, her addiction to the game Candy Crush notwithstanding, the London-based comic affects superiority and uniqueness as the “youngest, smallest, most normal” comedian. She accentuates her bravery in performing, for a show that's constantly sending up its own artistic merits and creator's egotistical, main character energy. The frivolous, superficial sheen does threaten to keep Silkworm stuck in a one-note anecdotal groove. But Roberts ultimately holds the most vulnerable aspects of herself up to scrutiny and still manages to eke out substantial laughs at her own expense.

Far more theatrical than Roberts' casual ease of delivery, US comic Olivia Levine shares the embarrassing disclosure that she used to masturbate in public, in a one-woman show-type production examining her Obsessive Compulsive Disorder. Sharing an on-off dialogue with a voiceover of her intrusive thoughts, the debilitating effects of her condition and the pressure it put upon her relationships and sexuality make her simply functioning as a person remarkable. So it's to her credit that she's crafted this arresting, if not always laughter-heavy, insight into the difficulties of her life. With the mitigation that she was subject to often inexplicable urges from her brain, Levine candidly shares countless examples of her extreme thoughts and behaviour, able to make amusing what were painful, destabilising episodes. Particularly hard-hitting is her admission that these instances are hardly in her distant past and continue today. The strictly chronological retelling works against Unstuck to an extent, as it reinforces an already pretty rigid mode of delivery that might benefit from greater variety and a few more temporal shifts. But it's an interesting delve into the workings of an atypical mind that's compelling if not bristling with jokes.