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I believe that curiosity, wonder and passion are defining qualities of imaginative minds and great teachers; that restlessness and discontent are vital things; and that intense experience and suffering instruct us in ways that less intense emotions can never do.
Every seventeen minutes in America, someone commits suicide. Mostly, I have been impressed by how little value our society puts on saving the lives of those who are in such despair as to want to end them. It is a societal illusion that suicide is rare. It is not.
Everything previously moving with the grain is now against - you are irritable, angry, frightened, uncontrollable, and enmeshed totally in the blackest caves of the mind. You never knew those caves were there. It will never end, for madness carves its own reality.
I think one thing is that anybody who's had to contend with mental illness - whether it's depression, bipolar illness or severe anxiety, whatever - actually has a fair amount of resilience in the sense that they've had to deal with suffering already, personal suffering.
Each way to suicide is its own: intensely private, unknowable, and terrible. Suicide will have seemed to its perpetrator the last and best of bad possibilities, and any attempt by the living to chart this final terrain of life can be only a sketch, maddeningly incomplete
An intense temperament has convinced me to teach not only from books but from what I have learned from experience. So I try to impress upon young doctors and graduate students that tumultuousness, if coupled to discipline and a cool mind, is not such a bad sort of thing.
When I am high I couldn't worry about money of I tried. So I don't. The money will come from from somewhere; I am entitled; God will provide. Credit cards are disastrous, personal checks worse. Unfortunately, for manics anyway, mania is a natural extension of the economy.
Lithium remains the gold standard, but many drugs now treat bipolar disorder. Medication is critical and should be combined with psychotherapy. Compliance is a major problem. Patients believe that once they're better, they no longer need the medication. It doesn't work that way.
When I'm talking about depression, I'm talking about the more severe forms of depression, and I think that conceptualising as a form of grief is probably not the most effective way of looking at it. I mean, at the end of the day, people suffer enormously, and you want to treat it.
Who would not want an illness that has among its symptoms elevated and expansive mood, inflated self-esteem, abundance of energy, less need for sleep, intensified sexuality, and- most germane to our argument here-"sharpened and unusually creative thinking" and "increased productivity"?
We all build internal sea walls to keep at bay the sadnesses of life and the often overwhelming forces within our minds. In whatever way we do this--through love, work, family, faith, friends, denial, alcohol, drugs, or medication, we build these walls, stone by stone, over a lifetime.
Lithium prevents my seductive but disastrous highs, diminishes my depressions, clears out the wool and webbing from my disordered thinking, slows me down, gentles me out, keeps me from ruining my career and relationships, keeps me out of a hospital, alive, and makes psychotherapy possible.
I don't think grief of grief in a medical way at all. I think that I and many of my colleagues, are very concerned when grief becomes pathological, that there is no question that grief can trigger depression in vulnerable people and there is no question that depression can make grief worse.
When public figures remain silent about depression, there is a cost to the rest of society. Silence contributes to the misperception that successful people do not get depressed, and it keeps the public from seeing that treatment allows many individuals to return to competitive professional lives.
There is no common standard for education about diagnosis. Distinguishing between bipolar depression and major depressive disorder, for example, can be difficult, and mistakes are common. Misdiagnosis can be lethal. Medications that work well for some forms of depression induce agitation in others.
I, quite literally, woke up from a coma, from having tried to kill myself and it was very clear to me what my psychiatrist had been saying for years. The choice is not between a drug that has side effects or not, life is not ideal. Yes, your drug has side effects and yes if you don't take it you're going to die.
Looking at suicide—the sheer numbers, the pain leading up to it, and the suffering left behind—is harrowing. For every moment of exuberance in the science, or in the success of governments, there is a matching and terrible reality of the deaths themselves: the young deaths, the violent deaths, the unnecessary deaths
No pill can help me deal with the problem of not wanting to take pills; likewise, no amount of psychotherapy alone can prevent my manias and depressions. I need both. It is an odd thing, owing life to pills, one's own quirks and tenacities, and this unique, strange, and ultimately profound relationship called psychotherapy
I decided early in graduate school that I needed to do something about my moods. It quickly came down to a choice between seeing a psychiatrist or buying a horse. Since almost everyone I knew was seeing a psychiatrist, and since I had an absolute belief that I should be able to handle my own problems, I naturally bought a horse.
Others would say to me, 'It is only temporary, it will pass, you will get over it,' but of course they had no idea how I felt, although they were certain that they did. Over and over and over I would say to myself, If I can't feel, if I can't move, if I can't think, and I can't care, then what conceivable point is there in living?
People talk about grief as if it's kind of an unremittingly awful thing, and it is. It is painful, but it's a very, very interesting sort of thing to go through, and it really helps you out. At the end of the day, it gets you through because you have to reform your relationship, and you have to figure out a way of getting to the future.
I think that when you're depressed, you can't concentrate long enough and well enough to read for the most part; some people can, but by and large people - that's one of the first things that goes, is the capacity to read meaningful literature. With grief, that's not true. For a while you can't read, but then you really are amenable to solace.
I wish I could explain it so someone could understand it. I'm afraid it's something I can't put into words. There's just this heavy, overwhelming despair - dreading everything. Dreading life. Empty inside, to the point of numbness. It's like there's something already dead inside. My whole being has been pulling back into that void for months. (81)
I was late to understand that chaos and intensity are no subsitute for lasting love, nor are they necessarily an improvement on real life. Normal people are not always boring. On the contrary. Volatility and passion, although often more romantic and enticing, are not intrinsically preferable to a steadiness of experience and feeling about another person.
The Chinese believe that before you can conquer a beast you first must make it beautiful. In some strange way, I have tried to do that with manic-depressive illness. It has been a fascinating, albeit deadly, enemy and companion; I have found it to be seductively complicated, a distillation both of what is finest in our natures, and of what is most dangerous.
I compare myself with my former self, not with others. Not only that, I tend to compare my current self with the best I have been, which is when I have been midly manic. When I am my present "normal" self, I am far removed from when I have been my liveliest, most productive, most intense, most outgoing and effervescent. In sort, for myself, I am a hard act to follow.
Others imply that they know what it is like to be depressed because they have gone through a divorce, lost a job, or broken up with someone. But these experiences carry with them feelings. Depression, instead, is flat, hollow, and unendurable. ... You're frightened, and you're frightening, and you're 'not at all like yourself but will be soon,' but you know you won't.
St. Andrews provided a gentle forgetfulness over the preceding painful years of my life. It remains a haunting and lovely time to me, a marrow experience. For one who during her undergraduate years was trying to escape an inexplicable weariness and despair, St. Andrews was an amulet against all manner of longing and loss, a year of gravely held but joyous remembrances.
I have often asked myself whether, given the choice, I would choose to have manic-depressive illness. If lithium were not available to me, or didn't work for me, the answer would be a simple no... and it would be an answer laced with terror. But lithium does work for me, and therefore I can afford to pose the question. Strangely enough, I think I would choose to have it. It's complicated.
The rites of passage in the academic world are arcane and, in their own way, highly romantic, and the tensions and unplesantries of dissertations and final oral examinations are quickly forgotten in the wonderful moment of the sherry afterward, admission into a very old club, parties of celebration, doctoral gowns, academic rituals, and hearing for the first time "Dr.," rather than "Miss" Jamison.
When people are suicidal, their thinking is paralyzed, their options appear spare or nonexistent, their mood is despairing, and hopelessness permeates their entire mental domain. The future cannot be separated from the present, and the present is painful beyond solace. ‘This is my last experiment,’ wrote a young chemist in his suicide note. ‘If there is any eternal torment worse than mine I’ll have to be shown.
I think that one of the many advantages of death accruing over a long period of time is that you do have time to meet a lot of other people who are going through similar situations and one of the great delights of our life actually was sitting around in labs waiting for the results of tests and talking to other people who were waiting to find out whether their cancer numbers were going in the right direction or not.
It was as if my father had given me, by way of temperament, an impossibly wild, dark, and unbroken horse. It was a horse without a name, and a horse with no experience of a bit between its teeth. My mother taught me to gentle it; gave me the discipline and love to break it; and- as Alexander had known so intuitively with Bucephalus- she understood, and taught me, that the beast was best handled by turning it toward the sun.
Manic-depression distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live. It is an illness that is biological in its origins, yet one that feels psychological in the experience of it, an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide.
the intensity, glory, and absolute assuredness if my mind's flight made it very difficult for me to believe once i was better, that the illness was one i should willingly give up....moods are such an essential part of the substance of life, of one's notion of oneself, that even psychotic extremes in mood and behavior somehow can be seen as temporary, even understandable reactions to what life has dealt....even though the depressions that inevitably followed nearly cost me my life.
I long ago abandoned the notion of a life without storms, or a world without dry and killing seasons. Life is too complicated, too constantly changing, to be anything but what it is. And I am, by nature, too mercurial to be anything but deeply wary of the grave unnaturalness involved in any attempt to exert too much control over essentially uncontrollable forces. There will always be propelling, disturbing elements, and they will be there until, as Lowell put it, the watch is taken from the wrist.
There is a particular kind of pain, elation, loneliness, and terror involved in this kind of madness. When you're high it's tremendous. The ideas and feelings are fast and frequent like shooting stars....But, somewhere, this changes. The fast ideas are far too fast, and there are far too many; overwhelming confusion replaces clarity. Everything previously moving with the grain is now against-you are irritable, angry, frightened, uncontrollable....It will never end, for madness carves its own reality.
It is tempting when looking at the life of anyone who has committed suicide to read into the decision to die a vastly complex web of reasons; and, of course, such complexity is warranted. No one illness or event causes suicide; and certainly no one knows all, or perhaps even most, of the motivations behind the killing of the self. But psychopathology is almost always there, and its deadliness is fierce. Love, success, and friendship are not always enough to counter the pain and destructiveness of severe mental illness
Suicide is a particularly awful way to die: the mental suffering leading up to it is usually prolonged, intense and unpalliated. There is no morphine equivalent to ease the acute pain, and death, not uncommonly, is violent and grisly. The suffering of a suicidal is private and inexpressible, leaving family members, friends and colleagues to deal with an almost unfathomable kind of loss, as well as guilt. Suicide carries in its aftermath a level of confusion and devastation that is, for the most part, beyond description.
Far too many doctors-many of them excellent physicians-commit suicide each year; one recent study concluded that, until quite recently, the United States lost annually the equivalent of a medium-sized medical school class from suicide alone. Most physician suicides are due to depression or manic-depressive illness, both of which are eminently treatable. Physicians, unfortunately, not only suffer from a higher rate of mood disorders than the general population, they also have a greater access to very effective means of suicide.
I remember sitting in his office a hundred times during those grim months and each time thinking, What on earth can he say that will make me feel better or keep me alive? Well, there never was anything he could say, that's the funny thing. It was all the stupid, desperately optimistic, condescending things he didn't say that kept me alive; all the compassion and wamrth I felt from him that could not have been said; all the intelligence, competence, and time he put into it; and his granite belief that mine was a life worth living.
But then back on lithium and rotating on the planet at the same pace as everyone else, you find your credit is decimated, your mortification complete: mania is not a luxury one can easily afford. It is devastating to have the illness and aggravating to have to pay for medications, blood tests, and psychotherapy. They, at least, are partially deductible. But money spent while manic doesn't fit into the Internal Revenue Service concept of medical expense or business loss. So after mania, when most depressed, you're given excellent reason to be even more so.
We all build internal sea walls to keep at bay the sadnesses of life and the often overwhelming forces within our minds. In whatever way we do this—through love, work, family, faith, friends, denial, alcohol, drugs, or medication—we build these walls, stone by stone, over a lifetime. One of the most difficult problems is to construct these barriers of such a height and strength that one has a true harbor, a sanctuary away from crippling turmoil and pain, but yet low enough, and permeable enough, to let in fresh seawater that will fend off the inevitable inclination toward brackishness.