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
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...
There is an assumption, in attaching Puritan concepts such as 'successful' and 'unsuccessful' to the awful, final act of suicide, that those who 'fail' at killing themselves not only are weak, but incompetent, incapable even of getting their dying quite right.
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
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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 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.