“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.”

“[The] persevering steadiness of my mother, her belief in seeing things through, and her great ability to love and learn, listen and change, helped keep me alive through all the years of pain and nightmare that were to come. She could not have known how difficult it would be to deal with madness; had no preparation for what to do with madness--none of us did--but consistent with her ability to love, and her native will, she handled it with empathy and intelligence. It never occurred to her to give up.”

“I had tried years earlier to kill myself, and nearly died in the attempt, but did not consider it either a selfish or a not-selfish thing to have done. It was simply the end of what I could bear, the last afternoon of having to imagine waking up the next morning only to start all over again with a thick mind and black imaginings. It was the final outcome of a bad disease, a disease it seemed to me I would never get the better of. No amount of love from or for other people0and there was a lot-could help. No advantage of a caring family and fabulous job was enough to overcome the pain and hopelessness I felt; no passionate or romantic love, however strong, could make a difference. Nothing alive and warm could make its way in through my carapace. I knew my life to be a shambles, and I believed-incontestably-that my family, friends, and patients would be better off without me. There wasn't much of me left anymore, anyway, and I thought my death would free up the wasted energies and well-meant efforts that were being wasted on my behalf.”

“Her parents, she said, has put a pinball machine inside her head when she was five years old. The red balls told her when she should laugh, the blue ones when she should be silent and keep away from other people; the green balls told her that she should start multiplying by three. Every few days a silver ball would make its way through the pins of the machine. At this point her head turned and she stared at me; I assumed she was checking to see if I was still listening. I was, of course. How could one not? The whole thing was bizarre but riveting. I asked her, What does the silver ball mean? She looked at me intently, and then everything went dead in her eyes. She stared off into space, caught up in some internal world. I never found out what the silver ball meant.”

“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.”

“In its severe forms, depression paralyzes all of the otherwise vital forces that make us human, leaving instead a bleak, despairing, desperate, and deadened state. . .Life is bloodless, pulseless, and yet present enough to allow a suffocating horror and pain. All bearings are lost; all things are dark and drained of feeling. The slippage into futility is first gradual, then utter. Thought, which is as pervasively affected by depression as mood, is morbid, confused, and stuporous. It is also vacillating, ruminative, indecisive, and self-castigating. The body is bone-weary; there is no will; nothing is that is not an effort, and nothing at all seems worth it. Sleep is fragmented, elusive, or all-consuming. Like an unstable, gas, an irritable exhaustion seeps into every crevice of thought and action.”

“When I am high I couldn’t worry about money if I tried. So I don’t. The money will come 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. What with credit cards and bank accounts there is little beyond reach. So I bought twelve snakebite kits, with a sense of urgency and importance. I bought precious stones, elegant and unnecessary furniture, three watches within an hour of one another (in the Rolex rather than Timex class: champagne tastes bubble to the surface, are the surface, in mania), and totally inappropriate sirenlike clothes. During one spree in London I spent several hundred pounds on books having titles or covers that somehow caught my fancy: books on the natural history of the mole, twenty sundry Penguin books because I thought it could be nice if the penguins could form a colony. Once I think I shoplifted a blouse because I could not wait a minute longer for the woman-with-molasses feet in front of me in line. Or maybe I just thought about shoplifting, I don’t remember, I was totally confused. I imagine I must have spent far more than thirty thousand dollars during my two major manic episodes, and God only knows how much more during my frequent milder manias.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.”