Kay Redfield Jamison Quotes

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?

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. It is also tiresome. People cannot abide being around you when you are depressed. They might think that they ought to, and they might even try, but you know and they know that you are tedious beyond belief: you are irritable and paranoid and humorless and lifeless and critical and demanding and no reassurance is ever enough. 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.

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 short, for myself, I am a hard act to follow.

No amount of love can cure madness or unblacken one's dark moods. Love can help, it can make the pain more tolerable, but, always, one is beholden to medication that may or may not always work and may or may not be bearable

Which of my feelings are real? Which of the me's is me? The wild, impulsive, chaotic, energetic, and crazy one? Or the shy, withdrawn, desperate, suicidal, doomed, and tired one? Probably a bit of both, hopefully much that is neither.

I am tired of hiding, tired of misspent and knotted energies, tired of the hypocrisy, and tired of acting as though I have something to hide.

Mother, who has an absolute belief that it is not the cards that one is dealt in life, it is how one plays them, is, by far, the highest card I was dealt.

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.

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.

Suicide is not a blot on anyone’s name; it is a tragedy

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, and you follow them until you find better and brighter ones. Shyness goes, the right words and gestures are suddenly there, the power to captivate others a felt certainty. There are interests found in uninteresting people. Sensuality is pervasive and the desire to seduce and be seduced irresistible. Feelings of ease, intensity, power, well-being, financial omnipotence, and euphoria pervade one's marrow. But, somewhere, this changes. The fast ideas are far too fast, and there are far too many; overwhelming confusion replaces clarity. Memory goes. Humor and absorption on friends' faces are replaced by fear and concern. 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.

Love, like life, is much stranger and far more complicated than one is brought up to believe.

I look back over my shoulder and feel the presence of an intense young girl and then a volatile and disturbed young woman, both with high dreams and restless, romantic aspirations

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 move uneasily within our restraints.

Love has, at its best, made the inherent sadness of life bearable, and its beauty manifest.

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

Somehow, like so many people who get depressed, we felt our depressions were more complicated and existentially based than they actually were.

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.

But, with time, one has encountered many of the monsters, and one is increasingly less terrified of those still to be met.

The awareness of the damage done by severe mental illness—to the individual himself and to others—and fears that it may return again play a decisive role in many suicides

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

Knowledge is marvelous, but wisdom is even better.

...Time does not heal, It makes a half-stitched scar That can be broken and again you feel Grief as total as in its first hour. -Elizabeth Jennings

One is what one is, and the dishonesty of hiding behind a degree, or a title, or any manner and collection of words, is still exactly that: dishonest.

It took me far too long to realize that lost years and relationships cannot be recovered. That damage done to oneself and others cannot always be put right again.

There is always a part of my mind that is preparing for the worst, and another part of my mind that believes if I prepare enough for it, the worst won’t happen.

Time will pass; these mood will pass; and I will, eventually, be myself again. But then, at some unknown time, the electrifying carnival will come back into my mind.

Chaos and intensity are no substitute for lasting love, nor are they necessarily an improvement on real life.

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.

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

I had a terrible temper, after all, and though it rarely erupted, when it did it frightened me and anyone near its epicenter. It was the only crack, but a disturbing one, in the otherwise vacuum-sealed casing of my behavior.

Suicide Note: The calm, Cool face of the river Asked me for a kiss. -Langston Hughes

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.

Look to the living, love them, and hold on.

I realized that it was not that I didn’t want to go on without him. I did. It was just that I didn’t know why I wanted to go on

I had been simply treating water, settling on surviving and avoiding pain rather than being actively involved in seeking out life.

The ancient dialogue between reason and the senses is almost always more interestingly and passionately resolved in favor of the senses.

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.

Depression is awful beyond words or sounds or images...it bleeds relationships through suspicion, lack of confidence and self-respect, the inability to enjoy life, to walk or talk or think normally, the exhaustion, the night terrors, the day terrors. There is nothing good to be said for it except that it gives you the experience of how it must be to be old, to be old and sick, to be dying; to be slow of mind; to be lacking in grace, polish and coordination; to be ugly; to have no belief in the possibilities of life, the pleasures of sex, the exquisiteness of music or the ability to make yourself and others laugh.

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.

You're frightened, and you're frightening, and you're 'not at all like yourself but you will be soon,' but you know you won't.

I am reminded of the importance of small kindnesses.

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.

Thank you for a lovely weekend. They tell me it rained.

Conditions of thought, memory, and desire, persuaded by impulse and irrationality, are influenced as well by personal aesthetics and private meanings.

The assumption that rigidly rejecting words and phrases that have existed for centuries will have much impact on public attitudes is rather dubious.

Often, people want both to live and to die; ambivalence saturates the suicidal act.

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

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.

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.

That such a final, tragic, and awful thing is suicide can exist in the midst of remarkable beauty is one of the vastly contradictory and paradoxical aspects of life and art.

It is true that I had wanted to die , but that is peculiarly different from regretting having been born. Overwhelmingly, I was enormously glad to have been born, grateful for life, and I couldn’t imagine not wanting to pass on life to someone else.

Now I had no choice but to live in the broken world that my mind had forced upon me.

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"?

Some part of me instinctively reached out, and in an odd way understood this pain, never imagining that I would someday look in the mirror and see their sadness and insanity in my own eyes.

I was bitterly resentful, but somehow greatly relieved. And I respected him enormously for his clarity of thought, his obvious caring, and his unwillingness to equivocate in delivering bad news.

I lost a great innocence when I understood that I and my mind were not going to be on good terms for the rest of my life. I can’t tell you how tired I am of character-building experiences. But I treasure this part of me; whoever loves me loves me with this in it.

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.

Feeling normal for any extended period of time raises hopes that turn out, almost invariably, to be writ on water.

It never occurred to her to give up.

One of the advantages of science is that one's work, ultimately, is either replicated or it is not.

The complexities of what we are given in life are vast and beyond comprehension.

I never again looked at the sky and saw only vastness and beauty. From that afternoon on I saw that death was also and always there.

The Chinese believe that before you can conquer a beast you first must make it beautiful.

Everyone has good cause for suicide, or at least it seems that way to those who search for it.

Violence, especially if you are a woman, is not something spoken about with ease.

An ardent temperament makes one very vulnerable to dreamkillers.

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. It is, at the end of the day, the individual moments of restlessness, of bleakness, of strong persuasions and maddened enthusiasms, that inform one’s life, change the nature and direction of one’s work, and give final meaning and color to one’s loves and friendships.

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.

لقد كانت حياة غريبة الأطوار: مدهشة , ورهيبة, وبغيضة, وعسيرة بما يفوق الوصف, وسهلة بصورة عظيمة وغير متوقعة, ومعقدة, وتسلية عظيمة, وكابوسا بلا مخرج!

ذاتك هو ذاتك، والخداع عبر الاختباء خلف درجة علمية، أو لقب علمي، أو أي سلوك وعبارات منمقة، لا يزال تماما : خداعا. ربما كان ضروريا ولكنه خداع.

Tumultuouness,if coupled to discipline and cool mind,is not such a bad sort of thing.That unless one wants to live a stunningly boring life,one ought to terms with one`s darker side ad one`s darker energies

Once a restless or frayed mood has turned to anger, or violence, or psychosis, Richard, like most, finds it very difficult to see it as illness, rather than being willful, angry, irrational or simply tiresome.

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.

Four thousand years ago, an Egyptian wrote out his despair onto papyrus in the form of a narrative and four short-versed poems. This document, now in the Berlin Museum, is thought by British psychiatrist Chris Thomas to be the first suicide note [...] "Death is before me today As a man longs to see his house When he has spent years in captivity.

Slowly the darkness began to weave its way into my mind, and before long I was hopelessly out of control. I could not follow the path of my own thoughts. Sentences flew around in my head and fragmented first into phrases and then words; finally, only sounds remained.

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.

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.

I had a horrible sense of loss for who I had been and where I had been. It was difficult to give up the high flights of mind and mood, even though the depressions that inevitably followed nearly cost me my life.

It took me far too long to realize that lost years and relationships cannot be recovered, that damage done to oneself and others cannot always be put right again, and that freedom from the control imposed by medication loses its meaning when the only alternatives are death and insanity.

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.

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

As best I could make out, having never heard the term until I arrived in California, being a WASP meant being mossbacked, lockjawed, rigid, humorless, cold, charmless, insipid, less than penetratingly bright, but otherwise---and inexplicably---to be envied.

Depression affects not only mood but the nature and content of thought as well. Thinking processes almost always slow down, and decisiveness is replaced by indecision and rumination. The ability to concentrate is usually greatly impaired and willful action and thought become difficult if not impossible.

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.

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 (nor are they incompatible). These are beliefs, of course, that one has intuitively about friendships and family; they become less obvious when caught up in a romantic life that mirrors, magnifies, and perpetuates one's own mercurial emotional life and temperament. It has been with my pleasure, and not-inconsiderable pain, that I have learned about the possibilities of love - its steadiness and its growth - from my husband, the man with whom I had lived for almost a decade.

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 a life can be only a sketch, maddeningly incomplete.

We all build internal sea walls to keep at bay the sadnesses of life and the often overwhelming forces within our minds... But love is, to me, the ultimately more extraordinary part of the breakwater wall: it helps to shut out the terror and awfulness, while, at the same time, allowing in life and beauty and vitality.

لقد تسبب لي الألم والخوف من المجهول اللذان تراكما عليّ إثر وفاة ديفيد بالإضافة إلى مرضي في تواضع وتضييق آمالي في الحياة لسنوات عديدة. انسحبت إلي نفسي , وأغلقت, بتصميم, قلبي عن أي احتكاك غير ضروري مع العالم. انهمكت في العمل. لم تكن كل هذه النشاطات بديلة للحب, ولكنها كانت مثيرة وخلقت قيمة ومعنى لحياتي التعيسة. فترات طويلة من التأمل مع ذاتي منحت كلا من عقلي وقلبي الفرصة لكي يعيدا ببطء ترميم معظم أجزاء روحي الممزقة.

The horror of profound depression, and the hopelessness that usually accompanies it, are hard to imagine for those who have not experienced them. Because the despair is private, it is resistant to clear and compelling description. Novelist William Styron, however, in recounting his struggle with suicidal depression, captures vividly the heavy, inescapable pain that can lead to suicide: What I had begun to discover is that, mysteriously and in ways that are totally remote from normal experience, the gray drizzle of horror induced by depression takes on the quality of physical pain. But it is not an immediately identifiable pain, like that of a broken limb. It may be more accurate to say that despair, owing to some evil trick played upon the sick brain by the inhabiting psyche, comes to resemble the diabolical discomfort of being imprisoned in a fiercely overheated room. And because no breeze stirs this cauldron, because there is no escape from this smothering confinement, it is entirely natural that the victim begins to think ceaselessly of oblivion.

Depression, somehow, is much more in line with society's notions of what women are all about: passive, sensitive, hopeless, helpless, stricken, dependent, confused, rather tiresome, and with limited aspirations. Manic states, on the other hand, seem to be more the provenance of men: restless, fiery, aggressive, volatile, energetic, risk taking, grandiose and visionary, and impatient with the status quo. Anger or irritability in men, under such circumstances, is more tolerated and understandable; leaders or takers of voyages are permitted a wider latitude for being temperamental. Journalists and other writers, quite understandably, have tended to focus on women and depression, rather than women and mania. This is not surprising: depression is twice as common in women as men. But manic-depressive illness occurs equally often in women and men, and, being a relatively common condition, mania ends up affecting a large number of women. They, in turn, often are misdiagnosed, receive poor, if any, psychiatric treatment, and are at high risk for suicide, alcoholism, drug abuse, and violence. But they, like men who have manic-depressive illness, also often contribute a great deal of energy, fire, enthusiasm, and imagination to the people and world around them.

[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.

كنت قد نسيت طعم الإحساس بالحياة عندما تنفتح الروح على الريح والمطر والجمال، وبدأت أشعر بتسرب الحياة مجددا إلى التصدعات الموجودة في جسمي وعقلي اللذين كنت قد شطبتهما تماما باعتبارهما مستنزفين أو هامدين. لقد استغرق الأمر سنة كاملة لجعلي أدرك أنني كنت فيما مضى أمشي على الماء مكتفية بمجرد محاولة البقاء على قيد الحياة وتجنب الألم بدلا من الاندماج الحقيقي في الحياة. الفرصة للهرب من بقايا المرض والموت، من الحياة القلقة، ومن مسؤوليات التدريس والعيادة. لقد أعطتني هذه الفرصة شكلا من السلام الذي كان يراوغني، ومكانا خاصا بي لكي أتعافي وأتأمل، ولكن الأهم أن أتعافى.

I read it as if it had been written by someone else, although it was my own experience being recounted. The endless questioning finally ended. My psychiatrist looked at me, there was no uncertainty in his voice. "Maniac-depressive illness." I admired his bluntness. I wished him locusts in his land and a pox upon his house. Silent, unbelievable rage. I smiled pleasantly. He smiled back. The war had just begun,

Love, success, and friendship are not always enough to counter the pain and destructiveness of severe mental illness. American artist Ralph Barton tried to explain this in his suicide note: 'Everyone who has known me and who hears of this will have a different hypothesis to offer to explain why I did it. Practically all of these hypotheses will be dramatic—and completely wrong. Any sane doctor knows that the reasons for suicide are invariably psychopathological. Difficulties in life merely precipitate the event—and the true suicide type manufactures his own difficulties.

Moods are by nature compelling, contagious, and profoundly interpersonal, and disorders of mood alter the perceptions and behaviors not only of those who have them but also of those who are related or closely associated. Manic-depressive illness—marked as it is by extraordinary and confusing fluctuations in mood, personality, thinking, and behavior—inevitably has powerful and often painful effects on relationships.

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. It is, at the end of the day, the individual moments of restlessness, of bleakness, of strong persuasions and maddened enthusiasms, that inform one's life, change the nature and direction of one's work, and give final meaning and color to one's loves and friendships.

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.

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 feelings. Depression, instead, is flat,hollow and unendurable. It is also tiresome. People cannot abide being around you when you are depressed. They might think that they ought to, but you know and they know that you are tedious beyond belief: you are irritable and paranoid and humourless and lifeless and critical and demanding and no reassurance is ever enough. You're frightened and frightening and you're "Not at all like yourself but will be soon," but you know you won't.