An Unquiet Mind

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. F

Certainly, patients who have suffered from the illness should have the right to choose whichever term they feel more comfortable with.

I have become fundamentally and deeply skeptical that anyone who does not have this illness can truly understand it. And, ultimately, it is probably unreasonable to expect the kind of acceptance of it that one so desperately desires. It is not an illness that lends itself to easy empathy. 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 as being willful, angry, irrational, or simply tiresome.

“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?

I felt as though only dying would release me from the overwhelming sense of inadequacy and blackness that surrounded me.

“To be sure,” wrote Hugo Wolf, “I appear at times merry and in good heart, talk, too, before others quite reasonably, and it looks as if I felt, too, God knows how well within my skin. Yet the soul maintains its deathly sleep and the heart bleeds from a thousand wounds.”

it is only now that I really begin to understand how desperately important it was to both my intellectual and emotional life to have had my thoughts and enthusiasms given not only respect but active encouragement

Time will pass; these moods will pass; and I will, eventually, be myself again.

ominous, dark, and deathful quality that I felt as a young child watching the high clear skies fill with smoke and flames is always there, somehow laced into the beauty and vitality of life. That darkness is an integral part of who I am, and it takes no effort of imagination on my part to remember the months of relentless blackness and exhaustion, or the terrible efforts it took in order to teach, read, write, see patients, and keep relationships alive.

The real dangers, of course, come about from those clinicians (or, indeed, from those politicians, pilots, businessmen, or other individuals responsible for the welfare and lives of others) who—because of the stigma or the fear of suspension of their privileges or expulsion from medical school, graduate school, or residency—are hesitant to seek out psychiatric treatment.