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.

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 am reminded of the importance of small kindnesses.

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

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

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.

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.