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

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.

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

There is a particular kind of pain, elation, loneliness and terror involved in this kind of madness... It will never end, for madness carves its own reality.

Never once, during any of my bouts of depression, had I been inclined or able to pick up a telephone and ask a friend for help. It wasn't in me.

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