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

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

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.

Confidentiality is an ancient and well-warranted social value.

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

Knowledge is marvelous, but wisdom is even better.

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.