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

The pursuit of knowledge is an intoxicant, a lure that scientists and explorers have known from ancient times; indeed, exhilaration in the pursuit of knowledge is part of what has kept our species so adaptive.

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.

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

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.

Everyone has good cause for suicide, or at least it seems that way to those who search for it. (74)