Wounds, I think, are never confined to a single skin but reach out to rasp us all.

Everyone knows that a lot of memoirs have made-up scenes; it's obvious. And everyone knows that half the time at least fictions contain literal autobiographical truths. So how do we decide what's what, and does it even matter?

Much has been said about the meanings we make of illness, but what about the meanings we make out of cure? Cure is complex, disorienting, a revisioning of the self, either subtle or stark. Cure is the new, strange planet, pressing in. The doctor could not have known. And that made me, as it does every patient, only more alone.

Mistrust is the fuel for so much mental pain, so many mental disorders. I am not talking here about the suspicions we sometimes have of one another, the distant but lurking sense that perhaps our lover lies to us, our best friend whispers behind our back. I am talking about a belief that betrayal inundates the atoms of the universe, is so woven into the workings of the world that every step is treacherous, and that below the rich mud lies a mine.

Are psychiatric crises so overwhelming to the mind that they inhibit the presence of ethics? Is depression at root an amoral phenomenon, its focus on the self preventing any other from really counting? Perhaps. Sometimes. Sometimes, even when we are two we are really only one; we can feel nothing but our own bones, our own difficult breaths.

The most miraculous moments of my life were not when my daughter and son were born, but when the second or third Prozac pill shot down my throat and catapulted me into a world called sane.

Depression is a death within, a knowledge - terrifying - that you cannot resurrect yourself. Depression is loss of the vision that lets leaves breathe and fall, that lets the air smell of seed and soil. And there must be rage, yes I think there is rage toward such a severing, such a ragged-deep rupture with the world.