Intense creative episodes are, in many instances, indistinguishable from hypomania

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.

An intense temperament has convinced me to teach not only from books but from what I have learned from experience. So I try to impress upon young doctors and graduate students that tumultuousness, if coupled to discipline and a cool mind, is not such a bad sort of thing.

I believe that curiosity, wonder and passion are defining qualities of imaginative minds and great teachers; that restlessness and discontent are vital things; and that intense experience and suffering instruct us in ways that less intense emotions can never do.

There is a particular kind of pain, elation, loneliness, and terror involved in this kind of madness. When you're high it's tremendous. The ideas and feelings are fast and frequent like shooting stars...But, somewhere, this changes. The fast ideas are far too faast, and there are far too many; overwhelming confusion replaces clarity. Everything previously moving with the grain is now against-you are irritable, angry, frightened, uncontrollable...It will never end, for madness carves its own reality.

What then after the medications, psychiatrist, despair, depression, and overdose? All those incredible feelings to sort through. Who is being too polite to say what? Who knows what? What did I do? Why? And most hauntingly, when will it happen again? Then, too, are the bitter reminders..... medicine to take, resent, forget, take, resent, and forget, but always to take.