It’s preposterous that I could get lost in this familiar place, but that fact barely registers in my mind. With no plan for where I’m headed, I simply continue to run.
For another hour or more, I jog along, misshapen and covered in gore. I’m oblivious, unaware of anything amiss. I just run and run, my thoughts drifting into open spaces and big skies.
Somehow, I finally come upon our two-story Colonial. I open the door and find myself in the cool, dark hallway. Tired and sweaty, I take off my sneakers and socks, which are completely soaked.
On my way upstairs, I catch a glimpse of myself in a mirror. My head is caked in sweat mixed with hair color, the plastic bag plastered on top like a weird swimming cap. Streaks of purple dye, long since dried to black, have crusted in thin rivulets down my neck and upper arms and all over my shirt, accentuating the sunken left side of my chest. My face is deep red from exertion.
Nothing strikes me as unusual. I continue past the mirror up the stairs.
In his home office, my husband, Mirek, is sitting at his computer with his back to the door. When he hears me enter the room, he says, “You’ve been away a long time. Good run?”
Then he turns to me with a smile—and freezes.
“What happened?” he exclaims.
“What do you mean?” I say. “It was a long run.”
“Did anybody see you like this?” He seems shaken.
“Why would I care if someone saw me? What are you talking about?”
“Wash it off,” he says. “Please.”
“Calm down, Mirek! What are you going on about?” But I head into the bathroom to do as he asks.
What’s wrong with him? Why is he acting so strange?
I emerge from the shower clean and relaxed. But something nags at me.
The man I love is alarmed. But why?
Mirek’s behavior should be a red flag, a clue that something is terribly wrong. But a moment later, the unpleasant thought simply slips through the cracks of my broken mind and is gone.
I am a neuroscientist. For my entire career, I have studied mental illness, first in my homeland of Poland and then, since 1989, in the United States, at the National Institute of Mental Health (NIMH), a division of the National Institutes of Health (NIH) in Bethesda, Maryland. My specialty is schizophrenia, a devastating disease whose victims often have difficulty discerning what is real and what is not.
In June 2015, without warning, my own mind took a strange and frightening turn. As a result of metastatic melanoma in my brain, I began a descent into mental illness that lasted about two months, a bizarre tailspin that I couldn’t recognize at the time. I emerged from that dark place through a combination of luck, groundbreaking scientific advances, and the vigilance and support of my family.
I’m a rare case; I lived through a terrifying dive into brain cancer and mental illness and emerged on the other side able to describe what had happened to me. According to psychiatrists and neurologists—medical doctors who specialize in the brain and nervous system—it’s highly unusual for someone with such serious brain malfunction to be successfully treated and return from the shadowy world of mental impairment. Most people with as many brain tumors as I had and the serious deficits they caused simply don’t get better.
As frightening as my breakdown was, I regard it as a priceless gift for a neuroscientist. I studied the brain for decades and conducted research in mental illness, but my brush with madness gave me firsthand experience of what it’s actually like to lose your mind and then recover it.
Every year, approximately one in five adults worldwide experiences a mental illness, from depression to anxiety disorders, from schizophrenia to bipolar disorder. In the United States, mental illness affects nearly forty-four million adults each year, and that number does not include people with substance-abuse disorders. In Europe, 27 percent of adults experience a serious mental disorder in any given year. Mental illness often emerges during young adulthood and lasts for someone’s entire life, causing tremendous suffering for the person who is ill as well as for his or her loved ones. A significant number of homeless and incarcerated people suffer from mental illness, and the societal consequences do not end there. Mental illness costs the global economy $1 trillion each year—$193.2 billion in the United States—as people who would otherwise be productive are unable to function because of their disabilities. More than just incapacitating, mental illness can also be deadly. Of the roughly 800,000 people worldwide who die each year by suicide—41,000 in the United States alone—90 percent suffer from mental illness.
The United States spends significantly more on treating mental disorders than it does on any other medical condition—a whopping $201 billion in 2013. (Heart conditions, for which the U.S. spent $147 billion that year, rank a distant second.) But even with these resources and the tremendous efforts of dedicated scientists and physicians, mental illness remains deeply enigmatic, its causes generally unknown, its cures undiscovered. Despite the overwhelming body of research on mental illness to which new findings are added almost every day, we scientists still don’t understand what happens in the brains of mentally ill people. We don’t really know yet which brain regions and connections are malformed or undeveloped or why the brain goes awry. Are people who become mentally ill destined to suffer because of some genetic predisposition, or did they experience something that broke their brains, mangled their neuronal connections, and altered their neurologic function?
Today, the data suggest that mental illness is caused by a combination of heredity and environment, the latter involving multiple factors—including drug use and abuse—that act in complex interplay with one another and with our genes. But it remains exceedingly hard to pinpoint the biological and chemical processes for mental illness, in part because these disorders are diagnosed through observations of behaviors rather than through more precise tests. Unlike cancer and
