In the course of losing and regaining my sanity, I’ve come to identify with other people who have known mental illnesses firsthand. This sense of connection with others who suffer has spurred me to share my story. While more attention is being given to mental illness than ever before, it nonetheless continues to be stigmatized by society. Even though mental disorders are physiological in nature—they are diseases of the brain, just as coronary problems are diseases of the heart—the mentally ill are often treated as if they are to blame, as if they have done something wrong. Their families are frequently stigmatized as well. If nothing else, I hope my experience helps others recognize that mental illness is no more the patient’s fault than cancer is and that the best response to mental illness is empathy and a greater commitment to finding cures.
After losing my mind and regaining it, I like to think I am more attuned to other people’s feelings and troubles, that I am more understanding as a mother, wife, friend—and scientist. While I believe that I’ve always been compassionate toward people with mental illness, since my own brush with madness, the quality of my compassion has deepened. I also live my life more consciously, aware of how lucky I am to be reunited with my family and able to continue my life’s work.
This book is an account of what mental illness looks like from the inside. But it is also a map of my evolution as a scientist and a person. It is the story of an incredible journey, one from which I could not have imagined I would ever return. It is a story that I never thought I would be able to tell, of how I went from being a scientist studying mental disorders to being a mental patient myself—and how, remarkably, I came back.
1
The Rat’s Revenge
I sit among a thousand brains, a thousand brains of the mentally ill.
As director of the Human Brain Collection Core at the National Institute of Mental Health, I work surrounded by brains; a library of brains, a bank of brains, a compendium of brains that for any number of reasons hadn’t worked the way they should have. Brains that saw hallucinations, heard mysterious voices, were buffeted by wild mood swings, or were deeply depressed. Brains that have been collected, cataloged, and stored here for the past thirty years.
About a third of these brains come from suicides. That desperate and heartbreaking act is the ultimate cost for so many people who suffer from mental illness, and my colleagues and I are reminded of this grim fact each and every day.
Each specimen arrives to us fresh and bloody, glistening inside a clear plastic bag placed carefully inside a cooler of ice. It looks like a piece of red meat, unconnected to any real humanness. Yet just a day earlier, it had directed every movement and thought of the person from whom it came.
To understand mental illness—and to treat and one day cure it—researchers need a steady supply of brains. This is where institutions like the NIMH, the leading federal agency in the United States for research on mental health, come in. At the brain bank, we gather these incredible organs, slice them into usable tissue samples, and share them with scientists around the world.
But collecting brains isn’t easy. It’s especially difficult to get brains that come from people with schizophrenia, bipolar disorder, major depression, anxiety disorders, and addictions to various substances—cocaine, opioids, alcohol, and even cannabis—that attract abuse. What’s more, we can’t use brains of mentally ill people who died of serious illnesses, who were in hospitals on ventilators, or who were heavily medicated before taking their last breath. Brains marked by other illnesses or medical issues would only add complexity to the already overwhelming puzzle that we are trying to solve: What causes mental disorders?
In order to begin to understand this, we also need brains from people without mental illness (control brains), so we can examine and compare them with diseased brains. In short, we need clean and healthy brains both with and without the terrible presence of madness.
We get most of our brains from the morgues in nearby medical examiners’ offices, where bodies typically arrive because people have died under suspicious or mysterious circumstances. And so, in addition to receiving the brains of suicides, we are also the unintentional beneficiaries of homicides and unexplained deaths.
First thing each morning, the technicians in our brain bank telephone local medical examiners’ offices and ask, Do you have any brains for us today?
We’re in a rush. If a person has been dead more than three days, we can’t use the brain. We need the brains before the tissue begins to decompose, before their proteins and other molecules, the ribonucleic acid (RNA) and deoxyribonucleic acid (DNA), begin to break down, rendering them useless for molecular studies.
The morgue workers tell the techs about the bodies that have arrived in the past twenty-four hours, sharing what information they have. Often, it isn’t much, just the barest of facts: A young man who overdosed on heroin. A middle-aged woman with a heart attack. A teen who hanged herself. At this point, it may be all we know about each person.
Once the technicians have compiled their list of candidates, they come to me, and together we narrow it down. Do we want this one, a drug overdose? Or this one, an elderly man whose wife told morgue investigators he was an alcoholic? Here’s a man who died in a car accident. There’s no indication he had mental illness, so maybe researchers will be able to use his brain as a control in their studies. But he might have sustained a head injury; do we
