Chapter Twenty: Russian Roulette


After I left my research position on the acute inpatient psychiatric unit of a Boston hospital towards the end of 2006, my life started a two-year spiral downwards into the depths of a darkness unlike anything I’d ever known possible.  As a young girl, I’d lived in a world of promise and possibility, a beautiful orchestra of crisp sights, sounds and vitality; this world now felt shut once and for all behind concert hall doors thick enough to completely dull my senses but thin enough to leave me with the teasing, faint remnants of what my childhood had given me— a sense of ease, a sense of being right with the world, and a sense of my ‘self’.  Filled with an agonizing nostalgia for what I’d once had, memories weaving in and out of the periphery of my darkening mind, I was now constantly filled with a yearning for what I had come to believe was no longer possible— the ability to see the beauty in life around me, and the capacity for faith in myself and hope in my future.

Keeping up a front of togetherness became increasingly more difficult, and the harder I struggled to appear free of psychological and emotional pain, the more pain I felt.  I somehow managed to slip into another research position, this time for two married professors, one of whom I’d taken classes with as an undergraduate at Harvard, and felt relief when I discovered that my new bosses would be researching abroad on a regular basis, and I would be left, for the most part, alone.

Desperate to tuck myself away from the painful sight of ‘normal’ people living ‘normal’ lives, I frantically sought shelter from the torrential downpour of life at the end of each workday as I’d push my way onto the ‘T’ and block out the world with my headphones as the train weaved its way underground.  The simple act of opening my eyes released floodgates of negativity that swept over me and filled me with poisonous resentments towards anyone emitting a sense of ease and comfort.  Being a part of this thing called ‘life’ had become a fruitless exercise, and it was with this mindset that I passed my days, weeks, and months for the following two years.

In this span of time, a lot of the same happened over and over.  My lunch hours ceased to be a time to eat, but instead became the only motivation that got me to work in the mornings, as I knew I’d be able to walk over the ‘T’ tracks to the local pub across the street for three quick Westmalle Tripels before heading back to work at an empty office in a state of tipsy, warm listlessness— the only state in which I had any interest being.  I had given up the search for happiness, and now sought complete and utter apathy.

Any determination I mustered to stick to self-imposed goals, however small or large, was fleeting and flimsy, from losing the ability to keep my kitchen sink clean and my laundry folded, to convincing myself that I wanted to become a psychiatrist and deciding to take Pre-Med classes, which ended in a panic attack after my first lab and an immediate withdrawal from the program.  Time and time again, I failed to manage my responsibilities or follow through on expectations from others, and time and time again, I began to use my bipolar diagnosis— what I now saw as a prison sentence— to explain why it was I couldn’t and shouldn’t be relied upon for anything.  I had come to believe, in my heart of hearts, that I was fundamentally broken and incapable of repair.

Collapsing in upon myself, a dying star in an otherwise thriving galaxy, I began to live my life in constant ‘crisis mode’, each day spent in a state of desperation, pushing back with all my might against the forces I was sure were coming from beyond me but that I had yet to see came mostly from the space between my ears.  My focus had narrowed so much so that I could only concentrate on getting through each dark day.

The dosages of my medications continued to increase, each time with the hopes that maybe this combination would do the trick, maybe this addition would be the magical tweak that would suddenly transform the psychotropic cocktail in my body into a fighting force of chemicals that would glue my brokenness together and make me whole again.  Instead of finding a resolution to my pain, however, I simply found myself with a bedside drawer of accumulating orange-brown pill bottles, the hole of despair growing deeper and deeper, light at its perimeter smaller and smaller.

It is somewhere around two in the morning.  The evening’s drinks have worn off, and my mind is on overdrive.  I am desperately fixated on the fact that there are thousands of people within a one-mile radius of me who are sound asleep while I am cursed with consciousness.  My head is on fire, pulsating with thoughts beyond my control.  All I want is silence— an abrupt termination of every cognitive formulation that my inexhaustible brain has the capacity of producing— but I know that’s not in the cards tonight.  I know this because it’s become my ‘normal’ for months now.  I am completely adjusted to the belief that it is impossible to have a reprieve from myself, and this submission has me feeling helpless and hopeless.  It is utterly exhausting to be imprisoned in my mind, this space of constant chaos, and it seems there is one final path to peace.  This morbid thought, by now a familiar friend yet still deeply disturbing, is one I don’t want to act on yet feel like I have no control over.  Panicked, I pick up the phone and call my psychiatrist. 

“Doctor F., my head won’t shut off and I don’t know what to do.  The pills are calling me.”  In my bedside table sit two-dozen bottles, a collection of different dosages and brands that have been tried and changed over time and that I have never discarded.  They are screaming my name louder than usual.

My doctor, whom I’ve been seeing since for about a year and a half, has told me to call her in times like this, when I feel desperate and impulsive and alone.  I know what a rare gift it is for a psychiatrist to be available at any time of day or night in times of crisis and I feel profoundly grateful, but more than gratitude, I feel a penetrating fear as I realize that my ability to stay safe has become entirely dependent upon her. 

“Laura, you need to get to sleep.  Get out the Seroquel and take a triple dose.  Do you want me to call an ambulance?  Do you think you can do this on your own?”

The thought of going inpatient for a second time sears through my mind and makes me cringe.  No matter how miserable I feel at this point, no matter how chaotic my life is and no matter how desperate I am to change my current circumstances, I am sure that I do not want to go to the Emergency Room.  It seems too drastic to be uprooted from my life, even though this life no longer makes any sense to me and seems to be nothing but an arrangement of living, moving things around a deadened me.  I can’t just leave it all.  Although I have no idea what it is I need or want to get relief, avoiding the ER and the inpatient stay that would surely follow is one thing about which I am clear.  I tell this to Dr. F., who sounds hesitant but is willing to trust me.

I take her advice and swallow the tripled dosage of Seroquel, and she stays on the phone with me until the dulling numbness of the medication first reaches my mind and I no longer care that I am lost in my life, and next reaches my body and I’m guided quickly into dreamless sleep.

And so went my life until the fall of 2008— each night, I suited up for the next round of a battle waged against myself, and each subsequent morning, I awoke with a foggy memory and hopeful but fleeting uncertainty that the previous night’s events had only been a terrible nightmare.  Life dragged on during those two years— I eventually quit that second research position, floating aimlessly without work before trying new jobs and inevitably quitting; I bounced around in relationships I was sure would fix me but never did; and I pulled myself further and further away from my family, whose concerns for me had grown exponentially but who had still not given up hope— but the guiding light leading me through those days was losing strength and flickering out, and my commitment to life was fast waning.

Come Thanksgiving of 2008, my turn in this proverbial game of Russian roulette was up.  I would find myself at death’s door, my hand willingly on its handle.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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