The Excruciating Hell of Psychic Pain

Patient Expert

Let's talk about psychic pain. In my book, "Living Well with Depression and Bipolar Disorder," Mildred recounts a depression from 50 years before as "unbelievably and indescribably painful." It felt, she recalls, "like a rat was gnawing on my brain." Suicide, to her, "seemed not like a harm to self, but a relief from self."

We've all been there. Here is a taste of what I went through, also from my book:

Just a little deeper into the Mount Everest Death Zone, I knew, and it wouldn't be a matter of me committing the act. The act, instead, would commit me. The rope would tie its own noose, the pond's frigid waters would warmly embrace me, the bridge would obligingly throw me off ...

Psychic pain is not limited to depression. Again from my book:

If one thinks of pure or mild mania as the music of Duke Ellington or Louis Armstrong on a cool, clear summer night, mixed mania is heavy metal and rap in a thunderstorm, the blast of jackhammers, the frizzle-frazzle of shorted out power lines, and the elbows on the black keys of every neuron in the brain vibrating to extinction.

In my writings here on HealthCentral and elsewhere, I also describe feelings of extreme unease inside one's head, of wanting to crawl out of one's skin, of being overwhelmed, and the sensation of the whole world - every rock and every tree - turning against you.

Depression, mania, stress, trauma, anxiety - it's all the same when your brain is in crisis. Pain, extreme psychic pain. Perhaps your brain is on fire and you feel an urgent need to jump out of a burning building. Or it may be that you feel trapped and suffocated. On one hand, too much coming at you. On the other, not enough. On one hand, you are struggling mightily, raging against the world, yourself, and your situation. On the other, you feel your life force being sucked out of you and there is nothing left but to submit, to yield to the darkness.

This week is National Suicide Prevention Week. Four years ago, almost to this day, I came home from a meeting to find a new message on my answering machine. The day before, my good friend Kevin threw himself in front of a train. He was 28.

Below are some stitched-together bits and pieces from a tribute I posted here the next day:

In 2004, back in Princeton, NJ, I was facilitating a DBSA support group. In walked Kevin, exuding a goofy charm, baseball cap on backward. But there was something about his presence that indicated he was no mere goofball. The others in the room felt it, too.

He carried that exceedingly rare quality of instant likability, but he wore it with a seriousness of purpose that endeared him not only to those in his age group, but to those twice his age, people like me.

It wasn't long before I asked Kevin to help facilitate the group. He took his new responsibility very seriously. He learned everything he could. We would talk for hours. He facilitated far better than I ever could, and it showed in the way the group responded to him. I had the book knowledge, but he had the real wisdom.

He had his setbacks, his dark moments. Yet, over time - in group, over coffee, over sandwiches, hanging out - I watched him blossom. With his extraordinary people skills, the sky was the limit.

Then, in late 2006, it was time for me to move on. My life was packed up in seven or eight FedEx cartons and I had a one-way ticket to San Diego. I popped into the DBSA group one last time. Kevin was facilitating. He gave me a heartfelt tribute. I felt the goodness in the man. Goodness, true goodness. That was the last time I saw him alive.

I am intimately familiar with psychic pain. I've been through it. I understand. But then I think of my good friend Kevin, and I realize - I really don't understand.