And why? Because I went off my meds.

Over the course of several weeks, I adjusted the 20 milligrams a day of Prozac that I'd been taking when I went into Meriwether and brought the dose down to 15 milligrams. Then 10. Then zero. It took a few more months before I hit the really rough stuff: to be exact, the three months between when I got out of Meriwether and when I made my trip to the bin in the hinterlands. The timing was almost perfect. I started sc.r.a.ping bottom, and then I got on a plane to present myself at a hospital once more. This time I didn't really have to convince anyone that I was depressed. It was pretty clear, even to me.

There are really two reasons why I went off my meds. One good and one not so good.

The good reason was that, while doing some of the background research to write this book, I'd been doing a lot of reading about psychiatric drugs: how they were and are discovered or synthesized; how they're tested, marketed, and prescribed; and how little anybody really knows about what they're doing to our brains. The more I read, the angrier and more apprehensive I became about using them. Hence my reluctance to take anything at Meriwether.

I just didn't want to be dependent for the rest of my life on a drug whose effects neither I nor the professionals could understand or predict, and whose glowing reputation had been based almost entirely on the meticulous propaganda of the companies that were profiting hugely from its sale.

I wanted to find a way to do without drugs, and not to succ.u.mb without a fight to what I considered to be the drug company's and my doctor's less than disinterested suggestions that I needed them.

I thought that that was a pretty good reason to try to go off my meds. I still do.

The not so good reason was that I did it for the book. I did it because, as I have said before, my brand of journalism is immersive. You have to have the whole experience, or as much of it as you can. You can't just stand outside as an observer, the way I had in certain respects at Meriwether. The whole point is that you are not objective.

Besides, I had started this book because I went to the bin that first time for real. I had experience with mental illness, or distress, or whatever you want to call it. I was a subject, too. My own subject. I couldn't brush that aside or keep it discretely apart while I watched everyone else crawl through the tar pit.

But, without actually becoming depressed again, I couldn't really pull myself into the experience in retrospect. That's the thing about depression, I have found, and this is a great mercy under normal circ.u.mstances. When you're over it, when you're not depressed, it's really hard to remember exactly what it felt like when you were depressed. You can remember it as an idea. You can describe it a.n.a.lytically. You know you felt terrible, and you know you don't want to feel that way again. But you don't really remember the details, the quality of the suffering. But I wanted to be able to reexperience that, and then render that in real time, as it was happening, not after it had pa.s.sed.

I know, I know. Stupid. But there it is.

And, for what it's worth, here it is.

So turn the page.

ASYLUM.

St. Luke's

It began with dread in the morning. I woke with a feeling of dread. The first conscious thought. Something is terribly wrong with my life, with life in general, how it works, how it goes. It's too much. I can't face it. I am frightened. I am too small and impotent to handle this. Something is terribly wrong with my life, with life in general, how it works, how it goes. It's too much. I can't face it. I am frightened. I am too small and impotent to handle this.

This was only an inkling at first, like the vestige of a bad dream. I could not even remember what I was dreaming about, but I woke with this feeling that lingered well into the morning, well into my coffee making and shower.

I stood in front of the toaster and thought: It is absurd to be this afraid of nothing. But I am. I am afraid of nothing. It is absurd to be this afraid of nothing. But I am. I am afraid of nothing.

I looked for reasons, causes to a.s.sign, but they were irrelevant. That was the point. The fear. The dread came from nowhere. It did not correspond to the present or the prospects of the day in front of me. I was on firm ground. I had an enviable life. But it felt as though I was perched above the void. Blankness below. And my world crumbling around me.

My doctors might have explained it as an incommensurate stress reaction, a flight response on overload but with no discernable provocation, my brain thinking I was rappelling on a cliff face, dangling in danger. Adrenaline pouring in, but nothing so extreme had happened. I was just standing in my kitchen. The cliff, the void, was in my brain, in my dreams-and then it carried over into the morning when I woke.

This was disconcerting enough when it began. More so as it grew and extended itself throughout the day, through more and more days. Then I was genuinely concerned. Taking a moment to step outside the immediate storm, which had become so consuming, I thought: This is not normal. I have never been normal, but this is diseased even for me. There is something really wrong. This is not normal. I have never been normal, but this is diseased even for me. There is something really wrong.

I thought this especially when somewhere around midday I crawled into the bathtub without running a bath. The fetal position, taking comfort in the cool, white porcelain pressing against my cheek, a substance both strong and smooth bending around my bent body, binding me, solid, firm, the bounds of a disintegrating self, the bucket that collects me, dissolving into a pool.

Who do I imagine I am? This was a pressing question suddenly. But unanswerable, of course. This was a pressing question suddenly. But unanswerable, of course.

I stood abruptly. Rushed to the mirror. I held my face close and stared, reminded of a friend who, after a traumatic brain injury, emerged from a coma, looked in the mirror, and did not know who she was looking at. Really did not know who that person was. Had never seen her before. Could not fathom ident.i.ty.

That was happening to me, only it was happening in the way that simple everyday words like "because" and "h.e.l.lo" lose their meaning when you stare at them too long on a page, or are suddenly unsure how to spell them. It was a fundamental falling away of the most basic a.s.sumptions. The known suddenly somehow foreign.

Who the f.u.c.k are you? And what the h.e.l.l are you doing in the bathroom?

This was a real question. I meant it. I really meant it.

I was in a bad way, and it was my own fault.

I wanted to go off the meds and so I did, tapering slowly, wisely, this time, or so I thought. I had coping mechanisms in place, exercise, meditation, work, experience. And for weeks I was fine flying solo, though fatigued and susceptible to cold, even gaining weight, such that I wondered whether my thyroid had been thrown out of whack by the serotonin, another of those effects no one seems to know about and can only guess at from the symptoms.

After a few more shaky weeks, I began waking in the morning with the dread. And then the bathtub and the mirror. And then the extension of the morning dread into the day, and a darkness being thrown over the world, and a solid belief in the untenability of my life. The infantilization. The curling up. The sense of being ill-equipped for everything, the conviction gathering speed that death was the only real option.

I cannot work. I am useless. I am taking up s.p.a.ce. Consuming resources. I have no function. I am stupid. I will fail.

I had gotten out of Meriwether untrampled and I thought I was on my game. And then there I was thinking about where I could buy a gun.

A gun seems best. I am a maimed animal. Perhaps I can hire a hit man. I will tip him very well to take a clean shot.

Cowardice. You see?

I had been commissioned to write a book about loony bins. I had been to one already. I thought it was going to be a success story. Look at how I got off the meds and learned to make it on my own. But that is not how it worked out. I was going in again, this time with a wound in my side.

For research?

If you say so.

Pah. For real.

There was no need to pretend this time around. I cried in earnest in the admission interview. And why? Because that is another thing that happens when I stop the meds. I cry a lot. Big jags of tears over things like Oprah, Oprah, which was what I was watching on a 52-inch plasma TV, waiting in the lobby of yet another hospital. which was what I was watching on a 52-inch plasma TV, waiting in the lobby of yet another hospital.

The intrepid reporter undercover.

I want someone to take me in. I want to pretend that I am doing my job, but I belong here. I am a pitch-perfect silent screamer, a forlorn lump.

Oprah. And I was crying in this tiny Catholic hospital-facility, really-more like a clinic, a specialty clinic for addicts and lunatics plunked down there in the middle of the plains where the freight trains pa.s.sed through town outside the rain-bespeckled windows, moaning like whales under the broad gray sky. And I was crying in this tiny Catholic hospital-facility, really-more like a clinic, a specialty clinic for addicts and lunatics plunked down there in the middle of the plains where the freight trains pa.s.sed through town outside the rain-bespeckled windows, moaning like whales under the broad gray sky.

I listened as I sat. Sometimes I walked to the window and looked, saw the red signal lights flashing on the gantries, the line of waiting cars with their echoing rows of red taillights blurring in the downpour.

In the corner of the room, next to the window, there was a life-size gilded statue of the clinic's presiding saint, Luke, standing over the four rough upholstered armchairs, one of which I was occupying.

There was a Fisher-Price play station at my feet, with ramps and tracks and obedient b.a.l.l.s, a knee-high table and chairs, a box of toys half scattered in the corner. They treated children here, too.

What a place, I thought. What a place. So kind. So homey. Carpeted and warm. Quiet. There was only the TV, the volume low, and then only the sound of fingers softly typing, phones mutedly ringing, genteelly being answered.

It was late Friday afternoon. I had come for an appointment I had made by phone earlier in the week. I had called in supposed distress. Said I was on the road, about a hundred miles out of town. But I really made the call on my cell phone safe at home in New York.

Right. Safe.

As soon as I got the appointment, the so-called needs a.s.sessment appointment, I booked a flight.

The flight had been due to arrive more than an hour before the appointment. This, I thought, would give me plenty of time to take a taxi, even if the flight was late. It wasn't, and the airport was a joke. Two gates and two baggage carousels, like something on a Caribbean island. It had never seen a crowd. I had to call for a taxi, and the one cop on duty at the curb knew all the drivers by name. It took ten minutes to get from the airport to "downtown." It cost $13 including tip.

So there I was, early, flipping through magazines. Waiting alone in the lobby. A business reply mail card fell out of Bon Appet.i.t. Bon Appet.i.t. On it someone had repeatedly scrawled the word "Bored" in big letters. Other cards that fell out of other magazines, On it someone had repeatedly scrawled the word "Bored" in big letters. Other cards that fell out of other magazines, Redbook, AARP, Popular Science, Redbook, AARP, Popular Science, had more messages embedded. Always the same. "Bored," "I'm bored," or "Boring." had more messages embedded. Always the same. "Bored," "I'm bored," or "Boring."

A good joke, and for me, an unexpected smile I was thankful for. Solidarity left behind.

Been there, my friend. I have so been there.

The admitting staff was not pressed. Behind the long bulwark desk, with its gla.s.sed-in hutches and computer nooks, impeccably dusted, veneered, and generic as a floor display, two menopausal moms floated at their workstations, their fat fingers fluttering papers.

They mult.i.tasked smoothly, smiled patiently like women who had spent years darning mittens and cutting the crusts off sandwiches. They watched s.n.a.t.c.hes of Oprah, Oprah, admitted the odd visitor, touched up a database, caught the phone on the second ring. admitted the odd visitor, touched up a database, caught the phone on the second ring.

This was restful. It calmed the fear-the extra added fear, even though I was convulsed by fear already-of having flown into a far-flung place to check myself into the bin. Yes, this was all of my own doing, of course, so whatever happened would be my own fault, perhaps even deserved. And yet. And yet.

It was not all bad. Not at all. I felt strangely young, sitting there, and new to the big world, guided by these ladies, as if this were Take Your Daughter to Work Day, instead of take yourself to the psych ward.

The harbingers of good care in the clinic above were in the furniture and the carpeting downstairs. The carpet was so impressive, so calming. Sage green. A luxury bespeaking control in the clientele. It meant they didn't expect anyone to vomit or s.h.i.t himself or otherwise besmirch the premises.

Effort had been made, even in the three yellow gerbera daisies in a pot on the side table in the small consulting room where they asked me to wait for the needs a.s.sessment counselor. There were color photographs on the walls. The trunks of tall oaks growing cl.u.s.tered in luxurious stretches of green gra.s.s with shafts of mystical sunlight beaming through them. There was a box of tissues on the coffee table, thoughtfully placed, close to hand, an accoutrement of admission. Admission of instability, depression, suicidal urge, and admission to the hospital for same.

Like a ticket in my pocket. Admit one.

I waited in the room and looked at the pictures and the tissues, and allowed myself to be soothed by them a little, until the counselor came in.

The counselor, the girl-she was a girl to me, no older than twenty-five. Or at least she had the sprightly affect of that age, and the uncreased eyes, and the babyfatted mode of inquiry, and the eiderdown belief in what she did. The girl was very kind.

She had not yet felt the bludgeon of experience. She sat with her legs crossed at the knee, a clipboard in her lap. And on her feet-one bouncy foot dangling over the other-a pair of what I would call Mary Janes if you could hike in Mary Janes. Sa.s.sy schoolgirl upper. b.u.mper toe. Gripper sole. I liked her for those. They made me trust her.

And so a tear rolled out of my eye.

I was seized unaccountably by rue. I was ashamed, awed by the unspoiled attention of a girl a.s.sessing my needs, a girl who wrote down my answers so carefully in slow, looping script.

She seemed somehow outsized in her kindness, almost allegorical, the figure of Help in the pilgrim's regress. And I was in retrograde motion for sure, slipping out of the light, the line of waning day making its way across my face and leaving me in shadow, like a planet turning from the sun. She saw this and understood. It was not beyond her, though she herself had never known that kind of orbit.

She asked what I was doing in that town, because it is not a destination, barely a stopover, and even to the locals it was the middle of nowhere. I told her I had been hitchhiking across the country from New York, fleeing an unmanageable life.

"When I got here," I said, "I knew I was in trouble."

My voice caught in the lie. She noted this with her eyes, then noted it down with the pen. She was filling out a form, several forms, back and front, the first of many. They were positively German about this. Her forms, along with the others completed by the doc, the nurse, the social worker, and me, would end up in a three-ring binder with my name on it. And next to my name the initials MI.

"What does MI stand for?" I would ask.

"Mental illness."

"Ah. I see."

The other labels were CD, for chemical dependency, and DD for dual diagnosis, which meant that you were a loon and you did drugs. Technically that was me. DD. My file would say "history of cannabis dependence," but not, thankfully, "unhealthy preoccupation with bowel movements" or "mean drunk." It would also say, notably, "Patient is h.o.m.os.e.xual."

This was one of Mary Jane's many questions in the interview, slipped in nonchalant.

"Do you consider yourself to be heteros.e.xual, bis.e.xual, or h.o.m.os.e.xual?"

They asked this of everyone, I learned, though I feel sure that "patient is heteros.e.xual" never appeared in anyone's chart.

There were other odd questions. Ones I hadn't heard before, designed, I presume, to see how cognitively impaired I was.

"I'm going to hand you a piece of paper with something written on it," she said. "I want you to read it aloud and then do what it says."

She handed me the paper. It said: "Close your eyes."

"Close your eyes," I repeated, and did.

"What is this?" she said.

I opened my eyes. She was holding up her pen.

"A pen."

She pointed to the door.

"What is this?"

"English as a foreign language?" I ventured.

No smile.

"Sorry. A door."

She handed me another piece of paper with two interlocking squares drawn on it.

"Draw what's on this paper, then write a sentence. Then fold the paper and hand it back to me."

I drew the boxes and wrote pompously, "When does it begin?" I folded the paper and handed it back.

She unfolded it and glanced at what I had written.

If I had to guess, I'd say she thought, "Geek." But maybe it was "faker."

"Are those real?" I asked, pointing at the daisies.

"No. Are you having thoughts of self-harm?"

"Yes."

I didn't believe that I really was. Not right then. But I had been a few minutes before, hadn't I? Or was it hours? Or days? Still, I said it anyway, for the research, I told myself, because admission of danger to self, others, or property is pretty much guaranteed to put you in the bin, if not of your own will, then against it.