Never once, during any of my bouts of depression, had I been inclined or able to pick up a telephone and ask a friend for help. It wasn't in me.

No pill can help me deal with the problem of not wanting to take pills; likewise, no amount of psychotherapy alone can prevent my manias and depressions. I need both. It is an odd thing, owing life to pills, one's own quirks and tenacities, and this unique, strange, and ultimately profound relationship called psychotherapy

Mood disorders are terribly painful illnesses, and they are isolating illnesses. And they make people feel terrible about themselves when, in fact, they can be treated.

When people are suicidal, their thinking is paralyzed, their options appear spare or nonexistent, their mood is despairing, and hopelessness permeates their entire mental domain. The future cannot be separated from the present, and the present is painful beyond solace. ‘This is my last experiment,’ wrote a young chemist in his suicide note. ‘If there is any eternal torment worse than mine I’ll have to be shown.

When public figures remain silent about depression, there is a cost to the rest of society. Silence contributes to the misperception that successful people do not get depressed, and it keeps the public from seeing that treatment allows many individuals to return to competitive professional lives.

Because I teach and write about depression and bipolar illness, I am often asked what is the most important factor in treating bipolar disorder. My answer is competence. Empathy is important, but competence is essential.