Susannah Cahalan - Brain on Fire - My Month of Madness

James thought on this for a moment. “No. Not in the least. That’s just not Susannah. Sure, she can be excitable and temperamental, but she’s not depressive. She’s tough, Mom. We all know that. She deals with a lot of stress, but she handles it better than anyone I know. Bipolar doesn’t make any sense to me.”

“Me neither,” my mom said. “Me neither.”

Later that next night, I had an epiphany. Forget bipolar disorder: it was the antiseizure medication Keppra. The Keppra must be causing my insomnia, forgetfulness, anxiety, hostility, moodiness, numbness, loss of appetite. It didn’t matter that I had been on the drug for only twenty-four hours. It was all the Keppra. An Internet search proved it. These were all side effects of that toxic drug.

My mother pleaded with me to take it anyway. “Do it for me,” she begged. “Just please take the pill.” So I did. Even during this time when I hardly recognize myself, there are still shadows of the real Susannah, a person who cares what her family and friends think, who doesn’t want to cause them pain. Looking back, I think that’s why, despite the battles, I often caved at my family’s insistences.

That night, as the alarm clock by my bed struck midnight, I lifted my head with a start. The damn pills. They’re taking over my body. I’m going crazy. THE KEPPRA. I need it out of my system. “Throw it up, get it out!” a voice chanted. I kicked off my sheets and jumped out of bed. KEPPRA, KEPPRA . I went to the hallway bathroom, ran the water, got on my knees, and knelt over the toilet bowl. I jammed my fingers down my throat, wiggling them around until I dry-heaved. I wiggled more. Thin white liquid. Nothing solid came up because I hadn’t eaten in longer than I could remember. DAMN KEPPRA . I flushed the toilet, turned off the water, and paced.

The next thing I knew, I was upstairs on the third floor, where my mom and Allen slept. They’d moved up there when James and I were teenagers because it had worried them too much to hear us coming and going at night. Now I stood over my mom’s bed and watched her sleep. The half-moon shone down on her. She looked so helpless, like a newborn baby. Swelling with tenderness, I leaned over and stroked her hair, startling her awake.

“Oh, my. Susannah? Are you okay?”

“I can’t sleep.”

She rearranged her mussed-up, cropped hair and yawned.

“Let’s go downstairs,” she whispered, taking my hand and leading me back into my bedroom. She lay down beside me, brushing out my tangled hair with her beautiful hands for over an hour until she fell back asleep. I listened to her breathing, soft and low, in and out, and tried to replicate it. But I didn’t sleep.

The next day, on March 18, 2009, at 2:50 p.m., I wrote the first in a series of random Word documents that would become a kind of temporary diary over this period. The documents reveal my scattered and increasingly erratic thought processes:

Basically, I’m bipolar and that’s what makes me ME. I just have to get control of my life. I LOVE working. I LOVE it. I have to break up with Stephen. I can read people really well but I’m too jumbly. I let work take way too much out of my life.

During a conversation earlier that day when we discussed my future, I’d told my father that I wanted to go back to school, specifically to the London School of Economics, even though I had no history of studying business. Wisely, gently, my father suggested that I write down all my racing thoughts. So that’s what I did for the next few days: “My father suggested writing in a journal, which is definitely helping me. He told me to get a puzzle and that was smart because he too thinks in puzzles (the way things fit together).”

Some of the statements are incoherent messes, but others are strangely illuminating, providing deep access to areas of my life that I’d never before examined. I wrote about my passion for journalism: “Angela sees something in me because she knows how hard it is to be good at this job, but that’s journalism, it’s a hard job. and maybe it’s not for me I have a very powerful gut.” And I went on about my need for structure in a life that was quickly falling to pieces: “Routine is important to me, as is discipline without it I tend to go a little bit haywire.”

As I wrote these lines and others, I felt that I was piecing together, word by word, what was wrong with me. But my thoughts were tangled in my mind like necklaces knotted together in a jewelry box. Just when I thought I had untwisted one, I would realize it was connected to a rat’s nest of others. Now, years later, these Word documents haunt me more than any unreliable memory. Maybe it’s true what Thomas Moore said: “It is only through mystery and madness that the soul is revealed.”

That night I walked into the family room and announced to my mom and Allen, “I’ve figured it out. It’s Stephen. It’s too much pressure. It’s too much. I’m too young.” My mom and Allen nodded empathetically. I left the room, but then, a few feet outside the doorway, another solution emerged. I retraced my steps. “Actually, it’s the Post . I’m unhappy there, and it’s making me crazy. I need to go back to school.”

They nodded again. I left and then turned straight around again.

“No. It’s my lifestyle. It’s New York City. It’s too much for me. I should move back to St. Louis or Vermont or someplace quiet. New York isn’t for me.”

By now they were staring at me, concern creasing their faces, but still they continued to nod accommodatingly.

I left once more, cantering from the family room to the kitchen and then back. This time I had it. This time I had figured it out. This time it all made sense.

The Oriental rug scraped my cheek.

Oval droplets of blood marring the pattern.

My mom’s shrill screams.

I had collapsed on the floor, bitten my tongue, and was convulsing like a fish out of water, my body dancing in jerking motions. Allen ran over and put his finger in my mouth, but in a spasm I bit down hard on it, adding his blood to my own.

I came to minutes later to the sound of my mother on the phone with Dr. Bailey, frantic for some kind of answer. He insisted that I keep taking the medication and come in for an electroencephalogram (EEG) on Saturday, to test the electrical activity of my brain.

Two days later, that Friday, Stephen came to Summit to visit and suggested that we get out of the house and grab some dinner. He had been debriefed by my family about my deteriorating behavior and was on high alert, but he knew that it was important for me to leave the house (because of the threat of seizures, I could not drive a car) and maintain some semblance of an adult life. We headed to an Irish pub in Maplewood, New Jersey, where I had never been before. The bar was crowded with families and teenagers. People hovered around the hostess’s desk, jockeying for reservations. I knew immediately that there were too many people. They all stared at me. They whispered to each other, “Susannah, Susannah.” I could hear it. My breath got shallower, and I began to sweat.

“Susannah, Susannah,” Stephen repeated. “She said it’s a forty-minute wait. Do you want to wait or go?” He gestured to the hostess, who did in fact look at me curiously.

“Umm. Umm.” The old man who seemed to be wearing a toupee jeered at me. The hostess raised her eyebrows. “Ummm.”

Stephen grabbed my hand and walked me out of the restaurant into the freedom of the frigid air. Now I could breathe again. Stephen drove me to nearby Madison, to a dingy bar called Poor Herbie’s where there was no wait. The waitress, a woman in her midsixties with frizzy bleached blond hair and gray roots, stood at the table with her left hand on her hip, waiting for our orders. I just stared at the menu.