The Center Cannot Hold: My Journey Through Madness

by Elyn R. Saks

I began to notice that the colors and shapes of everything around me were becoming very intense. And at some point, I began to realize that the houses I was passing were sending messages to me: Look closely. You are special. You are especially bad. Look closely and ye shall find. There are many things you must see. See. See. I didn’t hear these words as literal sounds, as though the houses were talking and I were hearing them; instead, the words just came into my head—they were ideas I was having. Yet I instinctively knew they were not my ideas. They belonged to the houses, and the houses had put them in my head.

it is not necessarily true that everything can be conquered with willpower. There are forces of nature and circumstance that are beyond our control, let alone our understanding, and to insist on victory in the face of this, to accept nothing less, is just asking for a soul-pummeling. The simple truth is, not every fight can be won.

I began to be regularly invaded by the strangest fantasies, very intense and hard to escape—they weren’t exactly hallucinations or waking dreams, but they were extremely vivid and, for me, not entirely distinguishable from reality. They’d come out of the blue, with no warning, and no reason that I could understand. It was as though in the absence of the familiar Vanderbilt routine, the fantasies had come to fill the void, and I couldn’t shut them off. Whole hours would go by at night when I was stuck in this alternative universe, struggling to decipher what was going on inside my head. Scenarios came and went of their own accord—it was like being unable to get out of the theater while demented movies ran endlessly through the night.

Every single night, when the house was quiet and everyone else was long asleep, there came a moment when my heart would begin to race. I’d break into a cold sweat, and my breathing would become shallow and very rapid. I didn’t know these events were panic attacks; I only knew my heart was about to burst out of my chest, and it terrified me. That’s it, I thought: Something is wrong with my heart.

The origin of the commands was unclear. In my mind, they were issued by some sort of beings. Not real people with names or faces, but shapeless, powerful beings that controlled me with thoughts (not voices) that had been placed in my head.

It never occurred to me that disobedience was an option, although it was never clear what might happen if I disobeyed.

I truly believed that everyone had the scrambled thoughts I did, as well as the occasional breaks from reality and the sense that some unseen force was compelling them to destructive behavior. The difference was, others were simply more adept than I at masking the craziness, and presenting a healthy, competent front to the world. What was “broken” about me, I thought, was my inability to control my thoughts and fantasies, or to keep from expressing them.

Right now, wherever you are—in your room, in a library, on a park bench, on a bus—literally hundreds of things clamor for your attention. On the outside, there are sights, sounds, and smells; on the inside, you have your thoughts, feelings, memories, wishes, dreams, and fears. Each and every one of these, both inside and out, is knocking at your door, all at once. But you have the power to choose which thing, or combination of things, to give your attention to. Maybe it’s the feeling of the book in your hand, or the temperature of the room you’re sitting in. You shift and reposition a pillow at your back. You reread the last paragraph on the page, then turn to the next one. You think about getting up and walking into the kitchen, maybe preparing a snack. Even though these actions address only a tiny fraction of what’s actually going on inside and around you, you are able to choose them and relegate the others to the background. Now consider this: The regulator that funnels certain information to you and filters out other information suddenly shuts off. Immediately, every sight, every sound, every smell coming at you carries equal weight; every thought, feeling, memory, and idea presents itself to you with an equally strong and demanding intensity. You’re receiving a dozen different messages in a dozen different media—phone, e-mail, TV, CD player, friend knocking at the door, ideas inside your head—and you’re unable to choose which ones come to the front and which are releg...