It wasn’t the first time. Mary was diagnosed with bipolar disorder — the brain disease that used to be called manic-depression — in the summer of 1995 after a dramatic psychotic break. From that moment onward she worked vigilantly to keep herself on the middle path between the terrifyingly seductive highs and the soul-destroying lows that are the two poles of the disease, and for the most part she succeeded, becoming along the way a vocal advocate for greater public understanding of mental health.
She wrote about it — a piece she published in Newsweek in 2002 called “Call Me Crazy, But I Have To Be Myself” is required reading in some college classes — she lectured, she taught, she worked with individuals. She took up shardware, a mosaic technique that uses broken plates to make beautiful and eccentric works of art, and she taught it to other people with mental illness as a metaphor for finding the beauty in brokenness.
Still, Mary had a bipolar brain. At about this time last year, she started feeling depressed again. At first she attributed it to the change in the seasons — she hated winter’s long nights and cold days — and a change in jobs. She went to yoga class more often, rode her horse whenever she could, asked her doctor’s help in adjusting her medications, reached out to family and friends for support. Mary had been writing off and on about her own life; after she died we found fragments of a memoir.
“Depression is its own country,” she had written. “You don’t know exactly how or when you got there, but you know you want to get out. The country declares sovereignty and says you will live there until you die. Which may be sooner than you think.”
The particular depression Mary was writing about occurred in 1998, three years after her first psychotic break. It took two years for her to fully crawl her way out of that one.
“I grew used to days that were shaded from black to pale gray, grateful for any that were pearly,” she wrote. “I started therapy with a Buddhist-oriented practitioner and came to know the strands of anxiety, insecurity, fear, hopelessness and grief deeply woven into my psyche. I learned to sit with them and study them rather than push the feelings away.”
Eventually the pearly days began to outnumber the gray days, and then the sunny days outnumbered the pearly ones and Mary went on with her full, creative and satisfying life.
* * *
By October of last year it was clear that the depression had returned. Mary was educated enough in her own illness to recognize that this was the depression that inevitably, in the cycle of bipolar disorder, follows the mania — in this case just a couple of years late. By November she was describing a sense of despair and anxiety that rarely lifted; by December she had lost a noticeable amount of weight and was having trouble sleeping. To those of us who spent time with her every day, she seemed like someone disappearing under a sheet of ice, looking out at the world from a greater and greater distance. It was like her psychotic break but in reverse: a sharp parabola that felt like reality to her. But wasn’t.
“What’s so strange is that I am my own worst enemy,” she wrote near the end of December. “It’s my imaginings, my fears, that render me incapable. If I could only find a way to let go of all that fear. It’s irrational, really — I have enough money to get by for quite a while. It’s not about base survival — it’s about the mind playing tricks on itself, distorting reality.”
* * *
In 1996, in the wake of a mass shooting, Australia dramatically tightened its firearm-licensing requirements, prohibited several kinds of firearms outright and held a mandatory buyback of all the guns that had been made newly illegal. The firearm suicide rate subsequently fell by 57 percent. When Israel no longer allowed its soldiers to take guns home on the weekend, the overall suicide rate in the Israeli Defense Force dropped by 40 percent. Twenty years ago the state of Connecticut passed legislation that barred a person who had been a patient in a mental health facility within the last six months from purchasing a gun, and started mandating an eight-hour safety training course for anyone who wanted a gun permit. The firearm suicide rate fell by 15.4 percent. To receive a gun permit in Massachusetts, where Mary was living when she experienced her first big depression, you must fill out and mail in a hard-copy application, be fingerprinted and photographed, pay $100 and take a certified gun safety course. Massachusetts has one of the lowest overall suicide rates in the United States, fewer than ten for every 100,000 people.
* * *
In early January, Mary spent a couple of days in a mental health facility in Winston-Salem, hoping that a new regimen of medications might begin to reverse the despair that had overtaken her days and her nights. She came home from the center on a Thursday evening feeling little better. On the Saturday after she got out, she sat down in her sunny workroom overlooking her sloping backyard and wrote: “Today I signed up for a gun permit. Apparently it takes 5-7 days for the permit to come through. The thought of buying a gun and shooting myself terrifies me, but so does the idea of living any longer. Maybe my meds will kick in during the next few days and none of this will happen.”
Mary applied online and paid the $5 application fee. On Tuesday around noon — fewer than two business days after her application was submitted — she received an email from the Guilford County Sheriff’s Office letting her know that she had been approved and could pick her permit up from their office.
Perhaps given another couple of days the meds would have kicked in as she hoped, perhaps a good night’s sleep or a warm day or a decent meal would have been enough to alter her state of mind, but now we’ll never know. Five days after applying for a gun permit, Mary was dead.