Three springs ago, I lost the better part of my mind. I remember it starting with my feet. I woke up one February morning in the South Bronx apartment I’d just moved into with my husband, and my feet were so swollen I could barely fit them into my roomiest sneakers. I called in sick and rode the train downtown to the doctor, who told me my blood pressure was perilously high.

The news didn’t come as a shock. I had been working and worrying nonstop. I was in my first year of a new job at a nonprofit; during breaks I called the cable company, the gas company, and the furniture store. I wanted everything to be just right, for the apartment to look instantly lived-in and spotless, and I was sleeping less and less in pursuit of this perfection. I spent an excessive amount of money on linens for a dining table we didn’t yet own. I imagined parties in a backyard that was home to both bountiful collard greens and stray cats. My doctor prescribed a five-day course of water pills and told me to cut down on salt and fast food.

I didn’t know it then, but I would never return to that nonprofit. I missed a deadline to submit an important grant application. I stopped responding to emails and soon stopped working entirely. I called my boss’s cell phone on a Saturday morning. Eventually, I think, she blocked my number. I was paid my salary for a while, and then went on short-term disability leave. That leave was extended once. When I tried to extend it a second time, I received an unceremonious email terminating me from the job. I had been consistently employed since I was fourteen years old. This was the first time I had ever lost a job.

I was once someone people would describe as steady, the kind of friend you turned to for advice on buying an apartment or negotiating your salary. The year before I became sick, I started tumbling, transforming from a high-achieving, fiscally responsible, and thoughtful person into someone you might call “messy.” From February to May of 2018, I felt profoundly unmoored, alternately joyful and inconsolable, fearful and invincible. I had never felt so free or so impulsive. My whims and emotions led me; my feelings were snakes that whipped me around. Some days, having a cigarette and a cup of coffee from the bodega—light with milk and one teaspoon of sugar—was the only thing that could cheer me up.

What the world saw most was my rage. I am typically a mild-mannered person who is slow to anger and patient to a fault—a pushover, even. I hate confrontation. But that spring, I was furious. It was as if the weight of every unsaid thing and every unaddressed slight had built up in my body and was being released in one intense burst. I was mad, and I had a lot to say. A wrong look or word was an invitation to spar. I cursed people out across boroughs.

I was angry, but also afraid. My old fears—of bridges, dogs, fire, things around my neck—were joined by new ones, including a fear of riding the subway. For six long months, I couldn’t travel underground: a twenty-minute train ride to Manhattan became an hour and twenty minutes by bus and foot. I started having panic attacks almost every day.

I know I could have crumbled, receded into the plush silence of my illness. I recognize myself in Anne Sexton’s poem “Her Kind,” from her 1960 collection To Bedlam and Part Way Back:

I have gone out, a possessed witch,
haunting the black air, braver at night;
dreaming evil, I have done my hitch
over the plain houses, light by light:
lonely thing, twelve-fingered, out of mind.
A woman like that is not a woman, quite.
I have been her kind.

As winter turned to spring, I slept less and less, sometimes only three or four hours a night. To pass the days, which stretched long and formless, I talked on the phone. In the early morning, while my husband slept, I called friends in Barbados. I called acquaintances and ex-lovers around the world, people I hadn’t spoken to in years who were kind and patient but unsure what to make of my ramblings. They listened and grasped for polite ways to end our calls. I wanted to talk about my wedding, which had been held the summer before at city hall with only a few witnesses. But mostly I wanted to air out my wounds, to talk about who had hurt me.

My husband was at a loss for what to do with me, how to keep me safe, so he sent me to spend time with my parents in Brooklyn. When I wasn’t talking on the phone, I sulked, watched basketball, and skulked around the house in a white nightie. I took long walks to the mall, where I got into arguments and one-sided conversations with strangers. I tormented my parents and demanded that my father, a deacon, pray for me.

One night, I babbled nonsensically and crawled on the second-floor landing of the house, wanting to stay low lest the police see me. I heard my family start talking about taking me to the hospital, which unraveled me further. I lit a cigarette in the living room, an act of war in their tidy West Indian home. My father, who rarely raises his voice, yelled at me to get in the car; I tried to jump out of it as it was moving.

My parents, stepbrother, and cousin drove me to an emergency room in downtown Brooklyn. I rambled about Saturday Night Live and The Cosby Show, about Oprah, Toni Morrison, and Rihanna. By the time we arrived, my mood had shifted again. I was elated. As we ascended the steps to the entrance, I jumped with joy and clicked my heels together, telling everyone within earshot that I was pregnant with twins. (I wasn’t.) The last thing I remember is a nurse with dreadlocks asking me questions and then administering medication that knocked me out. I woke up the next morning in a different hospital. My husband and stepmother were in my room. I joked that this wasn’t how I’d planned to spend Valentine’s Day.

It was either during this hospitalization or during one of the three that followed that I was diagnosed with bipolar disorder. I wasn’t sure what the diagnosis meant, or what it had to do with me and my life. That morning, I was furious that no one rode with me from the emergency room to the hospital a few neighborhoods over, that they’d left me alone with strangers. When my sister visited, I asked her how she could be certain that the medical staff hadn’t raped me. She said it was unlikely, but admitted that she couldn’t be sure.

For weeks afterward, I couldn’t write because my hand shook too much when I held a pen. I was terrified. I had written the entire first draft of my novel longhand, and I couldn’t imagine not even being able to jot down ideas.

A week after being released, I had an appointment with an endocrinologist. My family floated theories about a thyroid storm. Mercifully, no one said the obvious: that I was acting like a crazy person. But when the time came, I couldn’t get myself to the appointment for fear of being readmitted to the hospital.

I left the house that morning determined to walk to Harlem instead. I wanted to see my hairdresser on Lenox Avenue, and was somehow convinced that I’d be safe there. But again, I couldn’t quite make it. I called my sister-in-law and an old colleague’s husband for help. I called my husband from a funeral home on East 149th Street. I made it most of the way to the salon but couldn’t cross the Harlem River, about a mile from my house. I think I knew that if I got to the river I might jump. Finally, I called a childhood friend from a Dunkin’ Donuts on the Grand Concourse, and she told me to stay put. She picked me up in her car and drove me across the river. I remember that drive feeling like a marvel, the water a surprise.

In 1972, my beloved maternal grandmother was admitted for the first of many times to the psychiatric hospital in Barbados known colloquially as Jenkins, after the former plantation on which it sits. “Everything that is old is evil in Barbados,” someone once told me. Nowhere is the truth of that statement more evident than at Jenkins, officially Black Rock Psychiatric Hospital, where patients in varying stages of distress and dissociation wander the same grounds their ancestors may have toiled.

My grandmother was a loving, generous woman who doted on me and my older sister. She was always the first person to call us on our birthdays and insisted that people traveling from Barbados to Brooklyn bring us her exceptional Bajan sweet bread. She was also intense. On an intake interview for a nursing home, she described herself as “aggressive,” one of many reasons why her stay there was short. Granny called my father and stepmother’s house at all hours of day and night, looking for somewhere to park her worries.

My sister and I didn’t have a name for Granny’s ailment until after she died. On a visit to Jenkins, we met with a psychiatrist who had cared for her, and she showed us records that stretched back nearly forty years, to the early Seventies. My mother has the same diagnosis; her stays in American psychiatric facilities began in the Nineties, not long after she lost custody of my sister and me.

In her best moments, my mother was an attentive parent with serious ambitions for her children. She sewed Black dolls, assigned summer book reports, and took us to the library religiously. But she struggled through a contentious divorce from my father in the early Eighties, and the stress of raising two children alone in New York City and her emergent mental illness caught up with her. By the time I was eight years old, my mother was no longer herself. Sometimes she was a carefree spirit who blasted Peter, Paul, and Mary and the Amadeus soundtrack while we cooked on the fire escape of the small apartment she’d bought in Crown Heights. At other times she was catatonic, a present absence who barely responded when we needed her and occasionally disappeared for days on end.

That summer, my mother lost custody of us. I will forever feel guilty for telling the family court judge the truth when he asked which parent we wanted to live with. My father, I said, hoping my mother would never know that I had betrayed her. At Daddy’s house, the fridge was full, and there was always an adult around. My mother would cycle through homeless shelters, group homes, the streets, and the occasional apartment for the next thirty years, traversing Atlanta, Seattle, Boston, and Barbados in search of something or someone, I’m not sure exactly what. I do know that I inherited my mother’s hot foot. And that Mommy, Granny, and I all belong to the same strange club of the severely mentally ill.

My own story starts when I am a child and a seizure interrupts my nap. It is one of many somnolent afternoons in Antigua, the island my father hails from and where our parents ship me and my sister every summer. We stay in a four-bedroom house whose walls end just before the ceiling to let the air circulate, with a ragtag band of cousins, uncles, and tanties—our paternal grandmother presiding. I am sleeping next to my favorite girl cousin and having a bad dream about something that happened to me the summer before. The bad dream, which I know is real, is about a boy touching me on the school bus that takes me from a street corner in Brooklyn that smells like August garbage to what will become my prep school on the Upper West Side. The boy says that if I say anything, he will tell everyone that I wanted it.

I was having a nightmare about the boy and the school bus, and then suddenly I was awake, unable to breathe. My tongue was impossibly large in my mouth and the metal fan turned and turned and turned while I tried to find my breath. I remember what felt like an endless ride between our house and the hospital, and that somewhere along the way, or maybe even after I arrived, I peed myself. I remember my cousins’ brown, mosquito-bitten legs folding over one another in the back seat of the car. Later, I will get a CAT scan at a hospital in Brooklyn, my parents concerned that perhaps I have epilepsy. All the tests will be inconclusive.

For the rest of that summer, and for months after we returned to Brooklyn, I did not want to sleep alone. I was convinced that my cousin who ran to get help when I couldn’t breathe saved my life. I couldn’t risk falling asleep alone again. I mark the seizure as the first taste of the anxiety and depression that would haunt me in the years to come. I was a brooding, melancholic teenager and young adult. I was at once angry with and yearning for my mother, whom I didn’t have any contact with between the ages of fifteen and twenty-five. In my twenties, I cultivated coping strategies—therapy, music, meditation, prayer, yoga. In my early thirties, after I published my first novel, the anxiety and depression I’d felt as a child resurfaced. In 2016, a combination of work stress, heartbreak, and isolation pulled me into a suicidal undertow. I understand now that this was likely the prodromal or warm-up phase of my bipolar disorder, which preceded my full-blown psychotic break two years later.

One day in February 2018, I almost lost myself. It was unseasonably warm. I left the house in the early afternoon, the front door wide open behind me. I wore a black dress coat that I’d bought in France on top of a matching soccer jersey and pants that my husband had given me. As I walked up the Bronx’s Third Avenue, I became taken by the idea of trying to prove how difficult it was for a woman to use the bathroom. I asked to use the toilet at a dry cleaner, a day spa, and a State Farm agency, making scenes each time I was refused, sometimes claiming that I was pregnant to see how far I could push the experiment.

When I grew tired of the game, I stopped for a slice at a pizzeria, where I met a nice Black woman and her little girl. The woman had just picked up trophies for a soccer program she ran with her husband. She told me all about it as we walked twenty blocks north into a neighborhood I’d never visited before. Along the way, I yelled in French at a Togolese man. I could tell that the woman was worried about me, and perhaps a bit afraid, but she was kind.

Before we reached the southern edge of Crotona Park, I bid the woman and her daughter goodbye. I had what felt like an endless fount of energy. I wanted to play. I saw a pit bull I liked, and followed the dog and its owner into a building that I later found out was a homeless shelter. I walked to the top floor and rang a few doorbells; no one opened up, though one lady spoke to me kindly in Spanish through her door. I ran outside, where I saw a few kids. I introduced myself to one of them, who looked to be about eight years old; within a few minutes we were shadowboxing. I asked him whether he knew about Muhammad Ali and Malcolm X, quizzed him between feints and jabs until we both grew bored.

I told the boy that President Obama was going to officiate my wedding that evening on the Harlem River, and that Rihanna would be performing. I told him he should come along and bring his crew. A dozen kids amassed to follow me. Then they realized that I was lying. The mood changed. One of them, the oldest, cursed me out and chased me. I ran, weaving between parked cars, yelling back at him. I avoided a fistfight only because someone mercifully called the kids back inside.

A tall, scruffy man who had been watching the scene pulled me into his apartment about a block away. I had to get ahold of myself, he said. I looked around his apartment, which smelled like cats had been peeing in it for centuries. There was a punching bag in the cramped living room. His girlfriend was a Black woman whose skin seemed to glow in the dim light. The man said that I was too much, that I was upsetting her. She looked high. She looked like she had the same kind of problem as me. I told the man I couldn’t stay long because I was running from the FBI. As soon as I said that, he shoved me out into the dark night that had descended.

I headed to the Cross Bronx Expressway. I ran alongside cars on the highway for a while, stuck out my thumb for rides. I may have been trying to get to my wedding; I can’t remember. But no one would stop for me. I thought that the United Nations was in session, and I was convinced I saw Robert Mugabe. Soon I was playing a game with myself, trying to see which African dignitaries I could spy on their way into the city.

Suddenly I was unbearably hot. I stripped, peeling off my layers until I wore only a white tank top and green sweatpants. In doing so I became my grandmother, who’d been known to stand on the road in Barbados in her slip until an ambulance came to take her away. That night in the Bronx, I waved my blue hoodie at a helicopter circling overhead. I was tired, and though I didn’t want to go home, I knew I needed help. I sought refuge at a community center with a lactation station just above the highway, the woman with her babe a beacon. A man there called the police.

I had enough presence of mind to know to be afraid when the cops arrived. I knew that when mentally ill Black people spiraled, sometimes they didn’t make it out of encounters with the police alive. In 2012, Shereese Francis took her last breath in her Jamaican parents’ Queens basement after she was tackled by four police officers. In 2013, Miriam Carey, a Black woman with postpartum psychosis, was killed by police officers after driving her car into a restricted area near the White House. Her thirteen-month-old was in the back seat. In March 2020, Daniel Prude was pinned to the ground and died of asphyxiation after the police stopped him as he ran naked through the streets of Rochester. And that October, Walter Wallace Jr. was gunned down in Philadelphia while his wife tried to stop the cops by telling them he was “mental.”

By the time the police arrived, I was cold; February’s chill was wrapping its arms around me. I spoke rapidly in what I learned later was clinically known as “pressured speech.” Though I’m unsure now of what I said, I remember putting my hands up to show I was unarmed. I told a female officer that I had once wanted to attend medical school, but had quit a premed program to follow my dream of becoming a writer. Even as I unraveled, I tried to present my most well-mannered, professional self, hoping that my credentials might protect me. I got into an ambulance and talked with the medic the whole way there, grateful for the way he treated it like a taxi ride.

It was four o’clock in the morning when I called my husband from the emergency room. When he answered the phone, I could tell he hadn’t slept at all. Later, I found out that he and my sister had called the police when I didn’t come home, that they had combed the park near my house for signs of me. I want to cry when my husband describes how he and my sister looked in garbage cans, hoping and not hoping to find something that belonged to me. Even now, I am only dimly aware of how my sickness has affected them. I try to be grateful and not to feel guilty, not to be the burden I am convinced I always will be to them.

The early signs of my illness—impulsivity, reckless spending, defensiveness, sleeplessness—alarmed the people who loved me. One morning, my best friend at the time sent me an email suggesting that my behavior might be the result of a psychiatric issue. My doctors eventually agreed, but when she wrote it, it felt like an accusation, the withdrawal of her friendship a punishment. After that, she became more and more distant. A year later, when we were trying and failing to reconnect, I sent an email expressing my anger with her. In response, she said she needed to protect herself from me. While her words wounded me, becoming a parent has made me vigilant about who and what I allow into my own life, so in some ways I understand.

This was only one of the many friendships I lost. Even as I mourn the loss of these friendships, I also know what it’s like to be on the other side of mental illness. Having watched my mother and grandmother come undone by their illnesses, I know what it’s like to feel helpless, angry, and sad in the face of what often looks like self-sabotage and narcissism. I know that self-preservation can require setting boundaries, keeping distance, looking away.

There were others who stuck by me. Friends and family formed a kind of safety net that I fell against but never fell through. They visited me at home, and in the wards of each of the four hospitals where I was admitted. Friends in Santa Fe, Barbados, New Orleans, and Kigali called and wrote. A high school friend I hadn’t spoken to in years checked on me after seeing some of my alarming social-media posts. We made lunch dates around which I organized weeks that were otherwise spent sleeping, watching SVU marathons, and avoiding the shower. I wanted to talk, to know that someone I loved would pick up the phone and listen without judgment. I wanted to know that I was deeply loved. One day, a friend walked me slowly around my neighborhood while I smoked and stopped every few minutes to put my back against brick walls because I was convinced that the fire department and the FBI were hunting me down. Somehow the surety of a wall at my back made me feel invisible and safe.

My illness unfolded seven months into my first year of marriage, but my husband stayed steady, even as members of my family and his friends told him to cut his losses and run. Once I was home, and the hard work of rebuilding my life began, he made sure I took my medication every day, cooked and cleaned when I couldn’t bring myself to do much of anything, shouldered the weight of our bills while I was unemployed. Later, when I was well, he asked me whether I still wanted to be married to him, whether I was sure that our relationship wasn’t another impulsive decision I’d made as I was losing my mind. I told him that even if it was, it’s a decision I stand by.

In March 2018, a month after the first hospitalization, my therapist, my sister, and a friend convinced me to admit myself to the psychiatric ward of a hospital on the Upper East Side. I arrived with a stuffed overnight bag, shaky and afraid of nearly everything. In the spare intake room, a Black girl, a high schooler, was brought in for fighting. I was afraid of her; I saw in her wild eyes and hair the girls who bullied me when I was a chubby kid in Brooklyn. I worried that she would beat me up.

That night, I sat with the other patients in plastic chairs and washed down my meds with ginger ale and graham crackers, which I’d gotten from another patient in a trade for a PB&J. One of the patient-care associates sat down next to me. He asked me whether I was a frequent flier at the hospital, whether I’d been there before. I didn’t know until that moment that I looked deranged to people outside my family. Finally, I had a sense of how far gone I was. I think I frowned and shook my head no, but it’s possible that I didn’t say anything. At last, I understood the line that ends an Edwidge Danticat story: “Shame is heavier than a hundred bags of salt.” That long winter into spring, shame sat atop my chest, heavy and unmoving.

Shortly after I was released from the hospital, my mother came to visit. She had moved back to New York City the year before, leaving a stable but imperfect living situation in Boston to start over again in the city’s byzantine shelter system. It had been months since I’d seen her, a year since she’d told me, over a lunch I could barely afford, how little she thought of my “yuppie novel.” We walked in circles around my block. We shared a cigarette. She was the first person to accurately describe the way that a coffee and a smoke takes the edge off the emotions swirling inside me. When we spoke that day, we didn’t say the word “bipolar” or mention the diagnosis that belonged to her. I’d never acknowledged my mother’s illness to her directly; she is fiercely proud and private, like my grandmother and my sister. There is dignity in allowing ourselves to be more than the clinical language that describes how our minds work. I believe she asked me how long I was in for. We knew without saying it aloud how much being on a psych ward felt like being in prison.

Since then, I have been on a steady, slow journey back to myself, or more precisely, toward someone new who resembles the person I was before. I stopped taking psychiatric medications when I got pregnant in the summer of 2019, and I have remained off them while I breastfeed my child. I landed a tenure-track teaching position when I was thirty-nine weeks pregnant. After two years of not publishing a word, I saw my byline appear in print again last year. I am somewhat in awe that the postpartum months have not plunged me into another crippling depression or sent me flying into another bout of mania. Talking with an acquaintance who also has bipolar disorder and a child of her own makes me think that perhaps the simultaneously monumental and simple task of keeping another person alive has steadied me.

Some parts of the year when I was sick are fuzzy. But there are echoes that reverberate still. I developed a stutter that resurfaces when I am tired or nervous; some nights, I struggle to say simple sentences. The vestiges of an insidious self-doubt remain—the inability to fully trust my instincts and decisions; a constant wonderment about whether what I want is what is good for me; a persistent, draining interrogation of the lines between my highest self and my illness. The period after my intense recovery has also required that I reset the boundaries in my relationships; I am still working to discern what is appropriate concern and what is inappropriate meddling in my affairs.

Feeling better makes me wonder what’s changed, and whether and how the sickness will come for me again. Although I hope there won’t be a next time, I’m not naïve enough to believe that I am so exceptional as to be spared. A study in The American Journal of Psychiatry indicates that the likelihood of relapse within five years for people with bipolar disorder is more than 70 percent. This illness is the sixth-leading cause of disability for young people throughout the world. Before I fell ill, I identified as able in both body and mind; my life was a testament to privilege, luck, and a voracious appetite for achievement.

Now I identify as a person with a disability. This marker is more than a new box to tick. Becoming a disabled person has been alternately confusing and empowering, a source of new connections with people who are physically and cognitively differently abled. It has also surfaced a new kind of stigma. The material consequences of my illness continue to be grave. I couldn’t secure life insurance until a year after my psychiatric hospitalizations, and I am facing an uphill battle to stay insured now. It took two years to pay off the more than $30,000 in credit card debt I racked up during the manic phase of my illness. I’m profoundly aware both of my own resources and of the financial insecurity that too often defines the lives of disabled people.

When the next time comes, as I know it will, I pray for the patience and presence of my beloved community. I pray that I will not alienate my friends and family, that they will still want to walk with me, sit with me, listen to me. I know that what I needed the most when I was sick were compassionate, alert witnesses, people to listen and help keep me out of harm’s way.

Recently, a friend asked me how I came to be doing so well. The answer is deceptively simple: rest, childcare, therapy, meaningful work, healthier relationships. It matters that my therapist is a Black woman to whom I don’t have to explain certain aspects of my selfhood. The cultural shorthand that we share affords trust, intimacy, efficiency. A 2018 American Psychological Association report indicates that only 4 percent of therapists in the United States are African-American; Black people’s lack of access to high-quality, affordable mental-health care is well documented. For my part, I see my therapist only once a month, because she doesn’t accept health insurance.

Most importantly, I am writing again. What was disconcerting about being sick was that it robbed me of my focus, attention, and creativity. When I was manic, I had many ideas, but I was too wired to write; sometimes I couldn’t sit still for more than a few minutes at a time. When I was on high doses of medication, I was finally able to sleep, and my emotions were in check. But everything besides the most basic acts required immense effort. I had few ideas and no motivation to write them down. I felt as if I were crawling through quicksand, or perhaps more accurately, viewing the world through a scrim. Now I am reacquainted with myself as a writer, which is to say that I am reacquainted with myself.

Since the birth of my son in February 2020, I have been writing with ease and urgency for the first time in years. I am almost scared to say so, lest I jinx it, but I am even more scared to stop writing. More than ever before, I am aware of the sanctity and precarity of my life. I have been working six days a week. I have written reviews, essays, and pages of a novel. I know that I am courting danger by working nonstop and caring for a baby who does not sleep through the night. I know that just below these heights of creativity, there is a winding staircase that leads to mania. Still, I write as if I may never write again. I want to get it all down. In case my mind betrays me, let me say one last thing.