A Personal Note

I begin with a memory.

I wake lying on a thin mattress on the floor of an empty hospital room. By “empty,” I do not mean sparsely furnished—the mattress is the only object in the room other than myself. To my relief it is not a rubber room, and I am not wearing a straitjacket. But I do grimace at the raw, chafed skin around my wrist where a handcuff has been.

It is night, I think.

I do not remember how I got here, or how many days have passed since I arrived.

“You’re stronger than you think you are, think you are, THINK YOU ARE!”

Someone in the hallway is shouting.

“Just when the caterpillar thought its world was over it became a butterfly, a butterfly, A BUTTERFLY!”

I think I can now confirm that I’m in the psych ward.

I grasp at fragments of memory. How many days have I been here? How many nights had I gone without sleep? I remember hours of uninterrupted writing driven by a relentless inner monologue. The voice in my head had sprung into existence of its own accord and continued its narrative involuntarily and impersonally, a soliloquy both mine and not mine. There had been a moment of religious revelation, for lack of a better word; some grand discovery that would allow me to solve all remaining philosophical and scientific problems in a single stroke. A night spent suspended somewhere between sleep and wakefulness, during which it seemed the entire natural history of the human species from its most distant origins disclosed itself to me in dream. Then a day in which everything was bathed in light, as I proceeded through each of the seven days of Creation, experiencing everything as if for the first time.

Then, of course, total collapse. I had, it seemed, developed powers of telepathy. I was certain that a society of supremely enlightened aliens were attempting to contact me. They were streaming the code of existence into my mind through some minute antenna, and having cracked that code the world would now become something akin to a video game I could manipulate at will. A moment of sheer panic when my wife, Courtney, calls 911, sobbing, to plead for an ambulance. Instead, my cheek pressed to the cold hood of a cop car, arm twisted behind my back and the officer’s hand on his taser. Finally, the ambulance. At the hospital, the nurses and doctors parade around me as so many mythic figures, enacting the Stations of the Cross. I hear a crystal-clear auditory hallucination of Pink Floyd’s “Money” as I’m wheeled into the next room, before I lose consciousness. I would stay at the hospital for over a week, though the mania would take a month to dissipate before giving way to the most extreme depressive episode of my life.

Between my first psychotic episode in April, 2016 and the time I began to tweet regularly about madness as “Left Nietzschean” in 2023, I would experience about a dozen such episodes, one of which, in 2021, would land me back in the hospital. Looking for signs of mania or psychotic thinking patterns became a daily routine out of necessity. It also meant learning to manage the extreme irritability and tendency toward overreaction that accompanied the exaggerated sensitivity of manic periods. It meant worrying, on a daily basis, about whether I was acting under the influence of delusions or could feel confident in my lucidity. What made this even more difficult was how closely entwined my episodes were with my philosophical work. As time went on, thousands of pages of unpublishable speculations on everything from mysticism to anthropology to quantum mechanics accumulated, all in an effort to make some sense of what I was experiencing.

Anyone who experiences psychosis knows how ill-equipped the psychiatric establishment is to help you navigate the paradoxes of your condition. Therapies designed to manage depression and anxiety have little to offer someone for whom religious epiphany coincides with traumatic incarceration, or who finds herself hounded by demons that chatter incessantly for her alone. Psychiatry’s solution is to pathologize psychotic experiences and suppress them with anti-psychotic drugs. When I first started treatment for bipolar disorder, I decided against taking lithium, opting instead for a combination of mood stabilizers and hoping that, in conjunction with therapy and significant lifestyle changes, I could get my psychosis under control without brutally repressing it.

It was in this context that I rediscovered Nietzsche. The more I returned to Nietzsche, the more his lifelong struggle with comprehensive mental and physical illness stood out to me in new ways. Alongside the iconoclastic philosopher and prophet of nihilism I found a man incapacitated by his sickness and failed by the medical establishment of his time, forced to undertake his own voyage toward health across uncharted waters. I noticed the tinges of psychosis in Nietzsche’s writings near the end of 1888, and the affinities with my own experience reshaped my understanding of his most grandiose and manic pronouncements. Nietzsche, I realized, had also navigated the bipolarity of extreme mood swings and had sought to develop a philosophical method for giving form and expression to his inner contradictions. His experiment in becoming his own physician had ultimately failed to stave off madness, but it was a noble effort nonetheless, and one from which I could learn a great deal about my own psychotic experiences.

It was in a fit of Nietzschean irony that I adopted the moniker “Left Nietzschean” on Twitter and started to post about my personal struggles with mental illness. In retrospect, I was incredibly naïve. I underestimated how polarizing the handle would be, how many enemies it would make me, and in general how seriously people took it, as if I had a complete manuscript of A Left Nietzschean Manifesto tucked away and ready to present at a moment’s notice. I started to commit to the bit and post more often about what “Left Nietzschean” might mean, mostly explaining what I found valuable in Nietzsche’s thought and how it connected to my own broadly left political commitments. But in truth none of it interested me very much. The focus of my project was Nietzsche’s madness, and my overriding anxiety about social media had nothing to do with politics at all, but with the dangers of being public about having a psychotic disorder. I enjoyed using Twitter, but at some point, I worried, it was going to come back to bite me. My moods were too extreme, my temper too quick, and my thinking too vulnerable to delusion, for me to survive the treacherous waters of social media for long.

Recent experiences catching hell on social media for making an ill-advised remark remind me of the Catch-22 that people who decide to be public about their mental illness face. From the standpoint of public perceptions, it’s brave, authentic, and admirable to be open about one’s struggles with mental illness right up until the moment that you start exhibiting symptoms of that illness. It’s powerful to share your experiences with depression or suicidal ideation, but it’s cringe to “post through it”. If you have a personality disorder, a single borderline outburst might confirm for an army of reply guys that you’re a dangerous “Dark Triad” type. And even though mistakes are inevitable for anyone who experiences extreme mood swings and irritability, or psychotic delusions, or crushing depression, in the public sphere forgiveness is hard to come by.

I think the lesson for those of us who choose to be public about mental illness is to take responsibility when we trip up, then follow Nietzsche’s advice about the importance of “active forgetting.” There will always be those ready to pounce on you in a moment of weakness, but the advantage of responding to weakness with radical acceptance is that, once you’re ready to move forward, the predators will have revealed themselves, so you can now safely ignore them. Commit to doing better going forward, but don’t let the crowd for whom nothing short of perfection will ever be good enough shame you into ressentiment and bad conscience. Being public about your mental illness means, at some point, appearing before others at your lowest and most vulnerable, and there’s something powerful about owning that.

“You’re stronger than you think you are, think you are, THINK YOU ARE!”

I get up, feeling wobbly, and go to the door, relieved to discover it’s unlocked.

In the hallway, I see a young woman about my age, hunched over a telephone that she’s clutching like a life raft. I realize she’s repeating the phrase, like a mantra, into the phone. On the wall to her right is a placard, a child’s painting of a caterpillar entering a chrysalis. The words beneath it read: “You’re stronger than you think you are. Just when the caterpillar thought its world was over, it became a butterfly.” It’s a silly platitude, but over the coming week I’d come to understand that for her, repeating the phrase at odd hours of the day and night, always gripping the phone, was a survival strategy. Another guy on the ward would trudge mechanically down the hallways for hours on end, his expression fixed in catatonia (I’d meet him again months later in an intensive outpatient program. He was shy but affable, with interests in hockey and reading Adorno). At the extremes of vulnerability, rituals like this are what keep us alive.

In truth, however clichéd, there’s not much difference between the metaphor of the caterpillar and Nietzsche’s “what doesn’t kill me makes me stronger.” Nietzsche also tells us: “Where solitude ends, there begins the marketplace; and where the marketplace begins, there begins too the noise of the great actors and the buzzing of poisonous flies.” As sentimental as the caterpillar’s journey might seem, it’s preferable to being one of the flies in the marketplace. In truth, the tortuous evolution from egg to larva to pupa to butterfly may take months, but the tiny artworks these metamorphoses produce may live for as little as three days. Death, rebirth, and return to the rigors of transfiguration, with no goal beyond the process itself. Seen this way, the caterpillar’s voyage is less a romantic tale with a happy ending than another cipher for the eternal dismemberment of Dionysus responsible for true creation.