Depression is a painfully slow, crashing death. Mania is the other extreme, a wild roller coaster run off its tracks, an eight ball of coke cut with speed. It’s fun and it’s frightening as hell. Some patients – bipolar type I – experience both extremes; other – bipolar type II – suffer depression almost exclusively. But the “mixed state,” the mercurial churning of both high and low, is the most dangerous, the most deadly. Suicide too often results from the impulsive nature and physical speed of psychotic mania coupled with depression’s paranoid self-loathing.

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