“The thing with psychosis is that when I’m sick I believe the delusional stuff to the same degree that you might know the sky is above and the earth below. And if someone were to say to me that the delusional thinking is, in fact, delusional, well that’s the same as if I assure you now that we walk on the sky. Of course you wouldn’t believe me, and that’s why it’s sometimes so hard for people who are sick like this to know that they need treatment. Psychosis and severe depression have a huge effect on how you relate to other people and how you see the world. It’s a bit like being in a vacuum, or behind a wall of really thick glass . . . you lose any sense of connectedness. You’re cast adrift from everyone and everything that matters.

I’ve lived with acute psychosis and depression for the best part of twenty years. This is the story of my journey from chaos to balance, and from limbo to meaning.”

Kate Richards is a trained medical doctor who works in medical research. She is also, to paraphrase her in this book, “mad”.

This book takes the reader on a journey through her episodes of psychosis and self harm, through mania and a quest to find a useful psychologist and psychiatrist, as well as the medication and skills Richards needs in order to manage her illness.

This is one of the most beautiful, heart wrenching and painful memoirs of mental illness I have read.

Richards is a beautiful writer, and uses her skill to describe her illness in sometimes gut churning detail, especially in regards to the periods of self harm she goes through (the book, for example, opens as she tries to amputate her own arm in a period of psychosis).

My main thoughts upon finishing this book are these:

As a society, we are not looking after those who are mentally ill the way we should. Richards describes mentally ill people being refused treatment at a hospital after they have self injured (or sub-standard care being provided as “punishment” by emergency room doctors). There is help there, but the patient almost needs to be an advocate for themselves to get it, which many people in the depths of psychosis are unable to do.

How much difference a good psychologist or psychiatrist can make to a patient. I think it takes a very particular type of person to be able to work well in these fields, and it’s clear that if Richards hadn’t found a psychologist she could work well with (which seems to basically be a matter of chancing upon the right one, after going through the wrong ones, who can be damaging), she very likely wouldn’t be alive today.

I don’t know if there are answers to these issues, and Richards herself doesn’t begin to try to find any. But the issues are there, and it makes me wonder how many people are suffering in silence with mental illness, or are made sicker by medical professionals.

Truly an amazing book. I’d recommend anyone who has an interest in mental health to give it a read.