Coping and Overcoming Illness

A Lifelong Battle with Madness

UPDATED 08/27/2007 at 01:00 AM EDT Originally published 08/27/2007 at 01:00 AM EDT

Over an alfresco lunch, Elyn Saks listens patiently as three fellow University of Southern California law professors debate a question: Is it crueler to treat a psychotic killer with medication, so he'll be lucid when facing execution, or to let him live out a life sentence trapped in his insanity? Finally, Saks speaks up. "If I were facing death with a clear mind I'd be scared and sad," she says. "But I'd choose death rather than madness."

The debaters fall silent—for they know she speaks from harrowing experience. A legal scholar and author of four books, Saks has suffered since adolescence from schizophrenia, grappling with paranoid delusions and hearing voices stilled only with antipsychotic drugs and daily psychotherapy. For decades she kept her ordeal almost entirely private. But with The Center Cannot Hold: My Journey Through Madness, Saks, 51, is coming forward at last, "so others can see this diagnosis doesn't have to mean a life on the streets or being hospitalized," she says. "Having to live with this secret all your life is awful," says Stephen Behnke, director of the American Psychological Association's Ethics Office and one of few friends who knew of her condition. "Now she doesn't have to keep the secret."

Saks seems so placidly cerebral, it's hard to imagine that at Yale Law School she spouted gibberish, then climbed onto the library roof and burst into song. Or that she has thought, "I am being directed by space aliens." The first notable sign of her illness came as Saks walked home from high school in Miami and began to believe the houses were planting thoughts in her head like "You are especially bad." "I was scared out of my wits," she recalls. But when Saks told her attorney father and stay-at-home mother, the concerned parents feared she was using drugs because she'd earlier admitted to smoking pot. "I wish I'd seen a psychiatrist, but I don't know that it would have helped."

Meanwhile, Saks shone academically, graduating as valedictorian at Vanderbilt University—even as her condition kept poking through: At one dorm gathering she started quacking like a duck and downed a bottle of aspirin. "I ran into the bathroom and made myself vomit, then couldn't stop shaking from fear," she writes. That crisis receded, but when Saks went on to Oxford she experienced her first truly psychotic episodes, wandering the streets mumbling incomprehensibly, consumed with suicidal self-hatred. Saks writes of telling her physician she might "'douse myself with gasoline, set myself on fire ... because I am bad and deserve to suffer." Fortunately, she found a therapist who helped her complete her studies. But during her first year at Yale the disease became unmanageable. After the rooftop incident, Saks landed in a New Haven hospital, forcibly restrained and fed antipsychotics. "There is nothing more terrifying than to be tied down for hours without any idea when or if you'll be released," Saks says. She would spend the next year in and out of hospitals but finally graduated and worked in a public interest law firm before opting for academia.

USC hired her in 1989, where after years of teaching she was named associate dean for research in 2006. Psychotherapy proved a safety valve to help Saks hide her chaotic thoughts in public—and from colleagues. "My dark fantasies and delusions don't leak into my daily life," she says. Saks had long resisted voluntary medication, but relented in the early '90s because, she says, "I had seen taking pills as not being strong enough. But I know now that they can make my life more bearable." One area that improved dramatically was her love life—she'd gone years without dating. "I had so many demons in my head there wasn't room for another person."

Enter Will Vinet, a legal librarian and artist, who worked for a time at USC. "I tried to flirt with him, awkwardly. I don't think he got it." Not at first, perhaps, but they began dating in 1994 and married in 2001. Cautious, she took months to reveal her illness. "When she told me, I wasn't frightened," says Vinet, 59, who also helped her through a bout of breast cancer and a lumpectomy in 1999. "But I don't think I knew the extent of it until I read the manuscript." These days, Saks only experiences fleeting irrational thoughts, but she knows she'll have to fend off madness for the rest of her life. "It's always just off to the side, just barely out of my sight," she writes—whether it's the delusion that her husband is an impostor or "that I can kill thousands of people with my thoughts or that I'm profoundly evil." On one level, she considers herself lucky—"I didn't become the crazy lady talking to herself on the street"—but adds, "my illness has taken an enormous toll. I have missed relationships and professional opportunities. I can't have children because I couldn't get through a pregnancy without medication; that's probably the biggest loss. Unlike the poet Rilke, who said he didn't want to rid himself of his demons because his angels might leave him too, I would happily lose the demons. I think my angels left long ago."

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