To Rose
For the thing which
I greatly feared is come upon me,
and that which I was afraid of
Is come unto me.
I was not in safety, neither
had I rest, neither was I quiet;
yet trouble came.
This book began as a lecture given in Baltimore in May 1989 at a symposium on affective disorders sponsored by the Department of Psychiatry of The Johns Hopkins University School of Medicine. Greatly expanded, the text became an essay published in December of that year in Vanity Fair. I had originally intended to begin with a narrative of a trip I made to Paris—a trip which had special significance for me in terms of the development of the depressive illness from which I had suffered. But despite the exceptionally ample amount of space I was given by the magazine, there was an inevitable limit, and I had to discard this part in favor of other matters I wanted to deal with. In the present version, that section has been restored to its place at the beginning. Except for a few relatively minor changes and additions, the rest of the text remains as it originally appeared.
—W. S.