My family moved a lot when I was a kid, but the hardest move for me was the one before my senior year of high school. I left behind a small town with its small high school, many friends, and my beloved garage band with the accompanying minor celebrity status it gave me. All of this was replaced with a big city, a high school three times the size of my old one, social obscurity and isolation, and a ride on a school bus every day of my senior year of high school.

Yeah, I was bitter. And I didn’t respond very well to the situation. Mourning the loss of my former social capital, I made a conscious decision at my new school to avoid making friends. This was a pre-emptive rejection of everyone around me, intended as an expression of anger and retaliation directed towards people who weren’t really to blame for anything except for the crime of not being my friends. It was also, I think, a sort of coping strategy for my unrecognized social phobia (an ineffective coping strategy, I might point out). I don’t recommend this course of action to other people who may be in a similar situation, any more than I recommend cutting off your nose to spite your face. As you can likely foresee, things didn’t work out so well for me that year.

My social life was not the only thing to suffer. Dress and grooming habits took a turn for the worse, and I gravitated towards the darker side of music. Although I was near the top of my class academically in the small town high school, my grades took a nose dive that year because I just couldn’t see the point in trying any more. Much of my time at school was spent writing free verse poetry in my notebook or reading Dostoevsky — when I wasn’t sleeping in class, that is. My favorite poem from that year, and one which most concisely captures my attitude and feeling, went like this:

Alienation

I guess it would be sour grapes to say that I don’t want to be a part of you.
It just feels better to make the situation a matter of choice in my mind.

Typical teenager stuff, I suppose.

My little brother, a year younger than me, was equally miserable, and equally lonely, because after several weeks we got tired of saying the same old complaints about how miserable we were and how much we missed our old friends and our band, and we mostly just sat in silence. Then our class schedules changed and we had different lunch periods, so I sat alone.

Visitor

But this story isn’t about me; it is about Alyson. One day as I sat miserably alone in the lunch room, a girl walked up and sat across the table from me. I was startled, and didn’t know what to say. Our conversation, as I remember it, went something like this:

She said, “You’re new this year, right?”

“Yeah, I moved here from St. George,” I answered.

“My name is Alyson. What’s yours?”

“Alan.”

I couldn’t think of anything else to say. It had been a long time since I had spoken to anyone at school, and I was feeling a bit out of practice. The fact that she was an attractive girl and that we were talking one-on-one made me nervous, but her smile set me at ease a little bit. She seemed natural and comfortable, not like she was doing this out of any sense of duty but because she genuinely cared and wanted to do something nice for someone. It was clear to me even from this short exchange that she was a sincerely nice person, and I appreciated the fact that she was going out of her way to reach out to someone who needed some positive attention. For someone determined to refuse any and all new friendships, I found myself surprisingly eager to talk with her.

“Who is that on your binder?” she asked, pointing to a large picture that I had taped to the front cover.

“That’s Johann Sebastian Bach,” I replied. “He was the greatest composer of all time!”

“Really?” She looked interested. Suddenly I felt a tsunami of words break through the ice, and I probably spoke for several minutes about how J.S. Bach was the guru of polyphony, a virtuoso on the organ, the master teacher of keyboard technique. She was impressed, but I think a little overwhelmed by my sudden enthusiasm. I thought maybe I had said too much, and felt a little embarrassed, but it felt so good to talk to someone! After a few minutes she said goodbye and left my table to talk with one of her friends.

Thus began my friendship with Alyson, which grew for the rest of the school year. We smiled as we passed in the hallways, which was really a huge thing for me after wandering through crowds of empty faces for so long. I gave her a cassette tape of my old garage band recordings, which at the time was my most precious possession, and I made her laugh in choir class by pulling faces at her. She proved to be just as kind and genuine as my first impressions of her.

Once I had made a single friend, it became easier to accept other friendships, and by springtime things had changed a lot for the better. I wasn’t exactly popular at that school, but I did have a few friends and was no longer in paralyzing isolation. Alyson was the first ray of sunshine to start melting the winter in my soul.

Prayer

One day towards the end of the school year I noticed that I hadn’t seen Alyson for a while. I asked one of her friends if they knew where she was, but I got some evasive response that didn’t answer the question.

Later that day, or maybe the next day, one of her friends came up to me after choir class and asked if I wanted to go over to the seminary building after school, because they were going to have a group prayer. “Sure,” I said, so after school I followed a group of kids over there. In one of the classrooms there were gathered 20 or so of my classmates, as well as our choir teacher. We all kneeled down on the floor, and one of the kids asked, awkwardly, “Who’s going to say the prayer?”

After a silent pause, with no volunteers, I offered, “I’ll say it. What are we praying about?” Everyone looked at the floor, and in that moment I realized with embarrassment that they all knew something that I didn’t.

Finally our choir teacher spoke. “I’ll say it,” he declared. And then he offered a heartfelt prayer, pouring out his soul in asking the Lord to bless and heal Alyson. From the wording of the prayer I could tell that she must be gravely ill. I could hear people around me sniffling, choking back tears.

After the prayer, and before I got up from my knees, I turned to the person next to me and asked, with a mixture of concern and anger, “Is there something wrong with Alyson?”

Psychosis

She had been admitted to a psychiatric hospital a week or so before the day of the prayer, suffering from mania with psychosis. At the time I knew basically nothing about bipolar disorder. All I knew was that my friend had gone crazy, and that no one would talk to me about it. I thought back to the last time I had seen her, when I had visited her at work a few days before she disappeared. She had seemed a little strange, but I didn’t think much of it at the time. After she landed on the psych ward I began to wonder whether something I said that day had caused her to go off the deep end. Maybe that’s why no one would talk to me about it, because they knew I was to blame? This line of thinking sounds absurd to me now, but at the time I was a self-absorbed 18-year old who knew nothing about mental illness, so I really worried about it.

Alyson came back to school a couple of weeks later, just in time for graduation. There was something subtly different about her, but at the time I didn’t have the training to discern it or the vocabulary to describe it. Years later in medical school I probably would have said that she had a slightly blunted affect. I remember feeling a bit nervous to talk with her, not really understanding what she had been through, and still wondering whether I was partly responsible for it. After choir class on her first day back, she showed me a notebook she had written in while she was in the hospital, full of her manic delusions. Some of these were about me and her other friends. I was fascinated and horrified that something so bizarre and unexpected could happen to such a normal, friendly person.

About 6 months after this event I wrote a song about Alyson’s illness, as seen from my perspective:

Something Wrong

I haven’t seen her for a while
I used to see her every day
And when I ask, “What has happened to her?”
I can’t get anyone to say

Is there something wrong with Alyson?
Or is there something wrong with me?

And I was troubled at her leaving
I thought that I had caused her shame
And the way that people wouldn’t speak about it …
I would have taken all the blame

Is there something wrong with Alyson?
Or is there something wrong with me?

Did you know that I loved her?

(For more information about the song, including download links and guitar tablature, visit my music website.)

Aftermath

Alyson was treated with mood stabilizing medications, and she made a good recovery. Her manic episode was followed by a depressive episode, which is typical for bipolar disorder. She said that her freshman year at the university was difficult, but over time her condition stabilized and today she is doing well.

Alyson’s illness was one of my first close encounters with psychiatric disease. When I was a missionary in England I watched in astonishment as one of my friends went through a manic episode, followed by a deep depression. During medical school and internship I was fascinated by the patients on the psych ward, and I saw several patients with acute psychotic mania just like I had seen in my friends. If neurology hadn’t been even more interesting, I might have become a psychiatrist instead of a neurologist. In my practice today I am still amazed by the symptoms which can be produced by psychiatric disease.

Earlier I said that this story wasn’t about me, but that is not exactly true. In retrospect I can see that I was suffering from situational depression during the early part of my senior year of high school. This condition was both a result and a perpetuating cause of my social isolation. My symptoms included depressed mood, sleep disturbances, anhedonia, feelings of hopelessness and futility, anger, self-injurious behavior (mostly manifested in my social behavior), and even some delusional thinking. Alyson’s intervention in the lunch room that day was a major turning point towards my recovery. She was willing to invest a bit of her social capital on me, which made a world of difference in my life.

Alyson’s experience at the end of the year was like a mirror image of mine at the beginning, although hers was more severe. Both experiences illustrate the impact of peer relations on mental illness, and vice-versa. Her illness clearly had a huge effect on me and her other friends. Speaking with her after she returned to school was important for me, as it started to break down some of the mystery and stigma associated with mental illness in our culture. If it could happen to her, whom I considered to be one of the best people in the world, then it could happen to any of us.

Epilogue

This story took an unexpected turn when I recently got back in touch with Alyson, 20 years after we had lost contact. We messaged back and forth for several hours while I was in clinic one day, and I tried everything I could think of to jog her memory, but at the end of the day she still couldn’t think of who I was. I had been putting this girl on a pedestal for all of these years, writing and recording songs about her, and she couldn’t remember me at all!

She explained, “There is so much in my life that I can’t remember and just slips through my fingers! So please don’t take offense. Some times I think it’s a bit of a coping mechanism as well. There are some things with my health that would have been kind of painful to have a clear memory of. But coming back in contact with you has been nothing but a pleasure. And I’m glad that I was able to show you some kindness way back when, because I can always do kindness, no matter what!!”

I wasn’t offended, just amused and bemused. It doesn’t really matter whether Alyson remembers me; the important thing is that I never forget her. The friendship she gave me, the love and charity in her heart, the good that she did in my life, I will always remember.

God bless you, my friend.

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Alan B. Sanderson, MD is a member of The Church of Jesus Christ of Latter-day Saints and is a practicing neurologist. Permission was obtained from Alyson to post her story.