She not only said that she was depressed,but that she was going "mad", and beginning to hear voices.She could not concentrate,and believed shecould not read or write.She was hopeless and self-critical,and to the end maintained that her suicide was justified and that she would not recover.

    She had her first breakdown at the age of thirteen,and others when she was twenty-two, twenty-eight,and thirty.From 1913 to 1915,from the age of thirty-one to thirty-three,she was ill so often and for so long that permanent insanity was feared.These attacks were severe,requiring many weeks of medical treatment and bed rest.During the rest of her life she had milder mood swings.

     What most characterizes her illnesses is in particular, typical phases of mania and depression.When elated,her husband describes her incessant talking, the content becoming increasingly incoherent as she worsens in the next day or two,until,acutely manic,there is only a 'mere jumble of dissociated words'.Equally convincingly he describes her thought processes when depressed:she believes that she is not ill,that her condition is her own fault,and is unable to accept reassurance or to be argued out of her beliefs.The symptoms of elation and depression are convincingly described, and their severity made clear.
    This is a convincing life history of manic depressive psychosis,culminating in suicide at the age of 59,and including a suicidal attempt in her thirties which was almost successful.Because no specific treatments were available during her life, the illness can be observed running its natural course; such severe and lengthy attacks would be rare today.

     Her medical history can be followed in detail in her diaries.She had much minor ill-health between 1915 and her death in 1941.Some of this is attributable to mild mood swings,either up or down,perhaps managed by her husband and doctors with bedrest and curtailment of her social life.She suffered from frequent lengthy and disabling headaches,migrainous in character, accompanied by depressive symptoms and by palpitations.Flu-like illnessses and dysmenorrhoea are frequent.

      The doctors who attended her and her family were the most distinguished of the time, especially the psychiatrists,but despite their eminence had no effective treatment to offer at the time,and seem prejudiced and unhelpful to modern eyes,although their textbooks show they were able to make an accurate diagnosis.

      There is an impressive family history of affective illness.Her brother Thoby died young but was an emotionally disturbed child.Her sister Vanessa had an episode of depression in her thirties after a miscarriage.The attack lasted some two years,and was regarded by the family as similar to Virginia's depressions.Her brother Adrian also suffered from episodes of nervousness and depresssion.
    Her father was a gloomy pessimistic man who had two mild attacks of depression.His father-her grandfather-had three serious depressions which affected his career. Her first cousin on her father's side developed severe mania in his twenties and died within a few years in an asylum.

       For generations her family history is filled with gloomy men and eccentric women.The family was also very creative, not only in literature. Her father founded and wrote much of the Dictionary of National Biography. Many of her relatives were friends of Thomas Carlyle.Virginia resembled her father in many ways, and had a close but ambivalent relationship with him. Her siblings were creative in other ways.Her sister was a painter,and her brother one of the first English psychoanalysts.

        Her personality was a mixture of shyness and ebullience.She was remembered by friends not as a gloomy depressed person but as a brilliant conversationalist, laughing, joking,gossiping, and often indulging in malicious flights  of fantasy at the expense of her friends. She was loved by children, given to interrogating others in her search for material,and often rude and snobbish. She was awkward out of her social class,and had and odd eccentric appearance which made people stare at her in the street.

        As a child she was sexually abused,but the extent and duration is difficult to establish.At worst she may have been sexually harassed and abussed from the age of 12 to 21 by her stepbrother George Duckworth,16 years her senior,and sexually explored as early as six by her other stepbrother.It is likely that her sisters and stepsister were also sexually abused.In later life,probably as a result,she was sexually frigid in her marriage.She had several homosexual flirtations in adult life,some intense, but probably not involving physical relations.

        It is unlikely that the sexual abuse and her manic-depressive illness are related.However tempting it may be to relate the two,it must be more likely that, whatever her upbringing, her family history and genetic make-up were the determining factors in her mood swings rather than her unhappy childhood.More relevant in her childhood experience is the long history of bereavements that punctuated her adolescence and precipitated her first depressions.Early losses are known to be related to adult depression.

        Her life and illness accords with recent work on creativity and psychiatric disorder.Research shows that manic-depressive illnesses,especially bipolar ones,are common among writers , and that schizophrenia is entirely absent.It has also been shown that creativity,not necessarily literally,is common in the relatives of writers.Like the writers in these studies, Virginia Woolf created little or nothing while unwell,and was productive between attacks.Her detailed analysis of her own creativity over the years shows that her illnesses-the manic periods of their immediate hypomanic aftermath-were the source of material for her novels for many years to come. Measuring the variations in her literary output shows the effects of health and ill-health.