The physiological effects of this cycle, sustained over years and beginning in adolescence, were significant. Both amphetamines and barbiturates are physically addictive in the sense that the body’s regulatory systems adjust to their presence and require them for normal functioning. The tolerance that develops with prolonged use means that higher doses are needed to produce the same effects. The psychological effects — particularly the mood disruption associated with amphetamine use, which includes periods of elevated energy and euphoria followed by depression and irritability — interact with and compound the physical dependency.
By the time Garland was in her early twenties, she had been on this pharmaceutical cycle for approximately a decade. The patterns of dependency it had established were not ones that could simply be stopped through willpower or reduced through gradual tapering in the absence of comprehensive medical management of a kind that mid-twentieth-century psychiatry was not well-positioned to provide. The treatments she received during psychiatric hospitalizations in the 1940s included electroconvulsive therapy, which was the most aggressive psychiatric intervention available in the period and which Garland described as among the most distressing experiences of her life.
Sid Luft’s memoir describes his observation of Garland’s pharmaceutical management during their marriage — the stimulants, the sleeping pills, the cycle of dependence and management and crisis that punctuated their domestic and professional life. His account is a husband’s account, offered from a perspective shaped by his own relationship to her and to the professional partnership they maintained. But it corroborates, from a close observer with no particular incentive to exaggerate, the general character of what Garland’s own accounts described.