Ned Vizzini said this quote
“ Its so hard to talk when you want to kill yourself. That's above and beyond everything else, and it's not a mental complaint-it's a physical thing, like it's physically hard to open your mouth and make the words come out. They don't come out smooth and in conjunction with your brain the way normal people's words do; they come out in chunks as if from a crushed-ice dispenser; you stumble on them as they gather behind your lower lip. So you just keep quiet. ”