However, she writes that she embarked upon her book to encourage suffering individuals to enter treatment, not to shy away from it, given that without medication she could not be functional.
Jamison's relatively short (240 pages) text is broken up into four sections: "The wild blue younger," "A not-so-fine madness," "This medicine, love," and "An unquiet mind." The book is vaguely chronological, although Jamison dips back and forth in her past, so the reader can better understand the significance of different life events. The book is not pure memoir -- it is a story of her life as a manic-depressive, so every incident is filtered through that point-of-view. To some degree, this can be limiting, for as powerful as the illness may be, it can be difficult to accept that this, more so than any other aspect of Jamison's life, is what defined her existence, beyond relationships, athletics, and her impressive academic achievements. Jamison speaks of herself cutting classes, ignoring her obligations, but to have gotten as far as she did in academia it is difficult not to believe that her periods of lucidity were longer than she would like to admit. This is a portrait of an illness, more than a life -- people interested merely in a good read, rather than readers who seek psychological insight will be disappointed.
There is a manic tone to the work at times, as she pokes fun of her more excessive activities (like buying a horse in the middle of graduate school) and portrays herself as carelessly moving through life, picking up degrees along the way. Jamison, however, believes that to some extent this manic intensity and carelessness is linked to her success and her ability -- it is both her curse and her gift. That she views it as such, despite the fact that she calls her madness "not so fine" in one of the chapter headings is further underlined by the fact that one of her earlier works, Touched by fire, chronicled the inextricable bond between book's relatively sparse chapter breakdown, long and passionate sentences, even the ample white space at top and bottom of the book and large print, accompanied with swift jumps in narrative time recall a modernist works of fiction, rather than a psychological text, despite the book's singular focus on the illness. Only the Conclusion and Prologue ground the work in more scientific and linear language.
The book is a compelling portrait of something that most people will never experience -- a total break in consciousness. Its simplicity and accessibility makes it useful for anyone wishing to understand the illness who does not have the psychological background to wade through Jamison's more academic works. It also helps the reader understand what it is like to be in a manic state, and how easy it is for a bipolar person to shut him or herself out from reality. Jamison compares it to a blind person being unable to see, and only tenuously able to understand the need of the sighted to turn on a light in the room -- she knew that other people had a different sense of consciousness when she was manic, but could not fully comprehend it.
This book is by no means a conclusive portrait of manic-depression, merely the experiences of one woman, albeit a woman who has seen the illness manifested in many others, in her work and practice. The book was written in the 1990s, which may partially explain its somewhat confusing fixation on lithium as the main treatment for bipolar illness -- an explosion of new medications have been generated with different side effects than the ones detailed by Jamison. Jamison's experiences all took place before the current singular focus upon psychopharmacology and the explosion of patient-focused drug advertising. Given that she stresses love as well as medication as the source of her strength in managing her illness, one might wonder how Jamison might be treated today, if she was a graduate student with a recently-discovered illness -- would medication be given to her, without appropriate therapy? Although Jamison believes her illness is biological, she states that biology does not obviate the need for therapy and teaching patient new coping mechanisms, once the seduction of mania is taken away. The book is…
Jamison's work, Allen notes, has drawn public attention to the intertwined relationship or creativity and manic depressive disorder. Poets, out of all the artists, appear to suffer most often from mood disorders. One study Jamison notes, estimates that 50% of poets are adversely affected. A recent study of poets, however, at the famous Iowa Writers' Workshop, reported 80% are affected. Jamison likely felt confusion at one time regarding this contention.