An unquiet mind: a memoir of moods and madness

¶ … unquiet mind, a memoir of moods and madness -- Ka Redfield Jamison

Jamison, Kay. (1995). An unquiet mind. New York: Vintage

Kay Jamison is one of the leading experts on the subject of manic depression (bipolar) disorder. An accomplished researcher, she has studied CAT scans of individuals who suffer from the illness and explored different methods of treating bipolar disorder with a combination of therapy and medication. Jamison is also is the author of Touched with fire (1994) and of Manic-depressive illness (1990). The latter of which is one of the primary academic texts used in universities across the country on the subject of bipolar disorder. However, as revealed in her memoir an unquiet mind, Jamison's interest in buffering the highs and lows of this debilitating illness is not purely academic -- she is a sufferer herself.

Jamison's decision to reveal her condition in prose form is brave, given that it could have destroyed her credibility as an objective researcher. She admits that some of her academic colleagues were shocked, even disappointed when she revealed her condition: scientists are supposed to be separate from the illnesses they study, not sick themselves. However, Jamison sees her perspective as strength -- she has a unique vantage point to appreciate the balance between biology, genetics, environment, and personality that gives rise to bipolar disorder. What is personality, she asks, in light of her experiences? Because the swings of moods, from mania to depression can be so alarming in the case of bipolar disorder, the illness seems to challenge the very notion of identity itself.

Jamison also admits to the strange attractions of the manic state -- to be able to do without sleep and food, unlike ordinary people can be intoxicating. Mania is a period of intense creativity, but quickly burns itself out. When Jamison was stabilized by lithium, she experienced a sense of regret. Because of the seductive power of mania, Jamison argues from the force of experience as well as from the distance and knowledge her newly stabilized mental state has given her: "I have become fundamentally and deeply skeptical that anyone who does not have this illness can truly understand it" (Jamison, 1995, p.171). Her illness, which she speaks about in the third person at times, is "my fascinating, albeit deadly, enemy and companion" (Jamison, 1995, p. 5). It is both separate and a part of herself. Jamison's audience, unlike her previous scholarly works, is quite broad -- she speaks to fellow sufferers who may recognize themselves in her experience; she speaks to clinicians seeking to understand the illness from a more personal perspective in the words of someone they trust. She also speaks to laypeople who are trying to understand the illness of friends and loved ones. And she speaks to herself, talking back to her illness, trying to understand it.

Like many individuals who suffer manic depression, even before Jamison experienced her first manic episode, she was always a highly emotional, moody child and adolescent in a household of emotional people, especially her father. She had a distinguished undergraduate career, and later a graduate career in the field of human and animal psychology. Periods of lucidity, often quite long, alternated with occasional complete shifts to mania, the first of which occurred at seventeen. She speaks of her struggles with wry humor: "I decided early in graduate school that I needed to do something about my moods. It quickly came down to a choice between seeing a psychiatrist or buying a horse. Since almost everyone I knew was seeing a psychiatrist (this was Los Angeles), and since I had an absolute belief that I should be able to handle my own problems, I naturally bought a horse" (Jamison, 1995, p. 55). Jamison relates her life before being diagnosed as a series of disastrous decisions -- shopping sprees, bad marriages, and rejecting and collecting different friends and lives (including a wild horse).

One common question that plagues individuals who have never suffered from mental illness is 'why don't people who are suffering take their medication.' Jamison has the answer: lithium sapped her strength, took away her coordination, and made her feel too tired and numb to do the intense intellectual research that was an integral part of her life. She eventually found a dose that stabilized her moods and still enabled her to function, but in general she states that medications are not panaceas -- they have side effects that extract a terrible cost, more often than not. 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 creativity and madness in many great artists and authors, including Virginia Woolf. The 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.