An Unquiet Mind

An Unquiet Mind, written by Kay Redfield Jamison and first published in 1995, is a memoir about a clinical psychologist’s experience living with manic-depressive illness. The book details her life, from her early experiences as a child, through the beginning of her mood swings, her diagnosis of manic-depressive illness, her struggles with the disease, and her eventual management of and control over it, following years of therapy and medication. Aside from having experienced it, Jamison is herself an expert on the subject and has devoted many years to studying mood disorders; she currently holds the position of Professor of Psychiatry at Johns Hopkins University School of Medicine and has written extensively on mood disorders, including manic-depressive illness.

The book is divided into four parts, loosely focused on different periods of her life, although the narrative structure is not always in strict chronological order. Part 1 describes her childhood and the development of her mood swings as a teenager. Jamison spent the majority of her childhood moving around the world due to her father’s status as an Air Force pilot and scientist; despite this, Jamison considers her youth to have been one of relative comfort and stability. Her mother, the daughter of a professor of physics, was unintellectual but a warm, friendly, popular conversationalist; her father was given to impulsive passions, and though she has fond memories of her father while young, recalls that those wild passions frequently gave way to more somber periods. Nevertheless, she always felt support from her parents, and she believes that if she was given to moods herself as a child, they were likely alleviated by her comfortable existence. As a teenager, however, things began to change: her father left the Air Force for a job at the Rand Corporation, in California, but his mood swings and esoteric passions grew worse, giving way to alcoholism and ultimately costing him his job and marriage. Jamison likewise struggled to adjust to “civilian life” in California, and it was during this period in high school that she began to notice swings between weeks of high, passionate energy, followed by weeks of lethargy.

Following high school, Jamison attended the University of Southern California; she struggled with academics due to her mood swings, but loved learning and managed to accrue valuable research experience with some of her professors. She also spent a year studying abroad at the University of St. Andrews in Scotland, which had a profound effect on her. Following undergraduate work, she continued her studies at UCLA, pursuing a doctorate in psychology. Though she preferred graduate school to undergraduate school, she still largely disliked the more rigid academic requirements, yet passed her exams and joined the faculty at UCLA in her late twenties.

Part 2 focuses on the development of her manic-depressive illness, as it was around this time that she began to experience full-blown psychosis. She only gradually became aware of her illness, in part because she initially went a very long time in the manic phase without crashing into the depressive phase. Still, her mania grew worse and worse: she grew more impulsive, she spent money uncontrollably, her relationship with her husband began to deteriorate, and she grew suicidal. At the insistence of a colleague who recognized what was happening, she began to see a psychiatrist and take lithium. However, at the time, lithium was being prescribed in near-toxic doses, and its effect on her was quite pronounced: she frequently felt ill and lethargic, and she was unable to read or concentrate on anything complex. As a result, she entered a cycle of lithium acceptance and reluctance, continually stopping her medication only to bottom out and begin taking it again. Struggling with her illness and the effects of medication, she once again grew suicidal and attempted to take her own life via lithium overdose. She was saved, though, when she unwittingly answered her brother’s phone call, alerting him to the attempt and prompting him to seek emergency medical assistance for her. Following her attempt, she was helped back on track thanks to close friends and family. She eventually got her life back in order and made tenure at UCLA, which she credits in part to the periods of extreme productivity she experienced while manic.

Part 3 focuses on love and relationships. Jamison had originally married young and impulsively; although they did love one another and tried to make it work, their marriage eventually ended in divorce, in part due to irreconcilable differences stemming from her illness. “An Officer and a Gentleman,” the seventh chapter of the book, discusses her first romance following her divorce, with an English psychiatrist named David Laurie. Laurie was kind, passionate, and fully accepting of her illness, and it is strongly suggested that they likely would have ended up married; unfortunately, though, David suffered a heart attack at 44 and passed away. In the eight chapter, “They Tell Me It Rained,” Jamison writes of her sabbatical taken in England four years later; the chapter is largely about her relationship with England itself, but is additionally about a yearlong, passionate affair she had with another Englishman during that time. Additionally, though, it was during this time that she experimented with reducing her lithium dosage, which made all the difference in her ability to experience emotion and focus on complex things, such as books and journal articles, again. “Love Watching Madness” follows the result of living with the lower dosage of lithium, which was both liberating and frightening, as she had never experienced living in the world relatively normally before. Additionally, this chapter describes her meeting and relationship with her second husband, Richard Wyatt, a more moderate person for whom she moved from Los Angeles to Washington, D.C. Wyatt and Jamison remained married until his death in 2002.

Having concluded much of the chronological narrative, Part 4 deals primarily with several related facets of manic-depressive illness. Chapter 10, “Speaking of Madness,” wrestles with the terminology we use to describe mental illness and questions how much of an effect terminology has on our understanding and stigmatization of mental illness; for example, Jamison notes that her own illness in modern usage is known as bipolar disorder, a term she feels is not only not an improvement, but is actually inaccurate. In “The Troubled Helix,” Jamison considers the genetic component of her illness. She first discusses the roots of her own interest in the illness, moving from a conversation with Jim Watson to another with Mogens Schou, whose own family history pushed him to research effective medications, eventually leading him to lithium. She then describes her experience with a physician who chastised her for wanting children despite knowing that her illness is genetic, then questions what it might mean if we can identify the genetic marker, wondering if this might ultimately lead to a more homogeneous, less interesting society, given the association with manic-depressive illness and imaginative, creative types. She then turns her attention in “Clinical Privileges” to her reluctance to go public with her diagnosis, in part because of her personal experiences with people whom she had believed to be her friends, but more because of the potential negative impacts the knowledge could have on her professional life; however, at the end of the chapter, she is granted clinical privileges again by the department chair at Johns Hopkins, who not only already knew about her illness, but believed the department would be a much worse place if there were no manic-depressives on the faculty. Finally, in “A Life in Moods” and the Epilogue, Jamison meditates on what it means to have lived with manic-depressive illness and concludes that if given the choice, and given the existence of lithium, she would choose to have it again because, despite the psychotic episodes, she believes she has lived a much more vivid, interesting life as a result of it.