An Unquiet Mind provides a unique and no-holds barred insight into the euphoria that can escalate to terror, combined with the deep, dark depths of despair that bipolar sufferers experience on a regular basis.
This brilliant autobiography, written by Kay Redfield Jamison, delves into the dark and oft misunderstood world of bipolar disorder, once know as manic-depression*. Jamison is a Professor of Psychiatry, has worked extensively in clinical practice with people who suffer from mood disorders, and was for many years a director of the UCLA Affective Disorders Clinic, which was a large teaching and research facility. She also suffers from severe bipolar episodes. All of these elements put her in the unique position of being able to write about bipolar disorder from both a clinical perspective and personal experience.
Jamison describes bipolar disorder as:
“an illness that is biological in its origins, yet one that feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide.” (p.6)
Jamison recounts her early experiences with bipolar as a teenager, and then moves on to her college years where the illness progresses to much stronger episodes with more increasingly dire consequences. As she frantically attempts to keep up with her university course load studying medicine, and then post-graduate studies, her life is torn apart by manic episodes followed by soul-destroying bouts of depression that last months and even years.
Jamison writes with candour and brutal honesty about her manic-depressive episodes, her denial to admit that the mood disorder is destructive and dangerous not only to herself but others around her, and her long, slow path to healing and sanity. After many years of denial, and one particularly psychotic manic episode, she finally agrees to take medication: lithium. The use of lithium was still in its infancy, had only been approved for clinical use four years earlier, and as such she is reluctant to take the medication, concerned about side effects, and long term use. She points out that treating mood disorders requires not just medications but also psychiatric treatment, which focuses on “developmental issues, personality structure, conflict and emotional and unconscious thought”.
Bipolar disorder is a deceptive illness in that the manic highs bring about periods of intense activity and creativity; there is a wondrous and intoxicating rush of elated emotions, and the seductive nature of having gifted insights to problems. It is these elements that people with bipolar are reluctant to part with, as the rush is ecstatic. However, the shift from ecstasy to psychotic is dangerous and uncontrollable, after which sufferers are often plunged into black, despairing depression. It is an illness that kills thousands of creative and imaginative people each year.
Jamieson writes with clarity about the highs and lows, the confusion and despair, and madness that she experienced:
“When you’re high, it’s tremendous. The ideas and feelings are fast and frequent like shooting stars, and you follow them until you find brighter ones… Sensuality is pervasive and the desire to seduce and be seduced is irresistible. Feelings of ease, intensity, power, well-being, financial omnipotence, and euphoria pervade one’s marrow… now… you are irritable, angry, frightened, uncontrollable, and enmeshed totally in the blackest caves of your mind. You never knew those caves were there. It will never end, for madness creates its own reality… It goes on and on, and finally others’ recollections of your behavior – your bizarre, frenetic, aimless behaviors… All those incredible feelings to sort through… Which of my feelings are real? Which of the me’s is me? The wild, impulsive, chaotic, energetic, and crazy one? Or the shy, withdrawn, desperate, suicidal, doomed, and tired one?” (p.64-67)
She discusses her own struggles and the great lengths to which she would go to avoid dealing with her illness, often injecting humour into a serious subject. One example of this is when she realises in graduate school that she has a serious problem and needs either psychiatric help or needs to buy a horse. She explains her decision this way:
“Since almost everyone I knew was seeing a psychiatrist, and since I had an absolute belief that I should be able to handle my own problems, I naturally bought a horse. Not just any horse, but an unrelentingly stubborn and blindingly neurotic one, a sort of equine Woody Allen, but without the entertainment value.” (p.54)
She had created romantic notions of being best friends with this horse, of the horse running happily up to her in search of a carrot or sugar cube. The reality proved somewhat different:
“What I got instead was a wildly anxious, frequently lame, and not terribly bright creature who was terrified of snakes, people, lizards, dogs, and other horses – in short terrified of anything he might reasonable be expected to encounter in life – thus causing him to rear up on his hind legs and bolt madly about in completely random directions.” (p.55)
An Unquiet Mind is filled with reflections, chaotic events, the negative impacts of not being willing to accept that she needed medication, and even when she did take medication the resulting the episodes of despair and destruction that ensued every time she went off her meds, seeking the thrill and rush of the inspiring ‘high’ episodes. The book also combines scientific and clinical analysis of mood disorders. These medical approaches add balance and credibility to Jamison’s story and highlight the conflicts that she faced when trying to act in a medical capacity, how the mania and depression severely impacted upon her study, her work and personal life, and yet those same things informed her work, gave her insights into bipolar disorder, and inspired her to dedicate her life to understanding mood disorders and help others who also suffer from the illness.
The frankness of the writing, and Jamieson’s ability to include humour, and story telling techniques, made this an incredibly fascinating book to read. Her obvious pain and confusion, her distress and frustration are palpable. A singularly compelling read, and by the end of it I had a renewed sense of respect for people who suffer from bipolar disorder and the minefield of problems that they need to navigate every day.
* Jamison preferred the term manic-depression as she felt that it more adequately described the illness a she experienced it.
An Unquiet Mind: A memoir of Moods and Madness (Picador 2011) – eBook. ISBN 9781447204040 EPUB First published in 1995 as a Borzoi Book by Alfred A. Knopf Inc. in New York.