An Unquiet Mind, A Memoir of Moods
 and Madness


By Kay Kedfield Jamison, published by Picador, 1997, ISBN 0330
I W3 IZ Price £7.99 stg, paperback.


This is, quite simply, the most compelling account of manic depressive 
illness that I have ever read. In fact. I read it twice and was unable to put it
 down on either occasion since it begs to be absorbed in one sitting. And in 
reviewing it, it is tempting simply to quote huge chunks of the book itself, 
not only because the writing is lyrical, humourous and exhilarating but 
because any comment I might have would be merely superfluous.

Dr. Redfield Jamison is Professor of Psychiatry at the Johns Hopkins 
University School of Medicine in the United States. Quite clearly, she took 
an enormous risk in publishing this memoir. Not only is she one of the
 foremost authorities on manic-depressive illness but she has experienced it 
first hand. She writes, then, from the dual perspectives of the healer and
 the healed, enduring the same exhilarating highs and suicidal depressions 
experienced by many of her patients.

She came from a loving family. Her father was a pilot, a career Air Force 
officer with wild, fanciful notions and obsessions which delighted his
 children. “Rather like having Mary Poppins for a father” is how his 
daughter recalls him. She adored her mother and grew up in a safe, secure
 home. Sadly, in later life her father, too, developed manic depression and
 her sister never experienced the early years of happiness which Dr.
 Jamison enjoyed. “Not surprisingly, perhaps, when both she and I had to 
deal with our respective demons, my sister saw the darkness as being 
within and part of herself, the family and the world. I, instead, saw it as a
 stranger; however lodged within my mind and soul the darkness became, 
it almost always seemed an outside force that was at war with my natural 
self.”

She was a senior in high school when she had her first attack of manic-
depressive illness, a brilliant student clearly destined for high academic
 achievement. That she eventually made it through to be a tenured
 professor at one of the top universities in America is an amazing tribute to
 her tenacity. Through the soaring heights of mania when she went without
 sleep for weeks, bought enormous quantities of books she did not need, 
ran up bills she couldn’t pay, she continued to lecture and to do her 
research. Even when she was suicidally depressed, so tired she could not 
wash her hair, unable to concentrate enough to read or to answer the 
telephone, her work went on with only close friends and family realising
 what was happening.

Her biggest battle was with lithium. For a long time she was given high
 doses of this drug which stabilised her moods but which resulted in such 
nausea that she frequently slept on the bathroom floor covered by a
 blanket. When she stopped taking it, the illness would strike again with 
wild manic experiences followed by ever more devastating depressive 
episodes. At one point the risk of suicide was so great that her psychiatrist
 and her friends set up a rota whereby she could be watched at all times. So
 why this reluctance to take a stabilising drug? “Some of my reluctance
 stemmed from a fundamental denial that what I had was a real
 disease….Moods are such an essential part of the substance of life, one’s 
notion of oneself, that even psychotic extremes in mood and behaviour
 somehow can be seen as temporary, even understandable, reactions to
 what life has dealt…. It was difficult to give up the high flights of mind and 
mood, even though the depressions that inevitably followed nearly cost me 
my life.”

Eventually lower doses of lithium were prescribed and were just as 
effective as the higher doses had been. The medication, combined with 
long-term psychotherapy, stabilised the mood swings, though not
 completely.

I heard the author being interviewed on radio by Dr Anthony Clare. He 
asked her whether, if it were possible to replace the gene which causes 
main depressive illness she would choose to have it. Her answer was no. It 
is explained at the end of her book. “Because I honestly believe that as a
 result of it I have felt more things, more deeply; had more experiences 
more intensely; loved more, and been more loved, laughed more often for
 having cried more often; appreciated more the springs, for all the winters; worn death ‘as close as dungarees,’ appreciated it – and life – more; seen the
 finest and the most terrible in people, and slowly learned the values of
 caring, loyalty, and seeing things through….. Much of this is related to my 
illness – the intensity it gives to things and the perspective it forces on me. I think it has made me test the limits of my mind (which, while wanting, is
 holding) and the limits of my upbringing, family, education, and friends.”

Mavis Arnold