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.”