Articles from prior issues of The Advocate

September/October, 1999

An Unquiet Mind - A Memoir of Moods and Madness

by Kay Redfield Jamison A Review - by Ione Klima, Minnesota DDS

WHEN A DOCTOR GOES MAD it’s more than a little disconcerting. That and embarrassment are the reasons Kay Redfield Jamison hesitated to tell her story. She is the doctor, and although she knows the arguments against using labels such as “mad,” that is what she was, and that is what she calls it in telling her story. Jamison’s account serves the disability professional in several ways. Only a person with “inside” knowledge of psychosis can give a description for outsiders in the manner Jamison does. As a young person, she mentally soared along the rings of Saturn, thoroughly enjoying herself. Like many other manic depressives, she didn’t want to give it up. She fought a particularly hard battle because she believed so much in herself that she knew she was in charge and could control her moodiness. But, of course, she couldn’t. Later, after discontinuing Lithium, she discovered herself in her living room with bills for ridiculous items spread all around. She stared out her window and frankly hallucinated a person that dissolved into blood. She screamed and screamed. Only courage would drive her to tell the reading public about that. For several years, she cycled higher and lower, stopping medication until despair drove her to restart it. Luckily, she is one of the patients who responds well to Lithium, but she didn’t consider it luck during that period. She got to the point where the mania was indistinguishable from the depression; where one lurked while the other possessed her.

“I had, ever since I could remember, inclined in the direction of strong and exuberant feelings, . . . inflammability, however, always lay just the other side of exaltation. These fiery moods were, at least initially, not all bad: in addition to giving to a certain romantic tumultuousness to my personal life, they had, over the years, added a great deal that was positive to my professional life. Certainly, they had ignited and propelled much of my writing, research, and advocacy work. They had driven me to try to make a difference. . . always, there was a lingering discomfort when the impatience or ardor or restlessness tipped over into much anger.”

Eventually, she accepted her diagnosis and medical practice changed to treat the condition with lower dose Lithium. She has lived many years on the cusp between being a moody, adventurous and energetic person surviving only by the grace of a dose of medication. We have read about this in case files, now the experiences come alive. Our understanding is expanded by listening: the mental torture of her unquiet mind, her desire for suicide, her refusal to “see” that Lithium was necessary to her survival. At the same time as becoming possessed by her mood disorder, Jamison set high goals for her education and achieved high academic honors. Her first whopping breakdown came shortly after she was appointed to a professorship, doctorate fresh in hand. Her major? Academic psychology, specializing in moods! She was a clinician and teacher. She was promising everything to everyone. She knew she was insane. Yet, she kept working, even brilliantly. While some individuals knew her private madness, it was never known by those who had the power to take away her clinical privileges. While I admire Jamison’s courage, and have learned from her memoir something about living and working with and despite a severe mood disorder, I can’t help but cringe at the thought that she continued with such high level tasks. As a disability specialist, I conclude that she may never have been unable to do any work for 12 months in a row, but I would feel better knowing that she did a stint of unskilled work during the worst of her times. I hate to think of how she may have unawaredly influenced students and patients for the worse.