An Unquiet Mind is an honest and personal memoir of the clinical psychologist Kay Redfield Jamison, where she candidly shares her battle with bipolar disorder, formerly known as manic depression. Jamison examines her life from the perspective of a professional and patient, which gives the reader a unique insight from both sides of the fence into an often misunderstood mood disorder.

At the time of publication in 1995, as with today, revealing one’s struggle with mental illness as a clinical professional could easily jeopardize their career. Jamison addresses the stigma and shame associated with living with bipolar disorder, shedding light on a challenging journey.

Since then, our understanding of bipolar disorder has evolved. It’s now classified into two types, bipolar I and II, which are debated as being entirely separate disorders despite being clumped together. Bipolar I involves at least one manic episode, which can be accompanied by depressive episodes. Bipolar II, on the other hand, is characterized by recurrent depressive episodes and at least one hypomanic episode, with the periods of depression often being longer and more frequent. Mania comprises a constellation of signs and symptoms including elevated mood, delusions of grandeur, rapid thinking, increased impulsivity, and may include aggression and irritability. Hypomania is similar to the manic state however, to a lesser degree and duration, and generally does not cause significant impairment.

Individuals with bipolar disorder are at greater risk for suicide compared to the general population, and while most suicide attempts occur during depressive episodes, suicide attempts can occur during manic periods and tend to be more lethal. Current research has proposed that repeated periods of depression can make a person more susceptible to mania, also known as the “kindling hypothesis.”

While “bipolar disorder” is the accepted terminology in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), in her memoir, Jamison expresses disapproval of the use of “bipolar” as a description of herself and her disorder, finding the term “strangely and powerfully offensive.” The term “bipolar” in itself seems to obscure and minimize the severity of the disease it is supposed to represent, while the historical term “manic-depressive,” seems to capture the seriousness of the disorder. This sentiment aligns with a broader critique among professionals in the field of psychology who believe the DSM-V oversimplifies mental disorders in the pursuit of precise language. Bipolar disorder, like many other mental disorders, exists on a spectrum and can include many variations, for example, mixed states, which is when manic and hypomanic symptoms coexist with depressive ones. The existence of these various states is not readily apparent in the term “bipolar,” which implies only two states of mood.

I highly recommend “An Unquiet Mind” to anyone seeking a deeper understanding of life through the lens of a mood disorder. Jamison’s memoir takes you on a poignant journey of discovery, navigating the highs and lows of her life and her encounters with love. By the end, Jamison shows that peace may not come from quieting the mind, but from knowing it.

Author: Jenelle Rofe

Illustration: Ellen Forney from Marbles: Mania, Depression, Michelangelo, and Me

Want to read more? Subscribe to our newsletter!

References

Allsopp, K., Read, J., Corcoran, R., & Kinderman, P. (2019). Heterogeneity in psychiatric diagnostic classification. Psychiatry Research, 279, 15–22.

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). American Psychiatric Publishing.

Burger, J. (n.d.-a). It is all about the labels. Brain Matters. Retrieved October 21, 2023.

Burger, J. (n.d.-b). Schizophrenia and Bipolar disorder, a blessed misfortune regarding creativity? Brain Matters. Retrieved October 21, 2023.

Esterberg, M. L., & Compton, M. T. (2009). The psychosis continuum and categorical versus dimensional diagnostic approaches. Current Psychiatry Reports, 11(3), 179–184.

Forney, E. (2012). Marbles: Mania, Depression, Michelangelo, and Me: A Graphic Memoir. Penguin.

Fried, E. I., van Borkulo, C. D., Cramer, A. O. J., Boschloo, L., Schoevers, R. A., & Borsboom, D. (2017). Mental disorders as networks of problems: A review of recent insights. Social Psychiatry and Psychiatric Epidemiology, 52(1), 1–10.

Hanscom, D. (n.d.). The DSM Classification System: More Harmful Than Helpful? Psychology Today. Retrieved October 21, 2023.

Jamison, K. R. (1996). An Unquiet Mind. Vintage Books.

Kessels, R., Eling, P., Ponds, R., Spikman, J., & van Zandvoort, M. (Eds.). (2017). Clinical neuropsychology. Boom.

Mania | Johns Hopkins Psychiatry Guide. (n.d.). Retrieved October 30, 2023.

Nienke Jabben & Indira Tendolkar. (2017). Depression and bipolar disorders. In R. Kessels, P. Eling, R. Ponds, J. Spikman, & M. van Zandvoort (Eds.), Clinical neuropsychology. Boom.

Tondo, L., Isacsson, G., & Baldessarini, R. J. (2003). Suicidal Behaviour in Bipolar Disorder. CNS Drugs, 17(7), 491–511.