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 different in nature and 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. To best capture the essence of the book, I’ll leave you with Jamison’s own words as she eloquently recounters her struggle and life with bipolar disorder:
“I have often asked myself whether, given the choice, I would choose to have manic-depressive illness. If lithium were not available to me, or didn’t work for me, the answer would be a simple no – and it would be an answer laced with terror. But lithium does work for me, and therefore I suppose I can afford to pose the question. Strangely enough I think I would choose to have it. It’s complicated. Depression is awful beyond words or sounds or images; I would not go through an extended one again. It bleeds relationships through suspicion, lack of confidence and self-respect, the inability to enjoy life, to walk or talk or think normally, the exhaustion, the night terrors, the day terrors. There is nothing good to be said for it except that it gives you the experience of how it must to be old, to be old and sick, to be dying; to be slow of mind; to be lacking in grace, polish, and coordination; to be ugly; to have no belief in the possibilities of life, the pleasures of sex, the exquisiteness of music, or the ability to make yourself and others laugh.
Others imply that they know what it is life to be depressed because they have gone through a divorce, lost a job, or broken up with someone. But these experiences carry with them feelings. Depression, instead, is flat, hollow, and unendurable. It is also tiresome. People cannot abide being around you when you are depressed. They might think that they ought to, and they might even try, but you know and they know that you are tedious beyond belief: you’re irritable and paranoid and humorless and lifeless and critical and demanding and no reassurance is ever enough. You’re frightening, and you’re “not at all like yourself but will be soon,” but you know you won’t.
So why would I want anything to do with this illness? 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; 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. I have seen the breadth and depth and width of my mind and heart and seen how frail they both are, and how ultimately unknowable they both are. Depressed, I have crawled on my hands and knees in order to get across a room and have done it for month after month. But, normal or manic, I have run faster, thought faster, and loved faster than most I know. And I think 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.
The countless hypomanias, and mania itself, all have brought into my life a different level of sensing and feeling and thinking. Even when I have been the most psychotic – delusional, hallucinating, frenzied – I have been aware of finding new corners in my mind and heart. Some of those corners were incredible and beautiful and took my breath away and made me feel as though I could die right then and the images would sustain me. Some of them were grotesque and ugly and I never wanted to know they were there or to see them again. But, always, there were those new corners and – when feeling my normal self, beholden for that self to medicine and love – I cannot imagine becoming jaded to life, because I know of those limitless corners, with their limitless views.”
Author: Jenelle Rofe
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