Pretty much a book review, but not quite: An Unquiet Mind

Long had I lain thus, craving death,

When quietly the earth beneath

Gave way, and inch by inch, so great

At last had grown the crushing weight,

Into the earth I sank till I

Full six feet under ground did lie,

And sank no more,—there is no weight

Can follow here, however great.

From off my breast I felt it roll,

And as it went my tortured soul

Burst forth and fled in such a gust

That all about me swirled the dust.

-Millay, Renascence

This is an excerpt from a poem Jamison mentioned in her book; she said that it described her cyclic journey into madness. I felt these lines were very representative of her battle with moods, going from desiring death to having hypomania swirling about her in a gusty, yet invigorating way. Jamison’s journey into madness, as she puts it, and her recurring struggle with managing her intense moods, was the focus of the book. I unquestionably learned a great deal from her; not only did I acquire knowledge about manic-depressive illness (or bipolar, as it is referred to in the DSM-IV-TR), but also about my own, personal and intrinsic beliefs about the mental illness and its symptoms.

It seemed as if Jamison’s very clear intention in writing the book was education: furthering the public’s knowledge about the illness was a goal she had always worked for. This goal became more evident after her conversation with Mogens Schou, where the two related over having personal experience with the illness as their driving force in learning more about it and helping those who have manic-depressive disorder. I felt there was an underlying motivation, one of a more personal nature, which also showed itself in Jamison’s overall intent in writing the book. She mentioned numerous times her fear of ‘outing’ herself by revealing her illness to her all of her colleagues, and to the general public, for fear of having her clinical privileges rescinded, or for being termed ‘inappropriate,’ ‘unstable,’ or, ‘biased’ in her work. Throughout her life she has experienced positive and negative reactions from friends and co-workers when revealing her illness, and it seemed as if this book was another way to reveal herself, and still see that she can be taken seriously as a professional and as a person. I appreciated all reasons for her writing this book, and I am sure there are more intentions in publishing it than what I named.

I have been in the mental and behavioral health field for about four years, working with children and adolescents. Although I have contact with adults (families and parents), I usually do not obtain their psychiatric history, so I have not experienced anyone who has described a full-blown manic episode. I have completed assessments with children who I believe had hypomanic episodes; but the symptoms in children can be displayed in very different ways than in adults. I was intrigued from the very beginning, as part of me thought that there were very few people who actually has such intense manic (and depressive) episodes. Additionally, I had my own biases turned topsy turvy after reading this. I work with people who have AHCCCS (Arizona’s version of Medicaid,) so many of the people I work with on a daily basis do not have the higher education that Jamison did, and I will admit that I had a personal assumption that people with such a ferocious variety of mental illness would have difficulty functioning day to day. Although she mentions the struggle to work, among other daily life activities while in her depressive states, she generally can maintain her typical day to day life activities, and I think she does so with grace. The fact that she was able to obtain tenure in the midst of such an intense illness definitely says that my initial thought was wrong, that people with mental illness can handle and succeed in high stakes jobs that are filled with stress and crucial obligations.

I would say the biggest lesson I learned in reading this book, even before the lesson was stated explicitly, was that of suicide and my thoughts connected to its meaning. I grew up being told and thinking that suicide was a selfish way out, and that one attempted suicide because it was easier than other ways of treating or dealing with problems. I vividly recall Jamison stating that she felt she was an immense and undue burden to her family, friends, and at times colleagues and her psychiatrist. She felt that it would be better for them if she no longer had to be watched and taken care of, and not to mention that she didn’t see a purpose to live when she was experiencing her black depressions. While reading this section I had a mini-epiphany, if you will. I realized that people who are suicidal may not be thinking only of themselves, but of helping others by ridding their loved ones from the turmoil and stress they feel they are causing. Suicide may not always be a selfish act, I learned that the person may feel they are being considerate of others while ridding themselves of their own personal pain. For this reason alone I would highly recommend this book to others. I feel that there is an abundance of reasons to recommend this book, in addition to the aforementioned: advocacy to reduce stigma, education that mental illness does not mean a person is bad (sometimes they have little or no control over what we call symptoms), this book taught me to be a better friend, and probably a better person (in reacting and interacting with others), and lastly, I believe I have a renewed passion for my work and my life in general.

Initially I would say I felt that her target audience was people who were interested in manic-depressive disorder, but after completing the book I feel that her audience is of a wider birth, perhaps extending to skeptics, those with the illness, practitioners, and lay people who are looking for an honest memoir to read. I feel like this would be an interesting read to spark an interest in beginning social workers. I think she makes an excellent point, which all of us need to remember about many mental illnesses, “It is an illness that it biological in its origins, yet one that feels psychological in the experience of it.” I think that we too often forget that point and at times believe that people with such an illness are acting certain ways because they chose to, not because their body is compelling them to do so.

Another aspect of the book that I adored was her penchant for telling us that creative and different people are not crazy. I loved that her undergraduate professor told her that her Rorschach responses were creative and he praised her, instead of condemning her for having such ‘out of the box’ remarks. I agree with her in the sense that if we do find a gene that is connected to this illness and it can be tested for before birth, that people may chose not to proceed with the pregnancy, thus shrinking the potential number of such (possibly and potentially) great minds. It is a personal belief that many of society’s greatest discoveries  could have only been found by people who don’t think like ‘normal’ people. 

I am not very familiar with the disorder or being in remission from it, but I did notice a pattern. She seemed to go into remission when she was less stress (in London or Scotland), it was when she felt free and happy. I wonder if remission is related to environment and if so how we can use this to benefit treatment. Lastly, her discussion on wording, labeling, and stigma have a very direct thread to class discussion. I enjoyed her idea of calling the illness what the person who has it wants to call it. I think this adds to the  idea of empowering the person also.

I would highly recommend this book to others. I thoroughly enjoyed reading it and I took a lot from reading it. I am not sure that there is anything I would change about the book, I think its strengths of teaching lessons we can all benefit from learning, and whatever weaknesses it may have, are a lovely metaphor to her life, it is made better only with both present.