Book Review: An Unquiet Mind by Kay Redfield Jamison
Humanizing. What Kay Redfield Jamison does in her book An Unquiet Mind is that she beautifully humanizes a disorder. It is a disorder that, as she makes clear throughout the text, is generally represented (at best) as cold and clinical medical literature or (at worst) a horrible stigma. An Unquiet Mind provides a unique and irreplaceable point of view on manic-depressive illness, with its author serving as both the expert and the patient. At the end of the day, the book is a memoir, but it also has a very clear mission to bring multiple levels of awareness to the disease Jamison suffers from. Jamison connects with the reader as a doctor, using the latest medical information to help destigmatize manic-depressive disorder. She comes at you as an author, an artist even, with vibrant and haunting diction.
Most importantly, in this book she is a patient, and through her relationships, vulnerabilities, and personal admissions, Jamison ties it all back to her most important point is: she is not a diagnosis, but a human being.
Vulnerability plays a huge role in this humanizing process. Jamison is not quiet about her fears or her questions. In fact, at one point later in the book when she seems to have “found her groove in life,” she sits down to disclose her illness to the chairman of her newly settled John Hopkins position. Here, she tells the reader, “it was not without a sense of dread that I waited for his response to my telling him that I needed to discuss the issue of my hospital privileges” (pg. 209). She was fearful that her privileges would be taken away with the admission of her illness. She then dives deeper into her insecurities by contemplating, “Do I really think that someone with mental illness should be allowed to treat patients?” (pg. 204). Watching someone with so much knowledge and experience surrounding mental illness deal with such extreme worry and discomfort allows for the reader to associate that discomfort with the many struggling, often unemployed or homeless, victims of mental illness that weave in and out of one’s own life. In other words, her vulnerability evokes extreme empathy for those who endure manic-depressive illness and don’t have her knowledge/support/experience to help make sense of it all.
Considering the brutalities that manic-depressive disorder wreaks on Jamison’s life, it might surprise one to read her praises of mania. Since she clearly knows the dangers of the disease, it is tempting to expect her to rage against every bit of it; how unfair it is, how she is such a victim. But this, another humanizing element, is what she says instead: “I missed my highs” (pg. 101). It is so easy, as a healthy-minded human, to criticize those with mental disorders. “Just take your medicine!”, we say. But Jamison shows us it is clearly not that simple, not even for someone who knows the truth, who has seen the research. She acknowledges the beauty, excitement, and clarity that those with manic-depressive illness experience, and what a harsh reality it is to have that beauty taken away in exchange for – what? – a “normal” life.
What is normal anyway? Jamison’s state of normal comes across as mind-boggling and awe-inducing. It is certainly not the “normal person’s normal.” How does she do it? She flies at the speed of light, only to crash into the depths of nothingness, wanting to die. Furthermore, intertwined in all her sensory depictions are narratives of studies, work, relationships, tenure, research. How? How does she survive it all? The amazing experience of reflecting on this as one reads her text, is that Jamison is simultaneously reflecting on it as well. She doesn’t fully understand it herself.
But she is brave. She charges forward despite the excessive challenges she faces.
Throughout the book, she has a wonderful way of laughing at herself, like in her tale of buying a horse prior to learning of her diagnosis:
“I decided early in graduate school that I needed to do something about my moods. It quickly came down to a choice between seeing a psychiatrist or buying a horse. Since almost everyone I knew was seeing a psychiatrist, and since I had an absolute belief that I should be able to handle my own problems, I naturally bought a horse” (pg. 55).
The subtle jab at her own absurdity in thinking makes her even more likeable, more relatable, and more easily understood. Jamison puts her own reputation on the line, even refereeing herself, in order to help push forward the knowledge of, and hopefully eventual acceptance of, her terrifying disease.
Despite her existence on both sides of the disease, as the studier and the studied, Jamison still has the guts to admit that she doesn’t know it all. When she receives a powerful letter from a woman reviling Jamison’s use of the word “madness” in the title of a talk she gave, the woman’s harsh accusation stating that Jamison was “just one more doctor climbing [her] way up the academic ranks by walking over the bodies of the mentally ill” (pg. 179), Jamison pauses. She is further chastised and told that she “clearly had no idea at all what it was likely to suffer from something as awful as manic-depressive illness,” and still, she pauses. This exact move of hers, to analyze the truth in this letter rather than let her emotions run rampant, shows what an incredible (dare I say) asset her illness has become to her. It is because of her illness that she is able to consider how a diagnosis, a simple word even, can have such a profound effect on a patient (even if she does not find the word offensive, herself.) Jamison’s personal experience with manic-depressive illness gives her an insight that no “healthy” doctor could ever fully understand. It gives her empathy and, consequently, the ability to analyze people, experiences, and reactions in a completely unique way.
Jamison chronicles many types of loss in her memoir, some having nothing to do with her disease. As the reader, your heart breaks for these losses, but it breaks – perhaps more so – for her loss of the best home she’s ever known: her mind. “I missed my home, my mind, my life of books and ‘friendly things,’ my world where most things were in their place, and where nothing awful could come into wreak havoc” (pg. 96–97). This book is the roadmap that takes you through her journey of coming to accept her loss of home, and her loss of control. By the end, Jamison says, “I long ago abandoned the notion of a life without storms, or a world without dry and killing seasons” (pg. 215).
Beauty. Acceptance. Hope. These last descriptives are consistently manifested throughout Jamison’s memoir (with rare exceptions) in the responses of those she discloses her illness to. Her lovers accept her admission with grace, her superiors with kindness and often assurance. “’Kay, dear,’ [her chairman] said, ‘I know you have manic-depressive illness.’ He paused and then laughed. ‘If we got rid of all the manic-depressives on the medical school faculty, not only would we have a much smaller faculty, it would also be far more boring’” (pg. 209). And thank God, she was able to continue her work.
Jamison displays immense excitement throughout the text for the scientific advancements being made around manic-depressive illness. It is no secret that being diagnosed with a mental illness can come with many forms of judgement, from society and loved ones alike. Indeed, after Jamison shared her “secret”- including her suicide attempt – with a certain colleague, she was not granted compassion or even encouragement, but instead was confronted with anger and disappointment. He called her selfish, her attempt at suicide an “act of cowardice” (pg. 200). Simply the fact that he – a psychoanalyst, no less! – could refer to her act as if it was a well-thought-out choice demonstrates how misunderstood mental illness can be. Even to a professional in the field, it was understood that Jamison should be able to do something about her illness, to just snap out of it. It is understandable, then, that she expresses so much excitement at seeing the technological advancements being made in psychiatry.
“With PET, for example, a depressed brain will show up in cold, brain-inactive deep blues, dark purples, and hunter greens; the same brain when hypomanic, however, is lit up like a Christmas tree, with vivid patches of bright reds and yellows and oranges. Never has the color and structure of science so completely captured the cold inward deadness of depression or the vibrant, active engagement of mania” (pg. 196).
It is with hope that Jamison describes developments like this. Hope that science will open up the condemner’s minds to the biology of mental illness and just how cemented it is in the brain; it is not something one can just handle. Perhaps with the removal of this way of thinking, the stigma of mental illness – specifically manic-depressive disorder – can dissolve as well.
Of every work this book accomplishes, possibly the most beautiful is its expression of the importance of empathy.
Jamison is in a constant state of self-portraiture; both the photographer and the subject, the researcher and the researched, the doctor and the patient. And this distinctive experience gives her a worldview that most could never grasp. “I have often asked myself whether, given the choice, I would choose to have manic-depressive illness…Strangely enough I think I would choose to have it” (pg. 217). While she acknowledges that this statement can only be made because of the positive effect that lithium treatment has on her life, it still holds a lot of weight. “Who would choose to have a disease?”, one wonders. But for those who care so profoundly about the state of others, and about the advancement of the treatment of those who are considered “disordered,” suffering from the disorder themselves is a rare window, an enlivening opportunity even. It is a rare chance to speak honestly and truthfully on behalf of those who cannot/might not know how to/might not have the platform to speak for themselves.
It’s an interesting hybrid, this book. At the end of the day, it is a memoir, an enjoyable narrative and beautifully written story. But it is also can be taken as a teaching manual.
The reader learns of the damage done by judgement, of the opportunities created by acceptance, the importance of science in studying mental illness, and gains at least a sliver of understanding of what the inner experience of manic-depressive illness looks like.