An Unquiet Mind: A Memoir of Moods and Madness

by Kay Redfield Jamison

the prevailing wisdom had been that having a mental illness would prevent a doctor from providing competent care, would indicate a vulnerability that would undermine the requisite aura of medical authority, and would kill any patient’s trust.

informed by your experiences rather than blinded by them.

Not just on the run but fast and furious on the run, darting back and forth across the hospital parking lot trying to use up a boundless, restless, manic energy. I was running fast, but slowly going mad.

Within three months I was manic beyond recognition and just beginning a long, costly personal war against a medication that I would, in a few years’ time, be strongly encouraging others to take.

My illness, and my struggles against the drug that ultimately saved my life and restored my sanity, had been years in the making.

Intensely emotional as a child, mercurial as a young girl, first severely depressed as an adolescent, and then unrelentingly caught up in the cycles of manic-depressive illness by the time I began my professional life, I became, both by necessity and intellectual inclination, a student of moods.

The disease that has, on several occasions, nearly killed me does kill tens of thousands of people every year: most are young, most die unnecessarily, and many are among the most imaginative and gifted that we as a society have.

Because my illness seemed at first simply to be an extension of myself

And, because I thought I ought to be able to handle my increasingly violent mood swings by myself, for the first ten years I did not seek any kind of treatment.

still intermittently resisted the medications that both my training and clinical research expertise told me were the only sensible way to deal with the illness I had.

My manias, at least in their early and mild forms, were absolutely intoxicating states that gave ris...

they also brought with them seemingly intolerable side effects.

that freedom from the control imposed by medication loses its meaning when the only alternatives are death and insanity.

Manic-depression distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live. It is an illness that is biological in its origins, yet one that feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide.

my sister saw the darkness as being within and part of herself, the family, and the world. I, instead, saw it as a stranger; however lodged within my mind and soul the darkness became, it almost always seemed an outside force that was at war with my natural self.

times were good and his moods were at high tide, his infectious enthusiasm would touch everything.

was enchanting, really, rather like having Mary Poppins for a father.

She could not have known how difficult it would be to deal with madness; had no preparation for what to do with madness—none of us did—but consistent with her ability to love, and her native will, she handled it with empathy and intelligence. It never occurred to her to give up.

my curiosity and temperament had taken me to places I was not really able to handle emotionally, but the same curiosity, and the scientific side of my mind, generated enough distance and structure to allow me to manage, deflect, reflect, and move on.

I had a terrible temper,

God only knew what ran underneath the fierce self-discipline and emotional control that had come with my upbringing. But the cracks were there, I knew it, and they frightened me.

ninety patients for each psychiatric attendant.

drugs that could control most of the patients, but, now and again, it became necessary to “hose them down.” “Hose them down”?! How could anyone be so out of control that they would require such a brute method of restraint? It was something I couldn’t get out of my mind.

standing dead still, and looking around me at the bizarre clothes, the odd mannerisms, the agitated pacing, strange laughter, and occasional heartbreaking screams. One woman stood like a stork, one leg tucked up; she giggled inanely to herself the whole time I was there. Another patient, who at one time must have been quite beautiful, stood in the middle of the dayroom talking to herself and braiding and unbraiding her long reddish hair.

I was primarily frightened by the strangeness of the patients, as well as by the perceptible level of terror in the room; even stronger than the terror, however, were the expressions of pain in the eyes of the women.

He sailed over the cusp of reason at times, and his grandiose ideas started to push the limits of what Rand could tolerate.

With his capacity for flight came grimmer moods, and the blackness of his depressions filled the air as pervasively as music did in his better periods.

my father’s moods were further blackening, and I felt helpless to affect them.

I scarcely recognized him.

He also started drinking heavily, which made everything worse.

By the time I was sixteen or seventeen, it became clear that my energies and enthusiasms could be exhausting to the people around me, and after long weeks of flying high and sleeping little, my thinking would take a downward turn toward the really dark and brooding side of life.

and Hardy—we had set for ourselves. We all came by our black chaos honestly: two of us, we were to discover later, had manic-depressive illness in our immediate families; the other’s mother had shot herself through the heart.

was a senior in high school when I had my first attack of manic-depressive illness;

My mind was beginning to have to scramble a bit to keep up with itself, as ideas were coming so fast that they intersected one another at every conceivable angle.

I could not follow the path of my own thoughts.

I was wildly agitated, paranoid, and physically violent—but it was one he carried out with skill, grace, and understanding. He was very gentle but insistent when he told me that he thought I had manic-depressive illness, and he persuaded me to make an appointment to see a psychiatrist.

Lithium had been approved for use in mania only four years earlier, in 1970,

lithium was the only drug that had any serious chance of working for me. He prescribed lithium and other antipsychotic medications for me, on a very short-term, emergency basis, only long enough to tide me over until I saw my psychiatrist for the first time. He put the correct number of pills out for me to take each morning and evening,

spent hours talking with my family about my illness and how they might best handle

insisted that I take a short time off from work,

arranged for me to be looked after at home during those periods when he was unable to.

I felt infinitely worse, more dangerously depressed, during this first manic episode than when in the midst of my worst depressions. In fact, the most ...

first time I was psychotic...

I had developed mechanisms of self-control, to keep down the peals of singularly inappropriate laughter, and set rigid limits on my irritability.

Fragments of ideas, images, sentences, raced around and around in my mind like the tigers in a children’s story.

I wanted desperately to slow down but could not.

At one point I was determined that if my mind—by which I made my living and whose stability I had assumed for so many years—did not stop racing and begin working normally again, I would kill myself by jumping from a nearby twelve-story building. I gave it twenty-four hours.

could feel my mind being reined in, slowed down, and put on hold. But it was a very long time until I recognized my mind again, and much longer until I trusted it.

Patient care, on that particular ward, often took a backseat to staff neuroses, internecine wars, and self-indulgence.

another bad attack of mania, which, as day the night, was followed by a long, absolutely paralyzing depression.