An Unquiet Mind: A Memoir of Moods and Madness

by Kay Redfield Jamison

after I had impulsively left during my first manic episode.

lived in terror that someone would find out how ill I had been, how fragile I still was, but—oddly and fortunately—sensitivity and keen observation are not always the long suits of academic psychiatrists.

began to enjoy music and paintings again, to laugh again, to write poetry again.

couldn’t afford not to obtain new medication: the last time I had stopped my lithium I had gotten manic almost immediately. I could not survive another year like the one I had just been through.

It was rotten luck, and somebody finally understood.

Somehow, after that conversation, everything became easier for me: I felt, for the first time, that I was not alone in dealing with all of the pain and uncertainty, and it was clear to me that he genuinely wanted to understand my illness and to take care of me.

David’s death did not plunge me into unendurable darkness; suicide never crossed my mind.

In the language that is used to discuss and describe mental illness, many different things—descriptiveness, banality, clinical precision, and stigma—intersect to create confusion, misunderstanding, and a gradual bleaching out of traditional words and phrases.

allowing such language to go unchecked or uncorrected leads not only to personal pain, but contributes both directly and indirectly to discrimination in jobs, insurance, and society at large.

It gives an illusion of easy answers to impossibly difficult situations and ignores the powerful role of wit and irony as positive agents of self-notion and social change.

my official DSM-IV diagnosis is “bipolar I disorder; recurrent; severe with psychotic features; full interepisode recovery”

find the word “bipolar” strangely and powerfully offensive: it seems to me to obscure and minimize the illness it is supposed to represent.

But the question also arises whether, ultimately, the destigmatization of mental illness comes about from merely a change in the language or, instead, from aggressive public education efforts; from successful treatments, such as lithium, the anticonvulsants, antidepressants, and antipsychotics; from treatments that are not only successful, but somehow also catch the imagination of the public and media (Prozac’s influence on public opinion and knowledge about depression, for example); from discovery of the underlying genetic or other biological causes of mental illness; from brain-imaging techniques, such as PET and MRI (magnetic resonance imaging) scans, that visually communicate the location and concrete existence of these disorders; from the development of blood tests that will ultimately give medical credibility to psychiatric diseases; or from legislative actions, such as the Americans with Disabilities Act, and the obtainment of parity with other medical conditions under whatever health-reform system is put into place.

Attitudes about mental illness are changing, however glacially, and it is in large measure due to a combination of these things—successful treatment, advocacy, and legislation.