An Unquiet Mind
by Kay Redfield Jamison


Vintage Books, 1997. ISBN 0679763309.
Reviewed by Duffie Bart
Posted on 09/29/2004

Nonfiction: Memoir; Nonfiction: Life Lessons

"A man who is 'ill-adjusted to the world' is always on the point of finding himself. One who is adjusted to the world never finds himself, but gets to be a cabinet minister." —Hermann Hesse
I do not find it puzzling, as apparently many do, that a full professor of psychiatry at the prestigious Johns Hopkins University School of Medicine, would suffer from manic-depression. After all, being a physician has never brought immunity to any illness. What did puzzle me when I began her book is that Kay Redfield Jamison, a brilliant physician, even after assessing and acknowledging her illness, refused medication for more than ten years. Even then, Jamison went on and off her medication in dangerously erratic ways.

As I continued reading, I began to understand the truly seductive aspects of Ms. Jamisonšs illness. It's gift of almost super-human energy when her mania was in its high episodes resulted, in her case, in a stream of innovative and creative ideas and a flow of impressive papers and projects that enhanced her career. She would feel wonderful and frequently experienced remissions, allowing her to rationalize that she was well.

Tragically, manic-depressive illness kills tens of thousands of, primarily, young people every year, many of them among our most gifted and imaginative members of society. Reading the authoršs honest and courageous story, I felt grateful that this exceptional physician, writer, and individual is still with us.

Though she was 17 when she suffered her first attack, not until she had earned her Ph.D. and was well into her career as a professor of psychiatry was she willing to admit that she was a manic-depressive, that it is indeed a medical illness, and that it requires, beyond a shadow of a doubt, treatment with prescriptive medication. She states that any doctor who thinks otherwise opens himself to a well-deserved malpractice suit. Yet, she continued to be conflicted about taking the medication despite her extreme highs and lows. Frequently, her life seemed to be spinning out of control, As a psychiatrist, she believed she was capable of handling her fluctuating moods and intense perceptions without having to ask for help. She had been taught by her loving parents "to see things through." And she believed that antidepressants were only for psychiatric patients, those of "weaker stock." Her pride and upbringing held her hostage to her illness.

Dr. Jamison points out that the discrepancies between what one is and what one is brought up to believe is the right way of behaving toward others can bring about an unresolvable inner conflict. This is particularly true when onešs family, as hers did, tends toward strictness and conservatism.

Her symptoms and moods were classic of manic depressive illness—her spending sprees, her temptation to drop out of college because she was unable to concentrate and felt "as though only dying would release me from my overwhelming sense of inadequacy and blackness...," her feelings of utter aloneness, her bouts with insomnia. But she also describes the times she felt normal, allowing her to rationalize that medication was unnecessary: "Feeling normal for any extended period of time raises hopes that turn out, almost invariably, to be writ on water."

She explains that her fear of taking medication also had to do with the shame and stigma of the illness. If her colleagues "knew," her career would be over. She assumed that her personal relationships would be damaged as well. Finally, after countless sessions with her psychiatrist, one more major factor surfaced—medication would indeed be her last hope for containment of her illness, and if that did not work, her only possible alternative would be suicide.

Ultimately, she learned: "No amount of psychotherapy alone can prevent my manias and depressions. I need medication; I need them both."

Dr. Jamison freely admits that she chose the field of psychiatry so that she might gain a better understanding of her own disruptive, emotional volatility. In An Unquiet Mind, she shares with readers her relationships with her beloved meteorologist father and her older, supportive brother as well as her strained relationship with her sister.

I consider Jamison's book mandatory reading for anyone interested in mental illness. Adding to the reader's enjoyment, the book is not without humor and wit. I laughed out loud at a story or two and know you will, too.


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