Sunday, December 20, 2009

Books: "An Unquiet Mind: A Memoir of Moods and Madness" by Kay Redfield Jamison

Very dramatic and intriguing memoir of Kay Redfield Jamison presents the dark and yet mysterious workings of human mind as related to mood disorders. As a patient who’s suffering from manic depressive illness (a.k.a bipolar syndrome) and as a mood disorder expert in the leading academic institution her account is vivid and enlightening for all who is interested in the subject matter.

The book is chronologically written, morphing from a simple and wondering perspectives of a young girl in a happy military family into a complicated at times disastrous journey to manage one of the most severe mental illnesses and finally to a relative calmness found through acceptance of lithium treatment.

In the early stages of her illness Kay refuses to acknowledge her condition as medical disorder and without proper treatments submits to its perversities such as multiple days of work with no sleep and uncontrolled shopping spree. She describes these in her own words, “There is particular kind of pain, elation, loneliness, and terror involved in this kind of madness. When you’re high it’s tremendous. The ideas and feelings are fast and frequent like shooting stars, and you follow them until you find better and brighter ones. Shyness goes, the right words and gestures are suddenly there, the power to captivate others a felt certainty. There are interests found in uninteresting people. Sensuality is pervasive and the desire to seduce and be seduced irresistible. Feelings of ease, intensity, power, well-being, financial omnipotence, and euphoria pervade one’s marrow. But, somewhere, this changes. The fast ideas are too fast, and there are far too many; overwhelming confusion replaces clarity. Memory goes. Humor and absorption in friends’ faces are replaced by fear and concern. Everything previously moving with the grain is now against – you are irritable, angry, frightened, uncontrollable, and enmeshed totally in the blackest caves of the mind. You never knew those caves were there. It will never end, for madness carves its own reality.

Eventually Kay admits the heavy tolls of the illness having on her life and her relationships and she finally finds psychiatrist and prescribes to both the psychotherapy and the lithium. She writes, “At this point in my existence, I cannot imagine leading a normal life without both taking lithium and having had the benefits of psychotherapy. Lithium prevents my seductive but disastrous highs, diminishes my depressions, clears out the wool and webbing from my disordered thinking, slows me down, gentles me out, keeps me from ruining my career and relationships, keeps me out of a hospital, alive, and makes psychotherapy possible. But ineffably, psychotherapy heals. It makes some sense of the confusion, reins in the terrifying thoughts and feelings, returns some control and hope and possibility of learning from it all. Pills cannot, do not, ease one back into reality; they only bring one back headlong, careening, and faster than can be endured at times. Psychotherapy is a sanctuary; it is a battleground; it is a placeI have been psychotic, neurotic, elated, confused, and despairing beyond belief. But, always, it is where I have believed – or have learned to believe – that I might someday be able to contend with all of this. No pill can help me deal with the problem of not wanting to take pills; likewise, no amount of psychotherapy alone can prevent my manias and depressions. I need both. It is an odd thing, owing life to pills, one’s own quirks and tenacities, and this unique, strange, and ultimately profound relationship called psychotherapy.” In her psychiatrist’s vivid accounts of the effects of depression in her life it is noted: “Patient intermittently suicidal. Wishes to jump from the top of hospital stairwell”; “Patient continues to be a significant suicide risk. Hospitalization is totally unacceptable to her”; “Despairs for the future; fears recurrence and fears having to deal with the facts that she has felt what she has felt”; “Patient feels very embarrassed about feelings she has and takes attitude that regardless of the course of her depression is such an intolerable burden on others”; “Afraid to leave my office. Hasn’t slept in days. Desperate.”

About the influence of the illness and the eventual treatment on her relationships with the loved ones, she writes, “No amount of love can cure madness or unblacken one’s dark moods. Love can help, it can make the pain more tolerable, but, always, one is beholden to medication that may or may not work and may or may not be bearable. Madness on the other hand, most certainly can, and often does, kill love through its mistrustfulness, unrelenting pessimism, discontents, erratic behavior, and, especially, through its savage moods. The sadder, sleepier, slower, and less volatile depressions are more intuitively understood and more easily taken in stride. A quiet melancholy is neither threatening nor beyond ordinary comprehension; an angry, violent, vexatious despair is both.”

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