An Unquiet Mind: A Memoir of Moods and Madness (1995 original; edició 1996)

[Prelude: Once, I had an ugly mind, which has left me with an abiding interest in psychology. That phrase has been coming up in my mind, I had an ugly mind—trying to put it in the past; the basic strategy of my life is repentance, but this mustn’t become obsessive (just ask Luther)…. I don’t mean that as a pun or something, An Ugly Mind; I wasn’t thinking about that movie I saw one time—though really it wouldn’t have been such a bad title for that, either, although two hours is too little time to tell a story with a sense of subtlety, at least usually.]

[Cf ‘too bad you’re ill’ (Kay) with ‘the basic strategy of my life is repentance’ (me): on the one hand, I do make sense to myself, since for me the one thing worse than being a sinner is being a victim. I know how I’ve *wanted* to be crazy, even if you can’t call it back once you’ve decided, at least not in that way. But I understand that blah blah blah Religion blah blah blah It’s better not to hurt people. To be honest, sometimes I cannot figure out myself why, intellectually, I don’t see Religion as dun dun dun! *screams*.

*shrugs*]

This book has its moments. Certainly taking meds can sometimes be a good thing, especially if the main complaint is that it reminds you that you have a problem, and that you have a body, and that you have a body that’s in need. Certainly the more doctrinaire of the psychiatrists (feelings can be bottled because that’s what feelings are, little bottles, nothing more) are silly, but people are stiff-necked to fight them and fight them and not give an inch—even though, yes, I have a body, and unless that body gets food and sleep and protection from the elements and sometimes medicine, I feel miserable.

I’m theological so maybe I can speak to the uses of adversity argument. If there are uses to adversity, this is good news, since if you have a mental illness, you’ll suffer. (I mean, everyone suffers, although occasionally you meet people who don’t suffer much. They’re not bipolar or psychotic.) The medications can damp your symptoms to a livable level, but they’re not going to exchange your brain for some other brain that you pick out at a store. If you don’t have healthy sleep patterns or other life skills that can make mental illness worse, you have to deal with that. If you can’t handle your emotions or your childhood or other people, or if you think you have some illusionary problem—not a movie star—then you have to deal with that, too. You also have to work unless you’re too disabled to work or can’t find it, and if you can’t work then you still have to pass the time non-neurotically unless you want symptoms to emerge. Taking medicine is not a huge time sink that can fill that up for you.

But you do have a body, and a sort of automatic brain, even if you’re macho or scared of not being in control. (Don’t worry, you’re not in control.) Crises do come in life, and if you have un-dampened symptoms that you can’t handle flair up during crisis time, you might make a bad choice. Just because people didn’t have meds before doesn’t mean that things always work out without them, as if the past, in spite of everything we know about ancient history, was always Christmas Village…. I said that adversity has its uses. It does. But it’s like a medication, and medications have a therapeutic zone, and a toxic zone, as well as a do-nothing zone. Someone who suffers little and never has suffered much, if such a person exists—I suppose it’s possible to suffer less than most and to assign suffering only to trivial or vile causes—probably doesn’t have much to offer a hurting world. Someone who suffers, but can manage it, (someone who probably couldn’t manage it once), has something to offer to the alleviation of others’ suffering. (Suffering is not good in itself.) But a toxic level of suffering, such as the person who is born and dies in North Korea, for example, or any hell that you never get out of, is not in a productive situation. Some suffering is merely and simply destructive. Demonic.

To get biblical, despite the Cross, (which Jesus foresaw, both for himself and his true followers), the Lord’s Prayer asks that God “deliver us from evil” and even says, “do not bring us to the time of trial”. Not even “strengthen us in trial” or “give us victory in our trial” or “give us victory over our enemies”, there are prayers like that in the Bible, but the Lord’s Prayer says, Don’t tempt me. Temptation’s nothing to get excited about. It’s best avoided. Any war you could win, you could lose—and foolhardiness in war IS a sort of sin. It is, if you prefer, a strategy out of touch with reality.

Sometimes people don’t need certain medicines. But if the doctor insists, you should obey, not get macho and weird.

…. Other thoughts: At least she came to terms with her romantic nature in a probably mostly healthy way. Recovery progress is nice.

On another note, I do think that, as long as professionals aren’t proudly ignorant like Trump, that we should badger them about terminology. Some people won’t admit they have a problem even when they have to be admitted to the hospital and given medicine, and I think that’s where some of the badgering comes from. My own language is quite expressive, of course. On a different angle, people assume that Stick Ma comes from Out There, somewhere—somewhere out there; it’s a cliche, you know, the mythical cracker on the street…. But nobody can really stigmatize your mental illness unless they know your case history, which only people who know you or professionals can. But even then it’s not really the terminology. It’s that they get mad because they had to do X for you and they’re not good at their jobs, so it’s your fault because you’re Y—but renaming that Y is something some putz of a congress rep could do, but that’s all they can do. As far as the cracker you don’t know goes, all they can do is stigmatize you for improper behavior, weakness, ignorance, etc., the village gossip rounds, you know. That’s a much bigger kettle of fish than psychiatric patients, and we shouldn’t pretend it’s not. Unless—All—murder comes from mental illness, which I guess, I don’t know, it’s not mental health, right: but even if we were not stupid, you have to admit that free will comes in, which no one understands…. ‘mental illness’ implies lack of power over choice, and we shouldn’t stigmatize weakness, but some people do choose to murder; murder is their choice…. Then again, some people just believe in, put their faith in advertising—the big box store Must treat their hens right, because they put a little unicorn on the box. They’re probably unicorn eggs…. Mentally ill? No, no, surely not that….

Of course, the line probably blurs when people reject help and are content just being ill, you know.

…. I don’t really view mental illness necessarily as the definitive reason not to have children per se—I may have problems but I come from very intelligent people—but not being required to have children is one of the great comforts of my life. I don’t have the money—enter media/advertising horror story here—or the relationship skills, or the non-monkish disposition, I guess those are the main things, although coming from an alcoholic and para-alcoholic family and feeling like I probably don’t have the skills and support to break the cycle without not having children, are supporting factors. And basically, there are enough people in my family/the USA/the Anglo race/human lands already, and I think wherever souls need to take birth they will, even without me offering them cheap seats. In another time or culture, maybe, but I think in this time and culture, I think the best thing is to be a non-sitcom happy person.

But I’m sorry Herr Wilhelm of Victorian Germany rudely told her not to have children because of her illness. On the one hand I have a slight aversion to the frothy souled, always ready for the next thing, frothy milk, you know, but I try not to be too cold…. You must a book read; you must a puzzle solve. This is civilization; you’re bad! *punches air*

…. Although it’s sad that she never reports coming upon a calm happiness; calm happiness feels much better than mania, although there’s no ten point plan for calm happiness….

At least she has her poetry; the little-minded can be difficult. (I like salt. I like salt too. I like eating it, especially. I like just looking at it. Say, sometimes I just put it in my pants! You know, on the news they said that the price of salt is coming down again. Let’s watch TV.)

…. It’s a little sad, but it’s not like we take leisure and choose our personalities, like in a video game.

As a memoir of a clinical researcher suffering from the very pathology she studies, "An Unquiet Mind" is candid, eloquent, and remarkably human in the way is addresses the reader face-on and quietly. That the author's personal journey runs concurrently with the changes in medical diagnoses, treatments, available medications, and in societal perceptions of mental illness makes "AUM" a chronicle as well of the dark spectre of a treatable disease being brought out of the closet into the light and seen for what it is. Jamison's account is at its best when she interweaves the threads of family and love, medical treatment, friendships, and personal struggles to make her point that a human mind is not a singular thing but the nexus of a working system and should be approached as such. Jamison also makes good use of literary references, musical allusions, and plain-old cultural literacy to centrally locate her story in a living, societal context.

There are a number of contra-indications, however, and the most salient to me is the now very dated nature of this work, published in 1995. Jamison, at the time of writing, was very much an advocate of pharmaceutical treatment of bipolar disorder, or any and all mental illness for that matter. In the nearly-thirty years since, over-prescription of SSRIs, opioids, and a pharmacopeia of other drugs...driven by an increasingly powerful Pharma Lobby...has created an entirely different landscape, a field of 'cures' far more destructive than the diseases and a Psychiatry based solely upon brain-altering drugs. Lithium worked for Jamison, and was apparently the workhorse from the early-1970s onward, but that was then and this is now. I wonder what a new edition of this book would look like, and what Jamison maintains this far into the 21st century. ( )

"An Unquiet Mind" is an important, honest, and interesting book, but I'm not sure it's an entirely successful book. The author presents a kind of psychological autobiography here, tracing the development of her manic-depressive disorder and her continual struggle to keep it under control, even as she builds an impressive career as a psychiatrist, academic, and researcher. She doesn't have it easy, and she loses her way a number of times. Jamison's startlingly forthright descriptions of her deep depressions, her reckless behavior, and occasionally, her cruelty to others, hold nothing back. Neither do her descriptions of her manic states, in which she describes visions in which she literally felt herself sail through the solar system. Jamison's descriptions of what it feels like to experience manic high or a depressive low are astonishingly vivid, and particularly valuable to anyone who wants to understand what manic depression actually feels like. The flip side of these sections, appropriately enough, is Jamison's passionate advocacy for both talk therapy and medication. You could almost call "An Unquiet Mind" a sort of love letter to lithium, even as Jamison tells us that manic depressives -- herself included -- are often tempted to stop taking their medication. Jamison is somebody who's experienced mental health care from just about every perspective imaginable, and the depth of her expertise is certainly in evidence here.

Unfortunately, the rest of the book isn't quite as effective. Jamison demonstrates real insight when she describes the sheltered, straight-laced military environment she grew up in, but other parts of the book -- particularly those that describe the time she spent studying and teaching in Britain, dive headlong into cliché. There are a few too many picturesque fogs and nights in cozy pubs in these sections for my taste. And, as other reviewers have mentioned, Jamison takes pains to stress how her friends have family have provided invaluable help to her in her darkest moments, but sometimes I found myself that she'd do more showing, and less telling. "An Unquiet Mind" is, in some ways, very well written, but sometimes it feels a bit overworked. While Jamison's focus on moods and emotions is laudable, the prose doesn't really breathe. Perhaps it doesn't help that while Jamison is obviously astonishingly talented and driven, these same qualities made it a bit difficult for me to relate to her. Of course, this isn't to say that I don't admire her, or even that I didn't find things to like about "An Unquiet Mind." But I'm not sure this one really worked for me. But this one's received real raves from other users, so maybe that's just me. ( )

This book hit me really close to home. I learned so much and could not put it down. ( )

The biggest thing that struck me after reading this was not Jamison's brave admittal of her battles with manic depression, but of the availability of the unconditional love and support that she received from her close friends and family - which marks the importance for advocation and education to fight against the appalling stigma of mental illness in society.

Not many people have access to support and care, not even from their close friends and family themselves. If anything, it tempers the argument for education as essential routes for understanding and compassion. ( )