BTRIPP (btripp) wrote,

From one tormented moment ... to the next

One of the effects of being out of work for seven years (and the rejection implicit in having applied to 2,000-3,000 jobs in that time with only a mere handful of serious interviews resulting from that herculean effort), is that I struggle with depression … a lot. Of course, another effect of not being in a job is not having a paycheck, so my options for finding help with said depression are somewhat limited. Over the past year or so I've been going to DBSA meetings, which are sort of like group therapy sessions, but (generally speaking) without a therapist (yeah, it's a bit like “the inmates running the asylum”). The subject of this review is a book that was enthusiastically recommended by the folks who referee one of the groups I attended: An Unquiet Mind: A Memoir of Moods and Madness by Kay Redfield Jamison.

Now, Ms. Jamison is a clinical psychologist, a Professor of Psychiatry at the John Hopkins School of Medicine, and co-author of the “standard medical text” Manic-Depressive Illness, so I figured that An Unquiet Mind would be a book discussing depression, etc. But, no. This is an autobiography focusing on the author's OWN struggles with what is currently labeled as “bipolar disorder”. I don't know why, specifically, this confused me … but I guess I was anticipating that somebody might have mentioned (amid all the praise for the book) that it was “one woman's struggle” with the disease, even if from a standpoint of being on the leading expert on the disease, rather than presenting it as some definitive text on the subject.

This review may end up being a good deal less “in depth” that I would like it, largely due to it being an intensely personal tale of Jamison's life, with narrative arcs and illustrative details that are, if not “TMI”, hard to generalize from, as they're intrinsically interwoven with her individual experiences. Early on here she gives the broad strokes:
      For as long as I can remember I was frighteningly, although often wonderfully, beholden to moods. 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. It has been the only way I know to understand, indeed to accept, the illness I have; it also has been the only way I know to try to make a difference in the lives of others who also suffer from mood disorders. The disease that has, on several occasions, nearly killed me does kill tens of thousands of people every year …
Although she had, as detailed in the above, been “of the type” for most of her life, it wasn't until her late 20's (“Within a month of signing my appointment papers to become an assistant professor of psychiatry at the University of California, Los Angeles”) that the disease hit her full force.

Again, this is a very personal book, and while the particulars are certainly of interest in context, extracting them here seems awfully random. The author was a “military brat”, her father being a meteorologist with the Air Force, and her childhood was spent in that rather idiosyncratic environment, reinforced by her D.A.R. mother's appreciations of the social aspects involved. One of the factoids that is repeatedly raised here is that manic-depression/bi-polar disorder is frequently, if not predictably, found within families, and (although it was rarely diagnosed in previous generations) her father pretty clearly (from the difficulties of later years) had the disease.

When she was headed to high school, her father left the military, and took a position with the Rand Corporation out in California. This threw Jamison out of the familiar settings of the peripatetic military lifestyle, and into the less structured environment of Los Angeles. She survived high school, and reluctantly (she'd always planned on going to University of Chicago) enrolled in UCLA.

I have no reason to doubt the overall veracity of this book (unlike many others I've reviewed), but I found myself waxing incredulous at several points in the parts discussing her academic career, both as a student, and as she climbed the professorial ladder. If things were as bad as she paints them here, how could she have completed her college work? I assume that she is selecting material to discuss based on how it illustrates her disease, and avoiding the less “remarkable” parts, but reading through this made it hard to believe that she managed to get through college, get advanced degrees, do competent work, get tenure, etc. Sure, there were manic phases when she could move mountains, but the over-all tone of her academic life (and, OK, what do I know about the realities of those “ivory towers”?) sounded like something that would have resulted in a business person having long ugly chats with HR.

One of the pivotal issues in the book is that, for a very long time, Jamison was refusing to medicate. I realize that many of the “popular drugs” for depression, etc. can be quite debilitating (I had a few prescribed for me a decade or so back, and each was worse than the last, and I finally decided that I'd rather be miserable than various degrees of zombified), but she was a professional in the field, and should have known that she should have been on meds.
      I reaped a bitter harvest from my own refusal to take lithium on a consistent basis. A floridly psychotic mania was followed, inevitably, by a long and lacerating, black, suicidal depression; it lasted more than a year and a half. From the time I woke up in the morning until the time I went to bed at night, I was unbearably miserable and seemingly incapable of any kind of joy or enthusiasm. Everything – every thought, word, movement – was an effort. Everything that once was sparkling now was flat. I seemed to myself to be dull, boring, inadequate, thick brained, unlit, unresponsive, chill skinned, bloodless, and sparrow drab. I doubted, completely, my ability to do anything well. It seemed as though my mind had slowed down and burned out to the point of being virtually useless. The wretched, convoluted, and pathetically confused mass of gray worked only well enough to torment me with a dreary litany of my inadequacies and shortcomings in character, and to taunt me with the total, the desperate, hopelessness of it all.
Thankfully, I only suffer from “situational” depression (a form of PTSD, I'm told), but that sounds awfully familiar to me – waking up to that sort of state several times a week. One thing that I found interesting here (and which I've also gotten a sense of from various people at DBSA meetings), is how bad the flip side of depression (“floridly psychotic mania” in the above) can be. For somebody whose college nickname was “manic”, I never had a clue that for some folks “being manic” wasn't just about being up for days at a time cranking out awesome projects … and Jamison details some of these behaviors (which frequently involve massive spending sprees on things that no rational person would think was a good idea) which certainly parallel the horror stories I've heard in group.

Despite the difficulties generated by the manic phases (luckily for the author, her brother was able to “fix” her financial issues from these episodes) and the nightmares of the the depressive times (in which she regularly contemplated, and on occasion attempted, suicide), Jamison ends up having a rather sterling academic career, including co-“writing the book” on her disorder. However, her private life was not so lucky, as her initial (seemingly wonderful) marriage was destroyed by her disease, and she ended up having a series of other relationships which she goes into here … including one really tragic connection which was cut short by the sudden heart-attack death of her (young, athletic) intended (however, at that point she was religiously taking her lithium, and did not have a total crash in the wake of it).

While An Unquiet Mind was not the book that I thought I was getting into, it certainly was an interesting (if somewhat voyeuristic) read, and broadly illuminating on the subject of manic-depression / bi-polar disorder. It is, however, not a particularly comfortable read, and I don't think that's just from the perspective of somebody dealing with depression … but that could also be due to my having expected something more “clinical” here than the personal outpouring that this is.

This has been out for 20 years at this point, and is still in print (in the paperback edition), being a “classic” in its niche, so you should be able to get a copy from your local brick-and-mortar book vendor, although the on-line big boys have it at a substantial (40% off at this writing) discount. You can also find “very good” copies in the used channel for as little as 1¢ (four bucks with shipping), if you want to go for maximum affordability. I found a good deal of what the author presents in here of use, but (as noted) it wasn't the sort of book I was expecting, so my enthusiasm isn't quite up to that of the folks who had suggested my getting it. I guess if you know going in it's an autobiographical look at one (top professional in the field) woman's struggle with this disease, you won't be trying to extract the sort of info I was hoping for here … and probably get more out of it.

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Tags: book review
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