This Life on Lithium
A review by Ashutosh Tiwari

BOOK:An Unquiet Mind: A Memoir of Moods and Madness
by Kay Redfield Jamison
Vintage Books, New York 1996

Doctors enjoy talking about their specialties. What they don't enjoy is talking about their own battles with various afflictions, be they cancer, drug addiction or, God forbid, clinical depression.

Kay Redfield Jamison is a refreshing exception. A tenured professor of psychiatryat the prestigious Johns Hopkins School of Medicine in Maryland, USA, she is one of the world's leading experts on manic-depressive illness.

It is the illness she knows all too well personally as well. "As long as I can remember," she writes, "I was
frighteningly beholden to moods . . .[I]ntensely 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" she "started [her] professional life, by becoming, by necessity and intellectual inclination, a student of moods."

As such, this book is Jamison's brutally honest and
poetically charged memoir about how an intelligent, beautiful and cultured woman like herself has lived with two identities that stand in sharp contrast to one another. The first identity is that of a wailing, helpless manic-depressive who, from time to time, completely loses her emotional moorings, only to oscillate wildly
between feelings of giddy grandeur and crushing despair -- leaving relationships, credit ratings, academic performances and much else besides in utter ruins.

And her other identity is that of a stable psychiatrist who does path-breaking research, wins professional plaudits, savors romance with lovers, enjoys the arts and music,
and helps train the next generation of doctors. Against this backdrop, this memoir can best be read as riveting, frightening yet ultimately inspiring stories of Jamison's wars against herself as she continues to wrestle with bouts of manic-depression in an attempt to lead a happy, productive life.

But just what is manic-depressive illness anyway? Quite
simply, it is often described as a severe disorder of moods. It is a disease nonetheless, as Jamison eloquently writes in her quotable intro, that "kills tens of thousands of [women and men] every year: most [of whom] are young, die unnecessarily, and are among the most imaginative and gifted that we as a society have." Yet, "[t]he
major clinical problem in treating manic-depressive illness is not that there are not effective medications - there are -but that patients so often refuse to take them."

Besides, as Jamison puts it, "because of a lack of information, poor medical advice, stigma.
Or fear of personal and professional reprisals, they do not seek treatment at all." The illness "distorts moods and thoughts, incites dreadful beahaviours, destroys the basis of rational thought, and too often erodes the desire and will to live. It is biological in origins, yet one feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide."

Jamison's traces the roots of her manic episodes to watching her brilliant, idiosyncratic father periodically fly high and come crashing down on his emotional roller-coaster when she was a child. In college, which was an emotionally traumatic rite of passage to her, she spends more time on research at labs than get good grades. Her research skills get her into graduate school, where, she finds the "freedom from the highly structured existence of undergraduate studies", delves into experimental psychology, and, as a student-researcher, interacts with a variety of patients with mental health problems.

Offered a teaching position upon the completion of the PhD,
she starts a job at a time when her mania hits her with full force. Of that period, she writes, "my marriage was falling apart . . . I was increasingly restless, irritable and I craved excitement: all of a sudden, I found myself rebelling against the very things I most loved about my husband: his kindness, stability, warmth and love. I impulsively reached out for a new life . . . credit cards are disastrous [for manic-depressives], personal
checks worse . . . "

As pieces started to fall out of Jamison's life, it was her
elder brother who, out of love and without judgment, started to settle the dust for her. He paid her bills, bought her the medicine of manic-depressives, Lithium, and basically "spread his wing" over her. Jamison acknowledges that not many manic-depressives are lucky to have such a loving family member, and she credits the support
and care she received from her brother for putting her back on track of doing research. Meantime, she started going to therapies.

And so the memoir goes, in its very readable prose,
detailing intermittent periods of bliss and productivity in
Jamison's life with months of utter despair and madness. In
between, in lucid terms, she talks about the latest research being done in the identification of and in the treatment of manic-depressive patients. She addresses her concerns "about writing [this book] that so explicitly describes my own attacks of mania, depression, and psychosis, as well as my problems acknowledging the need for ongoing medication."

In appearing undeterred by the possible effects of her memoir upon her personal and professional life, she displays much courage, honesty and, interestingly, pure emotional strength. But then, as anyone who, like Jamison, has battled manic-depressive illness for any amount
of time may admit, once you learn to live with manic-depressive illness, there is very little that seems to be of "insurmountable difficulty".

All in all, this is a book I thoroughly enjoyed reading and
learning much from.

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Originally published in The Kathmandu Post Review of books (July 1999).

- http://www.asianstudies.emory.edu/sinhas/kprb.html

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A recent appearance by Kay Redfield Jamison

- http://www.thecrimson.com/article.aspx?ref=518186

The book itself

- http://www.amazon.com/Unquiet-Mind-Memoir-Moods-Madness/dp/0679763309