An Unquiet Mind: Chapter 11 Summary & Analysis

Jamison describes sitting in a meeting about finding the genetic basis of manic-depressive illness with a group of researchers, psychiatrists, geneticists, and biologists—including Jim Watson, a scientist who, in 1953, co-authored an academic paper proposing that DNA had a double-helix structure. As Jamison sat watching Watson twitch and yawn, she wondered what he could be thinking about. She writes that they have been colleagues for a long time, and that she knows him to be an “intense and exceedingly blunt” person with a kinetic, untamable energy.

Lately, Jamison’s career has become increasingly entwined with the field of molecular biology as she and her colleagues have sought a scientific understanding of manic-depressive illness and its causes. 

Returning to the meeting, Jamison recalls watching her colleagues share, via projector, the genetic pedigrees of the families affected by manic-depressive illness being studied by the team of researchers present. Completely blackened circles represented sufferers of manic-depressive illness, while half-blackened circles represented depressive illness. Dark s’s or crosses signified those family members who had committed suicide. Jamison remembers feeling excited by the prospect that the men and women sitting with her in the room could be on the verge of a major scientific breakthrough that would help sufferers of manic-depressive illness the world over.

After the presentation ended, Jamison found herself recalling a meeting with a Danish psychiatrist named Mogens Schou—the man responsible for the introduction of lithium as a treatment for manic-depressive illness—at an annual meeting of the APA in New Orleans. Taking a boat ride together on the Mississippi during a break in the conference, Schou and Jamison discussed their reasons for studying mood disorders. Schou revealed that his family was full of sufferers of depression and manic-depressive illness—all of his life’s research, he told Kay, had been driven by his personal investment in understanding the suffering within his own family.

Kay recalls feeling “relieved” by Schou’s honesty and thus emboldened to share her own diagnosis, as well as her family’s history, with the man. The two of them drew out their “pedigrees” on napkins together, and the visualization allowed Kay to realize that all of the instances of manic-depressive illness in her family were located on her father’s side. Kay credits that afternoon with Schou as a turning point in which the man’s “aggressive” encouragement allowed her to feel free to use her own experiences in her work. 

Jamison goes on to describe the complex feelings that understanding manic-depressive illness as a genetic disorder has made her feel over the years. She discusses visiting a physician who asked whether she was planning on having children—and then told her that if she did, knowing there was a good chance she might pass on her illness to her child, she was being irresponsible. Jamison felt “sick” and “humiliated” at having her personhood and her condition regarded so cruelly. Jamison had never before questioned her ability to be a good mother. The doctor’s “cold-blooded[ness]” shocked Jamison. Jamison writes that one of her life’s regrets is having no children of her own—Richard has three from a previous marriage, and though she regrets not having children of her own, she enjoys being an aunt to her niece and nephews.

Jamison admits that she sometimes has concerns about what locating the genes that are responsible for the heredity of manic-depressive illness would mean. Better and earlier diagnoses, she says, would no doubt benefit patients—but there are dangers in prenatal diagnostic testing, and she worries that parents who learn their child carries the genes would lead to those parents choosing abortion and thus making the world “a blander, more homogenized place.” These ethical issues, she states, are difficult to solve—while manic-depressive illness derails and devastates many lives, there are also advantages to the disorder related to personality, thinking style, energy, expression, and artistic temperament.

Jamison recalls attending a lecture at a psychiatry conference which she’d all but tuned out of until the speaker mentioned new updates on the research into structural brain abnormalities in sufferers of manic-depressive illness. Newly intrigued, Jamison listened as the speaker discussed studies revealing many small areas of “focus signal hyperintensities” which suggested abnormal brain tissue, the kind seen in other conditions such as dementia and multiple sclerosis. Jamison remembers feeling both excited and disturbed by the breakthrough, full of questions about what it could mean for her and her fellow manic-depressives. 

Back at her new job at Johns Hopkins, Jamison began reading articles about the new brain scans which showed structural abnormalities in sufferers of bipolar affective disorders—only to find that there were “far more questions than answers” in the literature available. Many things could explain the sites of abnormal tissue, and as she digested this information, Jamison recalls being full of hope that the scientists at the forefront of the research were developing new insights into “the concept of losing one’s mind.”