In An Unquiet Mind, lauded researcher and professor of psychiatry at Johns Hopkins Kay Redfield Jamison tells the story of her lifelong struggle with manic-depressive illness. The memoir narrates her journey toward a better understanding of her own mind through the realms of love, academia, and introspection. Jamison begins part one of her memoir by describing her childhood near an Air Force base in Washington D.C. Her father, a charismatic and gregarious Air Force pilot and meteorologist, and her mother, a buttoned-up homemaker, were supportive of the young Kay’s early interest in medicine as she volunteered as a candy striper at a local hospital. As a teenager, Kay’s moods became more mercurial and difficult to manage—but after a frightening visit to a nearby psychiatric institution, Kay grew too afraid to admit to herself or anybody else what she was experiencing. When Kay was fifteen, her father retired from the Air Force and moved the family to California. There, Kay began experiencing cycles of mania and depression, while her father, too, grew prone to violent rages, “black” depressions, and alcoholism. At eighteen, after her first true manic episode, Kay enrolled in the University of California Los Angeles and began studying psychology. Her moods continued cycling, frightening her and distracting her from her studies. Still, she managed to keep appearances up and even began working as a research assistant in one of her psychology professor’s laboratories. After graduating with a bachelor’s degree and marrying a sensitive and handsome French artist, Kay decided to continue her studies by enrolling in UCLA’s doctoral program in psychology. Even as she treated patients whose symptoms mirrored her own and studied disorders of the mind and moods, she remained in denial about what her symptoms indicated.
In Part Two, Kay describes her gradual descent into madness over the course of her first couple of years as an assistant professor of clinical psychology at UCLA. Kay experienced mania as a time of increased productivity, radical confidence, intense sexual desire, heightened joy, and the “cosmic” sense that everything in her life made sense—but the depressions that followed were mentally and physically debilitating. As Kay’s marriage suffered and her manic overspending brought financial troubles, her brother provided help and financial support. One of Kay’s concerned friends and colleagues at UCLA had begun to understand what Kay was going through, too, and he suggested she see a psychiatrist and start on lithium, a powerful mood stabilizer. After a particularly violent episode of mania, Kay relented and began seeing a psychiatrist at UCLA’s Neuropsychiatric Institute—though she began to fear that if anyone found out about her condition, she’d lose her job and her license to practice medicine.
Kay struggled to adjust to lithium and failed to take her medication as prescribed—the drug’s powerful physical side effects, her own sense of rebellion, and her judgmental, dismissive sister’s assertion that Kay should be able to weather her moods on her own contributed to her inability to remain on the regimen her psychiatrist prescribed. Even after watching one of her own patients take his own life after failing to adhere to the regimen of lithium she herself prescribed, Kay remained in denial as to the seriousness of her situation and continued to allow herself to cycle through manias and depressions. Eventually, Kay attempted to commit suicide by swallowing an entire bottle of lithium pills—but when she answered a phone call from her brother and he heard that something was wrong, he called the paramedics, and Kay entered the hospital.
In the wake of her suicide attempt, Kay’s mother came to her side to help care for her. The long road “from suicide to life” tested Kay—but with the help of her mother, her friends, her colleagues, and her psychiatrist, she began learning to reconcile the various parts of herself and start the healing process. As Kay got better and better, she began pursuing a tenured position at UCLA, craving the stability and security that tenure would provide. She worked extremely hard for several years to prove to her colleagues, her superiors, and herself that she could handle the rigors of clinical practice—even while suffering from her own mental illness. Eventually, Jamison secured tenure and celebrated her triumph not just over the sexist academic “maze” that led her there, but also over the parts of her own mind which had once threatened to hold her back.
In Part Three, Jamison explores the role love played in her healing process over the years. She writes about an affair with a British Royal Army Medical Corps psychiatrist named David Laurie which began just months after her suicide attempt. Kay and David visited one another in Los Angeles and London for over a year, falling deeply in love. When Kay confided in David about her manic-depressive illness, he reacted with kindness and understanding. Kay dreamt of building a life with David, but he died suddenly of a heart attack. In the wake of David’s death, Kay retreated into her work—but after months of pushing herself to the brink, she decided to take a sabbatical and focus on healing.
Kay traveled back to England, where she conducted research in London and Oxford and had another affair with another handsome Englishman who suggested that Kay—under the supervision of a psychiatrist—lower her lithium dose. Upon doing so, Kay found that her experience of the world’s vitality was renewed and her mental stamina was restored. Kay returned to California, where she began work on a textbook on mood disorders—still, she remained reluctant to include her own personal experiences in the project. At a party in Washington, D.C., Kay met Richard Wyatt—the Chief of Neuropsychiatry at the National Institute of Mental Health. The two fell in love right away, and Kay resigned from UCLA to take up a position at Johns Hopkins. Kay and Richard’s personalities were nearly polar opposites, yet Kay found her second husband’s love, understanding, and sensitivity proved to be “very strong medicine.”
In Part Four, Jamison investigates the broader stigmas that sufferers of mental illness must face every day. She shares how these issues have affected her and she explores her journey from feeling terror at the idea of sharing her personal experiences with manic-depressive illness to reaching a point at which it became unthinkable for her to hide the truth any longer. Jamison writes of how a combination of social responsibility, personal rejuvenation, and support from friends and colleagues allowed her to step into the light. She discusses her work with prominent psychiatrists and researchers like Jim Watson and Mogens Schou, investigates the implications of research which suggests that manic-depressive illness and other mood disorders are based in genes and biology, and writes about difficult emotional questions such as whether she’d choose to live with manic-depressive illness if given the choice. Jamison raises serious existential dilemmas—not all of which, she admits, have neat or simple answers—and ultimately concludes that while her illness has been a burden at times, it has ultimately given her “limitless” insight into her own capacity for loyalty and advocacy and has helped her to appreciate the fragility and resilience of the entire human race.
