Over the course of her memoir An Unquiet Mind, Kay Redfield Jamison explores the many ways in which society stigmatizes mental illness and its sufferers, relegating them physically, professionally, and ideologically to the sidelines of life. Jamison weaves her own experiences with feeling stigmatized into the narrative in order to argue that the more stigma society associates with mentally-ill people—and with their complicated diagnoses—the more devastating the effects of those illnesses will become.
Throughout her memoir, Jamison carefully catalogs the ways in which society stigmatizes mental illness on both large, structural levels and on smaller, more intimate, and perhaps more sinister ones, as well. Jamison details her own experiences with manic-depressive illness from her senior year of high school through well into her psychiatry residency at UCLA. She recalls the fear of being somehow outed as “mad” and of being institutionalized in a facility with unruly patients and “hosed down” by overworked orderlies (she’d seen this happen as an adolescent hospital volunteer). She also feared being perceived as weak or incapable, compounding the prejudices and difficulties she already faced as a woman working in a field dominated by men. By issuing critiques of the structural problems which perpetuate stigma against mental illness (inadequate treatment for society’s most vulnerable, limited professional opportunities for those who need additional resources, and a lack of understanding for the daily struggles those with mental disorders face), Jamison highlights the very real societal problems which contribute to the furthering of stigma.
Jamison also appeals to the personal in order to discuss and condemn stigma. She points out instances in which friends, lovers, colleagues, and even family members have condemned her as weak for taking medication and “lithiumizing away [her] feelings,” according to one particularly cruel comment from her elder sister. One colleague in Los Angeles, whom Jamison refers to as “Mouseheart” for his cowardice and cruelty, told Jamison he was “deeply disappointed” in her as a person after learning she’d attempted suicide many years before their friendship began. In another instance, at a routine visit to a physician, Jamison was told she should never have children due to her illness. When Jamison sarcastically asked the man whether he held this opinion due to the disorder’s genetic component or the possibility that Jamison might, as a result of her struggles, make a poor mother, he straightforwardly replied, “Both.” Jamison’s personal anecdotes of societal stigma against mental illness that she’s encountered throughout her life are sad and lamentable—but also deeply illuminating. Not only must Jamison, and countless others like her, contend daily with the structural barriers that limit their opportunities and cause them to live in shame—they must also deal with small aggressions and cruelties from people they love and respect.
Late in the book, after describing her own personal experiences with the different moods and states of “madness” her illness has caused, Jamison offers the following summation: “In the language that is used to discuss and describe mental illness, many different things—descriptiveness, banality, clinical precision, and stigma—intersect to create confusion, misunderstanding, and a gradual bleaching out of traditional words and phrases. It is no longer clear what place words such as ‘mad’ […] should have in [contemporary] society.” Jamison is effectively saying that the ways in which society talks about madness both deny the truth of what it’s like to experience “madness” and stigmatize the effects of mental illness. By failing to come up with ways to plainly, empathetically, and nonjudgmentally “discuss and describe” a slew of illnesses, disorders, and differences, Jamison argues that society is failing itself by stigmatizing mental illness. This ultimately leads to a widespread misunderstanding of people’s limitations and potential, and it perpetuates an outdated and false idea of “madness.” Jamison also points out many ways in which society can lessen or mitigate the stigma surrounding mental illness. One way is by changing the language we collectively use—eliminating words like “fruitcake,” “loon,” and “batty,” for example. Others include exploring public education efforts, publicizing successful treatments for mental illnesses, conducting genetic and biological research into the origins of such illnesses, and taking legislative actions such as the Americans with Disabilities Act. By adopting positive changes like these, Jamison says, the “glacial” pace of de-stigmatization just might speed up a bit and potentially save millions of lives.
Ultimately, Kay Redfield Jamison warns her readers against the stigmatization of mental illness throughout society not simply because of the emotional or ideological damage it might create within a person who is suffering, but also because of the larger systemic prejudices and imbalances it creates by relegating sufferers into the shadows. Without interrogating prejudices and reimagining how society might care for those it has historically sidelined, stigmatized, and even harmed, Jamison suggests, there will be no answer to the ongoing misunderstandings and cruelties facing individuals living with mental illness.
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Stigma and Society Quotes in An Unquiet Mind
Intensely emotional as a child, mercurial as a young girl, […] 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 and make a difference in the lives of others who also suffer from mood disorders.
The war that I waged against myself is not an uncommon one. The 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. Worse yet, 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 professor] was kind enough to call creative that which some, no doubt, would have called psychotic. It was my first lesson in appreciating the complicated, permeable boundaries between bizarre end original thought, and I remain deeply indebted to him for the intellectual tolerance that cast a positive rather than pathological hue over what I had written.
I decided early in graduate school that I needed to do something about my moods. It quickly came down to a choice between seeing a psychiatrist or buying a horse. Since almost everyone I knew was seeing a psychiatrist, and since I had an absolute belief that I should be able to handle my own problems, I naturally bought a horse. Not just any horse, but an unrelentingly stubborn and blindingly neurotic one, a sort of equine Woody Allen, but without the entertainment value.
Then, too, are the bitter reminders—medicine to take, resent, forget… […] Credit cards revoked, bounced checks to cover, explanations due at work, apologies to make, intermittent memories (what did I do?), friendships gone or drained, a ruined marriage. And always, when will it happen again? Which of my feelings are real? Which of the me’s is me? The wild, impulsive, chaotic, energetic, and crazy one? Or the shy, withdrawn, desperate, suicidal, doomed, and tired one? Probably a bit of both, hopefully much that is neither.
I was not only very ill when I first called for an appointment, I was also terrified and deeply embarrassed. I had never been to a psychiatrist or a psychologist before. I had no choice. I had completely, but completely, lost my mind; if I didn’t get professional help, I was quite likely to lose my job, my already precarious marriage, and my life as well.
I genuinely believed […] I ought to be able to handle whatever difficulties came my way without having to rely upon crutches such as medication.
I was not the only one who felt this way. When I became ill, my sister was adamant that I should not take lithium... […] She made it clear that she thought I should “weather it through” my depressions and manias, and that my soul would wither if I chose to dampen the intensity and pain of my experiences by using medication. […] One evening, now many years ago, she tore into me for […] “lithiumizing away my feelings.”
Manic-depression is a disease that both kills and gives life. Fire, by its nature, both creates and destroys. […] Mania is a strange and driving force, a destroyer, a fire in the blood. Fortunately, having fire in one’s blood is not without its benefits in the world of academic medicine…
Obtaining tenure was not only a matter of academic and financial security for me. […] Tenure became a time of both possibility and transformation; it also became a symbol of the stability I craved and the ultimate recognition I sought for having competed and survived in the normal world.
The question also arises whether, ultimately, the destigmatization of mental illness comes about from merely a change in the language or, instead, from aggressive publication efforts; from successful treatments [which] somehow also catch the imagination of the public and media [or] […] from discovery of the underlying genetic or other biological causes of mental illness; […] or from legislative actions, such as the Americans with Disabilities Act… […] Attitudes about mental illness are changing, however glacially, and it is in large measure due to a combination of [all] these things.
Talking with Mogens was extremely helpful, in part because he aggressively encouraged me to use my own experiences in my research, writing, and teaching, and in part because it was very important to me to be able to talk with a senior professor who not only had some knowledge of what I had been through, but who had used his own experiences to make a profound difference in the lives of hundreds of thousands of people. Including my own.
It was not without a sense of dread that I waited for [my chairman’s] response to my telling him that I was being treated for manic-depressive illness, and that I needed to discuss the issue of my hospital privileges with him. I watched his face for some indication of how he felt. Suddenly, he reached across the table, put his hand on mine, and smiled. “Kay, dear,” he said, “l know you have manic- depressive illness.” He paused, and then laughed. “If we got rid of all of the manic-depressives on the medical school faculty, not only would we have a much smaller faculty, it would also be a far more boring one.”
So why would I want anything to do with this illness? Because I honestly believe that as a result of it I have felt more things, more deeply; had more experiences, more intensely; loved more, and been more loved; laughed more often for having cried more often; […] seen the finest and the most terrible in people, and slowly learned the values of caring, loyalty, and seeing things through. I have seen the breadth and depth and width of my mind and heart and seen how frail they both are, and how ultimately unknowable they both are.
Even when I have been most psychotic—delusional, hallucinating, frenzied—I have been aware of finding new corners in my mind and heart. Some of those corners were incredible and beautiful and took my breath away…. […] Some of them were grotesque and ugly and I never wanted to know they were there or to see them again. But, always, there were those new corners and—when feeling my normal self, beholden for that self to medicine and love—I cannot imagine becoming jaded to life, because I know of those limitless corners, with their limitless views.
