An Unquiet Mind: A Memoir of Moods and Madness (24 page)

These comings and goings, this grace and godlessness, have become such a part of my life that the wild
colors and sounds now have become less strange and less strong; and the blacks and grays that inevitably follow are, likewise, less dark and frightening. “Beneath those stars,” Melville once said, “is a universe of gliding monsters.” But, with time, one has encountered many of the monsters, and one is increasingly less terrified of those still to be met. Although I continue to have emergences of my old summer manias, they have been gutted not only of most of their terror, but of most of their earlier indescribable beauty and glorious rush as well: sludged by time, tempered by a long string of jading experiences, and brought to their knees by medication, they now coalesce, each July, into brief, occasionally dangerous cracklings together of black moods and high passions. And then they, too, pass. One comes out of such experiences with a more surrounding sense of death, and of life. Having heard so often, and so believably, John Donne’s bell tolling softly that “Thou must die,” one turns more sharply to life, with an immediacy and appreciation that would not otherwise exist.

W
e all build internal sea walls to keep at bay the sadnesses of life and the often overwhelming forces within our minds. In whatever way we do this—through love, work, family, faith, friends, denial, alcohol, drugs, or medication—we build these walls, stone by stone, over a lifetime. One of the most difficult problems is to construct these barriers of such a height and strength that one has a true harbor, a sanctuary away from crippling turmoil and pain, but yet
low enough, and permeable enough, to let in fresh seawater that will fend off the inevitable inclination toward brackishness. For someone with my cast of mind and mood, medication is an integral element of this wall: without it, I would be constantly beholden to the crushing movements of a mental sea; I would, unquestionably, be dead or insane.

But love is, to me, the ultimately more extraordinary part of the breakwater wall: it helps to shut out the terror and awfulness, while, at the same time, allowing in life and beauty and vitality. When I first thought about writing this book, I conceived of it as a book about moods, and an illness of moods, in the context of an individual life. As I have written it, however, it has somehow turned out to be very much a book about love as well: love as sustainer, as renewer, and as protector. After each seeming death within my mind or heart, love has returned to re-create hope and to restore life. It has, at its best, made the inherent sadness of life bearable, and its beauty manifest. It has, inexplicably and savingly, provided not only cloak but lantern for the darker seasons and grimmer weather.

I
long ago abandoned the notion of a life without storms, or a world without dry and killing seasons. Life is too complicated, too constantly changing, to be anything but what it is. And I am, by nature, too mercurial to be anything but deeply wary of the grave unnaturalness involved in any attempt to exert too much control over essentially uncontrollable forces. There will always be propelling, disturbing
elements, and they will be there until, as Lowell put it, the watch is taken from the wrist. It is, at the end of the day, the individual moments of restlessness, of bleakness, of strong persuasions and maddened enthusiasms, that inform one’s life, change the nature and direction of one’s work, and give final meaning and color to one’s loves and friendships.

I
have often asked myself whether, given the choice, I would choose to have manic-depressive illness. If lithium were not available to me, or didn’t work for me, the answer would be a simple no—and it would be an answer laced with terror. But lithium does work for me, and therefore I suppose I can afford to pose the question. Strangely enough I think I would choose to have it. It’s complicated. Depression is awful beyond words or sounds or images; I would not go through an extended one again. It bleeds relationships through suspicion, lack of confidence and self-respect, the inability to enjoy life, to walk or talk or think normally, the exhaustion, the night terrors, the day terrors. There is nothing good to be said for it except that it gives you the experience of how it must be to be old, to be old and sick, to be dying; to be slow of mind; to be lacking in grace, polish, and coordination; to be ugly; to have no belief in the possibilities of life, the pleasures of sex, the exquisiteness of music, or the ability to make yourself and others laugh
.

Others imply that they know what it is like to be
depressed because they have gone through a divorce, lost a job, or broken up with someone. But these experiences carry with them feelings. Depression, instead, is flat, hollow, and unendurable. It is also tiresome. People cannot abide being around you when you are depressed. They might think that they ought to, and they might even try, but you know and they know that you are tedious beyond belief: you’re irritable and paranoid and humorless and lifeless and critical and demanding and no reassurance is ever enough. You’re frightened, and you’re frightening, and you’re “not at all like yourself but will be soon,” but you know you won’t
.

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; appreciated more the springs, for all the winters; worn death “as close as dungarees,” appreciated it—and life—more; 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. Depressed, I have crawled on my hands and knees in order to get across a room and have done it for month after month. But, normal or manic, I have run faster, thought faster, and loved faster than most I know. And I think much of this is related to my illness—the intensity it gives to things and the perspective it forces on me. I think it has made me test the limits of my mind (which, while wanting, is holding) and the limits of my upbringing, family, education, and friends
.

The countless hypomanias, and mania itself, all have brought into my life a different level of sensing and feeling
and thinking. 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 and made me feel as though I could die right then and the images would sustain me. 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
.

Writing a book of this kind would have been impossible without the support and advice of my friends, family, and colleagues. Certainly it would have been impossible without the excellent medical care I have received over the years from Dr. Daniel Auerbach; he has been, in every way, an excellent and deeply compassionate doctor. I owe him not only my life, but an important part of my education as a clinician as well.

No one has been more influential in my decision to be open about my manic-depressive illness than Frances Lear, a longtime friend and generous supporter of my work. She has encouraged and made possible my mental health advocacy work and is, in many significant respects, responsible for my decision to write this book. Her support and belief in my work have made a critical difference in what I have been able to do during the past eight years.

Several other friends have been particularly important. I am deeply indebted to David Mahoney for his support, many long and helpful conversations, and marvelous friendship. Dr. Anthony Storr has been one of the most important people in my life, and I am very grateful to him for our relationship. Lucie Bryant and Dr. Jeremy Waletzky, both close friends for many years, have been unbelievably kind and generous with their support. John
Julius Norwich has, for some time, encouraged me to discuss my manic-depressive illness more openly, and repeatedly stressed his belief that good will come from writing such a book; he has countered all of my arguments for privacy with yet stronger ones for straightforwardness. He has been a wonderful friend, and I am indebted to him for his persuasiveness. Peter Sacks, a poet and professor of English at Johns Hopkins, read over all of the drafts of this book, made many invaluable suggestions, and gave me much needed encouragement. I cannot thank him enough for the time and care he took with my work. Many other people have provided friendship over the years, and several of them were kind enough to read early drafts of my manuscript as well: Dr. and Mrs. James Ballenger, Dr. Samuel Barondes, Robert Boorstin, Dr. Harriet Braiker, Dr. Raymond De Paulo, Antonello and Christina Fanna, Dr. Ellen Frank, Dr. and Mrs. Robert Gallo, Dr. Robert Gerner, Dr. Michael Gitlin, Mrs. Katharine Graham, Congressman and Mrs. Steny Hoyer, Charles and Gwenda Hyman, Earl and Helen Kindle, Dr. Athanasio Koukopoulos, Dr. David Kupfer, Alan and Hannah Pakula, Dr. Barbara Parry, Dr. and Mrs. Robert Post, Victor and Harriet Potik, Dr. Norman Rosenthal, William Safire, Stephen E. Smith, Jr., Dr. Paula Stoessel, Dr. PerVestergaard, Dr. and Mrs. James Watson, and Professor Robert Winter.

During very difficult times in Los Angeles, Dr. Robert Faguet was an extraordinary friend; as I have written, he looked after me during my absolute darkest days, and he did so with great grace and wit. My former husband, Alain Moreau, also was remarkably kind and loyal during those days, and I am grateful to him for our continuing and close relationship. Drs. Frederick
Silvers, Gabrielle Carlson, and Regina Pally in quite different ways helped keep me going during those long, terrible months. Later, when David Laurie died, several people in England were exceptionally kind, and they have remained friends over the years: Colonel and Mrs. Anthony Darlington, Colonel James B. Henderson, the late Brigadier Donald Stewart, his wife, Margaret, and Ian and Christine Mill.

The chairman of my department at Johns Hopkins, Dr. Paul McHugh, has been singularly supportive, as was, earlier, Dr. Louis Jolyon West, chairman of psychiatry during the time I was on the medical school faculty at the University of California, Los Angeles. I will always owe a great personal as well as intellectual debt to the two men who were my mentors when I was an undergraduate and graduate student, Professors Andrew L. Comrey and the late William H. McGlothlin. I have learned more than I can say, or adequately acknowledge, from both my students and my patients.

I, like many others, was devastated by the death in 1994 of publisher Erwin Glikes. He was not only a remarkable intellect and a profoundly wise human being, he was also a close friend. He published my book
Touched with Fire
, and I found it virtually impossible to imagine entrusting something as personal as these memoirs to anyone else. Fortunately, I was able to work with Carol Janeway at Knopf. She has been everything one could wish for in an editor: deeply intuitive, extremely intelligent, witty, and unrelenting in her determination to make the book a more complete and better one. It has been a pleasure and privilege to work with her. Dan Frank, the excellent editor of
Chaos
, lent his formidable editing abilities to a somewhat different
kind of chaos, and helped give structure to this book. Working with the staff at Knopf has been delightful. Maxine Groffsky has been a wonderful literary agent—warm, lively, engaged, perceptive, supportive—and I am grateful that Erwin Glikes introduced us.

I am indebted to Oxford University Press for granting me permission to use material that I had written first for teaching purposes, and then incorporated—as a few brief clinical description passages—into a book I coauthored with Dr. Frederick Goodwin,
Manic-Depressive Illness
. Mr. William Collins, who typed my manuscript, was invaluably accurate, reliable, pleasant, and intelligent.

I have discussed my family at some length in this book. All meaningful relationships are complicated, but I cannot imagine choosing any family other than the one I have: my mother, Dell Temple Jamison; my father, Dr. Marshall Jamison; my brother, Dr. Dean Jamison; my sisters, Phyllis, Danica, and Kelda; my sister-in-law, Dr. Joanne Leslie; my nephews, Julian and Eliot Jamison; and my niece, Leslie Jamison.

My debt to my husband, Dr. Richard Wyatt, is beyond words. He encouraged me to write this book, supported me through all of my doubts and anxieties about doing so, read each draft of my manuscript, and made many helpful suggestions that I took to heart. I am grateful to him for a love that has endured, grown, and been wonderful.

Grateful acknowledgment is made to the following for permission to reprint previously published material: