Kay Redfield Jamison experienced her first manic episode at seventeen years old. Throughout the next 30 years, she rode a roller coaster of mania and depression that made her either insane or suicidal. Throughout this time, she struggled to build a career as a professor of psychology and clinician. After a life of suffering, she finally decided to write this book to reduce the shame and stigma surrounding a life of mental illness.
Jamison grew up in a military family as the youngest of three children. Her father was an AirForce pilot and meteorologist known for his intense enthusiasm for life. He often filled the house with music and discussed the amazing beauty of something as simple as a snowflake. Her mother was a kind, generous, and loyal woman who made a warm and stable home for her family. Both her parents supported Jamison’s dreams of becoming a doctor and encouraged her to think independently.
The reassurance Jamison found in the structured military world was ripped away after her father’s retirement. The family moved to Los Angeles when she was 15, and Jamison struggled to fit in. Around this time, Jamison’s father started to behave more erratically. His flights of fancy became dark brooding moods, and he was often violent and verbally aggressive. Jamison also started to notice her own severe shifts in mood, but she had always been a moody child and figured it was more of the same. Although others noticed both her wildly active mind and behavior and her withdrawn depressive symptoms, Jamison remained unaware that anything was wrong.
Jamison’s mood swings got worse after she started attending UCLA for undergrad. She swung between high-flying intense periods of passion and productivity, and days where getting out of bed and changing clothes were too much to ask. After studying the signs of depression in a psychology class, she decided to seek treatment. But she chickened out at the last minute.
The only blessing during Jamison’s undergraduate career was a job as a research assistant with a psychology professor studying unique manifestations of individual personalities. The slower pace of conducting research and case studies was more suitable for her unreliable moods. She quickly realized that she wouldn’t be able to handle the demands of medical school and decided to train to be a research psychologist.
After enrolling in the psychology doctoral program at UCLA, Jamison experienced a brief reprieve of her symptoms. She started working with patients in the medical center, but she never made the connection between the mental illness diagnoses she provided with her own behavior. Her lack of awareness translated into a lack of treatment, and shortly after she graduated and joined the medical faculty, she experienced her first severe manic episode.
The goal of every assistant professor is to receive tenure. Jamison worked toward this goal for 7 years in the midst of the worst period of her illness. She attributes her success in receiving it to the brilliance and ceaseless energy she experienced during her manic states. But these states carried significant consequences.
During her first major manic episode, Jamison separated from her husband and went on a massive shopping spree. Excessive spending is a sign of mania, but Jamison didn’t think of it this way. Within her first two major manic periods, she spent around $30,000 on everything from multiple Rolexes to taxidermied animals. Unfortunately, the repercussions of her actions usually hit right around the time her mania slipped into depression.
With the highs of mania come the dangerous lows of depression. After Jamison dropped into her first major depressive state, she started to hallucinate. The images she saw all related to death and decay. She became frightened and finally decided to seek treatment.
Jamison started seeing a psychiatrist she knew from her doctoral program. He was kind and professional, and he was too smart to be outwitted. He listened to Jamison’s excuses about her behavior, then very politely informed her she had manic-depressive disorder. He prescribed lithium to help.
Jamison took the lithium at first, but the dosage was too high, and she started to experience negative side effects. She lost her ability to read and concentrate. She was nauseous and sick often, and the effects of the drug made her appear drunk in public. In addition to these side effects, the lithium worked by dulling the edges of both her heightened mind and the shadows of depression. She lost her energy and enthusiasm for life, and as a result, she lost a part of who she was.
These factors made Jamison stop and start her medication many times. The consequence was an 18-month battle with suicidal depression. Somewhere in the middle of those months, she lost the battle and attempted to take her life by overdosing on lithium.
After her suicide attempt, Jamison started taking her lithium faithfully. Her moods started to stabilize, but she was still raw from the pain of wanting to die. Her marriage ended for good, but a new love entered her life. This love would save her in many ways.
David was a visiting professor at UCLA from London. He and Jamison fell in love quickly and started a romance that straddled two continents. His kindness and care for her after learning about her disease made her realize that tolerance was possible. She felt protected and accepted, and she started to heal parts of her she thought were broken forever.
A year after she started dating David, he died from a heart attack. Jamison assumed the grief would send her into a tailspin, but it didn’t. She focused on work and accepted the inevitability of death. Her grief started to fade, but her love for him never did.
David’s love and that of others along the way helped parts of her old self awaken. She still experienced mood swings, but they were less intense and more manageable. She realized most of her life was spent surviving, not living, and she decided to pursue the latter. She lowered her dose of lithium and regained her ability to enjoy life again.
Years later, she met her second husband, Richard, a prominent researcher in schizophrenia and the Chief of Neurosurgery at the National Institute of Mental Health in Washington, D.C. Richard was vastly different in personality and interests than Jamison. Where she was quick to anger, he was calm and reserved. He had no patience for poetry or the performing arts, two things that sustained Jamison’s life. Although her moods were often too much for Richard to handle, he always provided a solid foundation of love. His unwavering unconditional love taught Jamison that a predictable life was far more enriching than a life of reckless passion.
Jamison had many fears about informing others about her illness. Over the course of her career, she told fellow co-workers to ensure a safeguard against any impairments of her patient care. But she strongly feared professional backlash from others. She didn’t want her objectivity as a researcher to be questioned or for her students to fear insulting her during discussions of mental illness. But keeping the secret somehow constituted shame. Although she was ashamed of how her behavior had affected those in her personal life, she was not ashamed of her disease.
After moving to Washington to live with Richard, Jamison became interested in genetic mapping of precursors to mental illness. She knew that people might use another’s predisposition to mental illness against them. But she also thought knowing who carried the gene would tremendously help early diagnosis and targeted treatment. Her work has surrounded brain imaging to determine the causes of mental health disorders.
Jamison’s moods balanced out, and she was able to have optimism for her future again. However, even with all the suffering and damage her illness caused, she wouldn’t wish it away. Her manic episodes gave her deep, passionate experiences unattainable to the normal mind. She pushed the boundaries of her mind and found comfort in the knowledge that there was more still to discover. She knows that lithium saved her life, but more so, love is what gave her the strength to keep living.
Kay Redfield Jamison became an assistant professor of clinical psychology at UCLA in 1974. She was 28 years old and already entangled in the grip of manic depression. Three months later, her disease hit full throttle. She resisted treatment for years, the same treatment she often encouraged her patients to follow. She assumed her illness was just an extension of her character and believed she could manage it on her own.
Mood swings were nothing new for Jamison. She’d been an emotional child, a temperamental young girl, a depressed teen, and a manic young adult. This history with volatile moods is what motivated her to study mood disorders.
Manic depression is a seductive illness. One side of the coin involves episodes of enlightenment. For Jamison, this enlightenment took the form of unparalleled creative ideas and endless energy to bring them to fruition. This behavior translated into great productivity as a research scientist. But the other side of the coin involves distorted thinking, a loss of rationale, and a desperate desire to end your suffering, often through suicide.
Many people living with manic depression don’t seek treatment because of fear of professional backlash, stigma, and misguided treatment from doctors. Because of these deterrents, Jamison decided to open up about her illness. She wants to expose the beauty of the ugly beast she has inside, a beast that almost killed her and succeeds in killing thousands of others. She is tired of hiding and feeling ashamed. This book is her attempt to bring awareness to the disease and remove the shame for everyone afflicted with mental health disorders.
Jamison’s childhood differed greatly from the chaos that would become her adult life. She was the youngest of three in a military family. Her father was an Air Force officer who worked as both a pilot and meteorologist. He fancied all things related to the sky and had a robust personality. He was gregarious, charming, and easily aroused by art, life, and literature. He encouraged independent thinking and pushed his children to follow their dreams.
Jamison’s mother was a lovely woman. She was kind, generous, thoughtful, and social. She also encouraged her children to think big and for themselves, and she supported almost every endeavor they set their minds to.
As military families do, Jamison’s family moved often. By the fifth grade, she’d lived in Florida, Puerto Rico, California, Tokyo, and Washington twice. Because of this, the family was close. Her mother made a secure and loving home, and her brother, who was three years her elder, was her hero. She followed him everywhere and always felt protected when he was around. He was intelligent, capable, confident, and honest. He was athletic and a model student. He was everything Jamison’s sister wasn’t.
Her sister, the middle child, was the oddball in the clan. Her sister was a true beauty and keenly aware of the world around her. She was quick to anger, had dark moods, and behaved defiantly to any and all customs of the military lifestyle. She also resented Jamison for her seemingly breezy outlook on life. School and socializing came easily to Jamison, and she was an optimist, a natural leader, and a talented athlete, as well. For her sister, this charmed existence was an affront to the dark world she lived in.
Jamison’s father had a fascination with everything in life. He was funny, inquisitive, and magnanimous. He would spin beautiful discourses on life’s phenomena. A snowflake or cloud were things to marvel at. This level of enthusiasm was infectious, and the family would gather around and listen intently to his latest obsession. Music filled the house when he was in these elevated moods, and his ideas were grandiose and presented with passion. For instance, he was convinced windmills would save the world. He also thought the children should learn Russian so they could understand the beauty of Russian poetry. Jamison describes life with him as having your very own Mary Poppins in the family. He was the sun, and she loved him dearly.
Her mother brought a sturdiness to the household. She’d grown up popular, happy, and innocent of the pain life held. She believed in playing the cards you were dealt and maintaining a level of predictability in your life. Jamison’s maternal grandparents were of the same convictions and temperament and left their daughter with a great ability to behave honorably and follow through in any situation.
Jamison believes these steady and steadfast qualities helped her mother make it through the chaos that would become their lives in later years. Her mother’s ability to remain calm, loving, open, and committed is what kept Jamison alive so many times after she started down her dark road to madness.
Jamison had many interests as a young girl. She wrote poetry and plays, but she also was fascinated by science and medicine. She approached her interests with unwavering passion, emulating her father’s enthusiasm for whatever was in front of her. Her parents never limited her passions, but they understood her infatuations to be merely that at times—a keen obsession with whatever was strange at the moment.
For instance, when Jamison wanted to add a sloth to her long list of pets, including birds, dogs, turtles, and mice, they made a deal with her. If she conducted research and wrote a dissertation about her observations and the care required for a sloth, they’d consider it. The act of creating this document was enough to feed her momentary enthusiasm, and the sloth was quickly forgotten.
Of all her passions, Jamison was most interested in medicine. Her parents bought her medical manuals and dissecting tools. She dissected frogs, worms, and other small creatures in the basement. She also volunteered as a candy striper at the Air Force Base hospital. The doctors at the hospital allowed her to observe procedures and sometimes assist in minor procedures. She spent hours in the hospital, asking every question she could think of about the cases she witnessed.
Once, she was allowed to observe the autopsy of a small child. To keep the reality of what she was seeing from sinking in, she allowed her curious nature to dominate. As long as she treated the situation like research, the body was not real. Jamison would use this strategy many times throughout her life to detach emotionally from a difficult situation.
The encouragement Jamison experienced from her parents, family friends, and doctors made her feel respected for her passions and choices. This encouragement became a foundation of validation that would serve her after her diagnosis. When her doctors told her to temper her expectations and dampen her passions as an adult, this past support carried her through and made her resilient.
Part of military life for the children of officers involved the tradition of cotillions. These events were old-school formal affairs for adolescents in which manners, subservience, and rank and file were celebrated. Girls were meant to behave like proper ladies, including the development of a proper curtsy. For an independent, spirited girl like Jamison, this submissive behavior went against everything she believed. She refused to conform and felt a strong anger bubbling inside.
Still, there was something about the stability of tradition that spoke to her. She was somewhat comforted by the elegance of the cotillion formalities. Despite her independent nature, the security encompassed in the structured, predictable military lifestyle and standards soothed her. She knew where the barriers of behavior were and how far she could push them. And she knew what the expectations were and appreciated the simplicity of discipline.
Within those strict parameters, life was simple and made sense. She allowed herself to become swept up in the white-gloved world because it was safe. But this safety net disappeared when her father retired from the Air Force.
In 1961, when Jamison was 15, her father accepted a scientist position at the Rand Corporation in Los Angeles, California. The family packed up their structured military life and moved west, leaving behind the friends and traditions that had defined their lives.
Jamison enrolled in Pacific Palisades High School in a prominent neighborhood along the coast. She was used to starting school in the middle of the term as a military child, but the schools she’d attended in the past were always full of other military children. The students understood the sensation of being dropped into a strange environment as a stranger. They were forgiving in a way civilian students weren’t, and the rank of her father in the military easily translated into her position within the social hierarchy. But at Palisades High, those considerations didn’t exist.
Hollywood children replaced military children, and money replaced military rank as the social order. The students were of a different breed, as well. Jamison’s strict training in manners, such as referring to adults as “sir” or “ma’am,” was antiquated and ridiculous among her new peers. These students had more freedom, more confidence, and more ambition than she’d ever experienced. She struggled to find her place and missed the warm security of her old life. She also missed her boyfriend, who she’d grown to love in the full-bodied way a 15-year-old learns to love.
In Washington, she was an athletic star, a top student, and a leader. In California, competition was more fierce both in athletics and academics. Suddenly, she had to work for distinction, and it took a long time for her to prove herself. Over time, the strangeness of this cold world started to make sense, and she started to fit in. She began to appreciate the superior intellect these students possessed over her military companions. She also found the salacious details of the lives of the rich and famous fascinating. These kids came from broken homes, drove expensive cars, and behaved more like mini-adults than teenagers, especially when it came to sex.
Jamison grew up fast in this world and even started dating a college boy from UCLA. One thing that didn’t change was her passion for medicine. She started volunteering at the university’s pharmacology department to pursue this passion.
By the time the Jamison family moved across the country, Jamison’s brother had left for college. His absence meant a loss of a stable lifeline in her life and in the family structure. She and her sister continued to grow further apart and became virtual strangers. But her parents’ relationship rivaled the contentious estrangement between the girls.
Her mother had taken a job teaching and was now pursuing her master’s degree. Her father was consumed with his work at Rand. Although he still exhibited his high-flying enthusiasm for life at times, those moments were few and far between. His exuberance became less about the marvels of the world and more about his experiments at work. His ideas were often so outlandish, they ruffled the feathers of his employers.
Bleak spells of depression replaced her father’s heightened moods. Darkness now filled the space in the home that music once filled. Jamison hoped and waited for the joy to return to her father, but the opposite happened. He became angry, distraught, and withdrawn. Sometimes, his depression was so severe it paralyzed him. He stayed in bed for days and lost all hope for his life. Other times, he became so volatile with rage that both Jamison and her mother feared for their safety. The situation worsened once he started drinking.
After a year or so of watching her father deteriorate, Jamison became aware of a similar movement happening inside her. Her inflated vigorous spirit started to overwhelm those in her life. She’d be high for days or weeks, then spiral into darkness in the blink of an eye.
She learned how to be two different people. One was an engaged, fun-loving, and successful student. The other was a serious, brooding, and deeply troubled young woman. She worked hard to hide the second version from the outside world.
Jamison’s forays into the dark side would become her way of life starting her senior year of high school. Once the illness took hold of her mind, her emotional and psychological states deteriorated quickly. Her moods changed from moderate swings to full-blown episodes.
Her manic states were huge and explosive periods of creativity and productivity. She threw herself into sports, school activities, socializing with friends, books, writing, and elaborate plans for her future. She was like a wind-up doll that never had to be rewound. She felt amazing during these periods. Her mind took in information quickly and deciphered it even faster. Math came easily, her mind was clear and focused, and the world made sense.
Much like the way her father used to command the family’s attention, Jamison now commanded the attention of her friends. She thrust her insights and observations of the wonders of the world at them with a frantic zeal. Her friends frequently asked her to slow down or commented on how exhausting it was to listen to her. Eventually, she would slow down, but it was caused by a swing into depressive darkness, not her friends’ opinions.
In her adult years, the swings between mania and depression were frenetic and dangerous. But when she was 17, the inaugural wave of her illness was mild. Her manic episodes burned bright and hot for a brief period before fizzling into depression. The clarity and genius she experienced when she was flying high vanished when she plunged into darkness. She couldn’t concentrate, couldn’t take in information, and couldn’t make sense of the world around her. Her mind, once a trusted companion filled with wit, humor, and knowledge, became her enemy.
When Jamison was depressed, all of the thoughts and observations she had about life became silly notions of a stupid girl. She no longer found comfort in friends and often couldn’t muster the energy to engage with the world. She struggled to get out of bed. She wore the same clothes for days in a row because deciding what to wear was too big a task. Worse, her inspired thoughts now turned almost entirely to death.
Jamison obsessed over death. Living seemed unnecessary, even unreasonable, when everything alive eventually died anyway. She wandered cemeteries and wrote bleak poems about her decaying mind and body. She started adding vodka to her morning juice and became infatuated with the thought of suicide. Yet somehow she was able to hide this internal turmoil from the outside world. Only a handful of people ever noticed a disturbing change in her behavior, and she always assured them she was fine.
Inside, she was aware that something was terrifyingly wrong with her, but the idea of a mental illness never occurred to her. All she knew was that the darkness was tearing seams into the fabric of her mind and soul. She felt herself slipping away and death around each corner, and there was nothing she could do to stop it.
Jamison’s college life started with disappointment and continued to descend from there. Her dream was to attend the University of Chicago, where both her father and maternal grandfather had received their graduate degrees. The school was also known as a haven for free-thinkers and had the bonus of being away from her family and California. But her father’s mental disturbances led to his dismissal at Rand, and they couldn’t afford out-of-state tuition. In truth, she could barely afford in-state tuition at UCLA, and her own flights of fancy only aggravated the situation.
Whereas many people consider their college years to be some of the best of their lives, Jamison’s experience was the antithesis. Her swings between passionate enthusiasm and desperate despondency grew nightmarish. Like in high school, her manic periods brought an intense ability to focus and be productive. But added to those aspects was a tendency toward excess. Instead of buying 1 record, she bought 9. Instead of taking 5 classes, she registered for 7.
In one of her biggest examples of excess, she purchased 20 books from the university bookstore after walking through the botanical gardens. The small stream running through it reminded her of a poem by Lord Tennyson. The other purchased books only marginally related to the book of poems, but in her mind, they were interconnected. Something about their cumulative meaning represented some deeper truth of the universe. She was positive she could crack it.
These types of expenditures were damaging to her bank account as much as to her psyche. She was working near full-time at a clothing store to afford tuition, and the lost money consistently translated into late tuition payments. Of course, she always received the late notices when she was coming down from the high.
As regular as a ticking clock, her depression hit with almost the same force as the mania. She couldn’t muster any desire for school, work, friends, exploring, or daydreaming. Each day brought the horrible realization that she would have to get through it. She thought about dropping out of school. Her classwork stopped making sense, and suicide seemed like the only option to end the pain of wandering alone in her dark fog. Like her manic episodes, there was also a new element to her depressive state. Terrifying images now filled her mind—decaying bodies, animal carcasses, and corpses on metal slabs. She was lost, scared, and alone.
The only time Jamison sought help during this time was after a lecture in her psychology class about depression. The information hit too close to home. She went to the student health department to find a psychiatrist, but she couldn’t follow through. She was afraid and ashamed. She sat outside the building and cried for an hour before she gave up and went home.
Finally, Jamison received the first sprinkle of relief since her illness began from a professor in another psychology course. The class was asked to write their responses to several Rorschach cards and turn them in for the professor to read aloud. On this particular day, Jamison was alight with inspiration and passion. Her insights into the meaning of each image filled pages. In the moment, her thoughts seemed brilliant. But when the professor read her work aloud, she realized her associations were bizarre and ridiculous. The class laughed and the professor asked for the responsible student to stay behind.
After class, Jamison expected the professor to see through her normal facade and admit her to the nearest psych ward. Instead, he commented on the creativity and uniqueness of her responses. Rather than call her crazy, the professor appreciated the way her ideas pushed boundaries. It was the first time Jamison realized the boundaries between crazy and unique were not black and white. It was also the first time she realized that her erratic behavior might be tolerable to others.
The professor invited her to work as a research assistant, and the experience changed her life. She was now earning money for being inquisitive. She learned about research, analysis, scientific studies, and how to write academic papers. She learned about human personality and the variations of it across humanity. She threw herself into the work and found a much-needed escape from the rigid schedules and pedagogy of traditional classwork.
After two years of struggling at UCLA, Jamison received a federal grant to study abroad in Scotland for a year. She was drawn to Scotland because of her family’s Scottish roots, but she was also captivated by the melancholy of Scottish music and poetry. Her trip also allowed her to escape her father’s increasingly dark and volatile moods.
At the University of St. Andrews, Jamison studied zoology. Her grasp of the science was small and incomplete, but the town and sea made up for what her education lacked. The ancient ruins, medieval history, old cathedrals, and mystical undertones of Scottish life spoke to her. Life was slower in Scotland, and she found a peace that year she hadn’t felt at UCLA or since.
The transition back to the fast and jaunty world of UCLA after the beautiful melancholy and traditions of Scotland was jarring. The grant had removed her need to work, but now she had to manage school, work, and her mental state again. She struggled to fall back into place and embrace her old life.
One thing that changed while she was in Scotland was her desire to follow her childhood dream of becoming a doctor. She was certain her mood swings and restlessness were ill-suited for medical school. She doubted whether she’d have the discipline to put in the hours required and follow the strict schedule of a medical student. More so, the idea of losing her independence in that way repulsed her. Research and writing allowed her to move about at her own pace. That fact coupled with her interest in emotional disparities solidified her decision to pursue a career in mental health.
Jamison started working with a new professor of psychology. This professor’s research surrounded the effects of mood-altering drugs, such as stimulants and hallucinogens. He was also prone to immense mood swings and understood Jamison’s own mood fluctuations. In fact, the two bonded over their disorders and checked in with each other during black moods. They discovered that each was tracking their moods based on different scales of intensity to attempt to find some pattern that might explain them.
At times, they discussed whether they should take psychosomatic medications, but neither felt the risk of the side effects was worth it. Plus, they believed their depression was the result of some complex spiritual disturbance, not a chemical imbalance. It was an irrational belief, but it allowed them to continue denying their likely mental illnesses.
Jamison found great joy in the work she was doing with this professor. This work influenced her decision to work toward a Ph.D. in psychology. She applied to the doctoral program at UCLA and began her post-graduate studies in 1971.
Graduate school was a huge relief compared with Jamison’s undergraduate studies. Like in Scotland, Jamison felt free in graduate school. There was little emphasis on prerequisites and class attendance. As long as she performed well and finished the mandatory work toward her degree, the path she took to get there didn’t matter. She still struggled to make it to most lectures, but she was doing the work.
During her doctoral years, Jamison experienced several significant changes in her life. When she first started her program, she decided to do something to help her revolving moods. The choice came down to therapy or buying a horse. Her pride pushed her toward the horse. She wanted a horse that was calm, intelligent, and intuitive; instead, she got a cowardly, lame, and witless animal. The horse reared up at the slightest disturbance, whether wind, other horses, or a lizard. Riding him was terrifying, but the upside was that Jamison was so scared when on her horse, it overwhelmed any depressive feelings she had. Unfortunately, owning a horse is expensive, and she was spending all of her fellowship money on boarding and caring for the horse. She sold the horse and decided to focus on her work.
Jamison also got married during her doctoral studies. She met a French painter at a friend’s brunch in the early 70s, and the two moved in together quickly. He was kind, intelligent, and considerate. They were opposites in some respects. He was stable and consistent in his behaviors, and she was wild-haired, temperamental, and as consistent as a broken clock. But their personalities balanced each other out, and they were happy.
Another aspect that changed during these years was Jamison’s mental state. As often happens during the early stages of manic-depressive disorder, Jamison experienced a period of remission, in which her mood swings lessened. Her life felt relaxed and stable for the first time in years, and she thought she was back to normal.
Although Jamison’s first focus in graduate school was experimental psychology, she decided to switch to clinical psychology. She left the statistical and physiological aspects of mental health behind to pursue work that surrounded therapeutic methods, behavioral patterns, and patient work. Jamison loved working with actual patients. It was intellectually and physically stimulating.
Jamison was learning how to diagnose her patients’ conditions, but none of this knowledge caused her to turn inward. She saw no connection between the symptoms of manic depression in her textbooks and her own behavior. It was like the opposite of the typical medical student syndrome, in which doctors-to-be become convinced they have whatever disease they are studying. In Jamison’s case, her personal afflictions seemed removed from her training. The only indication of any connection was the sense of comfort she found working with psychiatric patients that other students didn’t have.
The field of psychology at the time was more concerned with psychoanalysis than diagnosis and treatment. This meant that interpretation of past experiences, behavior, and dreams was more important than actual symptoms and consequences of mental illness. Jamison learned the folly of this approach after practicing her clinical skills on her husband. She put him through personality tests and image interpretation exams and took the results to her advisor. The advisor spent an hour analyzing every aspect of his responses and gave her diagnosis. Jamison learned how misguided psychoanalysis could be when her docile, loving, and honest husband was deemed a sociopath with rage issues.
Finally, Jamison entered her last year of the program. She wrote an uninspiring dissertation on heroin addiction and defended it in front of five male professors. After three hours of conversations that felt more like accusations during a cross-examination, they finally approved her thesis. She was no long Miss Jamison. She was now Dr. Jamison. She joined the UCLA Department of Psychiatry as an assistant professor.
Manic depression is a deceptive disease. The sensations vary greatly depending on whether you’re up or down. When you’re in the throes of mania, you feel like a giant. Everything is working with maximum efficiency. Thoughts and emotions zoom in and out like falling stars. They light up your dark mind and show you where to follow. You are extroverted and certain of your charisma. You feel a keen gift for seduction and crave it in return.
Then, as fast as a snap of your fingers, the elation dissipates. The efficiency drains. You can’t hold all the thoughts anymore. You become overwhelmed and confused by the scattered ideas. You can’t remember simple things. You get annoyed, upset, and scared easily and feel yourself slipping into darkness. The darkness goes deeper than you thought it would and feels like it never ends.
The people in your life fill you in on what happened while you were consumed by your manic brain and unaware of your actions. You never know how much of your frighteningly bizarre behavior is being left out to spare your feelings. Overdrawn accounts and maxed-out credit cards are clues to what happened. You start a round of apologies to everyone who got caught in your storm. Some can’t handle it and leave. You can’t tell what part of you is the illness and what is the old you anymore. You hope it doesn’t happen again but are sure that it will. All you can do is wait.
Three months after joining the UCLA faculty, Jamison experienced a full-blown psychotic break. Her devolution into madness didn’t happen overnight. It was a slow burn that grew bigger and bigger until it consumed her and sucked all the air out of her life.
Everything seemed normal in July 1974 when she started her assistant professorship. Her job was to supervise psychiatric residents and psychology interns in the adult inpatient ward of the UCLA Medical Center. Her interest in clinical work regarding mood disorders had waned with the waning of her own mood swings. It had been a year since she’d experienced anything manic or depressive. She assumed those days were in her past.
Jamison liked teaching and took to her new position with ease. She was free to study and research whatever she wanted, and she threw herself into this freedom. She wasn’t sleeping much, but she didn’t think anything of it beyond a commitment to her work. She doubts it would have made any difference if she’d realized that sleeplessness was a sign of mania.
Every summer, the university chancellor threw a party for new faculty in his garden. Jamison attended, as did the man who would become her psychiatrist much later. In her memory, the party was a success. She was enthusiastic and friendly. She fluttered like a social butterfly between this person and that and drank and ate heartily. She kept people engaged in extensive conversations, assuming she was exuding optimal charm. She remembers having a marvelous time.
But as she would discover, her memories were not often accurate. After she met the man who became her psychiatrist, she learned what the objective opinion of her behavior at the party was. He said she was provocatively dressed and had a thick layer of make-up on. She was frenzied and babbling in her discussions with others. His immediate assessment of her that day was that she seemed manic.
In truth, Jamison noticed a change in her mental state around that time but didn’t think it was serious. Her thoughts came too quickly, and she couldn’t always keep them straight. Her verve for the work was growing to epic proportions, and she went to great lengths to express the outlandish connections she was making in her mind. For instance, one day, she couldn’t get a poem about depression and two academic articles about clinical work out of her mind. She was convinced they came together to prove something vital about her work. She made 40 photocopies for her students and the staff in the ward.
Her marriage was also falling apart at this time. Her ability to enjoy her quiet, stable life with her husband diminished the more manic she became. She was easily agitated, restless, and excitable. Her husband’s gentleness, love, and affection now felt oppressive, and she sought new experiences outside the home. They separated, and she moved into a modern luxury apartment overlooking the beach in Santa Monica. The rent was astronomical and she hated modern furnishings, but the sacrifice felt necessary. What she didn’t realize was that the urge to spend money is another sign of mania.
When Jamison was in the midst of a manic episode, spending money was as easy as breathing. She never worried about the consequences of her irresponsible spending sprees. Credit cards and personal checks removed her from the reality of money, and she spent money she didn’t have freely.
At one point, she bought 12 snakebite kits because she was positive they were vital to protecting her from the rattlesnakes in the desert. She decorated her apartment with extravagant furniture and once bought three Rolexes in three hours. She purchased and wore seductive clothing. And once, she spent hundreds of dollars on books solely because their titles and covers were enchanting. Another time she became too impatient to wait in line at a clothing store and shoplifted a blouse.
Within the space of her first two major manic episodes, Jamison estimates she must have spent close to $30,000. The reality of her spendthrift behavior never became clear until she was on the way down into the darkness. The consequences of her irresponsibility always made the depression worse.
Fortunately, Jamison’s brother received his doctorate in economics from Harvard. After one of her disastrous manic shopping sprees, she invited him over to help her deal with the mound of debt she’d accumulated. On her living room floor lay various piles of overdue bills and collection notices. Going through the evidence of her behavior was like digging through the artifacts of another person’s mind. She often didn’t remember most of the purchases. For instance, one of the bills was for a stuffed fox from a taxidermist in Virginia. Jamison had no idea why she would want, let alone buy, a dead animal.
Her brother looked at the stacks of paper and took them in stride. He was still the kind and generous person of his youth and often gave up his time and energy to help Jamison after her disease was recognized. He protected her from the nastiness surrounding her parent’s divorce, and he tried to protect her from the effects of her illness. Even today, he reaches out often and organizes times and places for them to meet. And he visits her at home to make sure she’s doing well.
Jamison’s brother didn’t judge her for her reckless spending. Instead, he took out a personal loan and helped her pay off the creditors. Over time, she was able to pay him back for the money, but she knows she can never pay him back for his love and support.
Jamison’s life was frenetic and terrifying during her first major manic episode. Up until then, her manic episodes were chaotic but always mild. Her biggest emotions had ranged from overexuberance to disorientation. She’d been able to manage the fallout publicly by avoiding chaotic or confusing situations and mastering the art of feigning concentration while her mind was on overdrive. Her work continued forward, and she felt she could control her mind enough to get by.
But this new version of mania was volatile, dangerous, and consuming beyond her control. None of her training or personal experiences prepared her for what insanity was like.
Jamison worked overtime and slept little. Her apartment became a warehouse of madness. Books were piled everywhere, clothes sat in disheveled lumps in each room, unopened packages cluttered various corners, and empty shopping bags were strewn across the floor. There was also an impressive collection of scraps of paper. Each scrap contained lines of incoherent scribbling stretching from edge to edge. Once, she found a poem inspired by her spice collection in the refrigerator.
Added to this material chaos was an increasingly chaotic mind. Listening to music became an intense experience. Each note came through with crystal clarity and provoked too much emotion. She couldn’t listen to classical music anymore because it was too slow for her mind to comprehend and too sad when it could. She ransacked her record and CD collection to find the perfect music to match her mood. But the music became noise, and after a while, she couldn’t listen for more than a few minutes without becoming confused.
She didn’t recognize anything in her life. She never tired and seemed lit up inside by some sinister light. Then, the darkness would seep in. She started to hallucinate. Her visions were dark and terrifying and filled with images of death. She saw plants decaying and heard their screams of pain as they withered into nothing. Once, she imagined the glow of the sunset had infiltrated her home and covered her walls with blood. She couldn’t tell what was real and what wasn’t, and she was scared to death.
At one point, she was so desperate to end the hysteria, she swore that if her mind did not return to normal within 24 hours, she would jump off a building. Of course, her mind raced to other thoughts during those 24 hours, and the idea was forgotten. She was on the cusp of losing not just her mind but her career.
If not for the therapist Jamison finally forced herself to see, her life would have completely imploded. She decided to seek psychiatric help after the bloody hallucination. Jamison first met the man who would become her therapist long before the chancellor’s faculty party.
This man was the chief resident of UCLA’s Neuropsychiatric Institute while she was a clinical psychology intern. He was tall, handsome, and incredibly intelligent. He’d supervised her work with patients and served as a rock of compassion and professionalism. He believed in medication to treat the symptoms of mental illness, but he also saw the value of psychotherapy to heal the mind. When she decided to seek professional help, she knew she would be able to trust this man. She also knew he was too adept in his field and too intelligent to manipulate.
Her first appointment was a terrifying experience. She was embarrassed and vulnerable, having lost complete faith in herself and her mind. But when she entered the room, the doctor spoke to her with such reassurance that a crack of light appeared in the darkness. He was patient as she rambled incessantly about her condition. When she finished, he asked her a slew of questions about her behavior and symptoms. She knew these questions well, having asked them to patients hundreds of times during her education and professional work.
When the examination was over, the doctor stated unequivocally that she suffered from manic-depressive disorder. He told her she would need to take lithium, likely for the rest of her life. Jamison felt both fear and relief. She was relieved to finally have a diagnosis and plan for help, but she feared what the medication would do to her. She used every excuse for her behavior she could find to explain it besides the diagnosis, but the doctor remained firm. She finally conceded and began her journey toward healing.
Jamison’s relationship with this therapist lasted for many years. She started seeing him once a week and more often when her depression was extreme or she was suicidal. He worked with her through every aspect of her emotional and psychological life. He understood how the medication affected her ability to create and find joy for life, but he also knew the dangers of not taking it. Because of this, he was always thoughtful in his insistence.
Her doctor treated her with respect and as someone who was capable of getting better. He exuded confidence in her recovery, which helped her find the same confidence. He showed her how her illness affected her personal and professional life, and how the aspects of her personal and professional life affected her illness. He used psychotherapy to help her find the balance between the two and the road to a meaningful existence.
Jamison knows the guidance and support of this doctor saved her life several times. He made her see that both medication and therapy were required for her recovery. The lithium dampened the strength of her delusions, mood swings, and confused thinking. It dulled the edges of her thoughts and helped her slow down. It also allowed her to be more civil and professional, which helped her to keep her career.
Likewise, the therapy served as a sort of battleground for her thoughts. Even when the thoughts came more slowly and softly, they were still dark in nature. Psychotherapy helped her make sense of her life with the clearer mind the pills created. Both were integral for her survival, but this was a lesson she would learn the hard way. In the beginning, her resistance to medication and the lack of significance she gave it made her cavalier about taking it.
Even after her diagnosis, Jamison struggled for many years to manage her manic-depression. Part of this struggle was her resistance to take her medication despite her education and clinical work. Her reluctance wasn’t from stubbornness. There were many factors that caused her to retreat from lithium.
As she believed in the early stages of her illness, she still felt as though she should be able to manage her mood swings on her own. Her military-bred resilience and independent upbringing reinforced this idea. Her sister, who was also battling volatile moods, tried to persuade Jamison to not take the lithium. She said it would steal Jamison’s spirit and the intensity of her experiences. She also said the medical profession wanted to turn Jamison into a shell of her real self. This advice was too tempting for Jamison, which meant it was dangerous. Jamison further distanced herself from her sister, essentially ending their already modest relationship.
The problem was that Jamison knew that part of what her sister said was true. She had experienced a loss of herself because of the lithium. The drug helped dampen her mania and depression, but it changed her, too. Those changes often seemed too great to abide.
After her psychiatrist prescribed lithium in fall 1974, Jamison experienced a reprieve from the mania. Her dark and dangerous depression had also subsided. But what replaced those symptoms was an immense grief.
In her manic states, Jamison experienced the sensation of flying. Her euphoria was held in the clouds. She often glided through space and around the rings of Saturn. It was a beautiful, ethereal high, and when it was gone, she missed the high-flying, starry beauty of her mind.
The problem was that Jamison didn’t recognize her disorder as an illness. Her high moods were as much a part of her as anyone’s moods were a part of their core personalities, whether psychotic or not. In losing the highs, Jamison lost a piece of her soul, and that was difficult to let go of. The new person she became was unrecognizable and a massive bore. What was normal to everyone else was dull, stifling, and unfruitful to Jamison.
Another part of her grief stemmed from the high dose of lithium she took. Before the data-driven, time-released lithium prescribed today was invented, doctors in the ’70s often gave manic-depressive patients incredibly high doses of the drug. These levels often lead to toxicity, which manifested in several unfortunate ways.
High doses of lithium lead to frequent nausea and vomiting, and Jamison suffered from both. She often slept in the bathroom at night or was severely ill in public. Sometimes, the lithium made her lose motor functions, and she would tremble, lose coordination, and slur her speech. These side effects carried the additional disadvantage of mimicking inebriation or drug use. In fact, Jamison was once pulled over by the police and failed a roadside sobriety test. They only let her go after she provided the name of her psychiatrist and the prescription bottles as evidence of what was wrong with her.
However, by far the worst loss was her reduced mental acuity. The lithium made it hard for her to concentrate or read. Her vision sometimes blurred to the point of obscuring the text. When she could see, she couldn’t comprehend what she was reading or remember any of it. She went from reading 3 or 4 books a week to reading only short journal articles, poetry, and simple children’s books.
One of these books summed up Jamison’s situation perfectly. The book was The Wind in the Willows, and she read it frequently. A particular passage about the mole brought her to tears. In the story, Mole walks through the forest after returning from adventures around the world. He smells his old home in the air and follows the scent until he finds it. He remarks how much he missed the comfort and warm security of his home and the familiar aspects that had become part of who he is. The Mole’s sentiment mirrored Jamison’s feelings about the intoxicating life she’d lost. She was forced to live a lesser life now, and she resisted it whenever she could.
Six months after beginning treatment, Jamison started a cycle of stopping and starting the lithium. Each time the lithium diminished her symptoms, she’d convince herself she didn’t need it anymore. Soon after, she’d fall back into mania and severe depression. Each episode was worse than the one before, and hers were growing in frequency and intensity.
Jamison knew the lithium worked. She was a proponent of medication to treat mental health disorders and had an inkling of the tragic consequences of not taking medications. But she was able to compartmentalize her physician brain from her personal brain where her own illness was concerned. It was easy for her to deny the recurring role her illness played in her life once the lithium started to work. Fortunately, her therapist was not persuaded to feel the same.
During her sessions, he allowed her to move through her explanations and justifications for why she didn’t need to continue the medication. And after patiently listening, he returned to the same reasoning—you either live sane or insane. Since she’d been more suicidal over the last few months, he was adamant that sanity would save her life, and insanity would likely end it.
In his notes from their sessions during that time, the psychiatrist discussed what he saw as fear in Jamison. He believed her resistance to medication stemmed from a fear that it wouldn’t work and she would have no way of controlling her illness. Not taking it was better than finding out she was beyond help. At that point, suicide would be the only option. Looking back, Jamison knows he was right.
Resistance to lithium is common among patients with manic-depressive disorder. Also common is the tragic way many of these patients’ lives end because of it. Jamison saw this tragedy up close with a long-time patient. This patient experienced severe psychotic episodes and came into the emergency room one night screaming hysterically. He was put in a bed and strapped down with leather cuffs. A year before, he’d held a knife to Jamison’s throat during a session. Now, when Jamison looked into his eyes, she saw that same fear, anger, and pain. The patient received an injection of Haldol, an antipsychotic drug, and started to relax. Jamison assured him he was going to be okay, but she couldn’t help but doubt the truthfulness of that statement.
Jamison knew he would relapse on his medication again. She knew he would quickly sink into mania and then a crippling suicidal depression. Despite her own issues with lithium, she was frustrated by his refusal to take his. He was a smart and funny man when he was well, and she saw how his illness damaged his life and that of his family. She continued to treat this patient for years until his illness finally ended his life. This patient served as a reflection of where her own life was headed. Still, she continued to resist the help she needed.
During one of Jamison’s periods of resistance to treatment, she slipped into a black depression that lasted 18 months. Even after she went back on the medication, the depression remained and was more intense than ever before. Every day was an exercise in pain management. She had no joy, no energy, no personality, and no hope. Her mind was fixed in quicksand. She felt useless and incapable of anything.
Jamison started wondering why life was worth living when she couldn’t experience emotions, couldn’t use her mind, didn’t care about anything, and couldn’t muster enough energy to get out of bed. She was also tormented by dark memories from her past.
She saw her therapist 2 or 3 times a week during this time. His notes from those sessions reveal a deep despondence and shame about her illness, as well as thoughts of death. He tried to convince her to get in-patient treatment, but she refused. She was currently working in an in-patient facility, and the thought of being one of the people she saw daily terrified her. She was also concerned that her professional life would be over if she agreed to be committed to a facility.
Nothing Jaminson’s doctor nor anyone in her social world said changed how she felt. She was trapped in an unrelenting bitter winter in her mind with no way to dig herself out. She decided to end her suffering and the burden on those in her life by killing herself. Her suicide would be a noble and compassionate act.
Once Jamison decided to kill herself, she started to work out the details. She bought a gun but got rid of it shortly after. For months, she stood on the stairwell platform on the eighth floor at the UCLA hospital ready to jump over the railing. What stopped her were thoughts of her family identifying the broken and bloody body. She finally landed on overdosing on the drug that was supposed to be saving her life.
Her foresight was remarkably clear regarding her suicide. She got a prescription for anti-nausea medication to keep from throwing up the lithium. She waited for a gap in the line of friends and family members who took turns checking on her. She took the telephone out of her room to stop herself from using it or answering it. Then, she took a handful of lithium pills and waited to die.
Despite her efforts to cover all possible intrusions, Jamison didn’t anticipate that the lithium would affect her brain while killing her. When the phone rang, she instinctively crawled to it in the next room in her drugged-out stupor. It was her brother checking in, and when he heard her slurred speech, he called her psychiatrist.
Jamison recovered in the hospital after days of going in and out of a coma. At the time, one of her close friends was an emergency room doctor. He took on her care with fervor. He checked her blood levels, forced her to move around to keep her blood moving, and made her laugh during the hardest moment of her life. Next to her psychiatrist, Jamison knows this friend helped save her life.
Jamison’s mother was also a lifeline during those days. Her mother took over most of Jamison’s domestic duties, like cooking, cleaning, and paying bills, and took Jamison to her medical appointments. Her mother protected her like a cat protects her kittens. Her mother’s strength, generosity, and love helped push through Jamison’s dark walls and expose a little bit of light.
Besides the act itself, the worst part of Jamison’s suicide was the way it changed who she was forever. She had always identified as the girl who loved life, had big dreams, and a fierce determined spirit to succeed. Now, she had to face a new image, one of a pained and broken woman who wanted nothing more than to die.
This type of reconciliation was not new. Coming to terms with who she became because of her illness was something she’d had to do many times, particularly after a manic episode. On the other side of the high-flying frenzy of her mania lived violence. She experienced wild fits of screaming, assaulted others, and tried to jump out of moving cars several times. She destroyed important mementos and relationships during her psychotic moments and found herself restrained by force or involuntarily medicated at other times. This life and behavior differed significantly from the quiet, polite, and considerate person she’d been. However, somehow she made it through this difficult time with her life and career still intact.
Jamison firmly believes that her ability to maintain her career is owed to the part of her mania that lights a fire in her. In the competitive and demanding world of academia, tenure is the goal of any assistant professor. The pursuit of tenure is intense, time-consuming, and difficult for women. In a medical school, it’s even more challenging. Therefore, an illness that makes you both brilliant and tireless has its benefits.
Between 1974 and 1981, Jamison worked toward tenure with as much determination as she could. Tenure would provide job and financial security, but mostly it served as a goal to achieve or reason to get out of bed. Jamison wanted to prove that something good could come out of all the pain she’d endured. Tenure, therefore, became a symbol of her ability to survive and thrive despite her illness.
After working in the adult inpatient ward, she grew tired of trying to maintain composure with people she likely had more in common with than she had with her colleagues. She dabbled in a plethora of other fields, including zoology, economics, and cancer research. But when the clutter settled, she decided to focus on mood disorders again, specifically manic-depression, to bring awareness to the disease and make a difference in others’ lives.
She and two colleagues started a diagnostic and treatment clinic for mental health disorders. The clinic grew into an important teaching and research branch of the hospital, and thousands of patients were seen, diagnosed, and treated. Her work exposed students and residents not only to the best diagnostic and treatment tools but also to the reality of life for people living with manic-depression. The focus was on both medications and psychotherapy, and Jamison used her own experiences to inform important aspects of the curriculum.
During all of this, Jamison was supported by both her department chair and director of the UCLA medical clinic, who both knew about her condition. They never tried to force her to reduce her work or responsibilities. As long as she was in treatment and completed her work, they didn’t think twice about her disease.
During the seven-year period when Jamison worked toward tenure, she rode the roller coaster of productivity. When she was depressed, her life came to a screeching halt. But when she was manic, she could make up all the missed work with her patients and at the clinic with ease. This is how she made it through the years of toil and finally received a promotion to the tenure-track position of associate professor. Her family threw her a celebration for both her academic achievement and her personal victory over the illness that nearly killed her.
For all the ways Jamison suffered because of her illness, one area of her life seemed to withstand the damage that manic-depression wreaked—love. Jamison had the pleasure of experiencing love many times, and some of these experiences ended better than others. But each one provided a reprieve from the roller coaster of violent highs and dangerous lows. And each one taught her something about herself and life. These lessons showed her that it was possible for the mind to heal given the right circumstances. Love brought a bit of light to her dark world and helped her learn how to keep moving forward.
Jamison first met David Laurie, a psychiatrist in the British Royal Army Medical Corps, during her first year of her assistant professorship. She’d already had her first major manic episode and separated from her husband. She’d also started treatment with her psychiatrist and stopped taking lithium the first time.
David was serving as a visiting professor for several months. The attraction was instantaneous and mutual. They had coffee after their first meeting and learned about their common interests. They both loved poetry and performing arts, they both had experience with the military, and they each had a fondness for Great Britain.
During his time at UCLA, Jamison had lunch with David several times. He attempted to pursue a relationship with her on more than one occasion, but she refused each time. She and her husband had reunited. She’d left her Santa Monica apartment behind and was living with him again. David eventually returned to London, but the two kept in touch through letters.
In the midst of Jamison’s 18-month battle with depression, she and her husband finally split up for good. Jamison told David about this in a letter but left it at that. Her depression worsened, she attempted suicide, and she recovered and started taking her medication again faithfully. Her pursuit of tenure kept her busy, and time went by. Then, to her surprise, she found David waiting in her office one day. He asked her out, and this time she accepted.
Jamison wasn’t sure going to London so soon after her suicide was a good idea, but something told her that time with David was exactly what she needed. She packed her bags and left Los Angeles to visit David for a few weeks.
Their time together was everything she’d hoped for. They took long walks at dusk, had picnics on the weekends, and shared immense moments of passion at night. The darkness of the last year and a half started to fade, and she found she was able to enjoy life again. She also remembered how important love was.
Jamison didn’t tell David about her illness right away. In fact, she only became motivated to tell him after losing her lithium pills one day. Fearing a quick relapse into mania, she knew she had to get another prescription quickly. The best solution was for David to write one for her.
After she told him, David stayed quiet for a long time. Jamison knew he understood the implications of her disease and feared that he wouldn’t be able to accept a life with someone so volatile. She also knew that her illness was hereditary, which made her a poor candidate for motherhood. She prepared for the worst.
When David finally spoke, Jamison was surprised to hear his response. He told her it was simply rotten luck. Her relief was immense, and she finally felt like someone understood how she felt. David questioned her about her disease like a physician. He asked her question after question about her symptoms, severity, and fears. He was kind and genuinely interested in learning what he could about how to love her properly.
When he found out she couldn’t read anymore because of the lithium, he started reading poetry and literature to her in the evenings. He organized dinners with two British officers he knew who also lived with manic-depression, not so they could share their experiences, but so Jamison could see that it was possible to live with her illness. Jamison felt her fears slip away during those dinners and was indebted to David for his instincts and kindness. Both made her realize that there was good in life, even when she couldn’t see it clearly.
Jamison returned to Los Angeles after that first visit afraid that her tumultuous world would ruin the new spirit she’d found. But the effects of David’s love were lasting. The darkness subsided, she took her medication, and she focused on work. Their relationship was maintained through letters and phone calls, and they continued to meet whenever they could over the next year.
In May 1979, Jamison returned to London for two weeks. One day, while they were out hiking, David’s breathing became labored after reaching the top of a hill. He joked about being exhausted from lovemaking the night before, and neither thought any more about it.
After returning to Los Angeles again, Jamison learned that David was going to be transferred to the Army Hospital in Hong Kong. Arrangements were made for her to visit once he was settled, and she waited eagerly to see him again. A few nights before she was to leave, she received a knock on the door. On the other side stood a courier with a letter from David’s commanding officer. David had suffered a major coronary event and died. He was 44 years old.
Jamison was in shock for a very long time after David’s death. Even during the funeral service in England, David’s death never seemed real. Two acts of kindness helped her find her grief. First, David’s commanding officer showed her his medical records, which stated that his heart attack was unavoidable. The familiarity of the medical knowledge opened a small crack in her denial.
The second was the reception she received from David’s friends and colleagues. Jamison was welcomed by everyone in David’s life, and they never let her out of their sight. They included her in their memories of David, and these stories, spoken in the past, made the reality of his death more apparent.
As time went on, Jamison slowly accepted that the love and support she’d come to rely on and the future she’d imagined were gone forever. She had many regrets about things they never did or arguments they’d had. Her grief took over, but she was able to manage it. Her grief was devastating and difficult, but there was an acceptance of it that she could never find with her depression. She didn’t spiral or become suicidal. She allowed the kindness of others to give her hope and used work to give her a purpose. Eventually her grief faded, but her love for him never has.
After David’s death, Jamison had fairly low expectations for life. She closed her heart off to love for years and made her life about her work. She still experienced mood swings, and although they were often still intense, she also experienced a stability she had never known thanks to the lithium. Still, she was tender inside and needed a break.
For the first time since joining the faculty 8 years earlier, Jamison decided to take a break from her duties at the hospital. Now that she was tenured, she could apply for a sabbatical. She chose to go back to England to write part of a medical text she and a colleague wanted to publish.
Like her time in Scotland during undergrad, Jamison’s year in England was cathartic and fulfilling. She still struggled with reading and writing, but without the frenzied pace of life at UCLA and her illness lurking around every corner, she was able to begin to write in peace. She started riding horses again and found great joy in trotting through the misty English countryside. Parts of her soul she thought were gone forever started to awaken.
Feeling those parts of her again made Jamison realize just how much of her life was about surviving, rather than living. To her amazement, she felt true healing. Her old self was coming back, and she once again saw hope on the horizon. This hope was about her possible future, which once again included love.
Four years after David’s death, Jamison found herself in the middle of another whirlwind romance in the same foreign city. This new man was an old acquaintance she’d met years before at a dinner party. The awe and attraction they had for each other at the dinner party were still there when they met up in London, and they fell into each other quickly. There was no delusion that their relationship would go on after the end of her sabbatical, so they made the most of their time together.
This man also experienced intense moods and understood the darkness that exists on the other side of life’s shining light. He took the news of her illness with the same grace and compassion that David had. He helped her through her darker moods and reinforced her strengths and value in the world.
It was around this time that Jamison started thinking about reducing her lithium intake. She was hopeful that a lower dose would cause some of the side effects to diminish. However, the fear of slipping back into a manic episode kept her from going through with it. The man suggested that lowering her dosage while in London might be the perfect time. She was away from her chaotic life and in the fold of someone who loved her deeply and would protect her. She agreed, and after receiving permission from her psychiatrist, she started taking a lower dose.
There was no way Jamison could have known how much her life would change by the simple action of reducing her lithium intake. But once her body adjusted, she woke up from a long sleep to find a brilliant world.
At first, in England, she noticed her gate was a bit peppier. She heard the sounds of nature and city life with more clarity. Without the extreme suppression of her mental and emotional responses caused by the high dose of lithium, the world seemed more vivid, and she could read once again. Music also came through more clearly, and she wept at the beauty and intensity of a Schubert sonata. The healing of her heart, the reopening of the world, and the maintained stability of her moods all gave her a new enthusiasm for life. She could imagine a future again. It was nothing short of a miracle, but her days in England were coming to an end.
One again, Jamison feared how returning to Los Angeles would affect her progress. Her hope for the future was hard to imagine in the chaotic world of the medical center and her teaching load. And the years of mania, violence, darkness, and dread made her real life seem foreboding.
However, once she was back, she realized her fears were unfounded. The year away had changed something in her core, and she found a true love for her work again. She started to enjoy teaching, running the clinic, and treating patients. She could seriously work on her book about manic-depression and drew from her experiences to deepen the text.
With her lowered lithium dose, Jamison’s resilience also returned. Her mind was freer to contemplate and analyze life, and she was able to manage stress better. After her temperament evened out, she finally understood how much everyone else took mental stability for granted. Coming back to a more stable life was like learning a new language in a foreign country. The landscape of an even, stable existence was new, and she had little knowledge about what it meant to live within this normal world.
Jamison still experienced dichotomous moods, but they were less intense and seemed more like an intrusion to her predictable life now, rather than life itself. Despite this predictability in her professional life, Jamison still believed that a certain amount of chaotic passion was required in a relationship. But after meeting her second husband, she learned that a certain level of stability was needed for love to grow into a deep and honest bond.
Jamison’s second husband, Richard Wyatt, was different from the other men she’d loved. He was also vastly different from her. He was a prominent researcher in schizophrenia and the Chief of Neurosurgery at the National Institute of Mental Health in Washington, D.C. He was a prolific writer and had published hundreds of articles and books about mental health disorders.
Richard was reserved in manner and emotion, a workaholic, and restless, albeit in different ways then Jamison. He wasn’t always searching for the next adrenaline rush. Rather, he had difficulty enjoying leisurely activities, like concerts, long walks, extensive conversations about life, and traveling. He was also even-keeled emotionally, and romance and passion were not part of his vocabulary. But Jamison didn’t know any of this when they first came together.
Jamison met Richard at a Christmas party in Washington. She knew of him and his research, and she found him charming and handsome. His manner was calm, and she enjoyed how easy it was to talk to him. They met often over the next few months. Jamison took another six-month sabbatical in London. By the time she came home, she had decided to quit her job and move across the country to be with Richard.
Jamison was sorry to be leaving her position and work at UCLA, but not the city. Los Angeles represented so much pain and heartache, and she was ready to leave it behind. It was only after uprooting her life and moving in with Richard that Jamison understood just how different they were. She still experienced the highs and lows more intensely than others and certainly more than Richard, who seemed to take life with a grain of salt.
Unlike the other men in her life, Richard was sincerely surprised when he learned of her illness. Still, he was kind and, like a good doctor, performed the typical psychological examination. He maintained his composure and was reassuring, and he never let his concerns show.
Richard’s love was never anything but a certainty for Jamison, but he struggled to deal with her wild emotional swings. Despite his training, his perspective of her behavior existed in the normal world. He treated Jamison’s violent outbursts and psychotic moments more as personality flaws than aspects of a disease. Because of this, Jamison struggled to articulate the depths of her mental state.
But her relationship with Richard taught her about tolerance and unconditional love. His grounded nature was a stabilizing force when she felt her control slipping. Richard’s love made her feel safe, and sometimes that was the best medicine of all.
Jamison used her personal struggles with manic-depressive illness to inform her research, treatment of patients, and lessons for students. But once she was free from the stronger grips of the illness thanks to medication and a stable personal life, she was able to come to her field of study with more objectivity.
One of the first events that forced her to look beyond her own experiences was receiving a letter from an angry civilian. The woman who wrote the letter was angry that Jamison had used the word “madness” in a lecture title. She voraciously attacked Jamison for her thoughtless insensitivity to people living with manic-depressive illness. Jamison’s first instinct was to push back against this woman’s accusations. But after some time, she also started to question the use of language and how that confounds the already stigmatized lives of those living with mental illness.
Language once acceptable within the inner circle of those who have, treat, or study mental illness has become morally questionable. Referring to someone as mad, crazy, or certifiable seems to carry an insensitivity to the palpable struggles those with mental illness live with. Phrases like “a sandwich shy of a picnic” or “losing your marbles” seem to diminish the severity of the illness and perpetuate a mundane and derogatory stigma about mental health disorders.
There is truth to these assertions. When we use these words and phrases to admonish the volatile behavior of a person with mental illness, we cause harm and pain. This type of language helps justify discrimination or prejudice, which are hurtful and damaging to a person’s sense of self.
On the other hand, Jamison believes that the power of this type of language is overblown and over-simplified. Language can help create awareness and sensitivity to illness, but it is unlikely to change public perceptions of mental illness to any significant degree. Those changes must come from education, dissemination of research, and viability of effective treatments.
Jamison considers the new trend of diagnosing patients with bipolar disorder, rather than manic-depressive disorder, as an illogical attempt to address stigma and discrimination through language. As a clinical and academic professional, she sees the benefit of standard diagnostic criteria with standardized language. But as a person living with the illness, she finds bipolar to be too reductive. The reference to polar opposite behaviors misses the intense nature of both mania and depression and the intersectionality that often occurs between them. In addition, Jamison wonders whether mania isn’t merely a more volatile expression of depression.
Changes in how society views mental illness are happening, albeit slowly. Most of these changes have come about by way of advocacy, representation in federal legislation, and the visibility of recovered individuals. In fact, several mental health advocacy groups have decreased stigma through community-education campaigns, increased treatment by confronting biased doctors, and improved legal rights for those with mental illness by lobbying politicians to enact protective legislation.
Although language seems like a small part of the efforts to better understand and address mental illness, it does serve as a positive gauge. The fact that these conversations are taking place at all is a small victory for patients and advocates.
Jamison became increasingly interested in the study of molecular biology in regards to mental illness after leaving UCLA. Her interests were largely due to the work of Jim Watson, the Nobel Prize-winning scientist who discovered the molecular structure of DNA. Watson started to seek the genetic explanation for manic-depressive illness, which fascinated Jamison.
Specifically, Jamison was interested in hereditary lines of mental illness and whether exposing a predisposition to manic-depression could save lives. Patients with the genes could be diagnosed earlier, possibly even before symptoms appeared. Treatments could be more specifically targeted, which would make them more effective and less invasive.
Jamison had plenty of personal history to draw from. On her father’s side, the lineage of mental illness stretched three generations. She wondered whether knowing she had the genetic coding for manic-depression would have changed her life. She also wondered if the advantages would have outweighed the negatives.
One negative aspect of understanding the genetic implications of mental illness is the reductive opinions of doctors. Jamison experienced this type of prejudice when still in Los Angeles.
On the advice of a colleague at UCLA, Jamison went to see a new physician. The doctor examined her and asked the requisite questions. When he was finished, he asked whether she was considering having children. Jamison answered honestly that she had. With an icy tone, the doctor conveyed his disdain for her desire to have children. He felt strongly that she wouldn’t be a good mother and that the world didn’t need more people with this disorder.
Jamison was livid and had some choice words with him before she left, but the damage was already done. She felt brutalized, stigmatized, and ashamed. The truth was, she never considered not having children because of her illness. She and David had talked about starting a large family. She did fear that her illness might affect her ability to mother properly. And she considered the pain it would cause her to watch her child suffer the same psychological harm. But despite everything she’d gone through, Jamison never once regretted her birth. And she doubted that her child would.
Jamison never did have children of her own. Richard already had three from another marriage, and it wasn’t in the cards. She regretted this decision more than anything else in her life, but her brother had two boys and one girl, and being their loving aunt was immeasurably fulfilling.
Jamison had other fears about the consequences of genetic knowledge. Would parents choose to abort fetuses if the gene were discovered? And if society loses the intense creativity and productivity that comes from heightened manic episodes, will it lose art, scientific discoveries, and inventions that sustain life?
These and other ethical considerations were growing in popularity within mental health research. Scientists and ethicists were making quick strides in answering some of these questions, but with each answer came more questions.
Still, Jamison found the pace by which science was discovering more about mental health disorders encouraging. She became fascinated by brain scans that lit up certain regions during depressive and manic episodes like the Northern Lights. These brain images reinforced the understanding that manic-depression is a brain condition, not a character flaw. These images also identified brain damage and its relationship with mental disorders.
At Johns Hopkins’ school of medicine, where Jamison was now teaching, she threw herself into the study of brain imaging and the findings of scan studies. There was something romantic, visceral, and vital about these images and what they could say about her illness. More so, these images represented advancements in science, and scientific advancement embodied hope. Without hope, there was nothing.
The decision to tell people about her illness was not an easy one for Jamison. Many times when she was courageous enough to open up to others, people showed her compassion and kindness. But other times, such as one instance with a UCLA colleague named Mouseheart, the responses were cruel, patronizing, or accusatory. Those last experiences, which she calls the Mouseheart factor, were less frequent but left deep scars that haunted her.
Mouseheart was a psychoanalyst at UCLA. The two had coffee or lunch on a regular basis. There was always a point in Jamison’s friendships in which she began to feel that her illness was a roadblock to forming a deeper, lasting bond. She and Mouseheart had come up against that block, so she decided to tell him the truth one day over lunch. After a long silence, Mouseheart started to cry.
Jamison was touched by his concern until he revealed that his tears were from disappointment. He’d held her in such high regard, he was devastated that she had been so selfish and weak in attempting suicide. He then questioned the severity of her illness in one breath, then in another, questioned whether she could handle an academic career. Jamison pointed out that she’d handled her career just fine up to this point and was more advanced in hers than he was in his. The next day, Mouseheart sent her a box of roses and an apology, but it was too late.
Jamison was reluctant to discuss her disease for other reasons beyond the Mouseheart factor. Because manic-depression is hereditary, she didn’t want to cause any harm to her family by exposing her mental health struggles. She also knew there was a fine line, especially for women, between quirky and crazy and courageous and impetuous. Jamison feared she would always be boxed into the extreme once people knew about her illness.
Mostly, though, Jamison’s fears centered around her professional career. One of her concerns was a lack of honesty from her students and colleagues, who might monitor or alter their ideas or opinions about manic-depression to spare her feelings. Another concern was losing her credibility as a mental health researcher and teacher. She feared her work would be taken less seriously if people thought there was a lack of objectivity in it. Would her thoughts and opinions be viewed as biased or based on a personal grudge against the system?
Still, keeping quiet was also a form of denial for Jamison, who feared having to truly question whether she was fit to treat patients. To allow herself to continue doing what she loved despite the risk, she set up safeguards. She made sure the doctors she worked closely with knew about her illness. She wanted to ensure that at least one person was there to watch for any signs of impairment in her patient care.
Fortunately, nothing untoward ever occurred between Jamison and her patients, and there was never any reason for her to be reported or reprimanded. This clean record was an advantage when she applied to teach at Johns Hopkins, but she was also required to disclose any health conditions that could interfere with her patient care. So, with much trepidation, Jamison decided she had to be honest with the chair of the psychiatry department. To her surprise and great relief, the chair said he already knew about her illness and wasn’t concerned in the slightest.
For the most part, Jamison’s life settled down and was more comfortable and manageable after moving to Washington. She became optimistic about her ability to maintain a state of stability in moods and wellness, but she remained realistic about the possibility of a backslide. The elements of madness still existed just under the surface and continued to inform aspects of her life.
Depression took Jamison to places darker than the normal mind could conceive. That darkness stayed with her even though she wasn’t in its clutches anymore. She could conjure the shape and sensation of it without effort. The emotional and psychological toll the depression had on her life and the lives of those close to her reared up at the blink of an eye, and the memories were often painful.
But like the darkness, the soaring brilliance of mania was also ingrained in her soul. The intensity of experience, the visceral passion for life, and the vividness of the world during those episodes were more than memories. She could still feel what life felt like during her manic episodes. Sometimes, this palpable memory made her nostalgic for those high-flying and creative days. She was strangely seduced by the energy and enthusiasm of her milder manic episodes. But any thought of revisiting them was thwarted by the inevitable violence, damage, and darkness that always followed.
Jamison also gained the luxury of hindsight, which made her more philosophical about life. Decades of riding the manic-depressive rollercoaster helped her recognize the signs of ascent or descent quickly and handle the respective moods better. Whenever she was in the midst of one state or the other, she was able to understand that it would pass and she would balance out again. Her experience of those highs and lows were also less intense than before. Finally, the small reminders of the best and worst moments of her illness allowed her to appreciate life more and move forward with open arms toward the path of the living.
None of this progress would have happened without medication. Jamison knows that without the lithium, she would be dead or irreparably insane. But more than medicine, love was her biggest lifeline. Love gave her a sense of worth and helped her maintain, heal, and grow. Whenever she was on the edge of life, love swept in to pull her back.
Although she struggled immensely because of her illness, Jamison wouldn’t go back and remove it from her life. Manic-depressive disorder gave her deeper experiences than many will ever know. And regardless of whether her mind was trapped in mania or depression, she always learned something new about it. How could she be disappointed with life after learning the depths of what there was to discover? Her illness colored all the good she now had in the world, and that made it all worth it.
Jamison’s story is about mental illness, but it is also about resilience in the face of struggle. How does her story make you think about your own struggles in life?
What aspects of Jamison’s journey with manic-depressive disorder are beneficial in helping you along your own journey in life?
In what ways do the symptoms of her manic episodes relate to your behaviors?
Do you resonate with any of her depressive symptoms? Which ones?
What inspiration can you take from Jamison’s struggles to help you manage the highs and lows of your life?
Part of Jamison’s motivation for writing this memoir was to bring awareness to the struggles of those living with mental illness. How do her experiences affect your beliefs about mental illness?
Before reading this summary, what assumptions did you make about people living with mental illness?
How has your perspective changed as a result of learning about Jamison’s life? If it hasn’t changed, why not?
What was one surprising piece of information you learned about manic-depressive disorder?
If a friend or family member revealed they had manic-depressive disorder, what would your initial concerns be? How would you react?