Life, Lunacy and Lithium: Book Review of an Unquiet Mind: A Memoir of Moods and Madness

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A key component in Jamison’s autobiography was the ongoing struggle against taking her medication as prescribed and refusal to accept she had a real a real disease. Furthermore, she had a profound sense of loss for her former self and terribly missed the euphoric moods and energy she was used to while in the state of mild mania. In addition to the emotional

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aspects that compelled her to resist medication, she experienced ten years of debilitating side effects from high blood levels of lithium.

While Jamison never questioned that the lithium worked well for her form of manic-depressive illness, she experienced severe bouts of nausea and vomiting every time lithium levels would get too high, and whenever they became too toxic, she would tremble, lose motor coordination, walk into walls and have slurred speech. However, inhibiting and oftentimes embarrassing as these were, nothing prepared Jamison for the effect lithium had on her ability to read and comprehend. It altered her vision, ruined concentration, impaired attention span and annihilated her memory. In order to comprehend anything, she had to reread the same passages over and over, and then take meticulous notes. Nevertheless, it usually went right out of her mind, “like snow on a hot pavement.” (page 95) Frustrated and infuriated, Jamison hurled books and flung medical journals around the room and at the walls. She desperately missed her old life and recalled,

Now I had no choice but to live in the broken world that my mind had forced upon me. I longed for the days that I had known before the madness and medication had insinuated their way into every aspect of my existence. (pg. 97)

Jamison’s persistent opposition to taking lithium was partly due to the above side effects, but mostly because she didn’t feel she needed it, a common trait that went along with the illness. As it is with many people, just as her symptoms improved and she felt relatively well, it became hard to accept that she had an illness, or believe it would come back. Furthermore, she loved the euphoric moods, didn’t want to give them up and equated it with the feelings addicts must get, sacrificing and risking everything for that transitory burst of some high. Between her “WASP military upbringing,” (pg. 99) and pigheadedness, Jamison legitimately believed she should confront any of life’s obstacles without leaning on medication as an aid. Her sister’s strong negative opinions about being dead-set against taking lithium only reinforced

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Jamison’s uncertainty and played into her guilt “about weathering it through, self-reliance, and not imposing your problems on other people.” (pg. 100)

Six months after she started taking lithium, Jamison stopped and became highly manic and gravely depressed within a few weeks.

Jamison related a particularly anguishing ordeal she experienced with a long-time patient who, as soon as he felt well, would quit taking his lithium. One day, she was called to the emergency room, to find him strapped, in restraints to a gurney, screaming, incoherently with paranoid delusions and “experiencing both visual and auditory hallucinations.” (pg. 107) She recalled never seeing “such fear in anyone’s eyes, nor such visceral agitation and psychological pain.” (pg. 107) Once the massive injection of Haldol finally took effect and he begged her not to leave him, Jamison thought back to the many times she was there, reassuring him, through countless hospitalizations, legal battles and unfathomable, hopeless depressions. She knew this man, inside out, his hopes and dreams, fears and follies. She knew and respected his perseverance, spirit, intellect and sense of humor. Yet, despite how wonderfully effective lithium was for him, his continual defiance to take medication, thoroughly exasperated Jamison. Even though she could certainly relate to his concerns, she couldn’t understand why he persisted in putting himself through repeated, avoidable episodes of such a devastating illness. Regardless of anything anyone did, nothing or no could ever get through and he ultimately took his own life. The experience tormented Jamison, and the similarities troubled her.

The stubborn refusal to take lithium as prescribed almost cost Jamison her life. Her defiance brought about a “floridly psychotic mania,” followed by a “long . . . black, suicidal depression,” (pg. 110) which engulfed her for over 18 months. Finally surrendering to taking lithium, regularly, Jamison’s depression continued to return, but not even wild horses could persuade her to be hospitalized. Ironically, at the same time, she worked on a locked psychiatric

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hospital ward and didn’t find any humor in not having the key. However, her foremost fear was having her clinical work and privileges suspended or revoked, if it became known.

Although she had “excellent medical care,” (pg. 113) Jamison could no longer stand the unyielding agony, relentless bleakness, nor did she want to impose any more chaos on family and friends. “It is a pitiless, unrelenting pain that affords no window of hope, no alternative to a grim and brackish existence, and no respite from the cold undercurrents of thought and feeling that dominate the horribly restless nights of despair.” (pg. 114) Suicide, she decided was her only solution – the most straightforward and reasonable solution for all involved. “One would put an animal to death for far less suffering.” (pg 115)

Perturbing as it was, Jamison thought of her family having to identify her body and decided not to jump off a high building or eat the barrel of a gun. Instead she took a massive overdose of lithium. Saved by a quirk of fate, she instinctively answered the phone, half-conscious.

As it turned out, eventually she had her dosage of lithium cut down and almost immediately experienced such a overwhelming relief from many of the symptoms, she finally felt like her old self again.

She goes on to talk about the conflict and reluctance to write this book and lay all the cards on the table. Yet, she realizes her tale must be told and no amount of wanting or wishing is going to change who she is. While she’s optimistic about her future, there is always a lingering doubt if she has seen the last of the demons. However, she came to terms with her mixed feelings over treating patients who have the same disorder as she has. After living with it for this many years, she feels who can be better to understand