An Unquiet Mind
by Kay Redfield Jamison
The questions, discussion topics, and author biography that follow are
designed to enhance your reading of Kay Redfield Jamison's An Unquiet
Mind. We hope they will expand your understanding of this extraordinary
and disturbing story of a singularly courageous woman.
For years, Kay Redfield Jamison
led a double life. An international authority on manic-depressive illness,
and one of the few women who have achieved the status of full professor
of medicine at an American university, Jamison was harboring a secret:
she herself suffered from manic-depression. A mercurial, emotional child
and adolescent, Jamison suffered her first severe attack of the disease
at seventeen; a decade later, shortly after she joined the UCLA faculty,
her mood swings had developed into full-blown psychosis.
In her memoir, An Unquiet
Mind, Jamison tells of her battle with the illness: the joy of the
manic highs, which gave her an omnipotent feeling of cosmic connectedness,
and the terrifying depressions, when she wanted only to die. Though she
responded to lithium, Jamison, like many patients, became addicted to
the highs of mania and resisted taking it. It was only after the disease
had destroyed her first marriage and very nearly her life that she accepted
the "rather bittersweet exchange of a comfortable and settled present
existence for a troubled but intensely lived past"[p. 211]. An Unquiet
Mind tells of how Kay Redfield Jamison used her zeal and intensity,
and her impressive intellectual gifts, to bring the complexities of manic-depressive
illness to the world's attention. Her work has helped save countless lives.
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1. "The long and important
years of childhood and early adolescence...were to be an extremely powerful
amulet, a potent and positive countervailing force against future unhappiness"[p.
15]. What aspects of Jamison's early life and upbringing helped to provide
her with emotional support on which to draw years later?
2. What benefits did the conservative
military lifestyle led by the Jamisons confer upon the young Kay Jamison?
With what disadvantages did that same culture, with its stiff-upper-lip
creed, afflict her in her battle with mental illness?
3. In graduate school, Jamison
writes, "Despite the fact that we were being taught how to make clinical
diagnoses, I still did not make any connection in my own mind between
the problems I had experienced and what was described as manic-depressive
illness in the textbooks"[p. 58]. Why did she refuse to acknowledge
the obvious? Why didn't she question the "rigid, irrelevant notions
of self-reliance"[p. 101] she had been taught?
4. "Being open is the sort
of thing that I advise people to think very long and hard about,"Jamison
has stated. "It's one thing if you're independently wealthy. It's another
thing if you're out in the real world"(Washington Post Magazine,
4/16/95). Why did Jamison avoid bringing her illness into the open for
so many years, and what made her finally decide to do so?
5. Jamison worries that we
could "risk making the world a blander, more homogenized place if we
get rid of the genes for manic-depressive illness"[p. 194]. On the other
hand, E. Fuller Torrey, a well-known author and schizophrenia researcher,
says he "would quite happily lose a van Gogh to treat the disease"(Washington
Post Magazine, 4/16/95). Which point of view do you endorse? Can
you sympathize with both sides of the issue?
6. With her book Touched
with Fire and her public television specials on artists like Byron,
van Gogh and Schumann, Jamison has been accused by some of her colleagues
of romanticizing manic-depressive illness by associating it with creative
genius. Does this accusation seem reasonable or unreasonable to you?
7. "Lithium moderates the illness,"Jamison
observes, "but therapy teaches you to live with it"(Time, 9/11/95).
Has she convinced you that drugs plus psychotherapy is the answer for
mental illness? In that case, might not psychotherapy benefit people
suffering from any debilitating illness, not just a mental one?
8. Some physicians wonder whether
the increased use of mood-regulating medications might lead to a society-wide
practice of chemically altering personality, with the result of making
people blander and more conformist (the widespread use of the anti-depressant
Prozac has helped fuel this debate). "Which of my feelings are real?"Jamison
asks. "Which of the me's is me"[p. 68]? Jamison's sister discouraged
her from taking lithium, saying that her "soul would wither if [she]
chose to dampen the intensity and pain of [her] experiences by using
medication"[p. 99]. How much of personality do you believe to be intrinsic,
and how much is a result of biological impulses and chemicals? Is such
a question even answerable?
9. Her work, and her own illness,
convinces Jamison of "the total beholdenness of brain to mind and mind
to brain. My temperament, moods, and illness clearly, and deeply, affected
the relationships I had with others and the fabric of my work. But my
moods were themselves powerfully shaped by the same relationships and
work"[p. 88]. Jamison expresses anger against physicians who draw a
distinction between "medical illnesses"and psychiatric illnesses [p.
102]. Does she imply that there is, in actuality, no difference? If
there is a difference, of what does it consist?
10. "Depression, somehow, is
much more in line with society's notions of what women are all about....Manic
states, on the other hand, seem to be more the provenance of men"[p.122].
What might the results of this stereotyping be when it comes to giving
11. After David's death, Jamison
reflects that "grief, fortunately, is very different from depression"[p.150].
How can you explain the essential difference between the two? Is it
more possible to cope with the "real"causes of grief than with the impalpable
causes of depression?
12. Through bitter experience
Jamison comes to recognize the value of emotional steadiness in a relationship,
but "somewhere in my heart,"she writes, "I continued to believe that
intense and lasting love was possible only in a climate of somewhat
tumultuous passions"[p. 170]. Is this feeling peculiar to Jamison and
her temperament, or does it reflect certain assumptions in our society?
How is the importance of love and friendship demonstrated again and
again in the story? How does each of the three principal men in Jamison's
life help her to seek a cure?
13. Jamison worries that her
work may now be seen by her colleagues "as somehow biased because of
my illness,"while admitting that "of course, my work has been tremendously
colored by my emotions and my experiences"[p. 203]. Does this make her
work less viable than strictly "objective"work, or more so?
14. "My major goal has been
to really try and make a difference in how the illness is seen and treated"(Philadelphia
Inquirer, 9/18/95). Has she succeeded, so far as you are concerned?
Which of your preconceptions were changed by reading her account?
15. "Do I really think that
someone with mental illness should be allowed to treat patients?"[p.
204] Jamison asks. She ultimately answers the question in the affirmative.
What would your own answer be?
Courtesy of Random House, Inc.
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