An Unquiet Mind by Kay Jamison
This is not a book report. Nor is it really a book review; I’m just fascinated by this woman’s story and work. Plus, she’s a damn good writer.
A friend recommended this book to me and said that Jamison’s descriptions of mania gave her (friend) language to be able to communicate with her therapist. Jamison’s descriptions of her mental states were as good as I’ve ever seen, but even so they’re unsatisfying. I’ve never had a full-blown mania, but her descriptions of depression weren’t exact. Language (at least English) just didn’t evolve with mental states in mind. There are no words for most of it beyond the rudimentary ideas of “happy,” “sad,” “angry,” “bored,” and words of that ilk to express feelings of those complexities. Throwing adjectives and impressions around is, I suppose, the best we can do.
Then I start to wonder if the lack of language contributes to the continued lack of understanding by laypeople about mood disorders and the unwillingness that a lot of mood disordered people have to coming to terms with the fact that they have a mood disorder. I suppose it’s actually a chicken and egg thing where, for a long time, there was no acknowledgement of mood disorders (or moods outside a norm) and so there was no language. Since there was no language to name these abnormalities, they couldn’t exist. And round and round we go.
I want to name them. Names provide a legitimacy that mere descriptions don’t. The need to describe something underscores how alien it is because what are you doing other than putting something unfamiliar in terms of the familiar? However, having each mood disordered person name her own, idiosyncratic perception of a mental state is not helpful. The people who should name are the people who treat mood disorders because they see what’s consistent throughout the myriad ways to experience a mood. Names in the collective consciousness would allow people to talk more effectively about their own and others’ mood disorders. Names would legitimize what people feel and perceive.
Another thing that struck me was something she alluded to (but didn’t follow up on) about the possible evolutionary role of bipolar disorder. She talked about her decision to either get therapy or get a horse when she was in college. She chose to get a horse and the one she got was a handful. Riding him took her entire concentration and she thought her life was in mortal danger when she rode. She said, “whenever I rode him I was generally too terrified to be depressed, and when I was manic I had no judgment anyway.” This makes me wonder whether, in a hunter-gatherer society or a community of the apes we descended from, there was any such thing as mood disorders. Did these traits, in the presence of mortal danger, provide an evolutionary advantage – quick thinking, fast connections, ability to function with little rest – that allowed the individual and the rest of the group to survive when they otherwise might not have?
Further, did the presence of mortal danger actually prevent these traits from getting out of hand? I might be misunderstanding the current thinking about bipolar disorder. That being said – my understanding is that the more times you have an episode of either mania or depression, the more likely you are to have a recurrence. And, the further you go “out of plumb” one time, the further you will go next time because the episodes get worse. And, with a lot of bipolar people, hypomania or mania precedes a crash, and the crash is commensurate with the severity of the mania. So, if the presence of mortal danger meant you didn’t become depressed because you were too scared to, did it mean that you didn’t become manic either?
I will, in true bipolar form, leave this thought unfinished and may or may not return to it some other time.