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Submitted by PatientsEngage on 12 July 2019

The memoir 'An Unquiet Mind'  is a must read if you want to insights into Bipolar Disorder from the perspective of a person living with it or Manic Depression as Kay Jamison prefers to call it.

Kay Redfield Jamison, a professor of psychiatry at the Johns Hopkins University School of Medicine, a leading expert on bipolar disorder writes a brilliantly vivid and honest memoir with very detailed descriptions of her phases, especially the mania phases.

She explains at length the challenges of lithium - the effect of lithium in the early days, the lithium toxicity, but also missing the highs of mania, especially mildly mania phase - controlled by lithium, hating the ‘normal’, how her sister raged against her need for lithium. And eventually learns to accept lithium in her life, even creating rules of acceptance with a sense of humour. She does talk of how Lithium threw off coordination. So she has to give up sports - Squash, horse riding she felt she was giving up a part of herself

As a trained doctor, she is very conscious of her reluctance to edication - "I ought to be able to handle whatever difficulties came my way without having to rely upon crutches such as Medication". She documents the challenges of adhering to medication protocol especially when feeling better. The hard side effects, missing the highs - "of course I am strong enough - I ought to be able to carry on without drugs"

Kay talks of how the resistance to treatment by patients with manic-depressive illness costs lives - "there was simply nothing that medicine or psychology could bring to bear that would make him take his medication long enough to stay well."

Her insights into her own experiences help her to draw up a clear arrangement (now called Advanced Medical Directive) with a psychiatrist and her family that if she again became severely depressed they have the authority to approve against her will if necessary both ECT (excellent treatment for certain types of depression) and hospitalisation.

She touches on the importance of acceptance from people who love her: 

1. A lovely example of a psychiatrist friend whose granite belief that hers was a life worth living and who would be there asking for her company and not make her feel like she was too huge a burden on him. He would suggest - "I really need your company. Let’s get some icecream"

2. A mom that took care of the mundane stuff like laundry and bills. Shopping, doc visits but more importantly endured her irritability and boringly bleak moods

3. Support of various people who did not use the illness as a way to curtail her clinical and teaching responsibilities - once convinced she was receiving good psychcare

She talks of the hurt when a physician told her to not have children because she had a manic depressive illness and the implication that she should not bring another person with the illness into the world and how she would be an inadequate mother. "Brutality takes many forms, and what he had done was not only brutal but unprofessional and uninformed. It did the kind of lasting damage that cuts so quick and deep to the heart can do."

An honest discussion on why she has chosen to not always talk about her condition. About the possible effects of the disclosure affecting her teaching and research. Although from an administrative standpoint she developed safeguards protocols and guidelines to work with. Always told colleagues. And her supervisors. 

The Chairman of John Hopkins reassures her: Doctors are there to treat patients; patients never should have to pay either literally or medically - for the problems and sufferings of their doctors. But that does not mean manic depressives are not part of the medical faculty. (She prefers manic depressive to bipolar)

And finally with lithium available and working for her she says she would choose to have manic depressive illness - the intensity of feelings and experiences and the perspectives it brings make it well worth it.

 

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