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If the ad nauseam of manic-depressive illness could be acutely and accurately summed up into words, these would be it;
I was used to my mind being my best friend; of carrying on endless conversations within my head; of having a built-in source of laughter or analytic thought to rescue me from boring or painful surroundings. I counted upon my mind’s acuity, interest, and loyalty as a matter of course. Now, all of a sudden, my mind had turned on me: it mocked me for my vapid enthusiasms; it laughed at all of my foolish plans; it no longer found anything interesting or enjoyable or worthwhile. It was incapable of concentrated thought and turned time and again to the subject of death: I was going to die, what difference did anything make? Life’s run was only a short and meaningless one, why live?
I was totally exhausted and could scarcely pull myself out of bed in the mornings. It took me twice as long to walk anywhere as it ordinarily did, and I wore the same clothes over and over again, as it was otherwise too much of an effort to make a decision about what to put on. I dreaded having to talk with people, avoided my friends whenever possible, and sat in the school library in the early mornings and late afternoons, virtually inert, with a dead heart and a brain as cold as clay.
Kay Redfield is a respected authority in her field –rightfully so. She is a Professor of Psychiatry at the Johns Hopkins University School of Medicine and coauthor of the standard medical text on manic-depressive illness, chosen in 1990 as the Most Outstanding Book in Biomedical Sciences by the Association of American Publishers. She is also the recipient of numerous national and international scientific awards. She has been the clinical director at the Dana Consortium on the Genetic Basis of Manic-Depressive Illness and was a member of the first National Advisory Council for Human Genome Research.
With the book, An Unquiet Mind: a memoir of moods and madness, brace yourselves for long –but not verbose, elegant and intelligently phrased paragraphs with informative details about what it means to live with a manic-depressive illness. She is able to view herself and her disease in an extraordinarily objective light. Thus, she can present her story in a helpful and enlightening manner for those affected by this form of mental illness. She describes depression as being a flat, hollow, tiresome and unbearable demon that is awful beyond any words or images or sounds. However, she does credit her mania and talks in length about how it has been a positive influence in her life, enabling her to roll high with the intensity and perspective it forces on to her, facilitating some of her achievements because of the high energy it brings along.
My manias, at least in their early and mild forms, were absolutely intoxicating states that gave rise to great personal pleasure, an incomparable ow of thoughts, and a ceaseless energy that allowed the translation of new ideas into papers and projects.
However, she is also keen to point out some of the negative effects of such fluctuating moods saying;
Lost years and relationships cannot be recovered, that damage done to oneself and others cannot always be put right again, and that freedom from the control imposed by medication loses its meaning when the only alternatives are death and insanity.
Manic-depressive illness…has been a fascinating, albeit deadly, enemy and companion; I have found it to be seductively complicated, a distillation both of what is nest in our natures, and of what is most dangerous.
“Manic-depression distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live. It is an illness that is biological in its origins, yet one that feels psychological in the experience of it, an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide.”
At the very core of the book, she remains a curious scientist rather than a story teller, with a mission to solve an unbiased dire problem that affects millions of people all around the world.
It seemed very likely, when I looked around the room, that among these scientists, and somewhere within these pedigrees, the location of the gene or genes responsible for manic-depressive illness was going to be found. It was a very exciting thought, because once the genes are located, early and far more accurate diagnosis is likely to follow; so, too, is more specific, safer, less problematic, and more effective treatment.
She highlights her difficulties with coming to terms with taking medication i.e. Lithium, what that hesitation cost her and, -finally, after beginning her treatment and adjusting her dosage-, what medication has gifted her and ultimately, her much sought-after experiential advice.
No amount of love can cure madness or unblacken one’s dark moods. Love can help, it can make the pain more tolerable, but, always, one is beholden to medication that may or may not always work and may or may not be bearable.
She highlights different examples from her own life where she has found and lost love because of this disease. It is understandably difficult for anyone to stay in love with a person suffering from serious mental health afflictions that adversely affect their temperament. There are twists and turns in almost every area of the relationship because of the virulent or deeply melancholic states of the affected. However, to the one suffering, love can indeed act as a soft cushion to this maddening and incredibly tumultuous ailment.
Madness, on the other hand, most certainly can, and often does, kill love through its mistrustfulness, unrelenting pessimism, discontents, erratic behavior, and, especially, through its savage moods.
She adds this appropriate and accurate anecdote:
But if love is not the cure, it certainly can act as a very strong medicine.
Vital questions in the field of medicine are pondered in the book including the question as to whether mania is simply a form of extreme depression and the dangers that come by identifying manic-depression as two separate things, unified by the term bipolar. Her pursuit in identifying the genomic factors that bring about manic depressive illnesses also raises the question of the danger pertaining to prenatal diagnostic testing of the disease.
Will prospective parents choose to abort fetuses that carry the genes for manic-depressive illness, even though it is a treatable disease?
Do we risk making the world a blander, more homogenized place if we get rid of the genes for manic-depressive illness—an admittedly impossibly complicated scientific problem?
Are manic-depressives, like spotted owls and clouded leopards, in danger of becoming an “endangered species”?
Technological developments that have brought about a wide berth of treatment options from medicine, psychotherapy to brain imaging scans that dig deeper into the root of the most problematic areas of the brain. An example is the PET scan, to which she says,
Never has the color and structure of science so completely captured the cold inward deadness of depression or the vibrant, active engagement of mania.
One of the ways she has coped with her illness is through expression in poetry. Writing poetry is even used as a treatment method in psychotherapy and is considered one of the best ways to express emotions. I find myself caught up in this act too. Here is a piece that was written under the influence of melancholia: How To Write a Poem
As Dr.Redfield suggests, writing, especially during these critical pandemic crippled times, can provide a catharsis only few things can. It can give you new insight, perspective and even hope in times of intense despair. For example, here is my opinion on the current Covid-19 turbulence bringing the world to its knees; The Dust and Silver Lining of Corona Virus.
She retells of stories that have encouraged her and others which have deeply humiliated her and cracked her armor. Stories of fellow doctors questioning her ability to treat as she is being treated and others going as far as questioning her intentions for motherhood saying, “You shouldn’t have children. You have manic-depressive illness.”
I felt sick, unbelievably and utterly sick, and deeply humiliated. Determined to resist being provoked into what would, without question, be interpreted as irrational behavior, I asked him if his concerns about my having children stemmed from the fact that, because of my illness, he thought I would be an inadequate mother or simply that he thought it was best to avoid bringing another manic-depressive into the world. Ignoring or missing my sarcasm, he replied, “Both.”
It is arguably one of the best books ever written about the struggles of mental illnesses particularly, manic depression. The language is rich and filled with vitality and her views combine both factual scientific data as well as her own experience as a patient and a doctor living with a mental illness while treating mental illnesses. The book circumspectly tells the tale of her growing up and succeeding in her career despite – and even because of – her disease. It is both a fine memoir and an educational piece.
My take? Grab it, and grab it now.
Some of her other works include:
- Touched with Fire: Manic-Depressive Illness and the Artistic Temperament
- Night Falls Fast: Understanding Suicide
- Exuberance: The Passion for Life
Outside sources and further scientific articles: