... is a memoir of mood and madness by Kay Redfield Jamison, a book I wish I have read before I became a psychiatrist. It is dazzling with tints of sadness, but alive with hope throughout for those "new, limitless corners" ...
We all build internal sea walls to keep at bay the sadnesses of life and the often overwhelming forces within our minds. In whatever way we do this-through love, work, family, faith, friends, denial, alcohol, drugs or medication-we build these walls, stone by stone, over a lifetime. One of the most difficult problems is to construct these barriers of such a height and strength that one has a true harbor, a sanctuary away from crippling turmoil and pain, yet low enough, and permeable enough, to let in fresh seawater that will fend off the inevitable inclination toward brackishness. For someone with my cast of mind and mood, medication is an integral element of this wall: Without it, I would be constantly beholden to the crushing movements of a mental sea; I would, unquestionably, be dead or insane ....
I long ago abandoned the notion of a life without storms or a world without dry and killing seasons. Life is too complicated, too constantly changing, to be anything but what it is. And I am, by nature, too mercurial to be anything but deeply wary of the grave unnaturalness involved in any attempt to exert too much control over essentially uncontrollable forces. There will always be propelling, disturbing elements, and they will be there until, as Lowell put it, the watch is taken from the wrist. It is, at the end of the day, the individual moments of restlessness, of bleakness, of strong persuasions and maddened enthusiasms, that inform one's life, change the nature and direction of one's work, and give final meaning and color to one's loves and friendships ...
I have often asked myself whether, given the choice, I would choose to have manic-depressive illness. If lithium were not available to me, or didn't work for me, the answer would be a simple no and it would be an answer laced with terror. But lithium does work for me, and therefore I suppose I can afford to pose the question. Strangely enough I think I would choose to have it. It's complicated. Depression is awful beyond words or sounds or images; I would not go through an extended one again. It bleeds relationships through suspicion, lack of confidence and self- respect, the inability to enjoy life, to walk or talk or think normally, the exhaustion, the night terrors, the day terrors. There is nothing good to be said for it except that it gives you the experience of how it must be to be old, to be old and sick, to be dying; to be slow of mind; to be lacking in grace, polish and coordination; to be ugly; to have no belief in the possibilities of life, the pleasures of sex, the exquisiteness of music or the ability to make yourself and others laugh.
Others imply that they know what it is like to be depressed because they have gone through a divorce, lost a job or broken up with someone. But these experiences carry with them feelings. Depression, instead, is flat, hollow and unendurable. It is also tiresome. People cannot abide being around you when you are depressed. They might think that they ought to, and they might even try, but you know and they know that you are tedious beyond belief: You're irritable and paranoid and humorless and lifeless and critical and demanding and no reassurance is ever enough. You're frightened, and you're frightening, and you're "not at all like yourself but will be soon," but you know you won't.
So why would I want anything to do with this illness? Because I honestly believe that as a result of it I have felt more things, more deeply; had more experiences, more intensely; loved more, and been more loved; laughed more often for having cried more often; appreciated more the springs, for all the winters; worn death "as close as dungarees," appreciated it-and life-more; seen the finest and the most terrible in people, and slowly learned the values of caring, loyalty and seeing things through. I have seen the breadth and depth and width of my mind and heart and seen how frail they both are, and how ultimately unknowable they both are. Depressed, I have crawled on my hands and knees in order to get across a room and have done it for month after month. But, normal or manic, I have run faster, thought faster and loved faster than most I know. And I think much of this is related to any illness-the intensity it gives to things and the perspective it forces on me. I think it has made me test the limits of my mind (which while wanting is holding) and the limits of my upbringing, family, education and friends.
The countless hypomanias, and mania itself, all have brought into my life a different level of sensing and feeling and thinking. Even when I have been most psychotic-delusional, hallucinating, frenzied-I have been aware of finding new corners in my mind and heart. Some of those corners were incredible and beautiful and took my breath away and made me feel as though I could die right then and the images would sustain me. Some of them were grotesque and ugly and I never wanted to know they were there or to see them again. But, always, there were those new corners-and when feeling my normal self, beholden for that self to medicine and love. I cannot imagine becoming jaded to life because I know of those limitless corners, with their limitless views.
