An Unquiet Mind: Chapter 3 Summary & Analysis

Kay Redfield Jamison attempts to describe the “high” of mania—during such states, she says, feelings are like “shooting stars” that grow brighter and brighter. One feels captivating, sensual, intense, capable, and euphoric—at least at first. At a certain point, she says, the feelings change and become confusing as thoughts pile up and irritability, anger, and terror take over. Jamison describes an inability to recall the things one said and did during a state of mania, leaving a kind of apocalyptic wreckage for the sufferer to sift through—even as they struggle to understand which feelings are legitimate, which self is the “real” self, and when mania will visit again.

Jamison writes that she didn’t wake up one morning to find herself mad—rather, the process of realizing she had lost control came gradually. In July of 1974, Jamison had just joined the faculty at UCLA and was assigned to an adult inpatient ward for her clinical and teaching responsibilities. She had a relatively stress-free transition from student to faculty, and she found that she loved the time and freedom she had in both her personal and professional lives—so much so that she barely noticed when she stopped sleeping, a hallmark sign of a new manic phase.

At an annual garden party given to welcome new faculty, Jamison felt charismatic and charming as she mingled with new acquaintances and old teachers and colleagues alike. She had long conversations with the chancellor of the university and the chairman of her department and was certain that both men found her engaging, even attractive. The man who would soon become her psychiatrist was also in attendance at the party. Months later, as they discussed it, he would report thinking that Kay was decidedly “manic.”

Around this time, Kay noticed that she was having difficulty keeping up with the rapidity of her own thoughts. She was drawing connections between strange, disparate research materials, often making hundreds of copies of poems and academic articles to distribute to her colleagues. While she can now look back and see that they had nothing to do with one another, these materials seemed, at the time, to have “profound […] relevance.” As her strange behavior at work continued, her marriage began to fall apart. She separated from her first husband, moved into a modern apartment in Santa Monica, and purchased an enormous amount of furniture she didn’t like or need, putting herself in serious credit card debt.

Kay reminisces about other times her mania caused her to overspend. Once, while picking up a prescription at the store, she purchased twelve snakebite kits; other times, she bought multiple Rolexes and even shoplifted. The compulsion to spend money one doesn’t have, Jamison writes, is one of the most devastating aspects of manic-depressive illness, and one which often debilitates sufferers even further by compounding their sense of isolation and hopelessness once they come out of their manic stage and see how much they’ve spent.

Kay’s brother, a Harvard economist, came to California to visit once and found himself confronted with a “sprawling” financial disaster. Kay, newly-medicated and feeling “dreary,” helped her brother sift through receipts, but found herself unable to recall or understand many of the purchases they detailed—one was for a taxidermized fox, a fact which horrified the animal-loving Kay. Kay’s brother, however, remained committed to helping her sort through the disarray. Jamison writes that, over the years, her brother has been a steadfast supporter of hers through thick and thin, always there for her without judgement whenever she’s needed him. Kay’s brother took out a loan to pay off her debt, and over the years that followed, she worked hard to pay it back to him—but she knows she’ll never be able to repay his “love, kindness, and understanding.”

Before Kay allowed herself to be medicated, she pushed through her mania by working long hours and shunning sleep. She kept purchasing books and clothes at an astounding rate and wrote incoherent poems on scraps of paper which she scattered about her apartment. Everything felt more intense, including the experience of listening to music, and soon Kay could not even listen to her favorite records without becoming overwhelmed and disoriented. Darkness began to infiltrate her mind, and soon Kay began hallucinating terrible images and figures. She recalls seeing a towering, bloody person infiltrating her apartment and spraying blood everywhere—the moment was so terrifying that she at last called a colleague and admitted that she needed help.

Kay’s colleague told her he believed she had manic-depressive illness and needed to be medicated. Kay was resistant to being confronted with the truth—but she agreed to read up on the illness and its treatments. Lithium, a mood stabilizer, had been approved for use in the management of mania in 1970, just four years earlier—but Kay was willing to try it in order to end her mania and hallucinations. Kay’s colleague helped her fill and take her prescriptions and inform her family of what was going on. He helped Kay file for a leave of absence from work and made sure there was always someone to look after her.

Kay met her psychiatrist when he was chief resident at the UCLA Neuropsychiatric Institute. He was a good-looking, charming, intelligent man who used a mixture of medical treatment and psychotherapy to help his patients. Kay was embarrassed when she first called him for an appointment, fearful that she’d lose her job, but as she arrived at the man’s office for her first session and answered his questions about her mental state, she began to realize just how serious her condition was. When Kay’s psychiatrist told her that she definitely had manic-depressive illness and needed to start on lithium right away (and would likely have to stay on it for life), she tried to blame her state of mind on stress from her job and her divorce, but the man did not waver.

Jamison writes about the gratitude she feels now, looking back, for her psychiatrist’s insistence on treating her for manic-depressive illness. Over the years to come she’d visit his office once a week, and his support would keep her alive “a thousand times over” as he helped her through mania, depression, madness, and despair. Through her sessions with her psychiatrist, Kay learned the totality of “the beholdenness of brain to mind and mind to brain.” She began to understand the complexity of her illness—and the combination of lithium, personal will, and self-awareness needed to fight it.

Jamison writes that now, she cannot imagine a “normal life” without lithium and psychotherapy in combination. Both have helped her to heal, but they each offer separate things: lithium attends to the chemical, while psychotherapy provides a “sanctuary” and space to learn more about her illness. While Jamison can see now that she ultimately owes her life to pills, it was hard for her to understand for a long time—and for years after her initial visit to her psychiatrist, she’d struggle with the problem of resisting her medication and failing to take the pills she needed to survive.