An Unquiet Mind

1 January 2017

Kay Redfield Jamison, born in 1956, starts the book vividly describing her standing outside in the playground, just outside of Washington, looking up at the skies, just as many of the other children would do because, like them, she was a daughter of a man who was in the Air Force. As an elementary school student, Kay recalls a plane flying low to the ground crashing nearby, and the pilot being remembered as a hero for not abandoning the jet and causing the lives of the children in the playground.

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Kay lived with her father, an enthusiastic meteorologist and Colonel of the Air Force, her mother, a kind, gentle, and caring woman, her brother whom she got along with very well despite their three year age difference, and her younger sister who was rebellious and the “black sheep” of their family. Kay grew up in many different locations because her father was stationed in those locations as an Air Force officer. Since she could remember, Kay had a great appreciation for music, poetry, animals, medicine, science, and the skies – most of which was introduced by her father.

Kay spent her adolescent years pursuing her passion for medicine and science, and along with her enthusiastic friends, family, and acquaintances she had acquired, she kept herself busy and interested by visiting St. Elizabeth’s psychiatric hospital in D. C. , volunteering for surgical procedures at the hospital in Andrews Air Force Base, and also volunteering at the Los Angeles Zoo to study animal behavior. In 1961, when Kay was fifteen-years-old, her father resigned from the military and took a job as a scientist in California.

Kay and her family moved to southern California. This sudden shift in friends and lifestyle, leaving behind a boyfriend, leaving behind a childhood of sports and activities, and diving into a society where everything she had learned from a military-like lifestyle did not provide her useful information in living in the west coast now. Her life fell apart. Having to start fresh in a foreign world was tough and required years of getting used to, but Kay overcame many obstacles and thrived in school and created new friendships.

Among these friendships, Kay had a unique, yet intimate, friendship with two attractive athletes; one boy had manic-depressive illness in his immediate family, and the other boy’s mother had shot herself in the heart with a shotgun. She acquired a boyfriend, who was older than her, a student at UCLA, and used him as a means of escape from her pressures and overcoming new barriers in life. In her senior year at Pacific Palisades high school, Kay experienced her full-blown manic episode.

Kay portrays her encounter as racing like a crazed weasel, fizzing with plans and enthusiasms, playing sports, staying up many nights with friends or reading, filling manuscript books with poems and plays, talking excessively, and making unrealistic plans for the future (“An Unquiet Mind”, p. 36). Kay recalls feeling great about herself, but she finally slowed down. The author explains how she felt terrible, wanted to die, couldn’t clear her mind of horrid images and thoughts, wasn’t able to concentrate on anything, and didn’t want to engage in any sports. (“An Unquiet Mind”, p. 37-39).

After high school, Kay began attending UCLA as an undergraduate, while she lived through high moods and depression. The personality laboratory in which she spent hours researching interested her very much. After two years at UCLA, she went to St. Andrews in Scotland and studied zoology, pursuing her love for animals since a very young age. After one year of escape from despair in Scotland, Kay moved back and continued her studies at UCLA. She now researches moods with a professor who, like her, had changing moods; they spent hours talking to each other about one another’s moods.

After graduating, Kay started her PhD program in psychology at UCLA in 1971. Kay kept herself busy with clinical research, a French artist and husband, internship at UCLA, dissertation in heroin addiction and moods, and becoming an assistant professor at UCLA Department of Psychiatry. Kay illustrates, on page 67-68, how horrible her depressive episodes were immediately following her manic endeavors. She explains how psychotic her manic stages were, but then replaced with worse depressive states. Dr.

Jamison now, lived through a failed marriage because of her manic buying sprees. During two of her intense manic episodes, Kay spent more than thirty-thousand dollars on books, music albums, a horse, and other needless things. After mania, when her depression caught up to her because of her illness, Kay felt ashamed, embarrassed, confused, and terrible for what she had done when she wasn’t depressed (“An Unquiet Mind”, p. 73-76). Her brother, now an economics professor at Harvard, helped her through her finances, and supported and loved her in every other way.

A colleague of hers prescribed lithium to help Kay battle her intense manic episodes. Without the lithium, Kay encountered psychotic manic episodes (“An Unquiet Mind”, p. 81), but along with psychotherapy sessions, the lithium kept her life more balanced. After taking lithium, despite the negative side effects of loss of coordination, lack of concentration, and vomiting, Kay’s psychosis cleared (“An Unquiet Mind”, p. 90-93). Throughout the next few years of her life, Kay took the lithium when she needed it, but stopped taking it when she felt her mood a bit more stabilized.

This brought more frequent and more severe manic and depressive episodes (“An Unquiet Mind”, p. 100-103). When she was severely depressed, Kay attempted suicide by lithium overdose, but the attempt failed because treatment and help was sought immediately by her brother and psychiatrist. After being cared for by her colleague, her physician, and her mother, Kay opened up a medical clinic for treating and diagnosing mood disorders at UCLA with the help of two physicians (“An Unquiet Mind”, p. 125-127).

Kay produced music concerts and television shows respecting composers and artists who had suffered from mood disorders, specifically manic-depressive illness (“An Unquiet Mind”, p. 129). Kay met David, a psychiatrist from London, and by spending time with him in California and in London, slowly, her depressed moods elevated and felt more stable than she had felt in a really long time (“An Unquiet Mind”, p. 139-146). After David’s sudden heart attack and death in Japan, Kay felt extremely sad, but did not fall into depression.

Four years after David’s death, she met an Englishman and started taking lower doses of lithium. This had a positive effect on her: she noticed sounds more loudly, saw paintings more vividly, and was able to concentrate and coordinate her movements and speech exceptionally better (“An Unquiet Mind”, p. 161). After receiving tenure at UCLA, Kay worked in the medical clinic at UCLA, lectured medical residents, treated patients, and most impressive of all, became a professor at John Hopkins School of Medicine. She currently teaches at John Hopkins as a Professor of Psychiatry.

For Axis I of the DSM-IV, Kay Redfield Jamison suffers from bipolar disorder type I, or what she likes to define as manic-depressive illness. In bipolar disorder I, mania is necessary and major depressive disorder is most likely, which is the case for the author. For diagnosis of mania, three or more symptoms should be present, and the author suffers all the symptoms.

These include: increased distractibility when she would have to read passages over and over, but still would not comprehend the material; excessive involvement n pleasurable activities such as sex and her irrational, yet expensive buying sprees; inflated self-esteem or grandiosity when she would feel like she was able to juggle everything in her life; flight of ideas when she was able to complete a research paper in one day because her thoughts were racing; an increase in goal-directed activity, like the times.

When the author would take on many difficult tasks such as directing the medical clinic at UCLA, teach and lecture resident students, treat and diagnose patients, read many books and poems, and write books and journal articles; a decrease in the need for sleep because in manic moods, Kay rarely slept, and spent endless nights reading and writing; and, more talkative than usual, for instance as an adolescent in high school when her peers would tell her to slow down, and also at the Chancellor’s garden party where she was dressed provocatively and engaged in multiple, long conversations with colleagues.

During her depressive states, Kay experienced many symptoms that are likely in MDD: a severely depressed mood throughout her lifetime; loss of pleasure in usual activities such as not playing sports, reading, or listening to music at various points in her life; insomnia; diminished concentration and trouble making decisions when she wasn’t able to read a passage and comprehend it; she did not really experience any specific gain or loss in weight during depressive times; psychomotor agitation when she fell off her horse and at times couldn’t walk straight and sometimes even walked into walls; and recurrent suicidal ideation, and she even attempted suicide by overdosing on lithium.

Kay also experienced atypical features (interpersonal sensitivity), melancholic features (anhedonia), catatonic features (disturbed speech), and psychotic features (periods of psychosis, such as grandiosity during mania) of her bipolar disorder. Kay did not have any personality disorders and no diagnosis for Axis II of the DSM-IV. Kay did not possess any medical conditions throughout her life; thus, there is no diagnosis on Axis III of the DSM-IV. For Axis IV of the DSM, Kay did experience some psychosocial stressors during her life.

Kay lived through the death of Richard Laurie, a lover whom she was very fond of and cared for very much, and the love and care for her was returned by him. Leaving Washington and moving to strange lands to start a fresh life left behind love and support from many people whom she trusted and loved. The geographic shift may play a role in her bipolar disorder, but the main stressor may come from leaving behind friends and relationships. College after college, studying as an undergraduate, a doctoral student, and a medical director may have put strain on the author. Although Kay was employed at a clothing store during her undergraduate years to help pay for school, her financial burden caused by unemployment may also be considered a psychosocial stressor.

Kay’s marriage to Richard, along with her divorce may have also posed as a stressor for her manic-depressive illness. On the final axis, Axis V of the DSM-IV, Kay had periods of high and low functioning, thus calling for two GAF scores. A score of 20 on the GAF is accurate as the lowest functioning ever because she had dangers of hurting herself, and even attempted suicide. She was frequently violent, and had manic excitement. A score of 70 on the GAF is accurate as the highest possible level of functioning because there were times when she had mild depressive moods, had meaningful interpersonal relationships, and slight difficulty in social, occupational, and school functioning.

A biological perspective on bipolar disorder, more specifically genetic theory, states that disordered genes predispose people to depression or bipolar disorder. On page 189 of the book, Kay mentions that her great-uncle spent most of his adult life in an asylum. Along with that, Kay’s father and two generations of relatives on her father’s side expressed manic-depressive illness. Earlier in the book, Kay portrays her father as being enthusiastic, intelligent, caring, and talkative, but later on he became depressed all the time, and resorted to drinking. Another perspective on the disorder that we have learned about in class is psychodynamic.

The psychodynamic theories state that depressed people are unconsciously punishing themselves because they feel abandoned by another person, but cannot punish that person. The psychodynamic theory, in my evaluation, is not accurate with the disorder that Kay possesses. There was not really anyone in specific that she felt abandoned by, except for Richard, but she did not feel guilt or necessary to punish herself. I believe the book written by Kay Redfield Jamison provides a very accurate depiction of her disorder. At first, she seemed to mind people knowing about her condition because she felt embarrassed or ashamed, but in writing this book and confiding in many of her colleagues about her manic-depressive illness, she is able to let out all her emotions and experiences with the disorder.

I had some knowledge about bipolar disorder, but after reading this autobiography I feel like I have first-hand experience to someone suffering from this disorder. I have a lot more knowledge and insight about the symptoms, manias, depressions, and overall moods of someone with manic-depressive illness. Someone who has just been diagnosed with bipolar disorder would probably find this book very informative because it provides such detailed accounts of moods and experiences of someone with the disorder. If a friend of mine was diagnosed with this disorder, I would definitely recommend him/her to read this book because there is a lot that can be learned from the author and her struggles with the disorder.

The main reason I would want my friend to read this book is not only because it would give him/her ideas of what to expect with being manic-depressive, but Kay discusses over and over the importance of medications. I would want my friend to have knowledge about, specifically, the importance of regularly taking lithium. Since this disorder is fatal to thousands of people, I wouldn’t want my friend to continue in a devastating path, and despite of lithium’s side effects that Kay vividly portrays, lithium and psychotherapy together can save lives, as is true with Kay Redfield Jamison.

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