Writing The Wrongs Of Mental Illness


Christine Rowett

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Homewood News and Information



     Professor and author Kay Redfield Jamison remembers going to

Paul McHugh, chairman of Hopkins' Psychiatry Department, to let

him know she had plans to document her own history and battle

with mental illness. 



     "I told him, 'The only real qualm I have at this point is

that I don't want to embarrass Hopkins,'" she said. "'You know,

we'll hear all the standard jokes that people are going to say

about crazy shrinks.'" 



     McHugh, Jamison said, told her that he believed Hopkins has

obligations to protect and care for both its patients and its

doctors.



     "He said, 'If Hopkins can't do that for you, Hopkins has no

business being in business,' " Jamison recalled. "It's hard to

say what that kind of support means. 



     "This is the first time I've had a chance to publicly

acknowledge Paul," she said, addressing McHugh Thursday evening

in the Mountcastle Auditorium. "I'd like to thank you."



     Jamison spoke to an audience of more than 200 as part of a

series of five seminars sponsored by the JHMI Office of Cultural

Affairs featuring authors describing their own illnesses. 



     Her 1990 book, Touched by Fire: Manic-Depressive Illness and

the Artistic Temperament, was named the most outstanding medical

book in biomedical sciences by the Association of American

Publishers. But An Unquiet Mind, published last year, is a

personal and at times painful account of Jamison's own dealings

with manic depressive illness, including honest descriptions of

euphoric feelings of mania and the following bouts of depression

that resulted in thoughts of suicide.



     "She's played a number of vital roles in getting the rest of

us here at Hopkins to think about mental illness," Humanities

Center director Richard Macksey said in his introduction of

Jamison. "She has reached both the professional community and the

community of patients."



     Jamison opens An Unquiet Mind with a chilling account of

how, as the daughter of an Air Force pilot, she watched as an Air

Force jet lost control and crashed just beyond the playground

where she and her elementary schoolmates stood in horror. The jet

pilot, killed in the fiery accident, was later remembered as a

hero for his successful efforts to avoid crashing directly into

the playground.



     "The memory of the crash came back to me many times over the

years," she wrote, "as a reminder both of how one aspires after

and needs ideals and of how knowingly difficult it is to achieve

them."



     She recalled a normal, happy childhood in her talk on

Thursday. During her senior year of high school, she had feelings

of high confidence and ecstasy, but they didn't last.



     "I had total certainty, total enthusiasm," she said. "But

then I crashed, and I got psychotically depressed."



     Her condition was not discussed in her self-described "WASP

military family." She struggled through school, as an

undergraduate and graduate student at the University of

California, Los Angeles, with a yearlong stint studying at the

University of St. Andrews, in Scotland.



     In 1974, Jamison was named an assistant professor of

psychiatry at UCLA. 



     "I had my first raving psychotic attack about three months

after joining the faculty," she said, "which says something about

joining a faculty."



     After a subsequent episode in which she hallucinated, seeing

frightening images of herself wearing a floor-length evening gown

and covered with blood, Jamison called a colleague at UCLA and

accepted his help.



     "The single most impressive thing through my denial was that

this colleague--a psychoanalyst--didn't believe in medication,

didn't believe in drugs," she said. "He said, 'You need drugs.

You're really out of control.' Coming from him, that made a deep,

lasting impression."



     But she was reluctant; fear and embarrassment initially kept

her from treatment, she said. She also recalled an intense

anxiety that left her shaking as she contemplated seeing a

psychiatrist for the first time. 



     "I shook for what he might tell me, and I shook for what he

might not be able to tell me," she said, quoting from An Unquiet

Mind. "Character building, no doubt. But I was beginning to tire

of all the opportunities to build character at the expense of

peace, predictability and a normal life."



     Her initial consultation included standard physician

queries.



     "The questions were familiar, but I found it unnerving to

have to answer them, unnerving to realize how confusing it was to

be a patient," she said.



     Her psychiatrist diagnosed her as manic depressive and

gradually, she said, helped her, with his respect, caring and

confidence in her ability to get well. During her treatment,

however, her doctor repeatedly suggested she check into a

psychiatric hospital, but she refused.



     "I was horrified at the idea of being locked up, being away

from familiar surroundings, having to put up with all of the

indignities and invasions of privacy that go into being on a

psychiatric ward," she said. "I was working on a locked ward at

the time, and I didn't relish the idea of not having a key." 



     In her research and writing, Jamison focused on depressive

illnesses, medications and their side effects, and suicide, all

topics she came to know firsthand.



     "The disease that has, on several occasions, nearly killed

me, does kill tens of thousands of people every year: most are

young, most die unnecessarily, and many are among the most

imaginative and gifted that we as a society have," she said.



     Twenty percent of people who have manic depression and go

untreated kill themselves, Jamison said. Those with depression

also have high rates of suicide.



     "If you had that kind of rate from tumors or heart disease,

specialists might focus their energies on exploring the causes of

those statistics," she said. "Somehow suicide always seems a bit

more idiosyncratic. It's almost much easier to make it more

poetic and romantic than it often is. It's often just as wired

into somebody who has manic depressive illness as a heart attack

is to somebody who's got cardiovascular disease."



     Jamison described the effects of mania that may cause

patients to stop taking prescribed anti-depressants; heightened

energy, optimism and a sense of awareness. It is hard to make

others understand the feelings of mania, she said, or the desire

to cling to them.



     "The intensity, glory and absolute assuredness of my mind's

flight made it very difficult for me to believe, once I was

better, that the illness was one I should willingly give up," she

said. "If you have had stars at your feet and the rings of

planets through your hands, it is a very real adjustment to blend

into a three-piece suit schedule, which is new, restrictive,

seemingly less productive and maddeningly less intoxicating."



     Jamison once discontinued her own lithium against medical

advice; an episode of severe depression followed. 



     In addition to the support she received from her colleagues

at Hopkins, Jamison was encouraged by the staff and

administration at UCLA. But that, she said, is not the norm.



     "In fact, since I've written my book, I've gotten hundreds

of letters from medical students, residents, graduate students

and faculty who have been thrown out of programs," she said. "I

know that I am unusual in the support that I have gotten."



     Jamison said she has questioned her objectives since writing

the book, citing her loss of privacy as a casualty of the

process. She may soon, however, have even less; her book is

scheduled to be made into a screenplay and film starring Annette

Bening, she said.



     She no longer sees individual patients and said she is not

sure if she will return to practice. She spends her time as an

author, an executive producer for a public television series on

manic depressive illness and a professor in the Department of

Psychiatry.  



     "I am a great fan of Johns Hopkins," she said. "I regard it

a great privilege to teach here."



     The authors and their illnesses series continues on March

28. All seminars will be held in the Mountcastle Auditorium; they

are free and open to the public.