by Jesse Garon

Kay Redfield Jamison is one of the most highly respected authorities on manic depression in America, coauthor of what is considered to be the standard medical text on the illness. She has served as the director of the UCLA Affective Disorders Clinic, has produced and written an ongoing series of public television programs on manic-depressive illness and the arts, and has won numerous awards for her research. And, for half her life, she has waged a struggle with her own manic depression.

Her newly published memoir, An Unquiet Mind (Knopf, $22), tells the story of her fight to overcome the debilitating condition with a stunning, almost cinematic eye for detail. Beginning with an Air Force jet crashing near her playground, Jamison presents an unrelenting stream of jarring images and scenes that powerfully depict her fall into madness, and the long, difficult process of recovery. As a medical student, and as a young professor, she originally kept quiet about her disease, entrusting only her closest friends, for fear that she would be seen as unsafe, and her privileges and access would be revoked. She used to include entries from her own journals in her scientific papers, using them as anonymous examples of a patient with manic depression. Now, 20 years later, she has gone public with her condition, and finds the experience liberating.

"For the most part it's been easier than I thought it would be," she says. As a gay friend said to her about coming out of the closet, "It's easier when you're out," and the pressure of keeping the secret has been lifted. But coming out in so public a way -- and being in the field she's in -- has complications. It was difficult enough when she revealed her condition to people in private, and their reactions, some of which she describes in the book, were often unsympathetic or patronizing. Now that's she publicly acknowledged her illness, she says, some colleagues who treat her much more coolly than they did before, if they bother to speak to her at all.

And yet, she's proved through her work that manic depression can be overcome, that one can suffer from it and still lead a life that is active and productive by even the highest of standards. In her case, the cure came from a combination of psychotherapy and prescribed doses of lithium, a treatment to which she reacted violently at first. Unwilling to deal with the physical side effects of the drug, and its suppression of her manic flights of imagination, she decided against her psychiatrist's advice to stop taking her medication regularly. A year and a half of suicidal depression followed, which she describes in her book:

Profound melancholia is a day-in, day-out, night-in, night-out, almost arterial level of agony. It is a pitiless, unrelenting pain that offers no window of hope, no alternative to a grim and brackish existence, and no respite from the cold undercurrents of thought and feeling that dominate the horribly restless nights of despair.

Numerous false starts and one botched attempt at killing herself convinced Jamison to accept her medication as a part of her life; I asked her if she still occasionally feels the urge to rebel against taking the lithium, as she did in the early years of her therapy. "I honestly don't get that feeling anymore," she told me. "I have learned that lesson so well. I don't even think about not taking my medicine. I am so scared that I would get sick again that I never even think about it." Describing the denial of her disease, and the attraction of the manic states that led her to reject lithium treatment, she wrote:

My family and friends expected that I would welcome being "normal," be appreciative of lithium, and take in stride having normal energy and sleep. But if you have had stars at your feet and the rings of planets through your hands... it is a very real adjustment.... When I am my present "normal" self, I am far removed from when I have been my liveliest, most productive, most intense, most outgoing and effervescent. In short, for myself, I am a hard act to follow.

But she does follow herself, every day, and she writes of the close relationships which, although they can never cure her condition, have helped to make her life much more bearable. The incredible support from those closest to her is depicted in An Unquiet Mind with emotional honesty. Infused throughout with her lifelong love of poetry and literature, Jamison's story strikes the reader with its beauty and its pain, but most importantly with its hard-fought optimism and Jamison's determination to live a productive life and evade the nearly fatal mood swings she barely escaped two decades before.