They mutter under their breaths; they sing on street corners. They talk to people who clearly aren’t there.
Often they are unkempt and oddly dressed; often, indeed, they are smelly and inappropriate. They shuffle; they dart. They fix us with piercing gazes and they speak what seems like nonsense.
And we laugh–what else is there to do? We laugh or we turn our backs; we walk away from that disturbing, unusual display. It’s weird, it’s odd; it hurts us to watch.
Even for those of us who live with it, for those who understand that this is physical, a brain disorder, it’s difficult. It is hard to be in the presence–it is hard to be in the LAND–of the mentally ill.
So imagine what it must be like to live there.
Kay Redfield Jamison, the blurb on the Robert Lowell: Setting the River on Fire book jacket will tell you, is the Dalio Family Professor in Mood Disorders, and a professor of psychiatry, at the Johns Hopkins University School of Medicine. She is learned in her field, which centers largely on bipolar disorder; she is well-educated and well-read. She has written a definitive textbook; she has written popular books that bring the reality of bipolar disorder into mainstream conversation.
She has done this because it is her field. She has done this because it is her life.
An Unquiet Mind is Redfield’s first memoir, and it talks about her childhood, in a quirky family, moving from coast to coast. She was a brilliant, intense child; her illness manifested itself, as it often does, in her college years. From then on, her life would have two paths: pursuing the dreams she had BEFORE, and controlling her descents into mania and depression.
Honestly and without self-pity, Redfield shows us what it’s like to have bipolar disorder, and what it’s like to live through a manic episode. “During these agitated periods,” she writes, “I became exceedingly restless, angry, and irritable, and the only way I could dilute the agitation was to run along the beach or pace back and forth like a polar bear at the zoo.”
In a manic state, she might wear dramatic makeup and dress more provocatively than she would when her mood was balanced; she would say things she’d regret, and she would spend money she could ill afford on things she didn’t need. And then, gradually, the manic state would end, and her mood would swing into its expected aftermath: depression.
“So after mania,” she writes, “when most depressed, you’re given excellent reason to be even more so.”
Yet even Jamison was medication-resistant. Even as a practicing psychologist, as one who clearly knew and advised clients that taking lithium was the key to controlling the disease, she thought she could do without it. She’d control it other ways–with exercise and diet, say, or with her brilliant mind. It took time and gentle guidance from trusted mentors, continuous family support, and descents into madness and depression, for her to finally grapple with her need for medication. She had to accept that she had an illness, and a chronic one–but one that, with the right drugs, could be controlled.
When Jamison tells of the story of Robert Lowell, who was, maybe, the finest American poet of the last half of the twentieth century, the weight and the cost of bipolar disease become even more clear. Lowell was brilliant and charming, a sweet, often shy man, and one who valued loyalty and strength of character. And when he became manic, it all changed. He commonly sought an extramarital connection, seeking out inappropriate, usually younger partners, hurting them, hurting his wife. He said harsh and damaging things, things he didn’t mean or think, to his dearest, closest friends. He was violent at times, and he drank, drank, drank, which exacerbated the problem.
He had to be institutionalized, often delivered by the police. Once, when they arrived to fetch him, Lowell made them sit at his kitchen table and listen to him recite a poem. Then he went meekly off to the mental hospital. Again.
Lowell’s illness afforded him a weird benefit–he remembered vividly every single thing he did and said during his manias. He knew how much he’d hurt his wife, his friends, his family. The subsequent depressions were made worse by this shameful knowledge.
And then, he’d come back into his right mind. And a measure of how wonderful that mind was is this: his friends and his family all stood by him. They sloughed off the hurtful things and awaited his return.
“We are all,” Redfield writes in her memoir, “as Byron put it, differently organized.”
I thought, in parenting a child with high-functioning autism,–who, like many autistic folks, has additional diagnoses of major depressive disorder and OCD–I understood the biological bases of mental illness. I thought I had relinquished the idea–taught in psychology classes not so very long ago–that I, and my son’s father, had somehow ’caused’ his illness.
We would not think a harsh word or over-indulgence would cause, say, diabetes; we are willing to believe, though, that bad parenting causes autism.
When Jim first was diagnosed, we decided that openness was key: we shared his illness, freely and openly, with family and friends. We invited questions. It’s an illness, we averred; it’s physical and chemical.
And yet—when our beloved boy, who is smart and funny and devoted,—enters into an ill time, I am am angry or embarrassed or hurt. How can he SAY that? I wail inwardly.
Jamison’s books help me feel the knowledge, as well as KNOW the knowledge, that mental illness is physical illness, not in the control of its victim.
Mental illness comes with pain and wounding, with despair and glimmers of hope. And we live in a time–the best time yet–when there is real hope of control, if not recovery; of maintenance, if not cure.
Jamison reminds me of the infinite contributions that have been made by people with mental illness, of the ways in which every society has been enriched and blessed by creative members who happen to be sick. I closed her book on Robert Lowell determined to track down his poetry and letters, to see what he had to share.
I’ll read the rest of Redield’s writing, too.
And I hope that I will be more enlightened, that I will practice understanding, that my demeanor may teach another. Mental illness is physical illness.
No one chooses to be mentally ill.