A Student of Moods--by Necessity : Books: Kay Redfield Jamison, an expert in manic depression, has firsthand experience with the disease--she's battled it for years. She details the fight in her new memoir.


She bought three wristwatches, all within an hour, and all in the Rolex category, not Timex. In one wild literary shopping spree, she scooped up 20 Penguin books, chosen not for subject matter but in hopes that the penguins might form a colony. She purchased costly jewels, impractical furniture and provocative clothes of the sort seen never before (or since) among faculty members at UCLA's department of psychiatry.

And there were the snakebite kits, an even dozen of them, the entire inventory of a pharmacy in the San Fernando Valley. Kay Redfield Jamison had inside information, direct from God, or so she believed, that an infestation of killer rattlesnakes was imminent. No one else may have known it, least of all the pharmacist who gave Jamison an indulgent smile as he filled her lithium prescription and rang up her snakebite kits, but much of Los Angeles stood to perish from the reptiles' wrath.

Jamison, then in her early 20s, was in the grip of manic depression, a disease that first surfaced in her senior year at Pacific Palisades High. The affliction put her in the company of at least 2 million Americans, one in 10 families. It also numbered her among remarkably creative individuals--Vincent Van Gogh, Herman Melville, Edgar Allan Poe, Franz Schubert, Robert Schumann, Lord Byron and Virginia Woolf, to name a few.

But Jamison stands out. Researcher, teacher, clinician and author, she is internationally known as an expert in manic depression.

"I became, both by necessity and intellectual inclination, a student of moods," she writes in "An Unquiet Mind: A Memoir of Moods and Madness" (Knopf), her riveting, just-published account of a lifetime of jousting with the disease she studies and treats. "It has been the only way I know to understand, indeed to accept, the illness that I have."

Pursuing a field in which one has personal stakes is not unusual, least of all in medicine. But mental illness has a darker stigma. And with garish symptoms such as sensational mood swings, grandiosity, buying binges and inappropriateness in dress, manic depression in particular puts many people off. It connotes a kind of dervish, someone who is "bouncing off the walls," Jamison said. "Which you are sometimes. But not all the time."

At home here, Jamison projects a portrait of steadiness, hardly the woman who sang "Fly Me to the Moons" in her days and nights of effervescent intoxication. Now she writes in a wood-paneled study where the books overflow off the shelves. She is married to a fellow scientist, schizophrenia researcher Dr. Richard Wyatt. Jamison is slender and blond, with an easy laugh that often bounces in her own direction. In her weekend attire of denim skirt and baggy Johns Hopkins University sweat shirt, Jamison, 49, looks more like a teaching assistant than a tenured professor.

Her decision to strip bare a rugged history, which included at least one nearly successful suicide attempt, flew in the face of the distance mental-health specialists tend to place between themselves, their students and, especially, their patients. The chairman of her psychiatry department at Johns Hopkins was only one of those who warned Jamison about traversing that fragile wall of separation.

"Because she essentially shows herself warts and all, I was afraid that she would find it difficult working with patients--that they would worry about her, that they would wonder if she was OK," Dr. Paul McHugh said. But "to a man and a woman," McHugh said, the opposite has proved true: "They find her book a source of great hopefulness."

With good reason she worried that her peers would view her as a patient, not a professional, or what Dr. Sherwin Nuland, author of "How We Die" (Knopf, 1994), called "the wounded healer."

Unaware when he hired her 21 years ago that she was slipping toward a psychotic breakdown, Dr. L.J. West, former head of UCLA's Neuropsychiatric Institute, said those concerns were not unwarranted. But he said Jamison's stellar reputation would offset most criticism, as would her "courage and generosity" in coming forward with a story that would help destigmatize her disease.

Even her own brother, Dean Jamison, director of the Center for Pacific Rim Studies at UCLA, had doubts about "An Unquiet Mind." He had "concerns for her career, concerns that the profession itself was not ready for this," he said. "Had I been asked to make the choice for her, I would have said let it go, protect yourself with some sense of privacy."


But Kay Jamison was restless with the pace of understanding manic depression. She wanted to stimulate discussion, and with its 75,000-copy first printing, her book promises to do just that. In some ways she seemed almost determined to flout the court of public and professional opinion. If a full professor of medicine at Johns Hopkins who co-authored the definitive medical text on the subject ("Manic-Depressive Illness," Oxford University Press, 1990) couldn't come clean about manic depression, she reasoned, who could?

"I thought it would help," she said. "People in general are very reluctant to talk about a psychotic illness, and especially in the profession."

Jamison's case had textbook-like qualities to it, anyway. A moody child, she was also an academic overachiever, a girl who filled every moment with something worthwhile, creative--or both. But while she was overachieving, she was also careening through highs and lows: "Gliding," she writes, "flying, now and again lurching through cloud banks and ethers, past stars and across fields of ice crystals." Brilliant colors encircled her, and in those delirious dream days, she fancied herself terribly funny.

In her mid-20s, Jamison crashed. The psychiatrist she finally consulted prescribed lithium, the most widely used of three drugs to treat manic depression. Lithium works for most patients, including Jamison, by restoring the chemical balance that depression throws out of kilter. But many manic-depressives--and Jamison was one of these--find the drug almost too successful. With stabilization comes denial, and perhaps, Jamison writes, a perverse nostalgia: remembrances, as it were, of euphorias past.

Jamison can sound coolly objective now when she pronounces that "that's the major clinical problem with manic-depressive illness, keeping people on the treatment, especially young people. It's one of those odd ironies, because the people who are least likely to take it are the most likely to respond."

But her ambivalence about lithium was so powerful half a lifetime ago that when she decided to take her life, she chose lithium as her exit vehicle. Even in a manic-depressive nadir, she was smart enough to take an anti-emetic along with her overdose. What she didn't count on was how slow-acting the drug would be, and that even in a fog, she would reflexively answer her telephone. Her slurred words gave her away, and the friend at the other end of the line rushed her to emergency treatment.

Jamison shudders to think that she has disclosed the details of this brush with self-destruction. But manic depression can be fatal, she stressed, claiming as many as 30,000 lives each year--more than fall victim to homicide.

Telling her story put her family on display as well. Both her father and sister suffered from manic depression, writes Jamison, who maintains that the disease is "clearly genetic." Colleagues call her a pioneer in research into the genetic origins of manic depression, noting that she has served on the National Advisory Council for Human Genome Research, among other scientific bodies. And if Jamison's research indicates a genetic breakthrough is near, her personal history convinces her that the connection is inevitable.


Still, manic depression remains a largely misunderstood condition, Jamison laments. Depression itself has achieved "a certain trendiness," she said, "getting your mental Maserati tuned." The antidepressant drug Prozac is as widely accepted as some vitamin tablets.

But talking about lithium is different from saying you're on Prozac, Jamison observed, adding: "It can be a little difficult to hear the cocktail conversation about Prozac." Her book includes a wry segment called "Rules for the Gracious Acceptance of Lithium Into Your Life." (Rule 1: "Clear out the medicine cabinet before guests arrive for dinner or new lovers stay the night." Rule 2: "Remember to put the lithium back into the cabinet the next day.")

Jamison praises public figures who have gone public with their struggles with manic depression: among them, communications czar Ted Turner, TV correspondent Mike Wallace and former magazine publisher Frances Lear. And now that she has revealed herself, Jamison has another plan in mind: "a public 'outing,' about 50 people in public positions who will come forward and talk about this disease." By their own lives, she said, such successful people could show how manic depression "confers an advantage on society--it moves it along, it shakes it up."

Like Jamison herself, not one of these people would "go around being delighted" to have manic depression, she said. "So what you do is, you try to change people's attitudes about it."

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