An Unquiet Mind

1. Would you schedule an appointment with a therapist if you knew that he or she was diagnosed with manic-depression?

2. Are you reluctant/opposed to people taking medication for psychological issues? Do you see mental illness in a similar way to any other disease?

3. Jamison tells a story from her childhood in which she witnessed a young pilot sacrificing his life in order to avoid risking that his plane would fall onto a playground full of kids? If you were in his situation, do you imagine that you would make the same decision?

4. Jamison talks of past eras where there was a certain feeling of predictability, ancestors who were reliable, stable, honorable, and saw things through. Do you think people have become more anxious, depressed, and unstable in the past century?

5. As a child, Jamison was hyper-focused on wanting a sloth as a pet. She now understands that she was simply in love with the idea of a strange idea, and that given some other way of expressing her enthusiasms, she would be quite content. Can you relate to this experience?

6. Is there an animal version of a mental hospital? If animals had a more advanced ability to communicate and build hospitals, would there be a sloth DSM and hospitals for disturbed sloths?

7. During her darker times, Jamison references her preoccupation with death: “I was going to die, what difference did anything make? Life’s run was only a short and meaningless one, why live?” Are these thoughts inherently a sign of an illness?

8. Can we determine the distinction between existentially based depression and genetically based depression? Is there a clear distinction?

9. Is “the real you” who you are on medication or who you are without it? Does it matter who “the real you” is? Are you always “the real you”?

10. Have you enjoyed aspects of being unstable? Did these feelings contribute to a reluctance to change?

11. Have you ever received a diagnosis or known someone who received a diagnosis which provided a sense of relief?

12. Jamison acknowledges several times her propensity for anger and being physically violent. She explains that “anger or irritability in men, under such circumstances, is more tolerated and understandable; leaders or takers of voyages are permitted a wider latitude for being temperamental.” This book was written thirty years ago, so perhaps things have changed in some way. What did you think of Jamison’s thoughts on this?

13. Jamison avoids taking meds at times as she fears that she will risk using her last resort. Have you ever avoided taking action that might help you due to a fear that you might no longer have a last resort?

14. Jamison explains that she owes her life to her psychiatrist. She says, “What on earth can he say that will make me feel better or keep me alive? Well, there never was anything he could say, that’s the funny thing. It was all the stupid, desperately optimistic, condescending things he didn’t say that kept me alive; all the compassion and warmth I felt from him that could not have been said; all the intelligence, competence, and time he put into it; and his granite belief that mine was a life worth living.” Have you had a relatable experience to this?

15. Jamison describes feeling more beauty and more sadness when she cuts back on her medication. Is there something beautiful about sadness? What is potentially lost if we diminish our ability to feel intensely, and how can we determine when these feelings are worth diminishing?

16. Jamison explains that she was “late to understand that chaos and intensity are no substitute for lasting love, nor are they necessarily an improvement on real life.” Do you prefer volatility and passion or steadiness of experience and feeling about another person? Have you been able to find a balance between passion and steadiness?

17. Jamison states that she is skeptical that anyone who does not have her illness can truly understand it. She explains that it is probably unreasonable to expect the acceptance and empathy that she desires – her anger and violence seen as an illness beyond her control. Is it true that one must have an illness to understand it? Should a mental health diagnosis result in more acceptance and empathy? Could anyone who acts with anger and violence be diagnosed with a mental health disorder? (There seems to be a pattern in these last two books -- desiring acceptance and empathy for unstable and damaging behavior but a somewhat limited expression of empathy towards those being hurt as a result of the behavior.)

18. Jamison is deeply hurt and offended when told that she shouldn’t have children due to her illness. Jamison claims that she has never regretted being born. She acknowledges that she has wanted to die (suicide attempt), but she states that this is different than regretting being born. Is this a trivial distinction? While telling someone that they shouldn’t reproduce is perhaps inherently offensive, is there any truth to the idea that Jamison should have had pause about having children?

19. Jamison is excited about advancements in science and research, but she also expresses a concern about making the world a blander, more homogenized place if we get rid of the genes for manic-depressive illness. She explains that manic-depressive illness comes with advantages to the individual and society. Is this really a complicated ethical issue as Jamison indicates? Are you as concerned as she is about making the world blander if we were to reduce or eliminate severe mental illness that often leads to suicide? Is there a contradiction in Jamison explaining throughout the book that this illness is a disease, but later indicating that we should be hesitant about implementing a cure?

20. What did you think of Jamison’s former colleague’s reaction to Jamison revealing her illness to him as well as her suicide attempt? Mouseheart (the former colleague) tells her that he is “deeply disappointed” that she could have attempted an act of such cowardice and selfishness? What are the advantages and disadvantages with being open with others about mental health struggles? How do you determine when it is worth it to be transparent about your struggles?

21. Jamison explains that she doesn’t mind the thought of being seen as intermittently psychotic nearly as much as she minds being pigeonholed as weak and neurotic. Do you relate to this?

22. “Although I continue to have emergences of my old summer manias, they have been gutted not only of most of their terror, but of most their earlier indescribable beauty and glorious rush as well: sludged by time, tempered by a long string of jading experiences, and brought to their knees by medication, they now coalesce, each July, into brief, occasionally dangerous cracklings together of black mood and high passions. And then they, too, pass.” Jamison goes on to explain (in the epilogue) that if given the choice, she would choose to still have manic-depression (as long as lithium was still available to her). Does this surprise you? Is there something a bit incomprehensible about her time devoted to curing an illness that she would be reluctant to cure in herself? Are we all generally biased towards wanting to be appreciative of all that makes us who we are due to a fear that if something were different, we would no longer exist?