Depression is a mental illness that plagues many people around the world. Manic depression is a form of depression but is much less common. Manic depression is characterized by intense mood swings and/or sudden behavioral changes (Pesic, 2007). Sudden mood swings and behavioral changes can last for hours, days, weeks or even months (Pesic, 2007). These mood swings and changes in behavior are challenging for individuals and families to understand.
While it is possible to determine patterns of changes in mood and behavior (Pesic, 2007), individuals and families often live in the unknown never sure what to expect. Manic depression is marked by periods of extreme happiness followed by periods of intense depression (Pesic, 2007). In An Unquiet Mind, Kay Redfield Jamison, a therapist, describes her personal experiences associated with manic depression and offers realistic information that has application in the lives of others suffering from the illness as well as their families.
This book is analyzed in order to increase overall awareness of the implications associated with manic depression as well as to increase awareness of feelings and beliefs associated with treating patients suffering from manic depression. The most important aspect of manic depression that has direct implications in quality of life for patients and their families is the extreme differences between manic highs and depressive lows. Jamison describes the intense happiness associated with her manic highs and how these times made her feel on top of the world and as if she could accomplish anything.
She also describes times of such severe depression that she only wanted to die (Jamison, 1995). Jamison goes on to discuss the importance of medication for those suffering from manic depression. She makes reference to her treatment using lithium. She describes how this medication helped her overcome her symptoms. At the same time, Jamison resisted taking lithium because she became addicted to the feelings she had when she was experiencing a manic high.
It took many years for Jamison to realize the importance of taking her medication in order to improve her own quality of life but also the quality of life of her friends and family members. It was only after the end of her first marriage that Jamison realized what her illness was doing to those she loved. She described her eventual decision to remain on lithium as a “rather bittersweet exchange of a comfortable and settled present existence for a troubled but intensely lived past” (Jamison, 1995).
When treating patients with manic depression it is not uncommon for some patients (and/or their families) to refuse medication. Many patients become addicted to their manic highs just as Jamison did because these time periods allow them to be carefree and creative. As a result, many patients are willing to suffer through the emotional periods of depression in order to have the opportunity to live the manic highs as well. Similarly, family members are often afraid that medication will change the person that they have come to know despite their illness.
For example, Jamison’s sister discouraged her from taking lithium because she was afraid her (Jamison’s) “soul would wither” if she did not have the chance to experience life associated with her manic highs (Jamison, 1995). When patients do refuse medication as treatment, therapy becomes the most important avenue for living with their illness. Therefore, counselors and therapists must often put aside their own beliefs and values associated with medication and modify their treatment methods so they are still able to provide patients with the tools necessary to understand and live with their illness.
A second key point that increases the overall awareness of manic depression presented by Jamison is the idea held by some in society that using medication for treatment “risks making the world a more homogenized place” (Jamison, 1995). This is not an opinion that is unique to Jamison. Many people within society feel that manic depression is often associated with creative genius and to rid the world of manic depression would also rid the world of genius (Jamison, 1995).
Similarly, many people who suffer from or work with those suffering from manic depression are afraid that medication will alter the personality of patients. This brings up another important point that is critical to this book and may have implications for other therapists as well. Should Jamison be allowed to treat patients when she also suffers from manic depression and feels this way? This is an interesting and thought provoking question that has implications to all those treating patients with manic depression.
Therapists must be sure that they are able to treat patients with manic depression, particularly if they are going to treat them without the benefit of medication. Further, therapists must uphold their vow to not cause harm by working with patients in order to reduce symptoms of manic depression through therapy, medication or a combination of both. Therefore, if a therapist, like Jamison, felt that manic depression is a positive aspect of society, they must be willing to keep that opinion to themselves in order to provide the most effective treatment to their patients.
While it should not be a therapist’s goal to completely alter the personalities of patients it is important to help patients and their families learn to live with and accommodate the symptoms that accompany manic depression. As I work with patients who have manic depression I will be able to help them understand their illness because of my increased awareness of the characteristics associated with manic depression. While I certainly do not believe that medication will rid the world of creative genius (Jamison, 1995) I now understand why many patients refuse medication as part of their treatment.
Therefore, it will be important for me to work with patients to discover ways to live with the symptoms or find ways to experience the joys of life even while taking medication because ultimately, the goal of a therapist is to improve the quality of life of those living with manic depression whether medication is used or not.
References Jamison, Kay Redfield. (1995). An Unquiet Mind. New York: Knopf Doubleday. Pesic, Milos. (2007). Manic Depression. Retrieved on April 29, 2009