Mental Notes - Johns Hopkins Medical Institutions

HEALTH / By Jane Marion
Mental
Notes
A famous Hopkins psychologist gets personal
when it comes to talking about bipolar disorder.
A
Even in Hopkins’s hallowed halls, Jamison
is considered a luminary—known for her
ability to offer acute insight on the disease
as clinician and patient, as well as for her
eloquent writings on mood disorders (among
them: the bestselling Night Falls Fast: Unt
first glance, the works of art in Kay Redfield Jamison’s
sparsely decorated office don’t seem to have much in common.
There’s a charcoal drawing of composer Gustav Mahler; a delicate
print of Romantic poet Lord Byron; a black-and-white
photograph of one of Jamison’s many muses, “confessional”
poet Robert Lowell. But beyond their extraordinary contributions
to the world of music and poetry, the thread that binds
these men—and what particularly interests Jamison, the
co-director of The Johns Hopkins Mood Disorders Center
and a professor of psychiatry of The Johns Hopkins Univer-
Pictured:
Doctors in the
House: Kay
Redfield Jamison
at home with
Thomas Traill.
sity School of Medicine—is
their struggle
with bipolar illness
(also known as manicdepression),
a mood
disorder characterized
by episodes of severe depression and mania.
Although this enigmatic illness (suffered
by more than 10 million people in the United
States alone, according to the National Alliance
on Mental Illness) was first classified
dating back to the time of Hippocrates, it
has lately found its way into the mainstream,
thanks to the success of the feature film Silver
Linings Playbook and Showtime’s wildly
popular Homeland, whose producer once
contacted Jamison to advise on an episode.
Of course, to Jamison, the disease is
nothing new: She is one of the most widely
regarded experts on mood disorders in the
world and has spent the greater part of her
66 years not only studying bipolar illness,
but living it. After years as a clinical psychologist
first at UCLA and then at Johns
Hopkins, she “outed” herself in her 1995
bestselling memoir An Unquiet Mind: A
Memoir of Moods and Madness.
“There were many concerns in writing
the book,” admits Jamison, who gave up
her clinical practice after An Unquiet Mind
came out, but continues to teach Hopkins
medical students and residents. She feared
that she might lose her license. (She didn’t.)
And beyond that, there was a fear of “how
one’s work would be perceived once you
have this diagnosis on your forehead. . . . it’s
very easy to be defined by that.”
There were more personal concerns
as well. “In my own WASP military family,
you didn’t talk about mental illness,” says
Jamison, with a smile. “You are brought up to
be private. The first time I got up and spoke
publically about this, all I could think about
was my grandmother and her white gloves
and her hat and her D.A.R. meetings, and
what on earth she would be thinking?”
derstanding Suicide, Exuberance, and a
1,262-page tome that is considered the
definitive textbook on bipolar disorder).
Associate professor of psychiatry at
Yale School of Medicine Thomas Styron,
whose father, the late literary titan
William Styron, was a close friend of
Jamison’s, has high praise for her.
“She is an absolute giant in the field of
psychiatry as someone who has been able
to combine top-notch academic work
with this incredible personal story, which
has been such a huge service to people
who suffer from mental illness,” he says.
Her students are starry-eyed, too.
“When medical residents come to look
at Hopkins, they say, ‘If I’m here, do I
actually get to work with Dr. Jamison?’”
says Dr. Karen Swartz, associate professor
of psychiatry and behavioral sciences
at Hopkins. “Ray DePaulo [co-director
of the Mood Disorders Center] once said,
‘She may be the most famous person with
bipolar disorder in the world.’”
She lives the more low-key life of a
scholar, though, as she shuttles between
the charming circa-1800’s renovated
barn in Sparks she shares with her husband,
Hopkins cardiologist and professor
of medicine Thomas Traill, and their
stately 1920s home in Washington, D.C.,
where Jamison spends most of her time
immersed in the life of Lowell, who is the
subject of her next book.
“He’s someone I read after my
first breakdown when I was 17,” says
Jamison, who obtained access to Lowell’s
hospital records to write her book.
“He has just stuck with me. I am writing
about him because I admire him as an
artist and a great, great original poet.
He was hospitalized 20 times for mania,
but he had depressions after each one
of them. He was a remarkable man; a
remarkable human being.”
Jamison’s husband can’t help but to
gush a bit when he discusses his wife’s
work. “She’s a major-league scientist,”
weighs in Traill, who laughs that their
obvious mutual affection for each other
can be “nauseating.” “You have to set
that against the fact that not only is
she someone who wrote a memoir, but
106 baltimoremagazine.net | MAY 2013 PHOTOGRAPHY BY DAVID COLWELL
MAY 2013 | baltimoremagazine.net 107

HEALTH
she’s also passionate about language and
writing. These books come from a prodigious
love of words and literature and
serious, worked-over writing.”
Given her long list of accolades, it would
be easy to assume that Jamison’s disease has
scarcely hindered her. But Jamison’s accomplishments—from
earning the MacArthur
Award to an honorary degree from Brown
University to being named Time magazine’s
“Hero of Medicine” in 1997—are not the
whole story, she is quick to point out.
“My life isn’t my C.V.,” says Jamison. “My
professional accomplishments mean a huge
amount to me, but it’s scarcely the only thing
in my life. There are years lost to pain. When
I would stop my medication, I would stop living.
I would get manic and then depressed—I
wouldn’t wish a day of that on anyone.”
As the youngest child of three, Jamison spent
most of her formative years around Andrews
Air Force Base in Washington, D.C.,
where her father, Marshall, was a meteo-
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she says. “I couldn’t have been any happier.
My father was in love with life and with
ideas. My mother was the best mother—if
you had to put together a mother, you
would say, ‘This was God on a good day.’”
Early on, a young Kay showed a passion
for science, receiving her first copy of Gray’s
Anatomy at 12 and touring St. Elizabeth’s,
the federal psychiatric hospital, when she
was 15. (“I found it fascinating and horrifying,”
she recalls.) “I knew I wanted a life in
science because the questions were always
interesting to me.”
By age 17, while a senior in high school,
Jamison experienced her first manic-depressive
episode. “I wasn’t sleeping very
much,” she recalls. “I was full of what I
thought were fabulous ideas, which, in fact,
were pretty terrible ones and, at the time, as
with a lot of people who get manic, I didn’t
see it as anything strange—it was pretty
much an extension of my natural personality.
Life was just too wonderful.”
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Until it wasn’t. “At some point, I
crashed,” she says. “I could scarcely get out
of bed. I had never thought about suicide
in my life, and I started thinking about
ways to kill myself.”
In the ensuing decade, Jamison managed
to convince herself that her violent mood
swings were merely an extension of her passionate
personality. It wasn’t until Jamison
was already an assistant professor of psychiatry
at UCLA in 1974, a full decade later, that
it became clear to her that she needed help.
“I was full of what
I thought were fabulous
ideas, which,
in fact, were pretty
terrible ones.”
“I [had gone] floridly, psychotically manic,”
recalls Jamison who, among other things,
went on a wild shopping spree at the height
of her mania and purchased a stuffed fox
from a taxidermist in Virginia. “Buying that
fox was absolutely characteristic of being
manic. I knew I needed it; I couldn’t wait,
and it took on a cosmic significance for me.”
By the time the fox arrived at her office,
Jamison had long forgotten about her
purchase. “I was sitting in my clinic one
day, and there were lots of patients in the
waiting room, and one of the secretaries
said, ‘Dr. Jamison, there’s a big shipping
crate out here,’ and it was this fox, which I
had somehow felt the need to fly first class.
It was just completely ridiculous,” she says,
now able to laugh at the memory.
She began treatment with “a tremendously
good psychiatrist,” she says. But even with
excellent care, Jamison attempted suicide in
1976 after going off of her lithium, a mood
stabilizer often used to control mania. “I
think about it all the time,” she says quietly. “I
think about the people who haven’t survived.”
Having been to the brink and back, these
days, she has made it her mission to advocate
and educate, particularly on college campuses
across the country.
“The major age of onset for mood
disorders is late teens, early 20s,” says
Jamison, who also sits on the advisory
board of the National Network of
Depression Centers, a mental-health
network working to transform the field
of depressive illness and related mood
disorders. “It’s a hard disease, but it’s
a common disease. People consistently
underestimate how serious these illnesses
are. They also don’t understand
how treatable they are.”
While Jamison chose to come clean,
she advises others to think it through
before coming forward. “You don’t know
what the consequences are going to be,”
she says. “In many instances, people find
it has a freeing effect, but you don’t know
how people are going to take it. I’ve had
incredible support from my colleagues
and friends, but there were also people
who have said wicked things—there’s
a lot of animosity out there. It’s not
simple; it’s not straightforward.”
And yet, thanks to her breaking the
silence, she is widely credited with helping
to lift the stigma often associated
with mental illness. “That she has been
so accomplished has got to challenge
people’s assumptions about bipolar disorder,”
says Karen Swartz.
Despite her severe illness, Jamison
is undaunted. “I’ve had a great life and
would have no cause to complain at all,”
says Jamison. “One of the things my
mother believed is that you absolutely
have to play the hand you’ve been dealt
and not sit around wishing your cards
were different. In life, you are dealt high
cards and low cards, but it’s really about
how you put them on the table and use
them to help other people.”
JANE MARION is a senior contributing
writer for Baltimore.
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