"Others imply that they know what it is like to be depressed because they have gone through a divorce, lost a job, or broken up with someone. But these experiences carry with them feelings. Depression, instead, is flat, hollow, and unendurable."
In this passage, Jamison makes it clear that she believes only those who have lived with clinical depression might know the implications of its despair. Depression has nothing to do with emotions, it is an enduring pain that sucks all meaning out of existence. It affects all aspects of daily life. When Jamison describes her illness in such detail, she hopes to show how devastating it can be.
"There is a particular kind of pain, elation, loneliness, and terror involved in this kind of madness."
Jamison attempts to describe the feeling of her manic episodes. To someone without the disorder, the basic idea—a massive high followed by a devastating low—is easily understood, but they could never appreciate the depth of actually experiencing this devastating cycle on a frequent basis. When experiencing mania, one is not experiencing the same world that others inhabit.
"It took me far too long to realize that lost years and relationships cannot be recovered, that damage does to oneself and others cannot always be put right again, and that freedom from the control imposed by medication loses its meaning when the only alternatives are death and insanity."
This passage occurs in the midst of a discussion on the issue of medication compliance among those with manic-depressive illness. Often, those who war against their medication do so because they feel as though the medication dulls their reality, inhibiting the high pleasures of mania and often even the smaller pleasures of daily life. Jamison writes that the seduction of mania inhibited her from relying on her medication for a long time. Only after a long time was she able to learn that sanity and stability are far more precious than the manic highs ever could have been, as a beautiful destruction is still destruction. This wisdom only came after decades-worth of pain—and it is Jamison's goal to share this knowledge so that others might avoid suffering in the same way. The lesson learned in this passage is one of the key moments of growth and development for Jamison's character.
"Moods are such an essential part of the substance of life, of one's notion of oneself, that even psychotic extremes in mood and behavior somehow can be seen as temporary, even understandable, reactions to what life has dealt. In my case, I had a horrible sense of loss for who I had been and where I had been. It was difficult to give up the high flights of mind and mood, even though the depressions that inevitable followed nearly cost me my life."
Jamison considered the choice between taking mood-stabilizing medication and further sickness as one that necessitated a sacrifice in the form of the permanent dulling of her experience and vitality. When the evidence of one's sickness is an expression of self that all other people convey, to attack that sickness feels like attacking one's substance. Jamison was never able to truly contend with this loss, although she was able to eventually get to a place where she once again experienced the highs and lows of her daily moods.
"Everything previously moving with the grain is now against—you are irritable, angry, frightened, uncontrollable, and enmeshed totally in the blackest caves of the mind. You never knew those caves were there. It will never end, for madness carves its own reality."
To describe mania, Jamison uses dynamic imagery that is full of life: shooting stars, pumping blood and passionate lovers. Until the switch is flipped, mania causes feelings of invincibility. When it is eventually flipped and all the intense pleasures become to be too much, the darker truth of mania becomes clear. In this passage, Jamison makes it clear that whatever pleasures mania might aford, a dismal pain always awaits. She is out of control and stuck in her own head. The most terrifying part of mania is the belief that it will never cease.
"There was a time when I honestly believed that there was only a certain amount of pain one had to go through in life."
At one point, Jamison would have liked to believe that because manic-depressive illness had brought such misery to her life, it should have been kinder to her in other ways. The hard truth she has to learn is that the fact of her illness can't protect her from the other heartaches in life—it is a part of her that she needs to carry through the natural ups and downs of life.
"Manic-depression distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live. It is an illness that is biological in its origins, yet one that feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide."
One of the critical aspects of mania is how pleasurable it can seem to those who experience it. It can bring a lot of advantages to those who experience it—and this will often discourage manic-depressives from getting help or from complying with their medication. In order to treat manic-depressive illness, mental health professionals must understand this aspect of mania in order to understand the unique relationship manic-depressives have with their illness. Even though it can completely devastate one's life, manic-depressive illness is not so easily accepted to be an illness or negative force in the life of those who experience it.
"As has been true a thousand times since, my curiosity and temperament have taken me to places I was not really able to handle emotionally, but the same curiosity, and the scientific side of my mind, generated enough distance and structure to allow me to manage, deflect, reflect, and move on."
At the center of Jamison's memoir exists a critical duality. The relationship between the scientific and emotional can seem to be non-existent, but Jamison is able to embody both sides of herself and use these contrasting natures to her advantage.
"Somehow, like so many people who get depressed, we felt our depressions were more complicated and existentially based than they actually were."
Often, those who deal with mental health issues struggle with getting the help they need because they feel as though their issues are both personal and psychological. This can mean that their mental health gets to terrible levels before they get professional help, if at all.
"An ardent temperament makes one very vulnerable to dreamkillers, and I was more lucky than I knew in having been brought up around enthusiasts, and lovers of enthusiasts"
Jamison credits the encouragement she got as a child from the adults in her life as crucial in her path to becoming a scientist and author. As a very emotional child, she wouldn't have been empowered to follow her passion if she had faced adversity in doing so. Because she felt emotions so strongly, she would have felt hurt and discouraged all that more.
