Second Chances (motif)
Throughout her memoir, Jamison gets and exalts in a number of second chances: in love, as she meets David and realizes that she can have a healthy relationship while sick; in her career, as she chooses to pursue her Ph.D. once she realizes that medical school isn't feasible; and in life, as she survives a suicide attempt and gets the chance to rebuild herself. Jamison's experience with manic-depressive illness has given her an extra appreciation for the ways that objects, experiences or people can come to mean new things with time. This is shown when she realizes that, even though lithium severely inhibits her ability to read, she can still enjoy the children's books she loved so much as a child: "They gave me a second chance, a second wind of pleasure and beauty" (95).
Choices (motif)
Jamison must learn to choose health and stability. One of the central conflicts of this memoir, and indeed of treating manic-depressive illness at all, is that of medication compliance. While choosing to comply with one's prescriptions can be spun as another kind of problem—a problem of the side effects, for example—it is at its heart a question of choosing health and life over sickness and, often, death. This is demonstrated in the following passage, where Jamison's psychiatrist makes the choice clear to her: "The issue was not whether lithium was a problematic drug; it was not whether I missed my highs; it was not whether taking medication was consistent with some idealized notion of my family background. The underlying issue was whether or not I would choose to use lithium only intermittently, and thereby ensure a return of my manias and depressions. The choice, as he saw it—and as is now painfully clear to me—was between madness and sanity, and between life and death." (102)
Despair for the future (motif)
In the depths of Jamison's depressions, a recurrent feeling is despair over the future, as seen vividly in this quote, taken from her psychiatrist's notes after one of their sessions: "Despairs for the future; fears recurrence and fears having to deal with the fact that she has felt what she has felt" (111)
The United Kingdom (symbol)
Jamison goes to the United Kingdom many times over the course of her life and career. The UK comes to symbolize a place of replenishment, where she is able to escape the pressures and stressors of her life in the United States. It is where she goes to cope with her sickness as well as to partake in old traditions unavailable to her in the US. She discusses the healing aspect of England following David's death in the following passage: "It took my year in England to make me realize how much I had been simply treading water, setting on surviving and avoiding pain rather than being actively involved in and seeking out life. The chance to escape from the reminders of illness and death, from a hectic life, and from clinical and teaching responsibilities was not unlike my earlier year as an undergraduate in St. Andrews: it gave me a semblance of peace that had eluded me, and a place of my own to heal and mull, but most important to heal." (157)
Darkness (symbol)
Throughout her memoir, Jamison uses the symbol of blackness to discuss the negative feelings and moods she would come to experience. She uses the language of blackness or darkness to indicate feelings of depression and often juxtaposes these feelings with the 'lighter' experience of mania. She also uses blackness or darkness as a way to establish the sinister nature in which she views her sickness at its worst. At its worst times, her sickness became a large and oppressive antagonist. Although the sickness comes from within Jamison, she uses a symbol of darkness in order to separate it from herself. so that it might become a foe: “Not surprisingly, perhaps, when both she and I had to deal with our respective demons, my sister saw the darkness as being within and part of herself, the family, and the world. I, instead, saw it as a stranger; however lodged within my mind and soul the darkness became, it almost always seemed an outside force that was at war with my natural self” (14).
Dr. Jekyll and Mr. Hyde (allegory)
Jamison often discusses her sickness as a destructive force both within herself and completely out of her control, much like the relationship between Dr. Jekyll and Mr. Hyde in Strange Case of Dr. Jekyll and Mr. Hyde by Robert Louis Stevenson. When discussing her suicide, Jamison relates her manic-depressive illness to Mr. Hyde, writing "I understand why Jekyll killed himself before Hyde had taken over completely" (113). When Jamison attempts to commit suicide, it is largely out of desperation that her illness will take control of her life forever.
