More Thoughts on Manic-Depressive Illness

My last post, written after reading Kay Redfield Jamison's An Unquiet Mind: A Memoir of Madness and Night Falls Fast: Understanding Suicide, ended with three questions:

• How can I conceive of a God who would design our brains to be capable of the horrifying pain of an unraveling mind as happens in severe mental illness?
• What does God expect of a person with severe mental illness?
• What does God expect of the spouse and family of a person with severe mental illness?

Another way of asking the first question is to ask how severe mental illness fits with a view of the world as gracious, as opposed to hostile or indifferent. As I think about this, I realize that Kay Jamison herself provides an answer. She says that, as excruciatingly painful as psychosis and depression can be, this is out-weighed, for her, by the joy she has experienced in life. Kay actually values her mania, at least in its milder manifestations, and she sees her depression as the price she has to pay for the mania.

When Kay first experienced symptoms of manic-depressive illness in her teens, the mania was not extreme. It allowed her to think fast, to feel euphoric, and to be exceptionally productive and creative. In subsequent years, the mania become more extreme, but Kay remembers even some of her psychotic visions with joy. Here is what Kay says on pages 90-91 of An Unquiet Mind:

People go mad in idiosyncratic ways. Perhaps it was not surprising that, as a meteorologist's daughter, I found myself, in that glorious illusion of high summer days, gliding, flying, now and again lurching through cloud banks and ethers, past stars, and across fields of ice crystals. Even now, I can see in my mind's rather peculiar eye an extraordinary shattering and shifting of light; inconstant but ravishing colors laid out across miles of circling rings; and the almost imperceptible, somehow surprisingly pallid, moons of this Catherine wheel of a planet. I remember singing "Fly me to the Moons" as I swept past those of Saturn, and thinking myself terribly funny. I saw and experienced that which had been only dreams, or fitful fragments of aspiration.

Was it real? Well, of course not, not in any meaningful sense of the word "real." But did it stay with me? Absolutely. Long after my psychosis cleared, and the medications took hold, it became part of what one remembers forever, surrounded by an almost Proustian melancholy. Long since that extended voyage of my mind and soul, Saturn and its icy rings took on an elegiac beauty, and I don't see Saturn's image now without feeling an acute sadness at its being so far away from me, so unobtainable in so many ways. The intensity, glory, and absolute assuredness of my mind's flight made it very difficult for me to believe, once I was better, that the illness was one I should willingly give up.

When Kay first began to take lithium to control her psychosis and stabilize her moods, she was appalled at the flatness of her emotional life. She now takes a lesser dose of lithium that controls the extreme fluctuations in mood but does allow for some mood amplification followed by some mood dampening, in other words, slight mania and slight depression. The dampening is worth it to Kay because of the benefits from the amplification. Apparently, you can't have the amplification without the following dampening--you get the full cycle or none.

So, back to God. Here are some things I notice.

• ABUNDANCE. God deals in abundance--there is an abundance of beauty and variety in minerals, plants, and animals. Within that abundance, there are things that I as an individual may not like--poison ivy, mosquitoes, manic-depressive illness. These are, nonetheless, part of the abundant whole.
• EXTREMES. God deals in wide ranges with vast extremes--from sub-atomic particles to super-nova, from the monotone gray of an overcast sky to a flaming sunset, from the silent rabbit to the roaring lion. Manic-depressive illness is an extreme of human experience.
• NATURAL PROCESSES. God deals with natural processes that unfold dispassionately. The universe does not reconfigure itself to avoid harming a person in the path of an avalanche, a tornado, or an out-of-control automobile. Manic-depressive illness is part of the gene pool and manifests itself in individuals with those genes.

It may be that, if God had to edit out everything that humans find unpleasant or harmful on the physical plane, the world would not be as beautiful, stunning, and fascinating.

It also strikes me that God's intentions are not necessarily our intentions. I, for example, consider a good life to be a life of financial security, physical comfort, and mental interest. God, I expect, considers a good life to be one of compassion and character growth.

I probably don't need to concern myself with the question about what God expects of a person with manic-depressive illness because I am not that person.

As for the spouse and family of a person with manic-depressive illness, it strikes me that our U.S. American society is at the far extreme of individualism, expecting individuals to manage their own problems and expecting families to manage their family members on their own. But, just as it takes a whole village to raise a child, it probably takes a whole village to contain a person with manic-depressive illness. Instead of making this the responsibility of an overwhelmed spouse or family, if this were considered the responsibility of the whole community, then the weight would be far less, and compassionate and workable solutions would far more likely emerge.