Thoughts & Questions about Manic-Depressive Illness

I have recently read two books by Kay Redfield Jamison: An Unquiet Mind: A Memoir of Moods and Madness and Night Falls Fast: Understanding Suicide. Kay is a Professor of Psychiatry at the Johns Hopkins School of Medicine. She also has manic-depressive illness, which she is able to control by taking lithium.

Kay describes what it is like for someone with severe mental illness to watch their mind unravel. It is absolutely horrifying to be trapped inside an unraveling mind. One cannot control one's thoughts, which race so fast that nothing makes sense. One sees and hears things that aren't there, often very frightening things. One watches the distress on the faces of one's family and friends, who simply cannot comprehend one's behavior. One behaves in ways that cause one intense shame.

One often ends the pain by committing suicide.

Some of the things Kay describes, particularly concerning mania, seem incredible to me. Someone in the early stages of mania feels on top of the world. She feels invulnerable. She is full of over-the-top energy, putting her on a high. In this state, things make sense that would never make sense in a normal mood. A person in mania will often dress provocatively, initiate unwise sexual encounters, and spend thousands of dollars on unneeded merchandise. When the mania ends and a normal mood returns, this person is faced with the shame of what she has done and with the bills she has accumulated for appalling purchases that made perfect sense in the manic state but which now make no sense at all.

If the illness is not treated, it escalates. The mania becomes so intense that the person cannot stay still, cannot sleep, and cannot control her cascading thoughts. The person may become paranoid and even violent.

Eventually depression follows the mania with its all-encompassing heavy blackness that sucks all joy from life. Life becomes unbearable, and suicide is often the result. The pain of an unraveling mind and the inability to do anything to stop it is excruciating.

Yes, there are now treatments for manic-depressive illness, but for centuries there were no treatments, and even today, not everyone responds to the treatments. For some people, the current treatments don't work.

Descriptions of losing one's mind--as happens in manic-depressive illness, in depression, in schizophrenia, and in Alzheimer's disease--are truly horrifying. For me, this raises an important question: How does God fit into this? How can I conceive of a God who would design a brain capable of such horrible suffering?

I can at least begin to understand other types of physical suffering that keep the mind intact. People are able to endure these, sometimes with great grace and courage. I can also begin to understand suffering inflicted by humans. Again, people do endure this, sometimes with remarkable love and forgiveness. But how does one endure an illness that causes one's very mind to unravel. Without a functioning mind, with what does one do the enduring?

So it's hard for me to envision a way of seeing God that includes severe mental illness. It makes me wonder why on earth God couldn't design a brain incapable of such unraveling.

And what does God expect of someone with severe manic-depressive illness? It's clear that a person in mania often violates normal standards of morality in the areas of sex, finances, and kindness to others.

And what does God expect of the spouse of someone with manic-depressive illness? I don't see how it's possible to live with a manic-depressive spouse who has sex with others, runs up impossible bills, and is violently paranoid. Manic-depressive illness is devastating to the spouse, family, and friends of the person with the illness. A good friend of my mother's had a daughter with severe mental illness who simply refused to take medication to control her illness and absolutely drove her family nuts with her uncontrollably wild behavior. She also had a number of unwise pregnancies and brought babies into the world with no means of providing for them. Yes, I understand that a person with manic-depressive illness is truly ill, but what is the person's family supposed to do with a person who causes utter havoc in the lives of everyone around her? Is the family supposed to just exist in utter havoc? What does God expect of the spouse and the family in this situation?

So these are my 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?