Jamison spends the rest of Part 2 discussing her life after she begins therapy. It is a story of failure, as her avoidance of medication compliance deeply costs her, as well as one of success—as she receives tenure from UCLA.
Jamison’s mental state begins to worsen. She finds herself in a mania characterized by “glorious delusion”; she is flying high and fast. She can recall this time clearly, and compares it to gliding through space: “an extraordinary shattering and shifting of light inconstant but ravishing colors laid out across miles of circling rings” (90). She is flying through Saturn’s rings as she experiences “that which had been only dreams” (90). She loses this experience after her medication takes hold and her psychosis clears, but she remembers it forever as vividly as any other memory. In the rearview mirror, this time takes on a new meaning. She is melancholic for it and for her time among stars: “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” (91). This makes it very difficult for Jamison to stick to her medication. She cannot believe that this pleasure is one she should so easily give up.
Part of the reason Jamison refuses to comply with her medication is an inability to believe that what she has is actually a disease. Moods are such an essential part of life and experience that “even psychotic extremes in mood and behavior somehow can be seen as temporary, even understandable, reactions to what life has dealt” (91). It proves to be extremely difficult for Jamison to adjust to her new life on medication. The side effects combined with psychological reasons to disdain the medication, and she stops taking it many times after it is prescribed for her. Some side effects she experiences are: severe nausea and vomiting, trembling and slurred speech at moments of high toxicity which would make her seem as though she were drunk or drugged, and losing her ability to read, comprehend and remember writing. This last side effect proves to be the most devastating to Jamison, and because of it she “did not read a serious work of literature or nonfiction, cover to cover, for more than ten years” (94). She finds solace in poetry and children’s books, which remain in her grasp. She misses reading desperately and feels as though she has “no choice but to live in the broken world my mind had forced upon me” (96).
But it is psychological issues that ultimately lead Jamison to repeatedly stop taking her medication: “I simply did not want to believe that I needed to take medication” (98). Jamison had become addicted to mania, dependent on her high moods. Her sister agrees with her hesitation. She too suffers from manic-depression, but strongly believes that to alleviate one’s suffering with chemicals is to sacrifice the necessary suffering of one’s soul. She tears into her sister for “capitulating to Organized Medicine” by “lithiumizing away my feelings” and asserts that she believes Jamison should “weather it through” her highs and lows (99). She cycles through many instances of dropping and picking up lithium, but eventually, Jamison recognizes the need to stay loyal to her medication. Once on a stable regimen, she must finally confront the bitter consequences of her past refusal of treatment.
The Charnel House
Jamison falls into a deep depression that lasts a year and a half. She is deeply miserable, and every day is a chore that she must endure without joy or enthusiasm. Her self-confidence plummets. Suicidal thoughts constantly arise and must constantly be battled. The hopelessness of depression continually asks her, “What is the point of going on like this? If I can’t feel, if I can’t move, if I can’t think, and I can’t care, then what conceivable point is there in living?” (111). Death becomes a constant companion, and everything reminds her of her potential end. She refuses to enter a psychiatric ward, terrified of being locked into somewhere she doesn’t have the key to, and of the potential professional consequences that hospitalization would cause. Soon, she resolves to kill herself. She tells herself that she is doing her friends and family a favor—killing herself to save their lives, like the pilot she watched die in her youth, so that they might be spared from the turmoil her illness caused them.
She decides to overdose on lithium and takes anti-emetic medication to stop herself from vomiting it up. She takes handful after handful of pills and curls up in her bed, waiting to die. Thankfully, she didn’t account for the fact that a drugged brain makes different decisions than an alert one, and when the telephone rings, she turns instinctively to answer it. Her slurred voice alerts her brother, who calls her psychiatrist. Her life is saved. In the months that follow, she is nursed back to health by her friends, family, and psychiatrist.
Jamison spends the rest of this section discussing the violence that arose in her mania and depression. She holds that violence is not a trait typically associated with women, and so her gender became part of the lens through which she reacted to violent episodes. These episodes in which she lost all control of herself terrify Jamison and cause her deep shame. After her suicide attempt, Jamison had to reconcile her notion of herself "as a young girl who had been filled with enthusiasm, high hopes, great expectations, enormous energy, and dreams of love and life, with that of a dreary, crabbed, pained woman who desperately wished only for death” (120). But after these violent episodes, she must reconcile her notion of herself “as a reasonably quiet-spoken and highly disciplined person, one at least generally sensitive to the moods and feelings of others, with an enraged, utterly insane, and abusive woman who lost access to all control or reason” (121).
Here, Jamison discusses achieving tenure at UCLA. It is a vital achievement for her, and in many ways, it demonstrates the progress she has made past her suicide attempt. It also shows her absolute strength—that she was able to remain in good standing with the University through all of her struggles is a true achievement. Of these years, Jamison writes, they were "marked by struggles to stay sane, stay alive, and to come to terms with my illness" (124). Tenure comes to mean more than itself, it becomes a time of "both possibility and transformation," as well as a "symbol of the stability I craved and the ultimate recognition I sought for having competed and survived in the normal world" (125). She focuses her career on manic-depressive illness and opens an outpatient clinic for those suffering from mood disorders, the UCLA Affective Disorders Clinic.
Once again, we see Jamison attempt to describe indescribable and intangible moments of madness. Although her literal experience is not one of flying through Saturn’s rings, she uses this imagery in order to convey the absurdity and impossibility of madness. She must overstate in order to convey how her daily life changed. Mania did not take her flying through the skies, but it did make her feel as though she could reach the stars. All of the fancies of her imagination became reality. This is part of the addictive nature of mania - it imbues one with power while making life incredibly fun.
Jamison spends a while discussing the falling out and subsequent distancing that occurs between her and her sister over lithium. Her sister comes to embody all hesitation she has about her medication numbing her experience of life. Ultimately, Jamison decides that she cannot be too near someone “representing, as she did, the temptations residing in my unmedicated mind; the voice of upbringing that said one should be able to handle everything by oneself; the catnip allure of recapturing lost moods and ecstasies” (99). Her sister represents the decision she has to make to commit herself to her medication. She is the personification of her hesitation, but ultimately the very physical reality of someone she has had a long and contemptuous relationship with helps her make her decision.
In the discussion of her recovery, Jamison touches upon the care her mother provided her throughout her depression and suicide attempt. This causes her to ruminate on the inheritable nature of the disease, a common theme in her relationship with her own illness. She compares her illness to a horse: “It was as if my father had given me, by way of temperament, an impossibly wild, dark, and unbroken horse” (119). Her illness is a nameless, wild, and unpredictable force. Although she doesn’t inherit illness from her mother, she does inherit the capacity to deal with it. Her mother teaches her how to handle her sickness, “to gentle it,” and taught her that “the beast was best handled by turning it toward the sun” (119). An Unquiet Mind is, as much as it is anything else, a rumination on the people we become despite or because of the influences of our parents.
Self-acceptance is another theme that emerges in this section. Jamison writes: “the discrepancies between what one is, what one is brought up to believe are the right way of behaving towards others, and what actually happens during these awful black manias or mixed states, are absolute and disturbing beyond description” (121). Illness turns Jamison into a woman she doesn’t recognize, and it is a person she is inclined to hate. It is certainly one she is deeply afraid of.