Kay Jamison explains her willingness to discuss her husband’s last years, and how she was helped through her own grief by the work of other writers.

Question: Was it difficult to write the story of your husband’s death?

Key Redfield Jamison: It was by orders of magnitude the hardest thing I've written. An Unquiet Mind wasn't hard to write in terms of the actual writing of it. With An Unquiet Mind it was extremely hard to decide to write it; there were a lot of things that made it difficult to go public and that was very anxiety-producing. But writing the book that I wrote now, nothing was the same. It was difficult, it was really hard. It was hard writing and it was hard to decide to write it, but it was necessary.

Question: Why was it a necessary book to write?

Key Redfield Jamison: I think because I had written An Unquiet Mind, it was -- that book I saw very much as a combination of advocacy and for mental illness but also trying to describe what the experience of bipolar illness was like. In my experience, with my own family, even though my mother's deeply empathetic, wonderful woman, she had no way of conceptualizing what mania was; for example, what I felt like when I was manic or suicidally depressed. So it was a descriptive book and with this book, with Nothing Was The Same, this was really I think more along the lines of an elegy which is a very, very different sort of thing. With writing memoir about mental illness there have been a lot of memoirs in the last ten years, 15 years, but elegies have a history of thousands of years.

It's a wonderful aspect of grief that it is so much a part of the human condition, that it is so universal, that people have written about it. So it's a very different kind of writing, it's a very different kind of thinking.

Question: What’s the difference between depression and grief?

Key Redfield Jamison: I mean, in some cases, some people do get depressed in the middle of their grief and they really need to be treated for depression. But what I wanted to do was make the distinction as many people have is that grief is fundamentally a healthy sort of thing; it's human, it's not a disease, it's nothing you want to medicalize. You don't want to treat it away, you don't want people to suffer unnecessarily, but you certainly don't want to take away the experience of that kind of re-establishment of a relationship.

And depression, the experience is unremitting for the most part. I mean, it's not like you don't get very much of a break from depression. Grief is different. Grief is much more tidal; it comes and goes. Anybody who has grieved knows and will describe that just being swept by a wave of grief. You think that you're over it, you think you're to the other side, and then all of the sudden you get blindsided by a wave of grief and each one of those waves of grief I am convinced serves a good function in the mind and heart, in the terms of forcing you to have to see somebody in a slightly different light. Each time is a slightly less painful.

Depression is just unremitting, it is much more disruptive of sleep, it's -- you're much more likely to be impaired intellectually with depression. It just goes on and on and people think about suicide. Grief is -- can respond to the environment.

It can respond to solace. One of the things that's pretty interesting is that literature does help. I think that when you're depressed, you can't concentrate long enough and well enough to read for the most part; some people can, but by and large people -- that's one of the first things that goes, is the capacity to read meaningful literature. With grief, that's true. For awhile you can't read, but then you really are **** solace. From friends, from family, from colleagues, from the rights of church, whatever it is, music, poetry, and in my case, I turned more to literature and I found it immensely helpful.

Question: Which authors were helpful to you as you grieved?

Key Redfield Jamison: Well I had read Tennyson's "In Memoriam" when I was 17 years old, in high school, and I had a psychotic depressive break at that time. I read him and I stood in awe of his capacity to capture that rhythms of life. The despair and the regeneration and the hope, and I suppose that there is something in Tennyson and I turned to him after my husband died, that you read this and you're in the process of somebody who has been wrecked by pain.

There is none of the kind of tidying up, it is agonizing pain and he doesn't make any apologies for that whatsoever. And he goes over -- it's a poem that was written over nine years, and over the seasons; Christmas to Christmas to Christmas, and the tolling of the bells and each time there is a different tolling of the bells, each time there is a different aspect to the Christmas season. There is something in that, to me, that captures grief. Each year it is different.

Question: Is grief a physiological, treatable experience?

Key Redfield Jamison: I don't think grief of grief in a medical way at all. I think that I and many of my colleagues, are very concerned when grief becomes pathological, that there is no question that grief can trigger depression in vulnerable people and there is no question that depression can make grief worse. All those people you really want to treat, but overwhelmingly people will do well by grief. I mean, it's the furthest thing from a medical condition; it is a human condition, it is from literally the first death, someone mourned. That wasn't sick, that's our capacity to appreciate that -- what we are missing. So I think it's a terrible thing to think of it as in anyway as pathological; it can become pathological. Again, I think that I just came out with a respect for grief that I never thought I would have.

Question: How do you pick up and move forward after losing a spouse?

Key Redfield Jamison: With incredible difficulty. I think the initial days and weeks are protected a bit by shock, that society tells you there are certain things you have to do; there are certain legal things you have to do, there are certain -- the funeral, all those things. The arrangements that keep you kind of occupied up to a point. It's those devastating moments when you start going through clothes and letters and correspondence and keys and all those private things that were someone else's that you learn different things. It is deeply private, there's no question about it. I think that people understand up to a point but nobody can understand because for each person that loses that person, the memories are **** sarcastic. You are the that remembers what your relationship was and that is incredibly private and you are the one who recognizes the things that you'll no longer have, that you're going to have to do things on your own. They are just -- you just can't rely on someone's support and love, you're going to have to do it yourself.

I think one thing is just to recognize up front that it's going to be really hard and, secondly, that other people can be really wonderful. If you've got good friends, it's great. And also, again, to reach out for solace because I do think you can get solace; sometimes through music, sometimes through religion, sometimes through reading, sometimes through friends, but usually through friends and family.

Question: What is it like to share your loss so openly?

Key Redfield Jamison: Well it's very odd and one of the things that I wrote about in my current book was the experience of going public in An Unquiet Mind and the public and professional repercussions of that, the loss of privacy. One of the things that was very hard for me, aside from the professional aspects of talking about having been psychotic and having tried to kill myself and realizing that I was going to face my colleagues in academic medicine, was that I was really brought up like most people who really your personal life private. And I was brought up in the military and I'm an Episcopalian and those things don't make you very likely to put your private life out there and I was brought up in a family where you kept -- a really warm family; I love my family deeply, but you sort of got a grip and you didn't talk.

My husband, oddly enough, who was a very reserved man, was the one who really pushed me about An Unquiet Mind because he said -- I said on the one hand I'd had all these reservations of privacy and professional things and on the other hand I thought it was the right thing to do as an advocate that people needed to talk about these things. He studied schizophrenia and he treated people who had schizophrenia and he said, "There is an obligation to do it and I will back you, and of course it's personal, of course it's private, and of course it's going to be excruciating for you." For the first 30 or 40 times I got up and talked about my manias and depressions, all I could think of was my grandmother with her white gloves and her hat and I would just be mortified. I was thinking, "What am I doing talking about this? How could I possibly talk about having tried to kill myself? How could I do this?"

And yet at the end of the day, you do it because you hope that it will help. It will be one part, one small piece, in making people more comfortable about it. If people can talk about having breast cancer, why can't people who have mental illness talk about mental illness? Until we're able to do that, we're not going to be treated with the same kind of respect for our diseases as other people. And my husband saw that absolutely equivocally. An actual **** out of the first part of the book is about how he dealt with my own illness but also how he encouraged me and I think that's where the role of other people -- nobody has a disease alone, you have a disease with other people around you and I was very fortunate in having this particular person in my life.

Recorded on: September 30, 2009