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Book Review

Night Falls Fast: Understanding Suicide
by Kay Redfield Jamison

Published by Alfred A. Knopf., Inc., 1999; 432 pages Hardcover: $26.00; Reviewed by; Judith Paterson, PH.D. and David Seaman, NAMI Literature Committee

Kay Redfield Jamison is one of the lucky ones. Her psychotic episode and suicide attempt when she was 28 years old changed her life without ending it. Helped by Lithium for her bipolar illness-plus a loving family and an insightful therapist-she went on to earn a Ph.D. in psychology and write books and do research on her illness. She is now professor of psychiatry at the Johns Hopkins School of Medicine and an ardent spokesperson for the rational and informed treatment of mental illness.

Her fourth book, Night Fails Fast: Understanding Suicide, is in many ways her best. Her first, which was coauthored, has become the standard text on bipolar disorder, also called manic-depressive illness. Since then her books have addressed an ever-widening audience of consumers, professionals, and general readers. With each new book, her writing has become more elegant and her message more urgent.

The somewhat scholarly Touched with Fire: Manic- Depressive Illness and the Artistic Temperament sold a surprising 300,000 copies, and opened a wedge of interest in and understanding of affective disorders. Her eloquent memoir, An Unquiet Mind: A Memoir of Moods and Madness, connected her own experience to the growing base of scientific information about the genetic and biochemical sources of her "florid madness." The book stayed on the New York Times best-seller list for over five months.

Night Falls Fast attacks the inability, or unwillingness, of both the public and its policy-makers to deal with suicide, its causes, the potential for prevention, and the rate at which it kills. If her other books were a cry in the wilderness, this one is a shout that neither the general public nor the policy-makers want to hear. Although suicide is a leading cause of death world-wide, we know less about how biology and environment interact to bring it about than we do about the causes of AIDS or cancer.

Dr. Jamison is especially concerned with suicide among people under forty-and for good reason. Suicide in the young has more than tripled since 1955. In the United States, it is the third- leading cause of death for people between 15 years old and 19 years old and the second-leading cause in women between 15 years old and 44 years old. One of ten college students has considered suicide as has one of five high-school students. Since 1987, 18,000 more young men in the United States have died from suicide than from AIDS.

Her messages are clear and often repeated: 1 ) suicide is a massively neglected public health issue; 2) acute psychiatric illness is the single most common and dangerous trigger of suicide; 3) a vast breach exists between what the experts know and what we, as a society, do to prevent suicide and treat the people most likely to attempt it.

What particularly distinguishes Jamison's work is the magic that eloquent writing and great passion bring to the presentation of actual material. In her skilled hands, cold facts come alive to illuminate the human condition. Her depiction of the psychological suffering of those who attempt or commit suicide is surpassed only by her image of the bottomless grief and confusion endured by those left behind.

Jamison has masterfully collected, synthesized, and interpreted a baffling array of scattered data. Her presentation of the unfolding mystery of the brain chemistry involved in mental disorders and suicide is precise and clear-and reads like a good whodunit. An appendix offers a useful list of sources (including NAMI) of information on suicide, mental illness, and alcohol and drug abuse. Extensive endnotes provide additional information to specialists without hampering the book's appeal to the general reader.

~ Reprinted with permission from the Survivors After Suicide Newsletter.
A program of the Didi Hirsch Community Mental Health Center: Suicide Prevention Center
4760 S. Sepulveda Blvd. Culver City, CA  90230
Jan/Feb/March 2000 Issue.