February 15, 2006

Mental illness isn't always the same as craziness

The brain is a complicated organ, and it can, from time to time, just like other organs, get sick. It doesn't mean you're insane. More typically, the emotions are affected, not the senses or reason. What we call depression today was called a nervous breakdown neurasthenia at various points in the past. Sometimes it's caused by something obvious, such as losing a loved one or loneliness, other times, we don't know what sets it off. It's seldom permanent.

Benedict Carey's NYT article "West Wing Blues" demonstrates that mental problems can happen to even the most successful people. And, often, they can fight back:

As a young man, Abraham Lincoln experienced bouts of despair so profound that friends were concerned he might commit suicide.

Ulysses S. Grant, the general under Lincoln who later rose to the presidency, often avoided social occasions and retreated into alcohol.

All told, almost half of American presidents from 1789 to 1974 had suffered from a mental illness at some point in life, according to a recent analysis of biographical sources by psychiatrists at Duke University Medical Center. And more than half of those presidents, the study found, struggled with their symptoms — most often depression — while in office.

"What is hopeful about this is that it is evidence that people can suffer from depression or other mental problems and still function at a presidential level, if not at their best," said Dr. Jonathan Davidson, who, along with Dr. Kathryn Connor and Dr. Marvin Swartz, cataloged symptoms from presidential papers and biographies, and identified those disabling enough to qualify as disorders. They reported their findings in the current issue of The Journal of Nervous and Mental Disease.

The authors acknowledge the hazards and uncertainties of diagnosing from such a distance. But the lifetime rate of mental illness they found in these 37 presidents is identical to that found in some surveys of the American population.

In some cases, they included problems not usually thought of as mental disorders: William Howard Taft, the 27th president, for example, suffered from difficulty breathing while asleep — most likely because of a disorder known as sleep apnea — and often dozed off during important meetings.

In most cases the disorders recall the men: the indefatigable Theodore Roosevelt and Lyndon B. Johnson showed symptoms of the manic energy that characterizes bipolar disorder; Richard Nixon drank heavily through the Watergate period; and Calvin Coolidge plunged into a pit of depression after his teenage son died of an infection.

TR would more reasonably be considered a hypomanic, that lucky state where you have consistently excellent energy, confidence, and happiness. I'm not aware of him ever suffering a full blown manic attack. He didn't suffer from depression until the last two years of his life, until after the death of a son in WWI.

The report also serves as a caution against judging troubled souls too early. "To contemporaries well acquainted with Madison, Hayes, Grant and Wilson," the authors write, "it must have appeared that, as young men, these individuals were doing very little with their lives."

From the abstract:

Eighteen (49%) Presidents met criteria suggesting psychiatric disorder: depression (24%), anxiety (8%), bipolar disorder (8%), and alcohol abuse/dependence (8%) were the most common. In 10 instances (27%), a disorder was evident during presidential office, which in most cases probably impaired job performance.

He didn't make it to the White House, but billionaire H. Ross Perot was obviously roaring through manic-depressive cycles during his extraordinary run for President in 1992. Early in the year he suddenly announced he intended to be elected President as an independent, and by the spring he was actually leading Bush and Clinton in the polls. Then, his mood collapsed and he went into seclusion for the entire summer, muttering paranoid nonsense about government operatives disrupting his daughter's wedding. In the fall, he re-emerged as energetic as before and won an impressive 19% of the vote, the most for a 3rd party candidate since Teddy Roosevelt. It seemed to me that Perot was too manic-depressive to be President, but few in the media ever brought it up.


My published articles are archived at iSteve.com -- Steve Sailer

No comments: