A First-Rate Madness (8 page)

This isn't a settled debate, and these interpretations could be proven wrong. But if they're correct, they raise several questions. Why do positive illusions occur? Can we only arrive at realism through personal hardship? Or are some of us inherently more likely than others to become realistic? Is depression the royal road to realism?

We tend to assume linear relationships about most things. If some is good, we presume that more is better. But for many things, there is a curvilinear relationship: too little is harmful, so is too much; in the middle is just right. Scientists call this the inverted U-curve, but we can also see it in the fairy tale about Goldilocks and the three bears, where the girl is choosing between bowls of porridge or beds until she finds the ones that are just right. We might call this the
Goldilocks principle
.

In biology, it's generally accepted that anxiety is curvilinear. A moderate amount is good for the organism, keeping it vigilant, ready to defend itself or flee. Too little would make an organism vulnerable to predators or other danger; too much would cause excessive stress, making the organism less capable of handling danger. Illusion may play a similar role, suggests Taylor, noting that most of the patients in her studies of physical illness were not completely out of touch with reality; they were far from psychotic, or even neurotic. They were basically normal people, in touch with reality, who, in relation to their medical illness, were overly optimistic. They were, in short, only
a little
unrealistic. Too little illusion, she suggests, makes us all too realistic, seeing the stark hopelessness of the facts, leading us to give up. Too much illusion, as Freudians argue, renders us unable to respond properly to the world's challenges. Positive illusion in people with medical illness is a moderate, in-between amount that helps them cope with adversity even better, to prepare responses to life's challenges and to meet them.

 

 

WHETHER ONE SUCCEEDS by luck or skill, the absence of early hardship often has a later negative effect; when difficult times arrive, one is vulnerable. Early triumph can promote future failure.

In contrast, early failures repeatedly experienced by a person predisposed to depression inoculate against future illusion. Like the ascending group in the Yale experiment, later success fails to swell one's head because one remembers one's failures and respects the role of chance in life. The philosopher Karl Jaspers once said that how a man responds to failure determines who he will become. Through suffering, one becomes more realistic about the world, and thus better able to change it. Lincoln suffered immensely; Churchill suffered much; so did Sherman. Others who were luckier in their early lives—including, as we'll see later in the book, McClellan and Neville Chamberlain—failed where the mentally ill leaders succeeded.

Of course, everyone suffers. But life's pain can come harshly or gently, earlier or later. For the lucky, suffering is less frequent, less severe, and delayed until it can't be avoided. The unlucky, who, early in their lives, endure hardships and tragedies—or the challenge of mental illness—seem to become, not infrequently, our greatest leaders.

 

 

 

We remember Winston Churchill the orator, the fiery leader, the man who refused to submit to tyranny, and in whose stubborn refusal a nation, and then the world, found the strength to resist and ultimately prevail. Other prominent British statesmen had failed to fill the role that Churchill rode to glory. Churchill alone emerged as the great leader, the wartime genius, the deliverer of democracy. And although some acknowledge that he had mental problems, few appreciate the relevance of those problems to his prodigious leadership abilities. I believe that Churchill's severe recurrent depressive episodes heightened his ability to realistically assess the threat that Germany posed.

One might suppose that such a great man would have to be especially whole, healthy and fit in mind and body, full of mental and spiritual capabilities that escape average men. But Churchill belied this notion. In fact, he was quite ill, and his story, if belonging to a middle-class American living in the twenty-first century, would seem a sad but typical tale of mental illness.

AS WE'VE SEEN, mental illnesses are partly genetic, and rare is the person with a severe illness who doesn't have some evidence of the same in her family. In Churchill's case, we don't have to search far: his father died insane. Lord Randolph Churchill, the eighth Duke of Marlborough, had attained political prominence quickly, as his son would later, becoming chancellor of the Exchequer by his thirties. In normal circumstances, he would have been marked for the premiership, but Lord Randolph had character flaws that would disqualify him. One of these was a special fondness for sex; he had many dalliances throughout his life, and his will provided £20,000 to a Lady Colin Campbell, known as the “sex goddess” of Victorian England.

Lord Randolph probably developed neurosyphilis (called “General Paralysis of the Insane”), which can cause manic and psychotic symptoms. In the nineteenth century, such cases were indistinguishable from schizophrenia, as defined by modern medicine. (Penicillin was used from the 1940s onward to cure neurosyphilis, hence it could be considered the most effective drug ever used for psychiatric symptoms.) Until the later development of laboratory tests for the bacterium that causes neurosyphilis, it was impossible to determine which patient had psychosis caused by syphilis and which had schizophrenia.

It complicates matters that manic-depressive illness, which also causes psychosis, and was often mistaken for schizophrenia in the past, can make patients sexually impulsive and overactive during manic episodes, often engaging in prostitution, unsafe sex, or other indiscretions. Sexually transmitted diseases (like neurosyphilis) are thus more common in people with manic-depressive illness than in the general population. Cause and effect are difficult to disentangle. Was Lord Randolph insane because he had neurosyphilis, or was he insane because he was manic-depressive, or both?

Neurosyphilis isn't genetic. Yet we'll see that Lord Randolph's son Winston had a different mental illness, as did Winston's daughter Diana, who had a major depressive episode in 1952 and committed suicide in 1963 by barbiturate overdose (despite being active in suicide prevention efforts). Churchill's first cousin, called “Sunny,” also suffered severe depressive episodes throughout his life. Thus we find a familial predisposition to severe depression among Churchill's relatives, and the presence of suicide indicates that this familial mood condition was more than a mild hereditary taint.

 

 

THE NEXT STEP is to examine Churchill's actual symptoms. There is no doubt that he had severe periods of depression; he was open about it—calling it, following Samuel Johnson, his “Black Dog.” Apparently his most severe bout of depression came in 1910, when he was, at about age thirty-five, home secretary. Later in his life, he told his doctor, Lord Moran, “For two or three years the light faded from the picture. I did my work. I sat in the House of Commons, but black depression settled on me.” He had thoughts of killing himself. “I don't like standing near the edge of a platform when an express train is passing through,” he told his doctor. “I like to stand right back and if possible get a pillar between me and the train. I don't like to stand by the side of a ship and look down into the water. A second's action would end everything. A few drops of desperation.” The desperate man of thirty-five was no different from the hero at seventy. In 1945, soon after Churchill lost his bid for reelection, Lord Moran visited his patient to find him complaining about the balcony of his new flat. “I don't like sleeping near a precipice like that,” he said. “I've no desire to quit the world, but thoughts, desperate thoughts, come into the head.”

Blaming someone's sadness on external events is common sense, but that approach can be as often wrong as right. In Churchill's case, it would certainly be wrong; there is no question his sadness came from within. In 1910 he was at the peak of success, one that he would not better until three decades later, after having presumed that his best days were behind him. In 1910 he was happily married, wealthy, famous, politically powerful, and widely respected. He had no reason to be depressed, much less suicidal, and he never claimed otherwise.

Churchill suffered from more than depression, though. Many historians now acknowledge his depression, but they generally don't appreciate that when he was not depressed, Churchill's moods shifted frequently. He was never “himself,” because his “self” kept changing. When his depressive episodes subsided, he became another person—disagreeable and aggressive. His friend Lord Beaverbrook noted that Churchill was always either “at the top of the wheel of confidence or at the bottom of an intense depression.” Said his military chief of staff, General Ismay, “He is a mass of contradictions. He's either on the crest of the wave, or in the trough: either highly laudatory, or bitterly condemnatory: either in an angelic temper, or a hell of a rage: when he isn't fast asleep he's a volcano. There are no half-measures in his make-up.”

This frequent alternation between being somewhat up and somewhat down is exactly what psychiatrist Ernst Kretschmer meant by
cyclothymic
personality. Numerous physicians who knew Churchill or studied him have concurred on the view that he likely had a cyclothymic personality, which, as we now know, is biologically and genetically related to bipolar disorder. For instance, Lord Russell Brain, a famed British neurologist, knew Churchill for almost two decades and saw him as a patient for twenty visits. Lord Brain concluded that Churchill had “the drive and vitality and youthfulness of a cyclothyme.” (“We are all worms,” Churchill once commented, “but I do believe I am a glowworm.”)

These observations suggest that when he wasn't depressed, Churchill probably had hypomanic (mild manic) symptoms: he was high in energy, highly sociable and extraverted, rapid in his thoughts and actions, and somewhat impulsive. He would routinely stay awake late into the night, with a burst of energy after midnight when in his bathrobe, he would dictate his many books and conduct much of his other work. He was incredibly productive, not only serving as a minister or prime minister for decades, but writing forty-three books in seventy-two volumes (not to mention an immense body of correspondence). There is also his courageous military service as a young man, fighting in India and the Sudan, and (when working as a journalist) even becoming a prisoner of war in South Africa during the Boer War (he escaped). Churchill was a famed, sometimes infamous, conversationalist; he dominated social settings even years before his fame, talking incessantly, vigorously, interminably. His mind never stopped; he was always thinking, always plotting and planning, whether or not he had reason to do so. Franklin Roosevelt observed this feature of Churchill's personality after the landings at Normandy, part of which involved creating artificial harbors made by sinking old ships filled with concrete one on top of the other to break the rough coast. Said FDR, “You know, that was Churchill's idea. Just one of those brilliant ideas that he has. He has a hundred a day and about four of them are good.”

Since cyclothymic personality involves the constant alternation between mild manic (hypomanic) and mild depressive symptoms, and since Churchill also clearly had multiple severe depressive episodes, it seems to me that he meets the official current definition of biopolar disorder, type II (hypomania alternating with severe depression). It is also possible that he had more severe manic episodes, which we cannot fully document yet, in which case he would meet the diagnostic definition of standard bipolar disorder (also called type I).

 

 

THE
COURSE
OF his depressive episodes is also consistent with an illness because it was recurrent. His first severe episode occurred in Cuba in his early twenties; the next came in his mid-thirties as home secretary, another at age forty-one during World War I after failing in the naval battle of Gallipoli, and at least two episodes per decade into his forties and fifties, which included the famed Wilderness years. His fifties were a particularly dark decade, when he was seen as politically washed up, rejected by his own Conservative Party as well as his enemies. Like Lincoln, he seemed less symptomatic during his period of greatest renown, in his sixties and onward. Yet by then doctors were treating him with amphetamines, and he actively self-medicated with alcohol. Even so, there is some documentation of manic-like symptoms, and depression, even when the war was going well. In July 1943, Anthony Eden's private secretary noted, “The PM was in a crazy state of exultation. The battle has gone to the old man's head. The quantities of liquor he consumed—wine, brandies, whiskies—were incredible.” In late spring 1944, Roy Jenkins notes that Churchill showed “great fluctuation of mood, with bursts of energy and indeed brilliance of performance intervening in a general pattern of lassitude and gloom. . . .”