TOI]CITED WITT{ FTRE rtrl THE FREE PRESS A Dioision of Macmillan, lnc. New York MAXWELL MACMILLAN CANADA Toronto MAXWELL MACMILLAN INTERNATIONAL New York Oxford . Singapore . Sydneg TO Manic -D epr essive ilness arrd tlre Artistic Temp erarnent Kay Redfield Jamison Copyright @ 1993by IQy RedfieldJamison All rights resenxd. No part of thtsbook may be reprodrced or transnitted in angform or by ang means,electronic or mechanical,including photocopying recording,or by any infonnationformation storageand retrieual sustem.sy stern, wlthoutusithout pnennissin e nnlss ion in writirq fron tlte Publblwr. The Free Press A Dioisionof Maanillan,Irc. 866Thtrd Ar,enue,Neu Yo*, N.f . 10022 MarusellMacmillan Canada,Inc. 1200Eglinton AoenueEast Suite2N Don MiIk, Ontario M3C JNf Maqnillan, Inc. is part of the Muwell Comffutnication Crwp of Companies. Fi,rstFree PressPapetback Edttion lgg4 Printed in the United Stad;esof tuneria printingnumber 2345678910 DesignedbyREM Stuilia, lnc. Ubrary of Congress C ataloglng-in-publication Data Jamison,IQy R. Toucheduith fire : manip-d.epresshseillness and the artistit tenperament/ YtayF,edficld J amison. P. an. /sBN042-9Iffi34 1. Manic-depressioepsychoses. 2. Attists-Mental health. 3. Authors-Mental lvalth. 4. Creathreability. L Title. RC5r6J36 1993 616.89'5t00887--4c20 92-18327 Crc Grateful acknowledgmentis $ven to the publishersfor permissionto reprint excerptsfrom the following works: "I Think Continuallyof ThoseWho Were Truly Great," from CollccteilPoemsi92&I953 by StephenSpender. Copyright 1934and renewed 1952by StephenSpender. Reprinted by permissionofRandom House, Inc. Reprinted by permissionofFaber and Faber Ltd. Excerpt from "Elegy," from FieldWorkby SeamusHeaney. Copyright @ 1976, 1979by SeamusHeaney. Reprinted by permissionof Farrar, Straus& Giroux, Inc. Reprinted by permission of Faber and Faber Ltd. Excerptsfrom "Visitors" and "Suicide" from Day by Dag by Robert I-owell. Copyright @ 1975, 1976, 1977by Robert Lowell. Reprinted by permissionof Farrar, Straus& Giroux, Inc. Reprinted by permissionofFaber and Faber Ltd. Excerpt from "Elegy," copyright @ f955 by New Republic,Inc., from The CollcctedPoems of TheodnreRoethke by "IlreodoreRoethke. Used by permissionof Doubleday,a divisionof Bantam Doubleday Dell Publishing Group, Inc. Reprinted by permissionof Faber and Faber Ltd. Excerpt from "May's Truth and May's Falsehood,"in Delmore Schwartz:Sel.eaed Poems: Sumner Knowlcilge.Reprinted by permissionof New Directions PublishingCorporation. Reprinted by permissionof l,aurencePollinger Limited. Excerpt from "It's After One" by Vladimir Mayakovsky,in Edward J. Brown, Magakoosky: A Poet in Reoolution. Copyright @ 1973 by Princeton University Press. Reprinted by permissionof Princeton University Press. Excerpt from "The First Day's Night Had Come" (poem410): Reprinted by permissionof the publishersand the Trusteesof Amherst College kom The Poemsof Emilg Dickinson, Thomas H. johnson, ed., Cambridge, Mass.:The Belknap Pressof Harvard University Press, Copyright @ 1951, 1955, f979, 1983 by the President and Fellows of Harvard College. Excerpt from "In a Dark Time," copyright @ 1960by Beatrice Roethke, Administratrix of the Estate of Theodore Roethke, from The Collpcted Poernsof Thcodnre Roethke by TheodoreRoethke. Used by permissionofDoubleday, a divisionofBantam DoubledayDell Publishing Group, Inc. Reprinted by permissionof Faber and Faber Ltd. Excerpt from "90 North" from The Conplete Poernsby nandall Jarrell. Copyrigbt @ by Mrs. Randall Jarrell. Renewal copyright @ f968 by Mrs. RandallJarrell. Reprinted by permission of Farrar, Straus& Giroux, Inc. Reprinted by permissionof Faber and Faber Ltd. Excerpt from "The Deceptive Present,The PhoenixYear" in: Delmore Schwartz:Selccted Poems:Sumnvr Knou>Icdge.Copyright @ f959 by Delmore Schwartz. Reprinted by per- missionof New Directions Publishing Corporation.Reprinted by permissionof Laurence Pollinger Limited. Excerpt from "Little Gidding" inFour Quartets,copyright 1943by T. S. Eliot and renewed 1971by Esme Valerie Eliot, reprinted by permissionof Harcourt BraceJovanovich, Inc. Reprinted by permissionof Faber and Faber Limited. Excerpt from "Glen Eyre" from Spring Tidz andNeap Tidz: Seleaed Poems, 1932-1972by Sorley Maclean (Edinburgh: Canongate,1977). Reprinted by permissionof Canongate PressPLC. Excerpt fiom "384. The Marker Slants" from Tlle Dream Songsby John Berryman. Copy- right @ f969 by John Berryman. Reprinted by permissionof Farrar, Straus & Giroux. Reprinted by permissionof Faber and Faber Ltd. Excerpt fiom "The Cuillin, Part VII" from From Wood to Ridge by Sorley Macl.ean. Reprinted by permissionofCarcanet PressLtd. For Richard Jed Wyatt, M.D. To those who, by the dint of glassand vapour, Discover stars, and sail in the wind's eye- -BYRON I think continually of those who were truly great. Who, from the womb, rememberedthe soul'shistory Through corridors oflight, where the hours are suns, Endlessand singing, Whose lovely ambition Was that their lips, still touched with fire, Should tell ofthe Spirit, clothed from head to foot in song. And who hoarded from the Spring branches The desiresfalling acrosstheir bodies like blossoms. What is precious, is never to forget The essentialdelight of the blood drawn fiom agelesssprings Breaking through rocks in worlds before our earth. Never to deny its pleasurein the morning simple light Nor its grave evening demand for love. Never to allow gradually the traffic to smother With noise and fog, the flowering of the spirit. Near the snow, near the sun, in the highest ftelds, Seehow these namesare ftted by the waving grass And by the streamersof white cloud And whispers of wind in the listening sky. The namesof those who in their lives fought for life, Who wore at their hearts the fire's centre. Born of the sun, they travelled a short while toward the sun And left the vivid air signed with their honour. -STEPHEN SPENDER COI\TENTS l. THAT FINB MADNESS lntroduction 2. ENDLESSNIGHT, FIERCE FIRES AND SHRAMMINGCOLD 11 Manic-DepressiveIllness 3. COULDIT BE MADNESS-THIS? 49 Controversy and Evidence 4. THEIR LIFE A STORMWHEREON THEY RIDE 101 Temperamentand Imagination 5. THE MIND'S CANKER IN ITS SAVAGEMOOD 149 George Gordon, Lord Byron CONTENTS 6. GENEALOGIESOF THESE HICH MORTAL MISERIES ]9] The Inheritance of Manic-DepressiveIllness 7. THIS NET THROWNE UPON THE HEAVENS Medicineand the Arts APPENDIXES A. DiagnosticCriteria for the Major Mood Disorders 261 Writers, Artists, and Composerswith ProbableCyclothymia, Major Depression,or Manic-Depressivelllness 267 NOTES 271 ACKNOWLBDGMENTS INDEX 1. TT{AT FII\E MADI\ESS fntroduction . his raptures were, All air, and ftre, which made his versesclear, For that fine madnessstill he did retain. Which rightly should possessa poet's brain. -MTCHAEL Dnevtoxl An Angel Descending:Dante's Dioine Comedg.Wlliam Blake, c. 1826 (The Pierpont Morgan Library, New York) TOUCIIED WITHFIRD "We of the craft are allcrazy," remarkedLord Byron about himseH and his fellow poets. "Some are affectedby gaiety, others by mel- ancholy,but all are more or less touched."zThis book is about being "more or less touched"; specifically,it is about manic- depressiveillness-a diseaseof perturbed gaieties, melancholy, and tumultuous temperaments-and its relationshipto the artistic temperament and imagination. It is also a book about artists and their voyages,moods as their ships of passage,and the ancient, persistentbelief that there existssuch a thing as a "ffne madness." The ffery aspectsof thought and feeling that initially compel the artistic voyage-fierce energy, high mood, and quick intelli- gence;a senseofthe visionaryand the grand;a restlessand fever- ish temperament-commonly carry with them the capacity for vastly darker moods,grimmer energies,and, occasionally,bouts of "madness."These opposite moods and energies,often interlaced, can appearto the world as mercurial, intemperate,volatile, brood- ing, troubled, or stormy. In short, they form the common view of the artistic temperament, and, as we shall see, they alsoform the basisof the manic-depressivetemperament. Poetic or artistic ge- TIIATFIND MADNESS nius, when infused with these fitful and inconstant moods, can become a powerful crucible for imagination and experience' That impassioned moods, shattered reason, and the artistic "fine a temperamerri be welded into a madness" remains ""r firrcely controversial belief. Most people find the thought that a destrultive, often psychotic, and frequently lethal disease such as (such manic-depressive illness might convey certain advantages as heightened imaginative powers, intensifted emotional responses, energy) counterintuitive. For others it is a troubling or"niirr"r""red unlikely associati-onthat conjures up simplistic notions of the "rrrad ge.rius," bringing with it images of mindless and unaesthetic reductionism as well as concerns about making into disease some- thing that subsumes vital human differences in style, perception, arrdl"mperament. Indeed, labeling as manic-depressive anyone who is unusually creative, accomplished, energetic, intense, moody, or eccentric both diminishes the notion of individuality within the arts and trivializes a very serious, often deadly illness. There are other reasons for such concerns. Excessesof psycho- analytic speculation, along with other abuses of psychobiography, hav. i.rviied well-deserved ridicule. Due to the extraordinary ad- vances in genetics, neuroscience, and psychopharmacology,-much of modern psychiatric thought and clinical practice has moved away from