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    Tough times call for troubled minds

    Psychiatrist Nassir Ghaemi explains why a mentally ill president may be just what we need, and how mania and depression have driven the triumphs and the tragedies of Lincoln, Churchill, Hitler, JFK, MLK, and, maybe, Newt Gingrich.

    The power of depression: empathy plus realism.

    The power of depression: empathy plus realism. Library of Congress

    Bipolar disorder made him effective, for a while. Amphetamines made him really crazy.

    Bipolar disorder made him effective, for a while. Amphetamines made him really crazy. Heinrich Hoffman/Wikimedia Commons

    A teenage suicide attempt foretold dark moods to come. Did it also lead to greatness?

    A teenage suicide attempt foretold dark moods to come. Did it also lead to greatness? Yoichi R. Okamoto, White House Press Office/Wikimedia Commons

    No excellent soul is exempt from a mixture of madness. —Aristotle

    Newt Gingrich’s sinking, soaring, and now sinking presidential candidacy has revived talk of a wild card in politics: the oft-murmured but only rarely broached question of leaders’ mental health. During the 2000 and 2008 Republican primaries, some adversaries of the famously hot-tempered John McCain circulated rumors that he was dangerously unstable, perhaps afflicted with PTSD from his ordeal as a POW. Now similar questions have hovered around the brazen, defiant, mercurial, and immodest Gingrich: Is this man too crazy to be president? Gingrich even has a family history; he teared up at an Iowa campaign event recalling his mother’s depression and bipolar disorder.

    Dr. Nassim Ghaemi has some very interesting things to say about Newt Gingrich’s mental health and leadership qualities (see below). But he might turn the question on its head: Is this man crazy enough to be president in a troubled time?

    Ghaemi, a professor of psychiatry at Tufts University School of Medicine and the director of the Tufts Medical Center’s Mood Disorders Program, made a stir last summer with his provocative book A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness. It challenged the assumption that healthy minds make good leaders, positing instead an inverse law of sanity: “The best crisis leaders are either mentally ill or mentally abnormal; the worst crisis leaders are mentally healthy.” Abraham Lincoln, Winston Churchill, John F. Kennedy, Adolf Hitler, Franklin Roosevelt, Mahatma Gandhi, Martin Luther King, Jr. — all suffered from depression and/or mania. By contrast, mentally balanced leaders such as Neville Chamberlain, Tony Blair, and (no kidding) Richard Nixon might fare well in times of peace and prosperity, but their normalcy is a liability in tough times, when realism and divergent thinking are critical.

    The 2012 presidential election approaches at a time that cries out for bold, innovative crisis leadership, yet it appears the race will come down to the conspicuously even-keeled President Barack Obama and a dull, gray, Republican, perhaps the consummate manager Mitt Romney or the stolid ideologue Rick Santorum. It’s all fair game for Ghaemi, who also holds degrees in history, philosophy, and public health. We spoke extensively in November, and he interrupted his New Year’s Eve to comment further on the presidential contenders.

    Nassir Ghaemi: Basically I’ve been treating and doing research on bipolar disorder and depression for almost two decades, and I knew from my own clinical experience and from my experience with other experts in the field that many of our patients were highly successful people: business people, politicians, professors, doctors, lawyers. But because of confidentiality issues and stigma, we often don’t know about these people. We think of mental illnesses like manic depression and depression as only harmful because we don’t hear about those who have them who are doing well.

    I decided to bring out this link between depression and mania and success through public figures from the past because their information would be publicly available.

    Lindley:  In your introduction, you compare your work as a psychiatrist with that of a historian. How is it possible to make a diagnosis of a historical person when you don’t have a direct examination?

    Ghaemi: Direct examination is overrated. The most important aspect of psychiatric diagnosis is the history, and it’s almost completely dependent on the history of the patient, [but] the history of the patient is poorly obtained if it’s solely from the patient. Many people do not realize what psychiatric symptoms they have. As clinical psychiatrists, what we must do is talk to family members, friends and other people to get outside information….

    With historical figures, I would add that we have all these other sources of information and we can directly interact with the patient because we have their autobiographies, their memoirs and their letters.… I had primary sources and didn’t engage in psychoanalytic speculation.

    Lindley:  How can people with a mental illness be better leaders than people without mental illness? 

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    Posted Thu, Jan 5, 7:16 a.m. Inappropriate

    There are known associations between mental health states and various human traits; just yesterday I was having a conversation with someone about creativity and certain forms of "madness." Certainly, some mental health conditions bring with them particular skills or qualities that can enhance their work performance. But one only need look as far as the Pierce Co. Assessor's Office to see the down side and ugliness that can result from an elected official with mental illness. I find it chilling to frame that characteristic as a "need" in our highest elected leader.


    Posted Thu, Jan 5, 7:47 a.m. Inappropriate

    I just recently read an article somewhere (I cannot remember where, or many other details) of a young man who goes off of his meds on occasion because he likes the feeling of energy he gets when he is manic. Here's hoping he posesses the empathy to channel that energy in positive ways.


    Posted Thu, Jan 5, 4:35 p.m. Inappropriate

    "but their normalcy is a liability in tough times, when realism and divergent thinking are critical."

    And this is proved how? That crazy people do the right thing when things tough? Sorry but having dealt with a crazy person, I can truly refute this claim. Crazy people make sane people crazy trying to clean up the messes they create. And they divert the sane people's energy from fixing the underlying problems to dealing with the emergencies created by crazy actions.

    Sorry, you can't lump mania in with depression. Then claim that we need crazy leaders to get us through the mess. Remember the current mess wasn't caused by craziness as much as greed. And if we had a modicum of Justice for the crooks to remove them from the system we would be out of this mess. Instead we've just dug the hole deeper.


    Posted Thu, Jan 5, 5:14 p.m. Inappropriate

    Generally I would be skeptical of trying to correlate leadership skills with mental traits, especially on the basis of just a few examples. Certainly there are plenty of counterexamples as well to all this.

    Still, some reconsideration is necessary of the concept of "mental illness" and "mental health". I see much more danger in a common assumption in our society, that we should always be upbeat and smiling, than in a moderate level of depression.

    Posted Thu, Jan 5, 5:36 p.m. Inappropriate

    Look Randy Revel was the King County Executive for a term and he suffered from mental illness, but through medication was able to function. All mental illnesses are not created equal. But to make a claim that crazy times call for crazy leaders, have I got a place in S.American for you to go visit. Bob Jones... anyone?


    Posted Fri, Jan 6, 8:49 a.m. Inappropriate

    Apropos this interesting article, I came across this quote from Martin Luther King Jr. in, of all places, the current issue of Car and Driver magazine:

    "Human salvation lies in the hands of the creatively maladjusted."


    Posted Fri, Jan 6, 10:26 a.m. Inappropriate

    There are degrees of severity of both bipolar disorder (BPD) and depression. For example, some people with BPD have only mild ups and downs which are not problematic, and, as the article points out, possibly helpful in boosting productivity and empathy and creativity. Many bipolar people lead happy and productive lives and work in a huge variety of occupations, including doctors, lawyers, politicians, writers, artists etc etc.

    But there's definitely a spectrum which goes from mildly affected people all the way to people with BPD who are unable to live life outside of a mental institution.

    So one cannot generalize. Certainly the people in the article have not had severe problems and, with a few exceptions, notably Hitler, have been good or great leaders.

    I'd take issue with the person who lumps all people with mental illness as "crazy". Most people are not. Those that have severe symptoms can certainly be a big problem in the workplace, but most people with BPD are not "crazy". With more public understanding of BPD, hopefully people will understand that distinction, and also be more informed about how to deal with a workplace problem such as the one GaryP describes.

    Maybe in Hitler's case, if there had been more understanding of mental illness at the time, and of his in particular, someone could have had an effect on the situation.

    Incidentally, debbalee, I would be interested to hear about what happened at the Pierce County Assessors office.

    Posted Fri, Jan 6, 4:45 p.m. Inappropriate

    In partial response to Nancy White, most members of Hitler's inner circle considered his doctor a quack, and even belittled him in Hitler's absence, dubbing him the "Injektionminister." Albert Speer wrote about this in detail in his memoirs. Unfortunately, it's awfully hard to pull your boss aside and question his choice of physicians when he's a totalitarian dictator. Many NS higher-ups decided to settle the issue instead with explosives, and we all know what happened to them.


    Posted Sat, Jan 7, 12:46 p.m. Inappropriate

    "but their normalcy is a liability in tough times, when realism and divergent thinking are critical."

    Both realism and divergent thinking are traits of left-handed people allowed to express their left-handedness. Many of our recent Presidents, including the current one, were/are left-handed.

    But as expressed by the photo of the ballet youngsters with only of them facing the "wrong" way, a left-handed divergent thinker still has to sell the "wrong" way to a sea of right-handers.


    Posted Sun, Jan 8, 11:11 a.m. Inappropriate

    "Lincoln, Churchill, Hitler, JFK, MLK, and, maybe, Newt Gingrich."

    Surely this list of mentally ill leaders is incomplete without including George W. Bush, who occupied the White House for eight years in spite of suffering from severe narcissism and delusions of grandeur, e.g., the notions that the US could "liberate" Iraq from centuries of tribal and sectarian warfare, and "win" in Afghanistan, which no army or occupying force has ever conquered.

    Mud Baby

    Posted Fri, Jan 13, 12:05 p.m. Inappropriate

    I do not mind being thought of as crazy.

    Posted Fri, Jan 13, 12:06 p.m. Inappropriate

    Nor am I saying I'd make a good political leader.

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