[Paleopsych] NYT: Hypomanic? Absolutely. But Oh So Productive!
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Health > Mental Health & Behavior > Hypomanic? Absolutely. But Oh So Productive!
March 22, 2005
By BENEDICT CAREY
"S ometimes when talking to people, I'll tell them that I've just had
a lot of coffee, even though it's not true, because I know I fire off
in all directions, and I can talk to you about anything - literature,
string theory, rock guitar - I once worked for Leo Fender - and one
thing I say to people is that, of course, I live near the edge; the
view is better."
Laurence McKinney, 60, who lives near the edge of Boston, is a
business consultant, a Harvard graduate and self-described polymath
who has had a career that is every bit as frenzied as his
Among other ventures, he said, he has started pharmaceutical
companies, played in rock bands and helped design electric guitars,
and written a book about the neuroscience of spirituality. This month,
for the first time, he helped start a Web site for people like
himself. They are known as hypomanics.
At some point, almost everyone encounters them - restless, eager
people, consumed with confident curiosity. Researchers suspect that
their mental fever shares some genetic basis with that of bipolar
disorder, known colloquially as manic depression, a psychiatric
disorder characterized by effusive emotional highs and bouts of
In recent decades, scientists have found that bipolar disorder is
widely variable, and that its milder forms are marked by hypomanias,
currents of mental energy and concentration that are less reckless
than full-blown manic frenzies, and unspoiled, in many cases, by
New research helps explain how people with manic or hypomanic
tendencies navigate the small triumphs and humiliations of daily life,
and provides clues to how some of them quickly shake off the emotional
troughs that their ambitious natures should make inevitable.
"It kind of goes against the common assumption, but many people who
are inclined to hypomanic or manic symptoms have an underlying
resilience," said Dr. Kay Redfield Jamison, a professor of psychiatry
at Johns Hopkins University. "They may get trashed by their peers,
laid low, but they respond very strongly."
In a new book, "Exuberance," Dr. Jamison argues that flights of joyous
energy similar to hypomanic states frequently accompany scientific and
literary inspiration.Psychiatrists have known for more than a century
that bipolar disorder, unlike any other mental illness, is often
associated with some financial and professional accomplishment. Mania
can inspire destructive shopping or gambling sprees, but it can also
generate bursts of creative and focused work.
Psychiatrists and psychologists have found ample evidence for bipolar
tendencies in the life histories of many famous writers and painters.
The composer Robert Schumann, for example, experienced extreme mood
swings; so, some now argue, did the poet Emily Dickinson.
Some studies suggest that first-degree relatives of people with
bipolar illness, who are likely to inherit some genetic basis for
bipolar disorder, are particularly likely to enjoy high socioeconomic
Most recently, researchers have turned their attention to the mild end
of the bipolar spectrum, and sliced it into many permutations. Bipolar
II, III and IV, for example, each include depressive episodes and
varieties of hypomania, or exuberant moods. Cyclothymic disorder
involves rapid cycling from moderate depressive to manic symptoms, and
hyperthymia is a state of elevated mood.
"When you look across the entire bipolar spectrum, you find that maybe
10 percent to 15 percent of these people never get depressed: they're
just up," said Dr. Ronald C. Kessler, a professor of health care
policy at Harvard Medical School.
As one psychiatrist put it, Dr. Kessler said, "The goal in life is
constant hypomania: you never sleep too much; you're on; you keep
With the exception of Bipolar II and cyclothymic disorder, which are
accepted as standard psychiatric diagnoses, these permutations of
low-level bipolar disorder overlap with each other and with normal
ranges of mental function so much that some scientists question how
distinct they are.
"For some of us, there is a lot of wariness about this tendency to see
bipolar disorder everywhere," said Dr. William Coryell, a professor of
psychiatry at the University of Iowa School of Medicine, adding that
"it's very difficult to determine reliable boundaries between one
diagnosis and another" and document the true prevalence of the
Yet even if bipolar disorders can be reliably diagnosed in only 2
percent of the population, some now believe that hypomania or similar
charged states are more prevalent than previously imagined. About 6
percent of college students score high on personality tests that
measure hypomanic tendencies, some studies find, and about 10 percent
of children rate as temperamentally "exuberant," a related quality.
Outsized delight in small successes may be central to what kindles
hypomanic natures and sustains them. In an effort to learn how the
joys and sorrows of daily life affect mania and depression, Dr. Sheri
Johnson, a professor of psychology at the University of Miami, began
surveying men and women in whom bipolar disorder had been diagnosed.
Originally, Dr. Johnson was interested in the effect of negative
events, like struggles at work or arguments at home. "But the people
in the study told us we were getting it wrong, that it was when good
things happened that they felt they had their manias," Dr. Johnson
In two studies involving 149 people, one completed in 2000 and the
other a continuing project, Dr. Johnson has found that personal
victories like a promotion oran award very often precede or coincide
with manic symptoms, though the person may be feeling neither manic
nor depressed when life takes a good turn.
Even when small successes do not arouse manic symptoms, they appear to
prompt exaggerated surges of confidence. In one study, scheduled for
publication later this year, Dr. Johnson led a team of psychologists
who rated a group of 153 college students on a hypomanic scale, which
included items like: "There have often been times when I had such an
excess of energy that I felt little need to sleep at night," "I often
feel excited and happy for no apparent reason," and "I often feel I
could outperform almost anyone at anything."
The scale was intended to identify people at risk for developing
The researchers gave the students a hand-eye coordination test, then
told them that they had scored very well, regardless of their true
scores. Offered a choice of which test to take next, the hypomanic
group selected a significantly more challenging exam than their peers
did. These students not only expected to do very well, Dr. Johnson
reports, they were more willing than peers to pursue difficult goals
after an initial success.
Researchers do not know whether this surging confidence and hunger for
challenge persists, or for how long, but it is a familiar pattern to
some psychiatrists who treat mild forms of bipolar disorder.
Dr. John Gartner, a psychiatrist in Baltimore who specializes in
treating hypomania, recently published "The Hypomanic Edge," a book
that identifies hypomanic symptoms in the lives of American historical
figures from Christopher Columbus to the biotech entrepreneur J. Craig
"These are people who are always moving the goal posts," Dr. Gartner
said in an interview. "If they do well at one thing, they shoot for
In a footnote in his book, Dr. Gartner recounts the story of how Henry
Ford sailed off on a luxury steamer on a whim in 1915 to personally
end World War I and bring world peace. "I'll bet this ship against a
penny," Ford boasted to the reporters, "that we'll have the boys out
of the trenches by Christmas."
This grandiosity practically begs for a tragic fall. Difficult goals
are by definition less likely to be achieved, even by those with
mental power packs, and there is little question that people with
hypomanic tendencies feel disappointment deeply. For some, their
fevered, scavenging curiosity may overwhelm any excess rumination: new
projects beckon before the old ones can be mourned.
"I'm not so much smarter than other people as faster," said Mr.
McKinney, the polymath near Boston, who contacted Dr. Gartner after
hearing of his book. "I swing more often, I make errors, but I make
them faster. That's how I sometimes describe it. If you can focus this
energy, you can do great things with it. If not, well, I think it can
And that is one catch. Dr. Peter Whybrow, director of the University
of California's Neuropsychiatric Institute in Los Angeles, said that
he considered true hypomanic types to be rare and that some of them
crashed at midlife, or later.
"Usually what happens in the clinical domain," Dr. Whybrow said, "is
that these people come in when they've had a business reversal and
they're very depressed. They look back on their lives and realize that
they were hyperactive, hypomanic, that they started a lot of projects
but finished very few of them."
The view may be better, but it is easy to lose your balance.
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