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Authors: Nassir Ghaemi

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Like FDR, John Kennedy had hyperthymic personality, probably biologically related to mental illness in his family. He also suffered from Addison's disease, which almost killed him several times and was tenuously kept at bay with steroids. Yet Kennedy used more drugs than he needed, abusing anabolic steroids for manic-like enhancement of his physical and sexual energy. Left to himself, he overused those agents to the point of becoming erratic and error-prone in his judgment. When his regimen was finally better regulated by some of his doctors, the drugs instead magnified his personality strengths, pharmacologically enhancing his natural hyperthymic resilience.
The results are well known; Kennedy is revered with reason. The sources of his abilities, long shrouded in mystery, include hyperthymic personality and the right mix of steroids. Dr. Herbst was right. John F. Kennedy was indeed a spectacular psychochemical success.
CHAPTER 13
HITLER AMOK
What about Hitler? More than one reader might have posed this question by now. Adolf Hitler would appear to be the most obvious counterexample to my theses: he seems so outrageously insane and abominably evil—far from empathic, realistic, creative, or resilient. I was fully prepared to find this the case and to write him off as an exception. Maybe his case would support the Goldilocks principle: he was too crazy to derive any benefit from mental illness. But in my study of the Hitler literature (in which I found much more psychiatric documentation than I'd expected), I came to a rather different conclusion.
(Given the unfathomably evil Nazi experience, I appreciate that this analysis is delicate. Many who went through the Holocaust still live, as well as many more whose parents or grandparents suffered or perished as a result of it. The memory of those who perished is justifiably cherished, and the subsequent sensitivity of those who remain is understandable. Rather than avoid this topic, however, I think this historical experience is a central modern trauma with which my theme must grapple. I only ask that what I write here be read in the spirit intended, that of seeking the truth, whatever it is, and without any intended moral or political inferences in favor of or against anyone.)
The question, asked in one form or another for generations, is this: Was Hitler mad?
Corollary questions are: Were the Nazi leaders mentally ill? Was the German nation, as a whole, deranged?
The usual answers are: for Hitler, yes; for most Nazi leaders, probably; for Germany, probably not. The minority dissenting view, that none of the above were crazy, was advanced most famously in 1963 by Hannah Arendt (student, friend, and follower of the psychiatrist/ philosopher and leading anti-Nazi thinker Karl Jaspers), who coined the phrase “banality of evil” to express the notion that ordinary people can commit atrocious acts. One perspective sees the fanatic Nazi leaders, and the German masses, as crazy; the other sees them as evil but rational ideologues at worst, conformist acolytes at best. The historical question, for both the leaders and the masses, is important. Was Nazism an aberration of the sick minds of a few men in a weird place, or was it something that could have happened anywhere, or could still happen in the future?
I will discuss other Nazi leaders in a later chapter, but here I hope to show that Adolf Hitler himself had a mental illness, most probably bipolar disorder. I choose to examine him because, as with John Kennedy, his drug use—and abuse—is key to understanding the nature of his leadership. In Hitler's case, intravenous amphetamines
interacted
with his baseline bipolar disorder to worsen his manic-depressive symptoms. Psychiatrists and historians have never previously understood this interaction: they said Hitler either abused amphetamines or not. They never understood that the amphetamine use was really harmful mainly because his underlying bipolar disorder was worsened by it. Kennedy's leadership was eventually enhanced by steroids, interacting with his hyperthymic personality; Hitler's leadership was eventually destroyed by amphetamines interacting with his bipolar disorder.
LET'S RETURN to the four validators of psychiatric diagnosis. Beginning with
symptoms,
Hitler had clear manic and depressive episodes throughout his life. Excellent evidence exists from the memoirs of his closest friend from young adulthood (written ten years after Hitler's death), August Kubizek, who described “dangerous fits of depression. I knew only too well those moods of his, which were in sharp contrast to his ecstatic dedication and activity, and realized that I couldn't help him. At such times he was inaccessible, uncommunicative and distant. . . . Adolf would wander around aimlessly and alone for days and nights in the fields and forests surrounding the town. . . . This state lasted several weeks.”
I will rely on Kubizek heavily because his recollections cover Hitler's young adulthood, before his political prime. (Most historians accept the general veracity of Kubizek's account.) These descriptions are psychiatrically important because they show presence of such symptoms outside of the political contexts that some might use to “explain” them.
Hitler's manic symptoms included overtalkativeness, grandiosity, euphoric mood, decreased need for sleep, and hyperactivity, all occurring episodically, and in alternation with depression, as occurs in bipolar disorder. Examples of those symptoms follow.
Kubizek frequently remarked upon Hitler's overactivity: “He walked always and everywhere. . . . I recall him always on the go. He could walk for hours without getting tired.” “I cannot remember a time when he had nothing to do or felt bored even for a single hour.” “Once he had conceived an idea he was like one possessed. Nothing else existed for him—he was oblivious to time, sleep and hunger.” Hitler's mania focused especially on his love of architecture; he was constantly imagining renovations of Linz, Austria, where he then lived: “Here he could give full vent to his mania for changing everything, because a city always has good buildings and bad. He could never walk through the streets without being provoked by what he saw. Usually he carried around in his head half a dozen different building projects, and sometimes I could not help feeling that all the buildings of the town were lined up in his brain like a giant panorama.” (Three decades later, Hitler in fact renovated Linz much in the way he had described to his friend Kubizek.)
Kubizek also offers much evidence of distractibility and probable flight of ideas: “When Adolf and I strolled through the familiar streets of the good, old town [Linz]—all peace, quiet, and harmony—my friend would sometimes be taken by a certain mood and begin to change everything he saw. That house there was in a wrong position. . . . That street needed a correction. . . . Let's have a free vista to the Castle. Thus he was always rebuilding the town. But it wasn't a matter of building. A beggar, standing before the church, would be an occasion for him to hold forth on the need for a State scheme for the old. . . . A peasant woman coming along with her milk cart drawn by a miserable dog—occasion to criticize the Society for Prevention of Cruelty to Animals for their lack of initiative. . . . [His restlessness] was a supernatural force, comparable to a motor driving a thousand wheels.” Hitler would begin many projects, such as writing plays, but never end them. He would take up a project for which he was unprepared, such as writing a new Wagnerian opera, work on it full steam for an extended time, and then give it up for no reason, without ever returning to it. “I had long since known this behavior of his, when a self-imposed task engrossed him completely and forced him to unceasing activity; it was as though a demon had taken possession of him. Oblivious of his surroundings, he never tired, he never slept. He ate nothing, he hardly drank . . . this ecstatic creativeness.”
And there is ample indication of Hitler's overtalkativeness: “He used to give me long lectures about things that did not interest me at all. . . . He just had to talk.” He liked to attend sessions of parliament as part of the audience. Then he would lecture Kubizek at night for hours: “Hysterically he described the sufferings of his people, the fate that threatened it, and its future full of danger. He was near tears. But after these bitter words, he came back to more optimistic thoughts. Once more he was building the Reich of all the Germans.”
A markedly irritable and unstable mood can mark manic periods, and here again Hitler's behavior matches the bipolar diagnosis: “Adolf was exceedingly violent and high-strung. Quite trivial things, such as a few thoughtless words, could produce in him outbursts of temper which I thought were quite out of proportion to the significance of the matter.”
As we saw with Hitler's renovaton of Linz, mania can generate creative and compelling ideas, which, even if outlandish at the time, can still exert an influence long after the manic episode has ended. Kubizek describes one such episode in rich detail. One night, he and Hitler went to see a Wagner opera. Usually, Hitler would critique a show in detail while there and afterward. But on this occasion he left the performance silently and walked rapidly, with Kubizek following him, to the top of the Freinberg mountain overlooking the city.
Adolf stood in front of me; and now he gripped both my hands and held them tight. He had never made such a gesture before. . . . His eyes were feverish with excitement. . . . Never before and never again have I heard Adolf Hilter speak as he did in that hour, as we stood there alone under stars. . . . I cannot repeat every word that my friend uttered. . . . It was as if another being spoke out of his body. . . . I rather felt as though he himself listened with astonishment and emotion to what burst forth from him with elementary force. . . . It was a state of complete ecstasy and rapture. . . . Like flood waters breaking their dykes, his words burst forth from him. He conjured up in grandiose, inspiring pictures his own future and that of his people. Hitherto I had been convinced that my friend wanted to become an artist, a painter, or perhaps an architect. Now this was no longer the case. . . . Now he was talking of a mandate which, one day, he would receive from the people . . . a special mission which one day would be entrusted to him. . . . His words were followed by silence. We descended into the town.
It was 3 a.m. The friends departed and never discussed that night again until over thirty years later, when, in 1939, the Führer invited his old friend to see a Wagner opera in Bayreuth, the site of the composer's annual festival. Kubizek recounted that special night in their youth. Hitler was moved. Later, when they both visited Wagner's widow in her home, Hitler took a turn retelling the story, concluding, “In that hour it began.”
 
 
I THINK there can be little doubt that these behaviors represented manic episodes, and if someone ever has a manic episode, it is 90 percent likely that he will also have depressive episodes. Hitler too had periods of behavior that meet our current definition of clinical depression, especially when he would suffer setbacks in life, such as being turned down twice by the Vienna Academy of Arts. At that time, Kubizek recalls:
His mood worried me more and more as the days went by. I had never known him torment himself in this way before. On the contrary! In my opinion, he possessed rather too much than too little self-confidence. But now things seemed to change round. He wallowed deeper and deeper in self-criticism. Yet it only needed the slightest touch . . . for his self-accusation to become an accusation against the times, against the whole world; choking with his catalogue of hates, he would pour his fury over everything, against mankind in general who did not understand him, who did not appreciate him and by whom he was persecuted. I see him before me, striding up and down the small space in boundless anger, shaken to his very depths.
Hitler himself admitted some of the depression in
Mein Kampf:
“As the Goddess of Misery took me in her arms and so often threatened to break me, the Will to Resist grew, and in the end the Will triumphed.”
Kubizek notes one more significant personality trait in Hitler: obsessionality. While this trait is unrelated to his bipolar disorder, it's worth mentioning here because we can use it to mark his later decline. This obsessionality was reflected in Hitler's attention to personal hygiene and correct behavior. Even when he was poor, as he was when Kubizek knew him, he was always well groomed and fastidiously dressed. At night he placed his trousers under his mattress to give them a sharp crease the next day. He also was polite in social situations and had good manners.
His obsessive rigor went well beyond personal appearance and cleanliness. Kubizek recounted that “the most outstanding trait in my friend's character was . . . the unparalleled consistency in everything he said and did. There was in his nature something firm, inflexible, immovable, obstinately rigid, which manifested itself in his profound seriousness and was at the bottom of all his other characteristics. Adolf simply could not change his mind or his nature. . . . I remember what he said to me when we met again in 1938 after an interval of thirty years. ‘You haven't changed, Kubizek, you have only grown older.' If this was true of me, how much more was it of him! He never changed.”
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