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Authors: Nassir Ghaemi

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As he advanced on Savannah he assured superiors of the value of the “total war” strategy that his march would make famous. “I attach much more importance to these deep incisions into the enemy's country, because this war differs from European wars in this particular,” he later telegraphed Henry Halleck, the chief general in Washington. “We are not fighting armies, but a hostile people, and must make old and young, rich and poor, feel the hard hand of war.” When he got to South Carolina, the state that started the whole conflict with its secession and takeover of Fort Sumter, Sherman was merciless. Wrote a Michigan soldier in his army, “In South Carolina, there was no restraint whatever in pillaging and foraging. Men were allowed to do as they like,
burn and destroy
.” Historian Michael Fellman notes that though Sherman opened the door to total war, he did not fully practice it. After Atlanta, he did not evacuate any city; rape of women was not practiced; no concept of genocide existed. All these practices came later, especially with the Second World War. For his time, Sherman was brutal. But compared with what would later come, he was mild.
This future misery gave no succor, of course, to the people of the South who stood in Sherman's path. Nor did Sherman think much about restraining his men; he mostly focused on destroying as much property and instilling as much fear as feasible. The general paid attention to how his victims reacted; years later he commented that Georgians at least “bore their afflictions with some manliness,” but South Carolinians “whined like curs.” By the time Sherman reached North Carolina in March 1865, he was steps away from meeting up with Grant in Virginia and forcing Lee's surrender. The manic general eased off, ordering one of his generals, “It might be well to instruct your brigade commanders that now we are out of South Carolina and that a little moderation would be of political consequence to us in North Carolina.” A month later, the war was over.
 
 
WITH ALL THIS military success, Sherman had rehabilitated his image from crazy failure to insane genius. Another military leader, George McClellan, as we will see later, evolved in the opposite direction—from precocious sensation to plain dud. Almost no psychiatric contrast in history stands out more clearly, side by side, than these two men.
The American Civil War lays out the stark contrast: the greatest generals in war are often abundant failures during peacetime, and vice versa. McClellan and Sherman are the sharpest contrasts; but there is also Grant the peacetime drunkard, and Stonewall Jackson the barely tolerable military professor. Only Lee stands out as effective in both peace and war (and even he had a mentally unstable father, and Lee himself may have been dysthymic in his general personality).
The contrast reflects, I think, the different psychological qualities of leadership needed in different phases of human activity, peace and war being two extremes. A civilian analogy might be when a president takes office in peacetime versus wartime, or in a strong economy versus an economic crisis. Another might be when a businessman manages an already successful company well, versus starting, building, and growing a new enterprise. The same kind of leader can be a successful Calvin Coolidge in one setting, a failed Herbert Hoover in the other. Or the very same person—a Ted Turner, as we'll see next—can be a bust in one context, a hit in the other.
 
 
FOR LEADERS IN any realm, creativity is not just about solving old problems with new solutions, it's about finding new problems to solve. Mania enhances both aspects of creativity: the divergence of thought allows one to identify new problems, and the intense energy keeps one going until the problems are solved. We can see these features in bipolar leaders as different from each other as William Tecumseh Sherman and Ted Turner. The problem for Sherman was not how to better attack and defeat the Confederate armies: many Northern generals had tried many approaches, without victory. Sherman gave up on that problem. He came up with a new one: How can you break the morale of the Southern people? If you can do that, then you might weaken the Confederate armies enough so that they will gradually dissolve. His solution: Destroy cities and farms, attack the economy, target people and property, and you will win by undermining the army's base of support.
The problem for Turner was not how to become a big mogul in the traditional news media. There was a standard solution to that problem: move to New York and work your way up the corporate ladder. Instead, Turner saw that the cable medium provided a new mechanism for news, and his solution was to start an all-day news provider in that medium.
None of this is to suggest that we should glorify Sherman or Turner. They solved old problems by creating new ones. Sherman solved the problem of brutal face-to-face army combat, which had produced the carnage of Antietam and Gettysburg, but he created a new and greater problem: targeting civilians in wartime. Turner ended the news monopoly of New York corporations, but he created a new problem: the twenty-four-hour news cycle and the endless punditry that treats opinion as news.
These leaders were creative, manic originators: they answered questions nobody had yet asked, but in so doing they produced other questions nobody can yet answer.
CHAPTER 2
WORK LIKE HELL—AND ADVERTISE
TURNER
 
 
The classic entrepreneur founds entirely new notions: Henry Ford and the mass-produced automobile, Thomas Edison and the light bulb, Bill Gates and personal computer software, Ted Turner and twenty-four-hour cable television news. Given the theme of this book, Turner is especially relevant because he has been somewhat open about his mental health.
In his recent autobiography, Turner describes a difficult childhood in which his father, Ed Turner, constantly moved the boy from one boarding school to another. Forever the new kid, Turner faced more than typical childhood harassment from his peers; at one point, when he was sent away from home at age four, he felt completely abandoned. When Ted was home, Ed Turner worked his son hard and sometimes beat him. The boy was once expelled from elementary school (“I was a restless kid and got in trouble a lot. I didn't do anything really bad,” Turner explains) and had poor grades, which he now attributes to his painful home life. (“Today's schools would probably jump to the conclusion that I had Attention Deficit Disorder, but that wasn't the case. After being isolated and alone for so long I was simply craving attention.”)
After his father placed the troublemaker in a high school military academy, Turner evolved into an academic and social success. Urged by his father to go to the Ivy League, Turner did well at Brown initially, but then partied his way to becoming a dropout. (He attributes this reversion to conflict with his father, who refused to support him financially after Turner chose to major in classics.) Around this time, Turner also describes potentially manic symptoms, such as reckless driving. He routinely drove about 120 miles per hour from his father's vacation home in South Carolina to visit friends in Savannah, Georgia. On one such occasion, while crossing a railroad track, he narrowly missed being run over by a train. He was also a highly energetic person, a personality trait that he acknowledges. (And explains away: “I have always had a lot of energy. Every since I was little, my mind and body were active and I couldn't stand sitting around. Even today, I'm constantly moving. Purgatory for me would be spending twenty-four hours with nothing to do but to be alone with my thoughts.”) His ex-wife Jane Fonda psychoanalyzes away this manic personality trait: “As a result of his upbringing, for Ted there's fear of abandonment that is deeper than with anyone I've ever known. As a result he needs constant companionship and keeping up with him can be exhausting. It's not just all the constant activity—it's his nervous energy that almost crackles in the air. He can't sit still because if you sit still the demons catch up with you. He has to keep moving.”
 
 
TURNER'S SYMPTOMS ARE put into relief by his family history: Ed Turner committed suicide at the peak of his professional success, after he had built up a thriving billboard advertising company in Atlanta. Turner explains the act as the paradoxical aftermath of success; his father had achieved all his goals and was left with no new ambitions. But Turner also describes, sometimes in literal terms, a sick mind: “The fall of 1962 was an exciting time. Dad was elated—the most energized I'd ever seen him. . . . Unbeknownst to all of us, this upbeat behavior came just as he was approaching the brink of collapse. He was like an engine that runs at its fastest right before stripping the gears. My dad had always had his mood swings, but almost overnight his behavior became significantly more erratic and unpredictable. One day he'd be high as a kite and the next he'd be in a state of abject depression.”
These mood swings were accompanied by paranoid and nihilistic thoughts: “My father knew the billboard business cold and while most of his advisers assured him that he wouldn't have trouble meeting his [debt] obligations, an irrational fear of losing everything began to consume him.” He also began drinking and smoking more, and eventually went to a psychiatric hospital in Connecticut. Turner's recollection at this point seems to get cloudier, and he attributes his father's worsening mental state and eventual suicide to having been prescribed the wrong medicines at the hospital. “He said they were for ‘his nerves,' and I'm pretty sure they included Quaaludes and a variety of other uppers and downers. In effect, my dad basically swapped alcohol and tobacco for prescription drugs.” This may be true, since in 1962 antidepressants were barely known, antipsychotics were rarely used for mania, and lithium (which likely would have saved his father's life) still languished in unread journals, unused until a decade later. The most common treatments in that era were amphetamines (“uppers,” which would worsen mania), and barbiturates or benzodiazepines (“downers,” which could exacerbate depression but lessened anxiety and encouraged sleep). His father finally decided to sell his growing, successful company at a large discount to a competitor. Turner, who had joined the family business, argued forcefully against this, but his father signed a letter promising to sell the company, and a few days later shot himself.
Faced with his father's death, and the impending loss of the family business, twenty-one-year-old Ted, to the surprise of many, rallied the company staff, hired lawyers, negotiated with his father's competitor, and settled the agreement to sell by giving company stock to the competitor. Turner not only kept the billboard enterprise going and growing, but eventually he expanded it to radio and television.
 
 
IN LATER YEARS, Turner himself saw a psychiatrist, but now he denies severe depression or clear mania, unlike his father, attributing most of his own mental symptoms to anxiety triggered by the stresses of an active life:
I'd had some problems with mood swings when I was a kid—probably because of being sent away at such a young age and the anxiety that my life produced. . . . Still, in the 1980s a doctor diagnosed me with bipolar depression and put me on lithium. I took this medication for a couple of years but I couldn't tell that it made much of a difference. When I switched psychiatrists, I had a thorough interview that led to a completely different diagnosis. My new doctor asked me questions like whether I ever went for long stretches without sleep (only when I was sailing, I told him), and whether I ever spent inordinate amounts of money. (We both got a chuckle out of that one. . . .) He concluded that while I definitely had an uncommon drive and still do struggle with occasional bouts of anxiety, I don't have depression, and he canceled the lithium.
The differing views of Turner's doctors reflect the state of our knowledge. Many psychiatrists in the 1980s and 1990s did not diagnose bipolar disorder: about 40 percent of people with bipolar disorder were misdiagnosed as not having it (and usually given anxiety disorder or depression labels instead, as Turner was).
For Turner, the evidence for at least some bipolar condition seems strong if we apply the four lines of diagnostic evidence, not just symptoms, but also course of illness, family history, and treatment response. His father likely had severe bipolar disorder; his mood symptoms began quite early in childhood (which is uncommon in mood conditions besides bipolar disorder); Turner's specific symptoms included decreased need for sleep (constant high energy), distractibility (self-described since childhood), agitation (being unable to sit still), notable self-confidence, rapid speech, impulsive behaviors like his reckless driving, and sexual indiscretions as documented in Jane Fonda's memoir. One might add excessive spending, but this criterion is difficult to assess in a billionaire. His self-described lack of response to lithium doesn't support the bipolar diagnosis, but it hardly rules out that interpretation either. Many people with bipolar disorder don't respond to lithium, and Turner's self-reported nonresponse would need to be verified by others, such as family and friends, who might have witnessed a change in his behavior he didn't pick up on himself. (Indeed, in 1992, Turner's female companion stated that for Turner, “lithium is a miracle”; at that time, both his ex-wife, Janie, and his wife-to-be, Jane Fonda, confirmed the benefits of lithium for Turner. Now Turner denies such benefit.) Based on Turner's own report (which can be wrong, since patients often have little insight into their own manic symptoms), his symptoms were constant, not episodic. This
course of illness,
if true, is consistent with hyperthymic personality (which is genetically related to bipolar disorder but less severe).
Though I believe Turner was a success because of, rather than despite, his bipolar symptoms, we will see below that in the long run a touch of lithium wouldn't have hurt.

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