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Authors: Kay Redfield Jamison

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Several years ago I conducted a
study of eminent writers and artists and found, like most researchers before and after me, that they were much more likely than the general population to have
been treated for mania or depression. One of my major interests was to look not just at psychopathology, however, but to try to better understand the role of moods in the creative process itself. Virtually all the writers and artists had experienced extended periods of intense creative activity, which were characerized by striking increases in enthusiasm, energy, rapid and fluent thought, and self-confidence. Most reported that a sharp rise in their mood
preceded
the onset of their creative work. Ruth Richards and Dennis Kinney, in a
Harvard study of manic-depression and creativity, found that the overwhelming majority of their subjects experienced at least mildly elevated moods during the periods when they were most creative. When their moods were most elevated, so were the ease and expansiveness of their thinking and the quickness of their mental associations. Eugene Fodor, of Clarkson University in New York, has shown that
students vulnerable to manic-depressive illness are particularly creative when their mood has been experimentally elevated.

The act of being creative, it is assumed, occasions elation. No doubt this is true, but studies of mania and creativity, along with results from studies of experimentally induced positive mood, suggest that the opposite may be at least as important: that is, elevated or expansive moods come first; creative thinking follows. Creativity may then, in its own right, elevate mood; this can lead to extended periods of reverberating moods, energies, and imagination. It may lead to decreased sleep as well, which can further elevate mood.

The links between manic-depression and creativity suggest some ways of understanding the connections between positive mood, thinking, and behavior. But mania is a pathological condition and represents extremes in mood and behavior. More illustrative of positive emotions and high energy—of “normal” exuberance—are the temperamental qualities closely allied with
manic-depressive illness. Emil Kraepelin, who remains for most of us who study the illness the preeminent authority on the subject, describes a temperamental variant, which he called a manic predisposition. “
The slightest forms of the disorder,” wrote Kraepelin, “lead us to certain personal predispositions still in the domain of the normal. It concerns here brilliant, but unevenly gifted personalities with artistic inclinations. They charm us by their intellectual mobility, their versatility, their wealth of ideas, their ready accessibility and their delight in adventure, their artistic capability, their good nature, their cheery, sunny mood.” But, Kraepelin goes on to say, there are liabilities to this temperament: “they put us in an uncomfortable state of surprise by a certain restlessness, talkativeness, desultoriness in conversation, excessive need for social life, capricious temper and suggestibility, lack of reliability, steadiness, and perseverance in work, a tendency to building castles in the air.” People who have this temperament, he observed, may also be inclined to depression, although it is usually their relatives who show the most severe pathology. This tendency toward depression, together with a typically strong family history of manic-depression, led Kraepelin to his belief that the manic predisposition (or the sanguine temperament) is to be regarded as “
a link in the long chain of manic-depressive predispositions.”

Modern researchers tend to support Kraepelin’s belief in the existence of “manic-depressive predispositions.” Hagop Akiskal and his colleagues, as we have seen, find that
certain temperaments, including hyperthymia—characterized by optimism, high energy, enthusiasm, and extraversion—are part of a continuum of traits in the general population. Individuals who score high on hyperthymia are more likely to switch into mania than those who score very low. This is also true for college students who obtain high scores on the
Hypomanic Personality Scale, a test developed by psychologists to identify people at high risk for developing bipolar disorder. A
thirteen-year follow-up study of students who scored high on the test found that they were more likely to experience subsequent attacks of mania and depression. (Typical items on the scale are: “I am frequently so ‘hyper’ that my friends kiddingly ask me what drug I’m taking”; “I often have moods where I feel so energetic and optimistic that I feel I could outperform almost anyone at anything”; “I often get so happy and energetic that I am almost giddy”; “I often get into excited moods where it’s almost impossible for me to stop talking.”) The Hypomanic Personality Scale correlates with personality dimensions such as extraversion and openness to new experiences. Six percent of college students tested meet the criteria for hypomanic tendencies, a figure reasonably close to the 8 percent who were categorized as hyperthymic in a
study of American and Italian students. These estimates are comparable to the 10 percent of children described as exuberant by Jerome Kagan at Harvard, and the 10 percent of infants characterized as exuberant by Nathan Fox at the University of Maryland.

It is clear from clinical observation and decades of scientific research that exuberance is an important phase of acute mania for most of those who become ill. A significant percentage of people who have manic-depressive illness also have an underlying exuberant temperament. Clearly, however, most people who are exuberant do not have manic-depressive illness. There are overlapping characteristics—high mood and expansive energy, among others—but there are critical distinctions as well. Exuberance is far from a pathological state for most who have it. It is, instead, a highly valued and integral part of who they are and how they meet the world. Understanding the role of exuberance in manic-depression can provide one perspective on exuberance—extremes in behavior will almost always illuminate more normal behavior—but there are limits to the comparisons that can be made. Still, the shading of normal exuberance into “pathological enthusiasm,” as
Robert Lowell once described a manic attack, is an important as well as a cautionary phenomenon, and it is one to which we will return.

Enthusiasm is intoxicating: it goes to the head. Just as it is hard to remember while under the spell of Champagne that beneath the fizz lies a dangerous undertow, so it is with exuberance. But if dangerous on occasion, far more often it is a delight, a lift, and a boon.

CHAPTER SIX
 
“Throwing Up Sky-Rockets”
 

(photo credit 6.1)

P
eople
like
to be humbugged, declared P. T. Barnum. They need sizzle and flair to lighten their otherwise “drudging practicalness”: they long to catch fire, be bedazzled, be a part of something that delights them, excites them, and binds them to others. They want someone to splash their world with color; someone, as Barnum put it, to “
throw up sky-rockets.” Barnum was more than glad to oblige; most people, as he knew to his advantage, shared neither his genius for invention nor his irrepressible exuberance.
He was, he wrote, “
blessed with a vigor and buoyancy of spirits vouchsafed to but few”; it would be, he continued, “
utterly fruitless to chain down the energies peculiar to my nature.” As we shall see, he never tried. Far from chaining down his energies and spirits, Barnum set them loose to infect others.

Emotions are contagious. We survive because we apprehend quickly in others, and then speed on their way, those emotions that alert us to risk or prospect. Emotions are part of the social glue of our immensely social species, elemental to the reverberating emotional circuitry that compels us at times to pull together and at others to disperse. Nothing, it would seem, is quite so wildly contagious as exuberance, and yet it remains curiously absent from psychological explorations of group behavior. Certainly it is easier to find studies of despair and anxiety than of infectious enthusiasm; perhaps the bent of the human condition dictates this, spelled as it is by uncertainty, suffering, and death. An undercurrent of darkness runs throughout our philosophical beliefs, and melancholy is woven into our great literature and music: “
We can hear it in all acuteness in Schubert and Schumann,” wrote Leon Edel. “It sounded for us in the cosmic cadences of Beethoven; it comes at us from almost every page of poetry.” Words for desolation come apace, those for exuberance less so.

Anyone who teaches about moods knows this to be true: it is far easier to convey the essence of depression to young doctors and graduate students than it is to depict mania or other elated moods. In part this is because the language for melancholy is such a rich and nuanced one, but it is also because those who are being taught about moods are more likely to have experienced depression than either mild or full-blown mania. This discrepancy was brought home to me when I was director of the UCLA Affective Disorders Clinic and responsible for teaching psychiatric residents and clinical psychology interns about depression and manic-depressive illness.
There was a glaring and disproportionate emphasis on clinical teaching about depression, even after taking into consideration the fact that depression is more common than mania.

Elated mood states were given short shrift in the medical and psychological research literature as well; their seductiveness to the individuals who experienced them was seldom mentioned and there was little or no discussion of their highly infectious nature. Anyone who treats the early stages of mania knows the exhilarating maelstrom they create, but few clinicians and scientists were writing or talking about this. As someone who had experienced the fleeting glories of mania firsthand, I found the oversight grating and difficult to understand. Yet I was as incapable of describing mania as the rest of my colleagues were.

At the height of my frustration in teaching about exultant and manic states I happened to see Jim Dale’s Tony Award—winning performance in
Barnum
, a musical shot through with exuberance. In a high gust of enthusiasm I wrote to Mr. Dale, explained my teaching conundrum, and asked him if he would be willing to meet with me to talk about how actors portray moods. He generously agreed to do so and turned out to be a highly intelligent observer of human behavior, as well as exceptionally thoughtful on the subject of how to depict exuberant moods and how to ignite them in others.

When words are neither the only thing nor the most important, Dale emphasized, then action is. And music. For it is in action, in dance and in music, in the kinetic thrusting upward of arms and legs and the throwing up and back of the head, that great joy finds its highest expression. Everyone on the
Barnum
set, he pointed out, is in near-constant, rollicking motion. The music is fast, loud, brassy, and exhilarating. Barnum talks fast and moves faster; others who are onstage are either singing or dancing, juggling, bouncing, or leaping. Or doing them all simultaneously. Everything—music,
lyrics, balloons, streamers—blasts out in primary, audacious color. Indeed, it is in the exuberance of color that the musical’s librettist, Michael Stewart, has Barnum sum up his life: “
The colors of my life,” Barnum sings,

Are bountiful and bold
·    ·    ·    ·    ·    ·    ·    ·
The dazzle of a flame
The glory of a rainbow
I put them all to shame
.
No quiet browns and grays
I’ll take my days instead
And fill them til they overflow
With rose and cherry reds
.
And should this sunlit world
Grow dark one day
The colors of my life
Will lead a shining light
To show the way
.

 

Jim Dale’s dazzling energy as Barnum electrified the rest of the cast and the audience. His actions and moods were, simply put, contagious.

The real P. T. Barnum showed little inclination toward muted colors or a quiet existence: “
I have lived so long on excitement, pepper, & mustard,” he wrote to a friend, “that plain bread & milk don’t agree with me.” He saw little reason to tone down his natural flamboyance; on the contrary, he delighted in it and used it to infuse fizz and spark into the world around him. Everything Barnum created was larger than life; his was a world of razzle-dazzle and poster colors. Neither time nor setbacks muted his zeal. When he was nearly eighty years old, the inexhaustible Barnum took his circus to
London. The bewilderingly complex production required three ships to transport the twelve hundred performers and more than four hundred horses and other circus animals. Billed as a “triple 100 act circus,” it featured a “Roman Hippodrome,” one hundred chariots, and a reenactment of the destruction of Rome. There were “wondrous mid-air feats” and “Mirthful and Astounding Visions.” The “united enchantments, delusions and displays of all ancient and modern magicians of every clime,” proclaimed one circus poster, were “commonplace and puerile, compared with the Supernatural Illusions [which are] for the first time exhibited, without extra charge, in the Great Show’s Electric-Lighted Wizard’s Temple.” Barnum never met an excess he didn’t like, never saw a rainbow whose colors he couldn’t improve.

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