A Summer of Madness

September 7, 2008 8:02 PM

Oliver Sacks on Manic-Depression.
posted by vronsky (30 comments total)

Man, I love Oliver Sacks, especially "An Anthropologist on Mars". I'm looking forward to reading this. "Uncle Tungsten was pretty neat, although I got the feeling he was hiding certain key elements of his relationship with his mother, who, when Sacks was 14 or so, brought home the cadaver of a 14 year old girl for him to dissect. How weird is that? Although it was described more explicitly in the book (and it was indeed in the family home, which doubled as a medical clinic), I found this on NPR:

His mother, a surgeon and professor of anatomy, hoped her son would follow in her footsteps. When Sacks was 14, she took him to the Royal Free Hospital in London to watch -- and take part in -- the dissection of a human corpse.

"I was very shocked and frightened," he says. "I had never seen a corpse before. It was suggested that I dissect a leg, and the professor said, 'here's a nice leg for you'."

Although Sacks had dissected plenty of worms and frogs before, this business of cutting up a human body was altogether different. And more disturbing for him, the body was that of a girl his own age. "I wanted to ask, what happened? How did she die? How did she find her way here?"

posted by KokuRyu at 10:09 PM on September 7, 2008 [3 favorites has favorites]

This is a great post.

What bugs me, though (and I am not kind of idiot who denies the existence of medical psychosis) is that the medicalization of these kinds of limit-experiences is not without consequences. This quote--

I wanted to believe this too,...to believe in her breakthrough, her victory, the delayed efflorescence of her mind. But how does one tell the difference between Plato's "divine madness" and gibberish? between [enthusiasm] and lunacy? between the prophet and the "medically mad"?

--really illustrates the problem.

"Divine madness," the experience of a breakthrough to some other level of reality, the moment of clairvoyance that brings the entire world together into a coherent and, as it were, effable whole, is not separable from mental illness. There can be no split between the "holy fool" and the mentally ill or between the mad poet and the psycho. The mind is the brain; when the mind has been loosed from its moorings, why shouldn't the brain go haywire as well? That moment, in the classic poetic or "tragic" vision, is never something that can allow reason, normally cool and calculating but momentarily deranged, to remain separate from a body that remains blissfully uninvolved with the whole process. It is as much a physical as a mental experience.

So the distinction between genuine poetic madness, which of course is laudable and has furnished motels across America with reproductions of "Wheat Fields," and fake clinical madness, which needs to be immediately and ruthlessly suppressed for the patient's own good, is not real. (The article touches briefly on Van Gogh and other classic figures, but it's easy to get carried away with diagnosing people from history with various disorders). The German poet Hölderlin spent the last half of his life pretending to be schizophrenic, or actually being schizophrenic. The symptoms are indistinguishable, in this case, from the cause.

We have a problem, then. We love our artists mad, but we want our children and ourselves to be sane and happy. These goals conflict. It is impossible to cure the sick without excising the element of derangement that drove them into their work in the first place. So as we medicalize and medicalize, we soon lose something that we see as fundamental to artistic creation. But on the other hand, it's easy for me to say: I'm placid and stable and have not destroyed my life or run in traffic.

Can there even be a solution? Maybe it is to give up on the tragic and to insist that art is order and reason. After all, the idea of the artist as inherently a crazy and irrational Romantic is very much a product of the nineteenth century--because it is only then that the artist becomes the Other of reasonable bourgeois society. Artistic classicism, with its clean white lines and mathematically precise arrangements, has been historically much more significant. And the alternative, an insanity carefully preserved and cultivated like a bonsai tree in a Japanese garden, is probably equally threatening. Maybe returning to a (neo)neoclassicism will let us finally stop using the mentally ill as footsoldiers in our battles against abstractions like Normality and Reason.
posted by nasreddin at 10:27 PM on September 7, 2008 [23 favorites has favorites]

Just to clarify, this is a review by Oliver Sacks of Hurry Down Sunshine by Michael Greenberg, whose daughter Sally is struck by manic depression, often referred to as bi-polar disorder, as a teenager.
posted by longsleeves at 10:31 PM on September 7, 2008

A book review is a great post?
posted by mrnutty at 11:24 PM on September 7, 2008

Huh. Sacks always gets me thinking. I adore his writing, his character coming through. There is something deeply lovable about this man.

Handling bi-polar must be so arduous, for the person suffering with it and for those who love the person, witnessing the pendulums.

It would seem that mania is a malfunction of the meso-limbic system?

His review got me wondering about dopamine and mania, dopamine and euphoria, dopamine and a sense of well being.

I've been thinking about dopamine as I've struggled with intense anergia (no-energy) after having my thyroid removed.

Reading about dopamine's connection with glutamate, it makes sense why taking glutamine supplements help in a sense of well being. L-tyrosine. Another intriguing supplement, dopamine related.

Related t-shirts, dopamine, bi-polar.

In India one would occasionally come across foreigners, travelers, who had succumbed to the stress or strangeness of the place and become mad. I remember sitting at a table in a hippie restaurant in the seaside town of Puri, in Orissa in February 1978. I remember that date because my father had died just a few weeks before and I had gone there to grieve in quiet. A young American man was raving, in a mania. It was an incredible stream of consciousness spew, kaleidoscopic vomitus that was mesmerizing but disturbing. A verbal depiction of an Heironymous Bosch painting sort of thing. Nightmare confetti. His manic ramblings remained in my memory all these years.
posted by nickyskye at 11:53 PM on September 7, 2008 [1 favorite has favorites]

and to insist that art is order and reason.
posted by nasreddin at 12:27 AM

Accounting is order and reason.


A young American man was raving, in a mania. It was an incredible stream of consciousness spew, kaleidoscopic vomitus that was mesmerizing but disturbing. A verbal depiction of an Heironymous Bosch painting sort of thing. Nightmare confetti. His manic ramblings remained in my memory all these years.
posted by nickyskye at 1:53 AM

I think I dated his sister ...
posted by dancestoblue at 12:49 AM on September 8, 2008 [1 favorite has favorites]

I am a twentieth century artist because it allows me to get away with being crazy and irrationally romantic. I very much hope it stays that way.
posted by JackarypQQ at 1:12 AM on September 8, 2008

That is an interesting review of what sounds like a really interesting book.
Thanks, I would not have seen it otherwise.
posted by From Bklyn at 2:33 AM on September 8, 2008

I am a twentieth century artist because it allows me to get away with being crazy and irrationally romantic.

No offence, but I am trying to get with the new millenium.
posted by Wolof at 5:31 AM on September 8, 2008

Thanks for the link. Sachs has written about a number of people whose minds seem to get overclocked by mental illness or injury (eg "witty, ticcy Ray"). The fascinating thing for me is that some seem to be really raving - seeing connections and insights that aren't there, yet some people in this state do seem to be on to something and gain a sort of ability to hyper sense reality. It is intriguing to think of the possibility that it might be a matter of degree, not kind, between a "normal" person who is a quick wit and sharp thinker and someone who has lost grip on reality.

I remember taking drugs with friends in college and thinking how insightful and brilliant we were, so we turned on a tape recorder (remember those?) to capture our thoughts for posterity. In the morning none of it made any sense at all.
posted by jetsetsc at 5:38 AM on September 8, 2008

mrnutty: "A book review is a great post?"

Ahem.. the New York Review of Books is "book reviews" like caviar is "fish eggs" and truffles with chocolate are "candy bars". May your pallet be exploded with new taste dimensions.
posted by stbalbach at 5:49 AM on September 8, 2008 [2 favorites has favorites]

Oliver Sacks on Manic-Depression.

I missed the part where he lit his guitar on fire.

I'm sorry, I'll shut up now.
posted by middleclasstool at 6:21 AM on September 8, 2008

Good post, thanks. Sacks writes well and the book sounds like a winner.
posted by RussHy at 6:38 AM on September 8, 2008

May your pallet be exploded with new taste dimensions.

Where can I get these truffles with chocolate? I only ask because I have some pallets that need to be exploded, or at the very least, educated.
posted by longsleeves at 7:12 AM on September 8, 2008 [2 favorites has favorites]

This association between Art with a capital A and madness makes me actively angry. The vast majority of people with manic depression do not make great art. Most artists with manic depression are hindered by their disease. Manic depression is only a crucible of creativity if you have a very limited idea of what creativity entails.

Creativity is not a constant stream of ideas and energy. It's the ability to choose between them effectively. Creativity is embodied by the choices we make and great. The difference between a great artist and a mediocre artist is not their skills - a forger can duplicate a piece of art perfectly (which is definitely skillful but can hardly be described as creative). The difference is in the way they apply their skills.

For me, hypomania (I don't go completely crazy) has got in the way of things I want to do, creative and otherwise. I can be hugely productive, but hypomania and mania destroy your judgement. It becomes impossible to make effective creative choices; any creative intuition I've developed is obliterated. I might be able to produce volumes, but that doesn't mean they're any good. The mentally interesting people I know would say similar things. The mania of manic depression only looks fun from the outside. It's good for a while; there's a sweet spot where the flow of ideas intersects with good judgement and creative intuition, but the disease doesn't let you balance there. A stream of thoughts, no matter how inspired is no fun and no good, when you can't stop to think about them in any detail, nor do anything interesting with them.

Manic depression is a treacherous disease. It convinces you that it's good for you, that you need it, that without it you'd be dull, boring, uncreative. It tells you that a life without highs and lows wouldn't be worth living, that the highs are worth the lows, that you're special, that you can be great, that you are great and why would you want to pharmaceutical that all away? The idea that art comes from madness is a pernicious idea that's generated by and plays to the disease. It keeps people ill. It destroys lives. I spent years and ignored deep, suicidal depression because I didn't want to take pills that would make me boring.

So yeah, the link between Art and creativity and madness makes me angry. It's a lie that keeps people ill. And it kills.
posted by xchmp at 7:52 AM on September 8, 2008 [18 favorites has favorites]

It's a good post because it's a relevant piece of writing which has given me some fresh insight into a good friend's recent "breakdown". It was over a year ago and she now seems to have made a full recovery but the visionary parallels are ominous indeed.
posted by philip-random at 9:07 AM on September 8, 2008

Bipolar can be fatal. It requires medication. And I don't really give a fuck how you like your artists.

Articles like this make me sick.
posted by sondrialiac at 9:49 AM on September 8, 2008

Bipolar can be fatal. It requires medication. And I don't really give a fuck how you like your artists.

Articles like this make me sick.

Wow, you didn't read the article or my comment, did you?
posted by nasreddin at 9:59 AM on September 8, 2008

Great comments everyone. The debate about madness versus artistic vision that xchmp and nasreddin bring up is explored more thoroughly in Touched with Fire: Manic-Depressive Illness and the Artistic Temperament.

I met Dr. Sacks at a book and author dinner once. I was always a fan of his essays in the NY'er and particularly one he wrote about his love of swimming. I was having a great conversation with him until I asked about his feelings on Bill Murray's winking portrayal of him in The Royal Tenenbaums. He obviously was not pleased and that was basically the end of the conversation.

(hey longsleeves, pointing out a homonym misspell makes you look like a douche. If you don't like my posts, please skip them)
posted by vronsky at 10:06 AM on September 8, 2008 [2 favorites has favorites]

I'm a little troubled by Sacks' glorification of the manic side of manic-depression. Having experienced manic-depression myself, I can attest that the intense energy and creativity of the manic or hypomanic state is always followed by the soul-crushing depths of depression. Riding the roller-coaster between the two states isn't a lot of fun and doesn't lend itself to a very stable life.

Sacks is particularly odd when he states, "There is relatively little attempt to understand Sally in the hospital—her mania is treated first of all as a medical condition, a disturbance of brain chemistry, to be dealt with on a neurochemical basis." Manic depression is a medical condition. The doctors can take the time to "understand" her once she is stabilized. For me, a psychological disorder becomes a problem when it interferes with one's ability to function normally. Clearly, Sally's manic-depressive states make it impossible for her to do so.
posted by oozy rat in a sanitary zoo at 10:25 AM on September 8, 2008

Wow, you didn't read the article or my comment, did you?

Yes, I did. What's your point?
posted by sondrialiac at 10:36 AM on September 8, 2008

Yes, I did. What's your point?

Neither Sacks nor myself are denying that it's a serious and potentially fatal disease. How you choose to interpret any of this as "ARTISTS GREAT DOCTORZ BAD" is beyond me. Not to mention that my comment attacks that argument directly.
posted by nasreddin at 10:42 AM on September 8, 2008

The debate about madness versus artistic vision that xchmp and nasreddin bring up is explored more thoroughly in Touched with Fire: Manic-Depressive Illness and the Artistic Temperament.

The strength and weakness of Jamison's writing on manic depression is that she's, as Sacks puts it, "brilliant and courageous". She lives up to the promises of greatness that manic-depression makes to its victims. Most people with manic depression never will. It's easier to see wonderful creativity and genius in the disease if you are, in fact, a wonderfully creative genius with the disease.

Which isn't to say her writing isn't interesting - hell, Sacks is right, it's brilliant - but this kind of work seems like a good example of confirmation bias to me.
posted by xchmp at 11:22 AM on September 8, 2008 [1 favorite has favorites]

I thought Stephen Fry's Secret Life of the Manic Depressive was interesting. It was a two part BBC documentary where he talks about his own manic depression and how it has affected his life, as well as talking with other people who have manic depression as well. For anyone interested in this stuff.
posted by bjrn at 12:28 PM on September 8, 2008

longsleeves: "May your pallet be exploded with new taste dimensions.

Where can I get these truffles with chocolate? I only ask because I have some pallets that need to be exploded, or at the very least, educated."

That's what I get for being snooty over NYRoB. Now I know how to spell pallet, palate and palette - at least for today.
posted by stbalbach at 12:48 PM on September 8, 2008

Nice article. Thanks vronsky. Sacks consistent allowing of patient's experiences to speak for themselves comes as so refreshing, especially given the high propensity for spurious positions and opinions within the topic of mental illness. Speaking of.. I have almost never encountered a study or article on bipolar that delves deep into non-drug treatments. I know my own experience involved heavy medication for 10 years, but also 10 years since with no medications at all, yielding a much more manageable (if also ever-present) "illness" using a variety of methods ranging from martial arts to disciplined studying. Can anyone point to information about treatments involving exercise, meditation, focused activity, non-drug therapy etc with (preferably published) results?

On preview: Bipolar can be fatal. It requires medication. And I don't really give a fuck how you like your artists

very well illustrates both the perception and even language of bipolar disorder. Yes it can be fatal, I have family members's pasts to remind me. No one who's experienced either the disorder or someone undergoing the disorder would dispute this. It is the second sentence I must contend, as a living example (as yet anyway) against this. The final sentiment sounds like a verbalized summation from the disease itself. Nicely done.
posted by sarcasman at 1:10 PM on September 8, 2008

Happy to help, sarcasman.
posted by sondrialiac at 1:47 PM on September 8, 2008

It could be said that a Summer of Madness is also very often a madness of summer, as it is in this case, though I don't remember whether the possibility Sally Greenberg's mania might be due to Seasonal Affective Disorder was addressed in the article.

Especially for people who live in the far north:

In sunny Sarasota, only 4 percent of those surveyed were diagnosed with SAD or at least showed symptoms of SAD. As degrees of latitude increased, so did the prevalence of SAD and SAD symptoms. About 17 percent of the residents of Montgomery County, Maryland, and those surveyed in New York City showed SAD symptoms. Twenty percent of those responding to a mail survey in Nashua, New Hampshire, were affected. In Fairbanks, where the researchers interviewed about 300 people who had lived there for more than three years, 28 percent were diagnosed with either SAD or SAD symptoms.

In fact, the 1992 study found that SAD may affect one of four people in Fairbanks. Researchers suspect that hormonal differences between women and men may make women more susceptible to SAD. The study showed that three women to every two men reported symptoms. ...

Maybe I wasn't just imagining, then, that the former mayor of Wasilla's burning gaze-- Wasilla is five degrees south of Fairbanks-- looked a lot like some of my friends' when they are in full-blown mania.

Sarah Palin may not be suffering from SAD or SAD symptoms, of course; with no other information her chances seem to be ~25%-- but there is that fixed and unchanging glare.
posted by jamjam at 4:08 PM on September 8, 2008

Sacks is particularly odd when he states, "There is relatively little attempt to understand Sally in the hospital—her mania is treated first of all as a medical condition, a disturbance of brain chemistry, to be dealt with on a neurochemical basis."

A common theme in all of his books (most notably in An Anthropologist on Mars) is that the "ailment" can be a fundamental part of self. For Temple Grandin, autism or Aspergers is note an abnormality but a fundamental part of self. Wiccy Ticky Ray became an different person once medication had neutralized his various ticks.

I would say that for Sacks the key is alleviating suffering. While Ray learned to regulate (but not abolish) his ticks by taking medication, there is the harrowing picture Sacks paints of a Tourette's sufferer he glimpsed in an alleyway suffering through one massive (and long) tick. Her quality of life was suffering.

Likewise, many great "artists" have experienced euphoria prior to migraines or a seizure. However, given Sacks' descriptions of the power of psychiatry and therapeutic drugs, I don't think for a second he is saying that someone who is bipolar is experiencing something noble. However, the condition fundamentally affects their personality, their very being. They cannot return to "normal", although they can return to a decent quality of life.

But Sacks, while a profoundly caring and humane individual and physician, would never romanticize the beauty of mental illness and it's (lack of) relationship to art.
posted by KokuRyu at 5:21 PM on September 8, 2008 [2 favorites has favorites]

The argument several people are making in this thread --- that the role of mental illness in inspiring creativity should presents a conflict with the need to treat mental illness --- is plainly silly.

It's like saying, "Great art has been inspired by poverty! It is so regrettable that our need to alleviate poverty may stifle the great artworks that would have been created as a result of poverty!"

Nasreddin says: "What bugs me, though (and I am not kind of idiot who denies the existence of medical psychosis) is that the medicalization of these kinds of limit-experiences is not without consequences."

Well, lots of terrible things in the world have inspired masterful works of art, but that's not an argument against eliminating the terrible things. To be "bugged" by the "medicalization of ... limit-experiences" is to romanticize mental illness and remain fixated by the idea of the "mad artist."
posted by jayder at 10:13 PM on September 8, 2008