[FoRK] NYTimes on Hypomania

Rohit Khare rohit at ics.uci.edu
Tue Mar 22 17:19:02 PST 2005


Fun piece, describes a lot of FoRKs, I'd bet :-)

PS. Darn the Times for removing the "email this article (full text)" 
option!

March 22, 2005
Hypomanic? Absolutely. But Oh So Productive!
  By BENEDICT CAREY
http://www.nytimes.com/2005/03/22/health/psychology/22hypo.html

"Sometimes 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 conversational style.

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 
paralyzing despair.

  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 subsequent 
gloom.

  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 
status.

  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 
going."

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 
conditions.

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 
said.

  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 
bipolar disorders.

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 
Venter.

  "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 the 
moon."

  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 
be difficult."

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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