On Churchill’s black dog, Barzun’s bicycle, and cartoon bears: living within the bipolar temperament

Abstract

Life lessons from a civilization’s most consequential individuals are hard to come by and, certainly, rarely find their way into a medical journal. However, such investigations can repay study—as Plutarch’s continued popularity demonstrates. Our subjects lived before the era of medications and might today be diagnosed, not coincidentally, as having bipolar temperaments, and possibly bipolar disorder as well, and suffered severe depressions. We consider Robert Burton, Samuel Johnson, Meriwether Lewis, Winston Churchill, William Osler, and Jacques Barzun with an eye toward understanding how they were able to get the best from themselves and stimulate the most intense expression of their remarkable gifts—all the while escaping crippling depressions to which they were prone. Their insights were forged in the harsh crucible of life experience. Five of them (there appears no record of how Lewis understood his temperament) sought to pass on what they had learned, even writing about their discovered truths in similar fashion. Each found salvation in total commitment to a creative and spiritually satisfying challenge of an all-encompassing sort. Such a technique proved to be both palliative and prophylactic for reasons that, scientifically, are unclear. Some of the questions that their distinguished lives suggest are discussed.

Introduction

“Every man is to take existence on the terms on which it is given to him.”

--Samuel Johnson to Thomas Boswell (Boswell 2007 p.547).

While how to live within one’s means is a skill that is often taught, how best to live within one’s temperament must be learned the hard way—if the concept is even considered at all. In no group is this art more important than those who live with bipolar temperaments, which can bestow great gifts but also exert a great toll.

We briefly visit six extraordinary individuals. All had accomplishments that we feel were beyond the reach of anyone else in their societies, belonged to eras before psychiatric medications were available, likely lived with bipolar temperaments (and possibly bipolar disorder), and experienced depressions. And all seemed to hit on the same means to sidestep depressive recurrences and get the most out of their immense talent, even to the point of wanting to pass on what they had learned.

Kraepelin was among the first to write about bipolar temperaments in his textbook (1921), believing them to be mild expressions of manic-depressive illness. This remains the consensus view (see Goodwin and Jamison 2007 and Akiskal and Akiskal 2005 for discussion and helpful descriptive reviews and Favaretto et al. 2024 for the recent state of the art). These temperaments—hyperthymic, cyclothymic, irritable, and depressive—are understudied, however, and still in the process of being better worked out (Perugi et al. 2017; Akiskal and Akiskal 2007). Their boundaries are not clean, and they may merge into each other and into bipolar disorder itself, or into normality. And a person can suffer true bipolar swings while keeping the temperamental style. One aspect of the temperaments, which exerts a powerful force, is the depressions with which they can be associated. In his treatise, Ernst Kretschmer (1926), who preferred the term cycloid temperament, approached these patients a little differently than Kraepelin did. He wrote, “It is not the temperament itself that is sad, but it is only more easily roused by sad conditions. Further, many of these [seemingly sunny hyperthymic individuals] have a permanent melancholic element somewhere in the background of their beings. … Goethe’s mother, a woman of the sunniest hypomanic disposition, gave her servants orders never to tell her anything unpleasant, so greatly did her emotions need this artificial protection from themselves” (Kretschmer 1926 p.126). It was an intriguing observation to let drop, but he never sought to elucidate why this might be, although he surmised constitution and childhood upbringing played a part. The depressions that such patients experience are far more than just a slowing down. In a memoir about his own illness (1992), William Styron wrote that “depression,” so casually used to describe a rut in a road or an economic downturn, is grossly inadequate to the experience. The DSM’s qualifier “major,” while an improvement, is not fully successful. Some writers have preferred “melancholia,” a word hundreds of years old. (It finds use now in the DSM to describe depressions with classic symptom clusters, such as anhedonia and vegetative signs.) But perhaps it is too beautiful-sounding a name for the agonizing affliction it describes. Unless one goes through a depression, there may be little true understanding of its corrosive effects, despite the efforts of many great writers (highly overrepresented as exemplars of bipolarity) to convey what it is like, or the imaginative and empathic efforts of a physician or therapist listening to the words of a suffering patient. What is clear, however, is that it can be a terrifying experience that often leaves a permanent mark in its wake: a persistent fear of recurrence, especially when it has been accompanied by paralysis, helplessness, overwhelming anxiety, and powerful urges to suicide which are difficult to defend against, and when there is little understanding of how or why it arose.

Among the temperamental types, hyperthymics can broadly be seen as among the movers and shakers of the world, human dynamos epitomized by Teddy Roosevelt, who seemed to his closest observers to be always in motion. They are natural leaders—optimistic (sometimes overly so), forceful, alert, fearless (sometimes too fearless), charismatic, socially at ease, radiating energy and needing little sleep. There may be depressions or movements toward hypomania to a greater or lesser degree throughout a life, but overall, most hyperthymics would probably find it odd to find themselves in a manual of psychiatric pathology (Akiskal and Akiskal 2007). Cyclothymia is the state often peopled by highly sensitive and creative individuals, who use the activation and mild upswings to get the most out of their creative gifts, although they are also prone to depressive reactions and suicide attempts (Perugi et al. 2017; Akiskal 2001). While writers can advantageously access more of themselves when in the grip of the intense emotions cyclothymia can stir up, the high sensitivity comes at a cost, and there is emotional instability. There is much variability in its presentation (Perugi et al. 2015). Little upswings, in some people, may occur often enough and last long enough for them to feel that their mild euphoria represents a sort of euthymic baseline and, having never known any different, is a normal part of a person’s life (Perugi et al. 2017). In irritable temperament that part of bipolarity is expressed inordinately, and in depressive temperament there is a dysthymic lifestyle. These last two personality types have garnered less interest among investigators than the first two.

The insights about life and bipolar disorder our six figures provide have not been scientifically studied (and perhaps could not easily be studied). Biographical information, first-person accounts, and supplemental case histories form the basis of our research. We therefore make no pretensions to being “scientific,” but rather truthful to the lives of our subjects. We acknowledge that retrospective diagnoses may appear an unworthy shorthand in our subjects; however, they are consistent with what is known about these figures and are provided to help organize our thesis. Although our cohort is small, we believe it has lessons to teach and generates issues to explore.

Robert Burton

Robert Burton (1577–1640) is remembered for The Anatomy of Melancholy, still in print after 400 years. It was a lifelong project which went through eight editions by the time of his death, and its six volumes consumed over a half million words. Not confined by the vagaries of any DSM, he was on his own, blazing his own trail with zestful verbiage and energy, and encyclopedic knowledge. The book’s continued popularity is due less to its medical virtues, though many remain relevant, than its wide-ranging literary forays into contemporary and ancient cultural life. Burton grew up in a loveless household. He fell into a severe depression when he was a student at Oxford, had to drop out, and was hardly functional for several years. Mental illness ran in his family, and today he might be diagnosed as bipolar disorder with cyclothymic temperament. He consulted an astrological physician for help on five occasions over five months (that doctor’s office notes have somehow survived) without apparent success. The depression seemed intractable, marked by complete emotional and physical prostration. Medicine could offer little at that time, and so Burton, a polymath of great energy and erudition when well (he was known for quoting extensive verses in Latin, both of important and obscure poems, even in general conversation) wisely decided to research the subject and cure himself. He memorably wrote: “I write of melancholy by being busy to avoid melancholy” (Burton 2002 p.24). And the remedies he discovered seemed in fact to help—subsequent drops below euthymia were apparently relatively brief and handled to a degree by the skills he had learned. Foremost among his insights was: “We should ever be in action. … There can be no better cure than continued busyness” (Burton 2002 p.106). He felt “the intelligent and sensitive suffer most” (Burton 2002 p.24). What he did not say outright but only implied: the busyness should best constitute a creative challenge. In general, melancholy was always lurking nearby, and it had to be surmounted or evaded repeatedly because all cures were only temporary. He said that he could not be alone or unoccupied for even an hour without sensing its encroachment.

In addition to his far-ranging studies as an Oxford don, Burton enjoyed and was quite knowledgeable about geography and mathematics, delighted in the natural world, and was an avid bibliophile, compiling a huge library for that time. When feeling energized, he was quite popular with students and peers and said to be a scintillating conversationalist. Oddly, despite all the words he wrote, he never discussed the particulars of his own illness, instead quoting what amounted to hundreds of other authors on the subject. Although he could not marry (a vow of celibacy was required for his Oxford position, something he decried, ahead of his time, as “unnatural”), he was not so constrained as a young man before taking that post, and in fact “love melancholy” is an important section of his work. He was constantly monitoring his fragile mood, and one quick booster he often used, when he saw himself starting to sink, was to go down to the wharves to watch and listen to the raucous give and take of the longshoremen, as they cursed and shouted at each other during their hard physical work. At this he might put his hands on his sides and begin to laugh. However, while he wrote (seemingly with a bit of envy but also incorrectly), “Entire idiots do best, they are not macerated with cares, tormented with fears and anxiety, as wise men are” (Burton 2002 p.xi), it is doubtful he really wanted to trade places with those of lesser intellectual gifts. Celibacy aside, he seems to have been made for the bookish life of an Oxford don.

Samuel Johnson

Samuel Johnson (1709–1784) also needed to drop out of college at Oxford for two years during a severe depression. (Burton explains why he thinks college students are so prone) (Burton 2002 p.51). His childhood was marked by poverty, marital discord, and lack of parental warmth. He noted he inherited “this vile melancholy” (Boswell 2007 p.25) from his father (his only brother was a probable suicide at 24), and it was a lifelong affliction. In fact, he lived his years in constant fear of going insane, which at that time might mean Bedlam and chains. We know quite a bit about him because Samuel Boswell, a friend and writer who himself likely meets criteria for a bipolar diathesis, wrote an extensive biography about him. The Life of Samuel Johnson is still believed by many to be the greatest biography ever written. There a reader will find evidence of the highs and lows which mark a bipolarity. Sometimes Johnson could “read like a Turk” (Krutch 1944 p.18) late into the night—but getting out of bed each morning to face a new day was an onerous chore. It is interesting that Boswell notes that the only thing that might rouse him two hours earlier was the prospect of reading in Burton’s tome. In addition to his unstable moods, he suffered with gout, edema, childhood tuberculosis that caused some skeletal deformities and required scarring facial surgery, poverty, death of his wife during his middle age, poor vision (in later years he needed to hold reading material two inches away to make out the words), and what appears to be a significant Tourette’s Disorder and obsessive-compulsive rituals. His depressions were marked by overwhelming anxiety and prostration. Johnson was fond of quoting Burton’s “Be not solitary, be not idle (Boswell 2007 p.747),” believing that “a man must always be tugging at his oar” (Boswell 2007 p.107). However, as with Burton, activity had best be commensurate with one’s gifts, “a task worthy of himself” (Bate 1975 p.252). Mere busyness, though helpful, was not sufficient. The activity must take possession of a person. Johnson’s emotional equilibrium was greatest during a seemingly impossible project he set himself to with just six staff and a rented house: creating the first true Dictionary of the English Language. To do it, he needed to know the exact way the language was used by the most educated people of his day. There he had an advantage: it was said that he had read everything of his time that was worth reading and much that wasn’t (he was well known for not finishing many books he browsed), and he illustrated his definitions with 140,000 examples of verse or fine writing of others. The project consumed him, though for the occasional “relaxation” required he tended to other literary projects, including some of the most profound essays for which he is known. That nine-year period was by far the most equable of his life. His mood began a slow decline over the ensuing years, “punctuated by bursts of activity” (Bate 1975 p.343), when he was not, to use a phrase he liked, “on stretch.” The depression in his fifties, which lasted for several years, was of such severity that he said he would gladly have sacrificed a limb to be rid of it. He remarked that “a kind of strange oblivion has overspread me, so that I know not what has become of last year” (Bate 1975 p.372). His terror was such that he even bought a set of padlocks and fetters to be used “lest the enemy that seemed to be winning against him pass beyond control” (Bate 1975 p.385). However, he refused to give in to despair and suicidal thinking, though they were strong temptations, relying on his strong Christian beliefs for support. They helped him make sense of the world.

Johnson’s personal heroism in the face of his many tribulations has won over his biographers. When W. Jackson Bate, a Professor of English literature at Harvard, reached the end of his semester-long course on Johnson, he was sometimes in tears. Thomas Carlyle summed up his life: “Shall we not say of this great mournful Johnson, that he guided his difficult confused existence wisely, led it well like a right valiant man” (Meyers 2006 p.31).

James Meriwether Lewis

James Meriwether Lewis (1774–1809), who undertook the greatest exploratory project in America’s history and one of the greatest in the world, was not an intellectual. Rather, likely hyperthymic and prone to depression, he was a fearless man of action and instinctive leader whose impressive physical bearing and assertive but kind demeanor gained him immediate respect. His father suffered periodic depressions, something well understood by Thomas Jefferson, who had known him. But Jefferson also knew that his son Meriwether, though he clearly showed those traits, was probably the man most capable of succeeding in a near impossible task he envisioned. Jefferson had wanted to discover whether there was a water route between the Mississippi River and the Pacific Ocean. He had recently doubled the size of the United States with the Louisiana Purchase, which included land all the way up through the west into what is now Montana and Canada. But beyond that, Jefferson, who was intensely curious about everything, also wanted to find out all he could about the plants, animals, rivers, rock formations, weather patterns, soil types, and the languages and customs of Indian tribes indigenous to these areas. To prepare Lewis, he invited him to live with him in the White House for two years. Dr. Benjamin Rush (a signer of the Declaration of Independence) taught him medical skills he would need to treat what might befall his men, and other experts tutored Lewis in flora, fauna, and how to most accurately describe them, and all else that might be applicable to know. Lewis then had to hire the right kinds of specialists to make the expedition and determine the right supplies to bring (obviously capacity was limited). They needed to know how to navigate by the stars and denote precise positions by their correct latitude and longitude, build boats (river rapids often necessitated abandoning their crafts and walking to where the current would support navigation), and ways to communicate by sign language with the sometimes hostile tribes they would encounter. Bringing along Sacagawea, a young Shoshone woman who was the wife of one of his men, was a stroke of genius. She was pregnant and delivered during the expedition. He correctly understood that no hostile native tribes ever attacked with a woman and child in their war party—thus he more easily gained the trust of the tribes he encountered. Had it not been for her, he would not have been able to procure the horses needed to traverse the Rockies at the farthest edge of his expedition. Lewis almost lost his life several times, surviving a grizzly bear attack armed with only his strength and guile and a bison attack while hunting alone. Smaller predators were challenging in their own ways—mosquitoes in some areas were so thick that it was impossible to keep them out of one’s nasal passages and throat. The clothes he and his men were given proved insufficient for the rigors of their task and soon fell away. Northwest winters were brutal. Starvation was close several times during the journey, there were some severe epidemics of illness, and warlike tribes contemplated attacks on the party to pillage it. And he needed to keep the copious journals Jefferson wanted—they could be written only at the end of the day, in the hours after his exhausted men had fallen asleep. The title of Stephen Ambrose’s biography, Undaunted Courage (1996), is apt—even the adjective is commensurate with the experience and his temperament. It did not appear that depression significantly impaired him during this 3-year project, except perhaps for some autumn/winter months when he made no journal entries, relying on Clark to do it. The intensity of the challenges he faced, predictable and unforeseen, physical and emotional and intellectual, consumed him and demanded the best of him and even seemed to fortify him—challenges which would have broken lesser men.

However, upon his return to civilization, the stasis of being a celebrity, the frustrations of the government post he was given, and dealings with backbiting and passive-aggressive bureaucrats, proved overwhelming to this larger-than-life leader, and Lewis lapsed into depression and alcoholism. He was heard pacing and talking to himself the night he died by self-inflicted gunshot wounds. He was only 35. It was Jefferson who provided the most insightful epitaph. In it he wrote, “During his western expedition, the constant exertion which that required of all the faculties of body & mind, suspended these distressing afflictions [i.e., his well-known tendencies toward depression]; but after his establishment at St. Louis in sedentary occupations, they returned upon him with redoubled vigour, and began seriously to alarm his friends” (Ambrose 1996 p.477). Kay Jamison discusses Lewis at length in her book about suicide and after Jefferson’s words adds, “Jefferson’s conjecture that Lewis’s melancholic tendencies were put on ice as long as he was actively and physically engaged but emerged later during slower, more sedentary times is perceptive, telling, and completely consistent with what is known about restless, energetic, and impetuous temperaments that have an obverse inclination to despair” (Jamison 1999 p.225). On a lesser scale, it is well known that some authors fall into depressions upon finishing their books—and they may last until the next project is begun (Storr 1965).

William Osler

William Osler (1849–1919) grew up in a loving Canadian family. He had prodigious gifts of empathy and observation, and was from childhood an unusually energetic and focused individual. William James commented on the intensity of energy that he radiated. Like Meriwether Lewis, he had the “innate ability to receive the trust and respect of patients and staff” (Howard 1983 p.73). The “Father of Modern Medicine” turned the Johns Hopkins Medical School and Hospital into models that every medical institution has since tried to emulate. He too advocated activity, and in the view of one biographer had “tendencies toward depression which he could not always disguise by continuing his heavy professional and social activities” (Howard 1983 p.73). Osler was a strong admirer of Burton’s work. In an address to the graduating Yale class of 1913 (Osler 1969), he recommended continuous focused activity, but at its proper pace (even then physicians could easily become harried with overwork). He felt that it should fully consume the day. An hour before bedtime (later decreased to 15 minutes) must be reserved for readings outside medicine, generally in literature or religion. He said one must neither slow down nor look backward (for we can do nothing about the past). Samuel Johnson had the same view: “The business of life is to go forwards. Cultivate the art of forgetfulness” (Sachs 1967 p.49). Nor should one even look forward (the future is unknown)—rather, he advised, concentrate all one’s energies on those 16 hours. He wanted his young doctors to “shut off the future as tightly as the past” (Osler 1969p.11). Actively moving through the day, stimulated and confined by the challenges that arise there, would produce the most fulfilling life. When not seeing patients and doing administrative work at Hopkins, he kept busy by singlehandedly writing his thousand page The Principles and Practice of Medicine, the major reference of the time and consulted worldwide. Work, however—he made it clear–must not consume all of every single day without burnout occurring, and he advised all physicians to have a hobby—but that hobby, like work, must be pursued vigorously. He advised his charges, once that hobby was found, to “straddle it and ride it hard” (Silverman et al. 2008 p.189). (He himself, like Burton, was an excellent amateur naturalist and avid bibliophile, bequeathing his 7,600-volume collection to his alma mater, McGill—and he even took it upon himself, when he moved from Baltimore to London, to better organize Robert Burton’s donated library.) Osler was said to have suffered a major depression in his fifties, after he had moved to England after beginning to feel overworked in Baltimore and had a lighter schedule—like Meriwether Lewis, done in by fruitless attempts to get a stultifying bureaucracy, impervious to his many gifts, to do the right things. His life at that time provided too few of the challenges that his prodigious talents required to remain, in Samuel Johnson’s words, “on stretch.”

Winston Churchill

It may not be an overstatement to say that Winston Churchill (1874–1965) “saved civilization” (Mandelbaum 2004). Understandably he has been the subject of a great many laudatory biographies, though few have sought to pursue his inner life. Of most interest to a psychiatrist, therefore, and perhaps most fascinating of all, is the 50 pages about him written by Anthony Storr, MD, a prolific psychoanalyst and an admirer (Storr 1965). Churchill’s mother was neglectful, his father neglectful and dismissive, and mood disorder ran in the family. He fell into a two-year long depression as a young man. In today’s terminology Churchill might be diagnosed as bipolar and of hyperthymic temperament—attributes which both hampered him and enabled his greatness. The energy and unwavering optimism and confidence that his temperament provided were what Great Britain needed at a time of great gloom and pessimism—indeed, “He was capable of tremendous physical and intellectual efforts, of high intensity, over long periods, often with little sleep” (Johnson 2009 p.5). However, his temperamental tendencies also tended to foster heavy drinking and gambling binges, which kept him close to bankruptcy, and some ill-advised decisions (during the war, at one important meeting he advocated the use of chemical weapons). He was a font of ideas, but his aides needed to separate the wheat from the chaff, with the ratio of one to ten, according to his military Chief of Staff (Keegan 2002). Activity—even constant activity—was of paramount importance to him. Storr writes, “Churchill was never happy unless he was fully occupied, asleep, or holding the floor” (Storr 1965 p.37). Lord Moran, who knew him well, wrote, “He was wretched unless he was occupied” (Storr 1965 p.16). He felt he could not let himself rest for even a moment—depression (which he called his “Black Dog,” an English nickname dating from the 1700s) might awaken to set upon him at those vulnerable times. Thus, when fatigued, he was famous for not resting but rather switching to a different activity. It might be building a wall (he was a skilled mason), painting (he became an excellent painter), or writing (his histories won the Nobel Prize for literature)—all creative endeavors. Samuel Johnson, too, used the technique, believing that momentum was all important, writing, “A momentous effort, if undertaken in any direction, more easily is transferred than summoned out of nothing” (Bate 1975 p.252). Yet this was no burden; indeed, “To act is far easier than to suffer,” as Johnson said (Davis 1989 p.134). One thinks of Mussolini, also likely hyperthymic: “There is no rest except in action” (quoted in Goodwin and Jamison 1990 p.360), and Teddy Roosevelt: “Black care [depression] never sits behind a rider who is fast enough” (Jamison 2005 p.9). Churchill well understood the risks of stasis, having seen its effects on other members of the family and on himself. His final five years, when he was in full retirement, were spent in a sort of depressive torpor during which he stopped reading and rarely spoke. He confided to his family, “I have achieved a great deal to achieve nothing in the end” (Storr 1965 p.19). (Ezra Pound, also likely of bipolar temperament, suffered a similar fate in his last ten years and described it thus to a visitor: “I did not enter the silence–silence captured me”) (Hall 1978 p.183).

Jacques Barzun

Jacques Barzun (1907–2012) grew up in an idyllic household in Paris, and was early on immersed in the high culture of the times. Composers, writers, and artists were frequent visitors to the home. The poet Apollinaire taught him how to tell time. All this crashed down when the First World War began. Some of the people he had known and loved were killed or maimed, or returned emotionally unrecognizable. Air raids, coal and food rationing, and more bad news were daily tribulations. The experience devastated him, and at age 11 he became severely melancholic, even suicidal that he should be spared. His family’s physician recommended that he be sent to the French seaside to recuperate, and there his spirits eventually did revive. He entered Columbia University at age 15 and remained there for fifty years, becoming Professor of History, Dean of Faculties, and Provost. Barzun helped create and was the most eminent practitioner of the field of cultural history, which includes not just political intrigue and wars but the study of day-to-day life, religion, psychology, philosophy, science, literature, art, music, education, and morals—obviously a job description that permits very few peers. While he did not realize it at the time, his childhood experiences led to his life’s work, a deep and coherent exploration of the West’s rise and decline. He began to speak and write about his ideas, to the bafflement of many, in a period of great American optimism, the 1950s. They are most comprehensively set forth in his 2000 magnum opus, From Dawn to Decadence: A History of 500 years of Western Cultural Life, really a lifelong project he had been thinking about since graduate school. Although the book was glowingly reviewed, and while it was generally agreed that he was the only person in the world who could have written it, it has not had the impact it deserves–even though it is presented in the highly readable “simple and direct” style for which he was known—probably because it is 800 pages long. An acquaintance with this masterful study would obviate the efforts of many commentators on the current scene. (A simplified preliminary, ominously entitled The Culture We Deserve, written in 1989, is much shorter and would provide a good introduction for an interested reader. And his erudition is on display, at age 94, in a three-hour C-Span interview available from YouTube.) Barzun long wrestled with the concept of “intellectual.” What really did that mean? He felt the question was an important one. While riding the subway to work one day, he noticed many people sitting in the car, seemingly occupied with various of life’s demands, and another person standing at a strap, holding a briefcase. He felt this epitomized an insight: that intellectuals cannot just go through life but must devote themselves to reading and contemplating, cultivating their minds, and understanding the human condition deeply. But this has its risks and dangers–namely depression, “a soul-destroying disease” to which they are prone (Barzun 2000 p.59). He was an admirer of Robert Burton and devoted space to him in the larger work, believing him to be the first “systematic psychiatrist” for the many case histories he presented. It is unclear whether Barzun could be said to have had a bipolar temperament. He was known for his unwaveringly composed and gentlemanly demeanor throughout his life, in fact has been described as one of the true “ornaments” to the Columbia faculty (Kimball 2003 p.6), but he had unusual energy–writing, translating, or editing over 40 books and penning hundreds of essays and reviews in addition to his teaching and administrative duties, and led an active social life. Five hours of sleep a night—and that often fitful–was all he needed. He started his magnum opus at age 83, unsure whether he would be able to finish it. (He did seven years later.) We devote space to him because of his similar advice to those active and talented people whose creative gifts put them at the vanguard of society, but who also have tendencies toward depression. For him, getting through life best is akin to riding a bicycle: one must look straight ahead and keep briskly pedaling. “[Happiness] comes from momentum,” he believed (Murray 2011 p.232), echoing Johnson and Churchill. (“An added benefit: no time to whine and groan”) (Murray 2011 p.203). The technique is also reminiscent of the surprisingly allegorical insights of our Saturday morning cartoon-makers: when a bear runs off a cliff and looks straight ahead, much progress can be made—until he pauses and looks down. If one can keep pedaling, an intellectual man or woman might become a “cheerful pessimist—that is, the evil of the day doesn’t eat into you and make you go around with a hangdog look” (Murray 2011 p.xvi). It allowed him, like other intellectuals he admired (e.g., William James and George Bernard Shaw) to lead “a painful but happy life” (Murray 2011 p.203) --in his estimation, perhaps the most that an intellectual can hope for. In the same way, Samuel Johnson, who seemingly lived life a day away from a depressive break, was “a pessimist with an enormous zest for living” (Krutch 1944 p.1), particularly relishing good food, literature, and conversation even though he felt that “human life is everywhere a state in which much is to be endured, little to be enjoyed” (Boswell p.376).

Discussion

Robert Burton, Samuel Johnson, Meriwether Lewis, William Osler, Winston Churchill, and Jacques Barzun refute the often-heard refrain that one person cannot make a difference. All likely lived with a bipolar temperament and some, perhaps, with bipolar disorder as well. Each seemed to sense the specter of depression lurking just around the corner. Almost all advocated momentum and activity—particularly absorption in a project that taxes one’s creativity and is all-consuming—as a needed means to keep depression at bay. Further, the project must, in Osler’s words, “satisfy the soul” (Silverman et al. 2008 p.58) and, in Barzun’s, encompass “loftier goals” which “transcend the self and which leave a mark” (Barzun 2019 p.34). (Lewis’s views are unknown. While his life clearly exemplifies these ideas, no record seems to exist of what he said or felt about his depressions.) For them, knowing the advantages and limitations of one’s temperament was as important as knowing the advantages and limitations of one’s intelligence or physical gifts. What else might their lives teach? For one thing, all imply that, on a lesser scale, these interventions could help almost anyone. Burton and Johnson advocated mere busyness and exercise as of value, and exercise is used as an adjunct or preventative measure in depression treatment today (Pearce et al. 2022). They did not feel that their lessons were confined to the most gifted, even if that group required grand projects. Further, it would follow that the optimal time of application would—as in our small cohort—occur at the first signs of depression, when its hold is most tenuous. Burton, Johnson, and Churchill could sense its encroaching presence when they were idle and immediately began to beat it away before it could become entrenched, much as some migraine sufferers can evade an attack when its distinctive aura has been sensed.

Our examples also reveal that properly living within one’s temperament, while of the highest importance, it is not the whole story. Understanding what one was born to do is also critical. Johnson was so consumed with literature that, Boswell wrote, he might work and rework a seventy-line poem in his head for hours, then take up pen and discharge it perfectly line for line when he was satisfied with it. Lewis was a born explorer and leader, more at home in the wilderness than the White House, something Jefferson easily discerned, aware that no one else was as fit for what he had in mind. Burton’s obsessive tendencies, love of cataloging, mnemonic gifts, and attraction to all things literary drew him to his project. The young Churchill was a poor student who cared only about history–and proving himself. Osler found the ideal way to combine his exceptional empathic gifts, organizational abilities, and scientific bent. And Jacques Barzun began mulling his life’s work at age 11, from the traumas he received, using his overpowering intellect and literary and organizational talents. All these individuals found what they were meant to do and with keen awareness used their temperamental gifts to their best advantage while minimizing the associated dangers, and they tried to share their insights with others. Know thyself, Socrates advised. And fortunate indeed is the gifted individual with bipolar tendencies who learns how best to live within his or her temperament and intuitively understands his or her gifts.

Modern bioscience furnishes a corroboration of sorts. Depression is now seen as relating to a reversible hippocampal atrophy (Tartt et al. 2022; Price and Duman 2020; Roddy et al. 2019). In studies with rats, four interventions have been found to replenish the area: electrical stimulation, antidepressant treatment, exercise, and “enrichment”—this last approach consisting of adding complexity and challenge to the rat’s environment (Zocher 2024; Van Praag et al. 2000; Pittenger and Duman, 2018), in effect placing these small creatures “on stretch.”

It is interesting to speculate about whether it is harder or easier for supremely talented people to live large lives now. In a lecture given 55 years ago, Barzun set out the reasons why he felt it is more difficult (Barzun 2019). On the other hand, our treatments for depression are very good and continue to improve, and Burton, were he still alive, could have filled a volume VII with them.

One interesting subject that our small cohort illuminates concerns Kretschmer’s notion of “soft temperament” and a buried “melancholic element” and the spectrum of sensitivities that various people show. Churchill would not let himself get near the tracks while waiting for a subway train (preferring to stand behind a post), or near the edge of a boat where a view of the dark water was permitted (Johnson 2009). Goethe, while talking with two friends who suggested that the first of them to die should return to share what the afterlife was like, suddenly turned and walked away. Later he wrote them: “I was very collected, but your conversation [about death] has torn me apart. … Had I stayed with you for another moment I would not have held up” (Holm-Hadulla et al. 2010 p.46). As noted, Kretschmer wrote that Goethe’s mother, likely of a sunny temperament–Akiskal et al. distinguish between “sunny” and “dark” varieties (2003) --forbade her servants to give her any news that was not positive. Robert Schumann, the great composer, who clearly suffered with bipolar disorder and made two suicide attempts, wrote: “I am obliged to avoid carefully all melancholy impressions of the kind. And if we musicians live so often, as you know we do, on sunny heights, the sadness of reality cuts all the deeper when it lies naked before you” (quoted in Goodwin and Jamison 1990, p.349). The intensity of such reactions will appear puzzling. Did severe early depressions somehow sensitize these individuals? Was their recovery from depression incomplete? Or might they be congenitally oversensitive to life’s inescapable insults and tragedies? For example, while most people can be brought to tears when discussing a particularly charged memory–or chuckle when recounting a funny anecdote–bipolar patients, in just an hour’s examination, might display euphoria, shed tears, and become irritable or hostile. It is now understood (as Kraepelin suggested) that all emotions are intensified and easily triggered in the activation of hypomanias (Akiskal et al. 2001). In fact, bipolar patients can feel both sadness and euphoria at the same time (Hantouche and Akiskal 2006) (perhaps not as strange as it seems, as many people under the right intense circumstances can shed tears of joy or laugh at a great misfortune). It may be that the “melancholic element” that Kretschmer hypothesized exists in the hyperthymic is present in almost everyone merely on the basis of life experiences, perhaps strongest in those whose temperament is sensitive and less stolid, as may be the case in creative and “intellectual” people. It must be remembered that in past ages major traumas were common enough and severe enough that human nature required the protection of a harder temperament – a dynamic that forms the basis of the concept of resilience (Malhi et al. 2019). Life was short, nasty, and brutish, as Hobbes famously said, and the Psalmist saw life’s passage as through a vale of tears. A harder temperament is protective. The life of Goethe’s mother, for example, was anything but sunny: her famous son had the first of his debilitating depressions when he was only 14–and seemed suicidal enough that the family hired someone to stay with him all day–and the second at age 16, and his sister, a year younger, suffered severe postpartum depressions with both of her children and died three months after the second was born. A brother died at age seven and five other siblings died in infancy. One must forgive her apparent apprehension when someone approached her with “news,” while giving thanks that such overwhelming traumas hardly exist today. Solving some of these riddles may require both scientific and humanistic insights. It is unfortunate that, as Barzun laments (2000), the humanities and sciences parted ways in the 1600s: the marriage was really quite compatible. Our current focus on neurotransmitters and (epi)genetics, which may soon require the use of supercomputers, can take us only so far and will be best complimented by close examination of individual case histories.

Author contributions

Both D.V.D. and D.C.D. contributed to the conception, writing, revision and approval of the work. They agree to be accountable for all aspects of the work.

Funding

None.

Data availability

No datasets were generated or analysed during the current study.

Declarations

Ethics approval

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.