WSJ: Depression in Command

Psychiatrist links depression with activist crisis leadership while stable minds are better suited for caretaker status quo management, or Winston Churchill versus Neville Chamberlain.

About: Dr. Nassir Ghaemi is a professor of psychiatry at Tufts University School of Medicine and director of the Mood Disorders Program at Tufts Medical Center.

This essay is adapted from his new book, "A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness."

Excerpt:

Great crisis leaders are not like the rest of us; nor are they like mentally healthy leaders. When society is happy, they toil in sadness, seeking help from friends and family and doctors as they cope with an illness that can be debilitating, even deadly. Sometimes they are up, sometimes they are down, but they are never quite well.

When traditional approaches begin to fail, however, great crisis leaders see new opportunities. When the past no longer guides the future, they invent a new future. When old questions are unanswerable and new questions unrecognized, they create new solutions. They are realistic enough to see painful truths, and when calamity occurs, they can lift up the rest of us.

9/4/11 up to page 110 thoughts: I've read about GEN Sherman, Lincoln, Gandhi, Churchill, and MLK. Unfortunately, the book is flawed by an unthoughtful anti-Bush, anti-GWOT prejudice; I view the GWOT as fitting the qualities the author describes. It seems these great empathic crisis leaders, who are rare, rely on being fellow travelers with both the objects of their resistance and their own normal followers. When it works, their movements are cohesive due more to effectively shared rational (political and/or economic) goals than a universal empathic journey toward agape. (The empathy v rationality theme reminds me of the conflict in Stephen King's The Stand.) For normal people who value more tangible goals, the values held so dear and articulated so carefully by empathic leaders amount to only so much pretty rhetoric. After their erstwhile followers eventually, and perhaps inevitably, diverge on their normal course, many of these empathic crisis leaders, although revered by their communities for their successes, come to view themselves as ultimate failures. These leaders aren't pacifist ideologues: nonviolent resistance is the preferred way to resist injustice, but not the only way; violent resistance is preferred to acquiescence. Gandhi and MLK, one a London-educated lawyer and the other a classically educated Christian American minister, were able to succeed with nonviolent resistance by defining their movements with intimate appeals to their objects' Western liberal values and altering their objects' political-economic calculations. Empathic crisis leaders succeed with deeply held convictions, their determination, empathy and realism. But what if the empathic crisis leader is resisting an object who is determined to resist back by whatever means necessary, with an incompatible perspective that views the crisis leader's justice as injustice for the object, and is less vulnerable to political-economic calculations? Then the empathic leader who prefers nonviolent resistance but refuses acquiescence takes on the violent resistance of the Civil War, World War II, or the War on Terror. What happens if the crisis leader's followers, who only pay lip service to their leader's values, decide that their rational interests are better served by decamping the resistance movement?

I finished reading the book quick reaction: The author compellingly supports the validity of his hypothesis and gives me needed hope and insight about my mental pathology and food for thought. His point is novel but simple once explained: certain mental pathologies, when applied the right way, enhance crisis leadership as much as they have been popularly known to enhance the arts. The idea rings true from personal experience. Crisis leadership, as a field of innovation, and interactive and expressive human endeavor, is much like an art form. Unfortunately, perhaps to fill a book with an idea that could have been explained more simply and concisely in a short paper, his presentation weakens when it departs from his basic descriptive methodology and attempts suspiciously simplistic, neat antithetical contrasts. The antithesis, as such, is less convincing than the thesis. When the book veers from the basic premise, Ghaemi seems less than rigorous, and right/wrong judgemental at times, and is possibly selective in his presentation (a no-no in scientific study). Already thinly veiled in other sections, Ghaemi's political bias overwhelms his work in the antithetical section devoted to "homoclite" Bush and Blair and the bad/wrong/lie Operation Iraqi Freedom and the War on Terror. His attempt there to claim he wrote as an honest broker weakens his credibility. The author has a follow-up article. Lots of reviews on-line, which I'd like to read. It seems Ghaemi's thesis has struck a chord ... or a nerve. Again, while an imperfect work, Ghaemi successfully supported his hypothesis, enough to give me hope. For the record, using the definitions laid out in the book, I qualify as empathic, depressive realist (too much so), and creative, but I'm not resilient. I'm more dysthymic and not hyperthymic, and become more cyclothymic when plugged into a cause.

Eric