Beethoven and Tolstoy to name a few, in their list of famous personages who lived with mental illness. NAMI specifies that this is a list of those who suffered with Bipolar Disorder and Schizophrenia. The literature on this topic is of two types. The first is by writers who are qualified to make a diagnosis but have superficial knowledge of Churchill. A recent example is Nassir Ghaemi’s A First Rate Madness (reviewed on page 44)—the premise of which seems to be that mental illness is present in many if not most great leaders. The second is by writers who are knowledgeable about Churchill’s life but have a superficial understanding of mental illness. Even certain admiring works about Sir Winston assert that he was Bipolar. Either way, the myth of the “Black Dog” is central to their conclusions.
A
s an art therapist working for twenty years in outpatient mental health, I have seen hundreds of patients who were Bipolar or had Major Depression, and children diagnosed with Attention Deficit Disorder with Hyperactivity (ADD-H). Churchill’s childhood and painting have long interested me. I presented a peerreviewed paper for the American Art Therapy Association exploring my thesis that the young Churchill had ADD-H, and continued to cope with many of those traits in his adult life. I do not purport to examine Churchill’s medical minutiae, nor to propose that he never suffered from milder forms of depression. I do, however, object strongly to sweeping generalizations about his alleged Bipolar Disorder. More biographers should follow the example of one who spoke at the International Churchill Conference in Charleston, South Carolina. He disagreed, he said, with the assertion that Churchill suffered from serious depression, so he presented an anonymous description of Churchill’s personality, symptoms and achievements to three distinguished psychiatrists. Independently, each agreed that no one who was able to achieve so much could have suffered from Bipolar Disorder or Major Depression. Mental health professionals in the conference audience agreed. Bipolar Disorder is a severely disabling mental illness. Without medication, victims have difficulty maintaining relationships or employment. Their lives are chaotic, and often unproductive. They are unable to focus and lack the energy to marshal their thoughts even to write a convincing letter to the editor, much less fifty books. They are not likely to create 500 paintings or support a family of five in an upperclass way of life, or become one of the world’s most highly paid journalists. The psychiatric state formerly called Manic Depression is still the core of the Bipolar diagnosis, according to The Diagnostic and Statistical Manual of Mental Disorders (DSM). Using the list of symptoms for a Major Depressive Episode, Churchill would need to experience at least five
symptoms which “have been present during the same two week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.” The DSM notes that these symptoms cannot be due to a general medical condition, such as the circulatory illnesses (heart attacks and strokes) that Churchill experienced in the last twenty-five years of his life when Lord Moran served as his physician. Let us consider the DSM’s nine criteria for “Major Depressive Episodes”:
1. Depressed Mood Churchill did have dark moods during periods of his life when his talents were underutilized or he’d suffered serious personal or professional losses. His term for these moments was “Black Dog,” a common description of Victorian nannies to characterize their charges. “Black dog on my back” roughly corresponds to getting out on the wrong side of the bed. His daughter, Lady Soames, stated that her father was not depressed unless he had good reason. For instance, after the terrific loss of life in the Dardanelles disaster, she said he would have had to be a “monster of insensitivity” not to be depressed. Historians, she added, have made “rather a big meal” out of the Black Dog, echoing Colville’s concern. Sadness after periods of loss and devastating events is called grief, not clinical depression.
2. Diminished Interest or Pleasure When Churchill lost his position of First Lord of the Admiralty, following the resignation of First Sea Lord Fisher over the failure of the Dardanelles campaign in 1915, he certainly felt bereft, writing in his essay, Painting as a Pastime: “Like a sea beast fished up from the depths, my veins threatened to burst from the fall in pressure.” But did he show no interest in life’s activities? On the contrary, he threw himself into his new hobby of painting, while planning to salvage his political career. His recollection of his rescue by “The Muse of Painting” is as joyful an account as could be rendered by anyone with his burdens at that time.
3. Significant Weight Change Churchill was throughout most of his life a burly figure, but he never appeared significantly obese until perhaps the last years. But contemporary photographs from 1915 and other critical periods do not support any rapid weight gain or loss during this or similar depressing experiences.
4. Insomnia or Hypersomnia Churchill seemed to need less sleep than the average person, but he said this was owed to his practice of an afternoon siesta, which he had learned in Cuba in 1895. The very drive that kept him writing and dictating until the wee hours again belies the notion that he lost interest in life. >>
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