Free A First-Rate Madness by Nassir Ghaemi Page B

1952 and committed suicide in 1963 by barbiturate overdose (despite being active in suicide prevention efforts). Churchill’s first cousin, called “Sunny,” also suffered severe depressive episodes throughout his life. Thus we find a familial predisposition to severe depression among Churchill’s relatives, and the presence of suicide indicates that this familial mood condition was more than a mild hereditary taint.
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    THE NEXT STEP is to examine Churchill’s actual symptoms. There is no doubt that he had severe periods of depression; he was open about it—calling it, following Samuel Johnson, his “Black Dog.” Apparently his most severe bout of depression came in 1910, when he was, at about age thirty-five, home secretary. Later in his life, he told his doctor, Lord Moran, “For two or three years the light faded from the picture. I did my work. I sat in the House of Commons, but black depression settled on me.” He had thoughts of killing himself. “I don’t like standing near the edge of a platform when an express train is passing through,” he told his doctor. “I like to stand right back and if possible get a pillar between me and the train. I don’t like to stand by the side of a ship and look down into the water. A second’s action would end everything. A few drops of desperation.” The desperate man of thirty-five was no different from the hero at seventy. In 1945, soon after Churchill lost his bid for reelection, Lord Moran visited his patient to find him complaining about the balcony of his new flat. “I don’t like sleeping near a precipice like that,” he said. “I’ve no desire to quit the world, but thoughts, desperate thoughts, come into the head.”
    Blaming someone’s sadness on external events is common sense, but that approach can be as often wrong as right. In Churchill’s case, it would certainly be wrong; there is no question his sadness came from within. In 1910 he was at the peak of success, one that he would not better until three decades later, after having presumed that his best days were behind him. In 1910 he was happily married, wealthy, famous, politically powerful, and widely respected. He had no reason to be depressed, much less suicidal, and he never claimed otherwise.
    Churchill suffered from more than depression, though. Many historians now acknowledge his depression, but they generally don’t appreciate that when he was not depressed, Churchill’s moods shifted frequently. He was never “himself,” because his “self” kept changing. When his depressive episodes subsided, he became another person—disagreeable and aggressive. His friend Lord Beaverbrook noted that Churchill was always either “at the top of the wheel of confidence or at the bottom of an intense depression.” Said his military chief of staff, General Ismay, “He is a mass of contradictions. He’s either on the crest of the wave, or in the trough: either highly laudatory, or bitterly condemnatory: either in an angelic temper, or a hell of a rage: when he isn’t fast asleep he’s a volcano. There are no half-measures in his make-up.”
    This frequent alternation between being somewhat up and somewhat down is exactly what psychiatrist Ernst Kretschmer meant by cyclothymic personality. Numerous physicians who knew Churchill or studied him have concurred on the view that he likely had a cyclothymic personality, which, as we now know, is biologically and genetically related to bipolar disorder. For instance, Lord Russell Brain, a famed British neurologist, knew Churchill for almost two decades and saw him as a patient for twenty visits. Lord Brain concluded that Churchill had “the drive and vitality and youthfulness of a cyclothyme.” (“We are all worms,” Churchill once commented, “but I do believe I am a glowworm.”)
    These observations