IS MENTAL ILLNESS ALL BAD?

Is mental illness all bad? I wrestled with this question while writing my biography Candace Pert: Genius, Greed, and Madness in the World of Science.

During my research, I discovered both that Candace Pert had been diagnosed with bipolar disorder, and that the fields of psychiatry and neuroscience were rife with bias against the afflicted. Ironically, as a result of this intolerance, Candace – who was doing cutting edge work in psychopharmacology – was unwilling or unable to help herself.

As the stress of her workplace and her father’s death took its toll, Candace became increasingly volatile, and soon it was clear that her emotional swings veered well outside the norm. She had been hospitalized after a “nervous breakdown” during her freshman year of college, but otherwise had never shown signs of depression or psychosis. Primarily, she was hypomanic, a state characterized by supercharged energy during which the “afflicted” can be remarkably fruitful. Indeed, she went undiagnosed by both her boss at the National Institute of Mental Health (a branch of the NIH), Fred Goodwin, and her lab chief and administrator, Steve Paul, who were both psychiatrists with expertise in bipolar disorder.?

“I never saw her floridly manic. She had bouts of hypomania, as do some of the more creative people in the world,” says Paul, who spent eighteen years at the NIH as a laboratory/branch chief and as scientific director of the NIMH. “Occasionally, there was a pretty intense element to her passion, but I can’t say yea or nay. As a shrink, I’m not sure it would be appropriate.”?

Here, Paul references the work of Kay Redfield Jamison, a professor of psychiatry at the Johns Hopkins University School of Medicine who co-authored with Fred Goodwin the medical text Manic-Depressive Illness and has written extensively about her own experience being bipolar. In her 1993 book Touched with Fire: Manic-Depressive Illness and the Artistic Temperament, Jamison explores the link between hypomania and intellectual or artistic achievement, arguing that hypomania increases the “fluency, rapidity, and flexibility of thought on the one hand, and the ability to combine ideas or categories of thought in order to form new and original connections on the other.”?

After conceding bipolar disorder’s obvious downsides, including suicidal tendencies, Jamison asks, “Who would not want an illness that has among its symptoms elevated and expansive mood, inflated self-esteem, abundance of energy, less need for sleep, intensified sexuality and—most germane to our argument here—‘sharpened and unusually creative thinking’ and ‘increased productivity’?”?

Candace’s first husband Agu Pert concurs, acknowledging that she did some of her most inspired, original thinking while hypomanic. He notes that Sir Isaac Newton likely suffered from bipolar disorder and psychosis, penning delusional letters to family and friends while inventing calculus and deciphering the force of universal gravity. And Beethoven and Winston Churchill used their manic stretches to compose back-to-back verses and books, respectively, before falling into dark depressions. Similarly, for a period of seven or eight years, Candace flourished in this state.?

That is, until 1979, when Candace learned that Solomon Snyder, her lab chief and mentor in her PhD program at Johns Hopkins University School of Medicine, had failed to acknowledge her 1972 discovery of the opiate receptor, the mechanism by which opioids function in the brain, and instead positioned himself to win the Lasker Award, America’s highest scientific honor. Snyder’s betrayal precipitated Candace’s next psychotic break, Agu says. She began crawling on the floor and clawing at her husband’s face, claiming he was the devil. “Her brain was fried,” he says. “She was delusional.”?

At a loss, Agu called Snyder for help. Candace’s mentor had instigated her trauma, but he was also a psychiatrist operating at the forefront of his field and could recommend a course of treatment. On Snyder’s advice, Agu drove Candace in the middle of the night to Adventist Hospital in Langley Park, where she remained sedated and dosed with antipsychotics for three weeks. She was clinically depressed for several months afterward and prescribed the heavy antidepressants she’d been investigating in her lab. In a painful twist on the catchphrase “research is me-search,” just as Candace was working at the National Institute of Mental Health to understand and treat mental illness, she was suffering a cycle of bipolar disorder.?

Though Agu confided in the couple’s branch chief, at the time the stigma around mental illness was so severe that even doctors on the cutting edge of psychiatry and psychopharmacology were loath to discuss it. “Candace couldn’t afford to get treatment with bipolar. They’d kick her out!” says Betsy Parker, her NIH peer. “She probably didn’t want to accept it herself, but professionally she could never have admitted to mental illness. Of all the fields you would think there would be acceptance, the people studying mental health were terrible about it, the most judgmental.”?

Anne Young, a Hopkins colleague who later became the first female Chief of Neurology at Massachusetts General Hospital, agrees that any hint of emotional instability was, and arguably still is, the kiss of death for women. In the 1970s and ’80s, even doctors went to great lengths to hide chinks in their mental and emotional armor. “No one saw a psychiatrist,” she says. “It meant you were crazy.”?

So, upon returning to work, Candace labored to conceal her debility. In a 1979 Washington Post magazine profile that chronicles Candace and Agu’s search for therapies for schizophrenia and depression, she depicts their mission flippantly as “trying to cure the crazies.” A year prior, she was quoted in a separate article as saying, “People will tell you the most intimate details of their sex lives—I mean strangers on a plane. But if someone has a brother or a sister or a husband who has cracked up, that’s a deep dark secret.”?

All the while, Candace was keeping a secret of her own: that mental illness ran in her family. Candace’s paternal grandmother had “taken to her room” to escape a loveless marriage, and while her father Bob had been hospitalized for PTSD after World War II, he also suffered from bipolar disorder. Candace’s middle sister, Wynne, had been diagnosed as well.?

Candace continued to deny her illness and came to hate the very drugs she was researching, as she felt they dulled her edge. “She never admitted she was ill, which is a characteristic of the disorder, saying, ‘It’s not me, it’s you. You’re the one who has the problem,’” Agu says. Candace had psychotic episodes every seven to eight years, but in between them she was undeniably prolific. Much of her life was spent in the hypomanic state that allowed her to prosper, and one is left to wonder, as she did, whether medication would have blunted her genius.?

Was Candace subject to the bias that dominated her field, or was madness the price of carrying a torch to illuminate humankind?