Hatred Often Lurks in the Shadows of Mania

While mental health professionals and patients yearn to see mental illness destigmatized, it is contrary to society's interests to ignore or minimize the role of emotional disorders in bigotry, hate crimes, and genocide.

Consider the perpetrators of the most terrible hate crimes in history. Those who knew or studied Adolf Hitler and Josef Stalin offer vivid descriptions of the paranoid, delusional form of manic depressive order both men experienced.

One side of Hitler was despairing, indecisive, isolated, unable to care for himself and had impaired concentration and memory. His speech was hesitant, he was confused, despondent and apathetic and suffered paranoid delusions, especially about Jews. This Hitler was afraid of water, horses and the moon. He washed his hands constantly because of his phobic dread of infection. He survived six suicide attempts before succeeding with the seventh.

The other side of Hitler was egotistical, arrogant, grandiose, loquacious, aggressive and irritable. He had delusions of omnipotence, invincibility and infallibility, violent mood swings, rages, racing thoughts and pressured speech.

At 17, Hitler was twice rejected by the Vienna Academy of Arts. It caused him to fall into a deep, paranoid, delusional depression in which he spewed anti-Semitic hatred. His bigotry became a raging obsession. Unable to admit to himself that his talent or training might be insufficient, he blamed the Jewish members of the academy faculty for keeping him out of the art school. “For this, the Jews will pay,” he wrote to the academy's director.

During World War II, Theodor Morell, Hitler's personal physician, had daily contact with him and supplied him with amphetamines and cocaine for his depression. In 1943, the doctor was emboldened to state publicly that the Fuhrer was a manic depressive.

Anti-Semitism is a pathologic state of mind. Why else would it continue to thrive in a country like Poland, with a Jewish population of less than 4,000?

In depression, Stalin was indecisive, anxious, pessimistic, indifferent, gloomy, lonely, paranoid and had low self-esteem. In mania, he had grandiose delusions, rages, paranoia and hypersexuality. He abused alcohol in both phases.

As early as 1919, when Stalin was commander of Tsaritsyn, later called Stalingrad, now Volgograd, Leon Trotsky observed how “a military setback …. became in his [Stalin's] mind a product not of error or accident, but of treason.”

Stalin targeted his paranoid, murderous hatred at those who he feared knew more than he did on any subject and people who he suspected of knowing his personal affairs. His paranoid delusions led him to accuse of treason and execute millions for failures of his own making. Any person or group might become a target. No one was safe, not even his own family or his inner circle.

The paranoid delusions of manic-depressives are as infectious and as virulent as a deadly microbe and can easily infect those in thrall to the host figure. It is a phenomenon known as “induced psychosis,” and we have seen it operating in Guyana, Waco and Tokyo.

Despite the catastrophic consequences of the paranoid delusions of such manic depressive demagogues as Jim Jones and David Koresh, our modern institutions have made no effort to educate society that the hatred of bigots and demagogues, whether expressed in incendiary language or in deed, is often a symptom of manic depressive disorder.

The classification of manic depressive disorder as a single psychiatric disease was published by the German doctor Emil Kraepelin in 1921. One of the paradoxes of this disease is that while its benign form has given us many of our creative geniuses, its paranoid sister has unleased bigots and mass murderers.

With the war defeat closing in on him, Hitler committed suicide in 1945. Four years later, Australian psychiatrist John Cade established the therapeutic value of lithium in treating manic depressive disorder. Had lithium been available in Hitler's time, humanity might have been spared World War II and the Jewish genocide. It is a quirk of fate that should not be lost on anyone interested in preventing hate crimes.

Julian Lieb is a psychiatrist in Woodbridge, Conn. He is coauthor with D. Jablow Hershman of “The Key to Genius” (Prometheus Books, 1988) and “A Brotherhood of Tyrants” (Prometheus Books, 1994).

Commentary

The piece above was published on the Op-Ed pages of the L.A. Times on February 16, 1996. I am pleased to say that a couple of days later it got the scathing denunciation in a letter to the editor that it so richly deserved.

This particularly offensive bit of writing is offered to illustrate the lengths to which some influential members of society are willing to go to cement their brand of correct-think into the minds of the masses. Think like I do or you must be crazy.

The good doctor discovers an elemental fact known to wise men millenia before psychiatry rose up to cloak insight in pretension – namely that powerful and creative people tend to have mercurial personalities, and are given to wide mood swings. In listing the manic-depressive monsters, he forgot to include people like Winston Churchill, Franz Kafka, and the entire host of those afflicted with a “disorder” that affects more than 10% of the population in general, and perhaps 90% of its movers and shakers.

It is horribly ironic that the first sentence of this poisonous missive mentions how much those afflicted with mental illnesses want to see their conditions destigmatized. Just so. And equating manic-depression with evil incarnate certainly accomplishes that goal doesn't it? Telling people that the seeds of evil are to be found in manic-depression, and that it is as infectious and virulent as a deadly microbe seems to this reader to be a good example of what the writer purports to deplore – acts of hate. He hates antisemitism so much that he's willing to brand a huge group of innocent people with the mark of the beast to make his point that people who dislike members of other ethnic groups or wish them harm are mentally ill. If he were to make public comments in a similar vein about AIDS victims, the Times wouldn't publish it to begin with, and he'd be hounded into silence if it did find a public forum.

Where do opinions like this lead? See An Alternative: Criminalize Bigotry for a preview.

The bold sections in the main text of the article were added for emphasis.