While other psychiatric disorders disable or destroy their victims, manic-depressive disorder sometimes bestows extraordinary gifts on those in its grasp. Mania gives the fortunate ones unlimited ambition, and enough confidence in their powers to try to achieve their dreams, putting the brain into high gear, increasing the speed of thinking, speech and everything he does. It floods him with ideas and energy. It is the disorder of legions of creative geniuses. While the benign variant has given us geniuses,1 its paranoid, megalomaniacal twin has unleashed bigots, mass murderers and warmongers.2 The disorder has produced the great destroyers in history, when in addition to ambition and egotism have been added ruthlessness, willfulness, intolerance of criticism, a consuming need to dominate others, paranoia, an indifference to the suffering of others, and delusions of omniscience, invincibility, infallibility, and invulnerability.2
An open and shut case for Hitler’s manic-depressive disorder may be found in the pages of “The Young Hitler I Knew” by August Kubizek,5 Robert Payne’s” The Life and Death of Adolf Hitler6” and our “A Brotherhood of Tyrants: Manic Depression and Absolute Power.
For four years Hitler confided completely in his only friend August Kubizek, whose memoir provides the earliest, clearest picture of Hitler’s mind and behavior. Kubizek was both sensible and perceptive, quickly realizing that there were two Hitler’s, one remarkable for his “ecstatic dedication and activity” while the other had “dangerous fits of depression,” so severe that they isolated Hitler from all human contact for weeks at a time. After the Vienna Academy of Arts twice rejected Hitler during his seventeenth year he fell into a deep, paranoid, delusional depression in which he spewed anti-Semitic hatred, his bigotry becoming a raging, paranoid obsession. Unable to admit to himself that his training or talent might be insufficient, he blamed the Jewish members of the faculty. “For this, the Jews will pay,” he wrote to the academy’s director.5,2
In “The Life and Death of Adolf Hitler,” historian Robert Payne unwittingly captures Hitler’s manic-depressive disorder, as the tyrant self-destructed when he could have annihilated retreating Allied forces. Payne writes, “Hitler slept very little during the first week of the invasion. By the end of the week his nervous condition surprised his staff, who found him simultaneously elated by victory and in a state of profound depression, screaming and abusing his generals, constantly warning them of disasters ahead, afraid that victory might be grasped from his grasp at the last moment. At the same time he was writing long letters to Mussolini, vaunting his own achievements."”6
“On the evening of May 17 General Franz Halder, Hitler’s chief of staff, wrote in his diary: “A most unfortunate day. The Fuehrer is terribly nervous. He is frightened by his own success, is unwilling to take any risks, and is trying to hold us back.” Hitler, for reasons of his own, had allowed a large enemy force to escape. His reasons were confusing and sometimes contradictory, and they owed much to his strange emotional state.”6 In his epic “Manic Depressive Insanity and Paranoia,” Emil Kraepelin referred to the concomitant occurrence of symptoms of mania and depression as a “mixed state.”4 Today the entity is firmly entrenched in psychiatric diagnostics. When not in both phases simultaneously, Hitler was in one or the other; in depression, he was despairing, indecisive, isolated, and unable to care for himself, concentrate and remember. He was hesitant, confused, despondent and apathetic, and had a phobic dread of horses, water and the moon. He washed his hands constantly because of his obsessive fear of germs. He had a phobic aversion of and paranoid delusions about Jews as contaminants, and compulsively tried to cleanse the world of them. 2
When manic Hitler was egotistical, arrogant, grandiose, loquacious, aggressive, and irritable, had delusions of omnipotence, invincibility and infallibility, Aryan delusions, violent mood swings, rages, racing thoughts, and pressured speech. He was ruthless, willful, indifferent to the suffering of others, intolerant of criticism, and had a consuming need to dominate others. His overwhelming emotional force and persuasiveness, both symptoms of mania, were instrumental in infecting millions of his countrymen with his grandiose and paranoid delusions. He threatened, instigated and perpetrated war in his drive for world domination and the destruction of the Jewish people.2
Hitler’s hatred of Jews emanated from his paranoid, obsessive, and delusional fear of them. Paranoid visions of (nonexistent) Jews in the Kremlin hurling the Soviet hordes against Germany’s eastern flank compelled him to invade Russia while England remained undefeated. While Hitler thought he was preempting a Russian attack, Stalin was eager to remain at peace for at least a year while he built his military strength.6 Historian John Toland describes Hitler’s depression as so incapacitating that a physician dosed him with oral and intramuscular amphetamines, cocaine, heart and liver extracts and other potions.7 Theodor Morell, his quack, publicly referred to Hitler as manic-depressive.2
Starting World War II was an act of insanity. By invading Poland, Hitler turned what had been a Japanese plan of conquest of the Pacific into a world war. On a sudden impulse in November 1937 Hitler summoned his military leaders to his office where, in a manic state of exaltation, he spent four hours warning them that Germany would be at war within a year. The depressive delusion that he was running out of time due to heart disease, and manic delusions of omnipotence, omniscience and invincibility propelled Hitler. His irrational hatred of Poles formed part of his determination to conquer Poland.2
After denying defeat until the moment that Soviet forces were racing towards his bunker, Hitler gave orders for the destruction of everything of value in Germany before joining Eva Braun in a suicide pact. His suicide is viewed in the context of denying the allies their revenge. It is also an act not unknown among manic-depressives, and Hitler had tried before. Hitler’s one stable element, among his violent mood oscillations was hatred. He detested Jews, Jehovah’s witnesses, golfers, Catholics, Poles, Gypsies, gays, Communists, skiers, hunters, journalists, judges, smokers, poets, Freemasons, and anybody not a vegetarian. He even hated the German middle class, which he accused of “dragging a whole nation with it into the abyss.”2 A Central Intelligence Agency file made public on April 27, 2001 revealed that in 1937 Adolf Hitler’s physician considered the tyrant to be “a border case between genius and insanity” and predicted that he could become “the craziest criminal in history” and Hitler obliged.
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 phenomenon known as “induced psychosis.” In manic contagion, a leader infects his followers with his enthusiasm, confidence, ambition, optimism, fearlessness, bravery, and energy. Had Hitler succeeded in his grandiose ambitions, he would have been on course to exterminate every human being, for ultimately everyone would have earned his enmity. Generations later, the elite of American psychiatry failed to educate society that peace and security depend more on the actions of paranoid/grandiose manic-depressives, than on the mere possession of weapons of mass destruction.
For twenty-one years Dr. Jerrold Post profiled foreign political leaders for the White House, the Federal Bureau of Investigation, the Central Intelligence Agency, and the State Department and the Pentagon.10 In reviewing our book, Post asserts that what we describe is not manic-depressive disorder, but “malignant narcissistic personality disorder.”11 D.S.M. 1V lists narcissistic personality disorder, but not malignant narcissistic personality disorder.12 Malignant narcissistic personality disorder is a psychoanalytic concept, and not a psychiatric disorder, yet Post diagnosed Saddam Hussein and Osama bin Laden as malignant narcissists. As far as I know, no one has explained how the egotism of the manic differs from the narcissism of the narcissist, or how the grandiosity and paranoia of the narcissist differs from the grandiosity and paranoia of the manic-depressive.
At this moment, a tyrant is threatening to unleash nuclear weapons at an enemy more perceived as such than real, while many of our psychiatry and psychotherapy elite are probably thinking, “What will that narcissist do next?” Kim Jong II followed in the footsteps of his father, who modeled himself after the equally manic-depressive Joseph Stalin, in attaining absolute power and abusing it in a gargantuan fashion, establishing a cult of personality, indulging in every excess imaginable, purging real and imagined enemies, hating everyone that earned his displeasure, abusing alcohol, megalomania, and developing paranoid delusions. In common with other tyrants, Kim Jong II made war on his own countrymen, and ruined his country.
In “A Brotherhood of Tyrants” Hershman and I write, “Tyrants see enemies everywhere within and outside their own borders. Those that can afford it turn their countries into fortress states. Their paranoia turns tyrants into time bombs, set to misinterpret the policies of another head of state as aggression, and then order their own forces to attack… Tyrants, in their monstrous egoism and frenzied fears, are willing to destroy the world rather than submit to defeat… The greatest threat that tyrants present today, is that they can endanger the world if they possess weapons of mass destruction.” (p 201).
As manic depressive tyrants are often beyond reason, attempting diplomacy with them is apt to fail. On June 27, President Obama is quoted as stating that his offer to loosen the decades-old diplomatic freeze with Iran through direct talks is in question, adding, “There is no doubt that any direct dialogue or diplomacy with Iran is going to be affected by the events of the last several weeks.”
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1. Hershman, D.J and Lieb, J. “Manic Depression and Creativity.” Amherst. Prometheus Books, 1998
2. Hershman, D.J and Lieb, J. “A Brotherhood of Tyrants: Manic Depression and Absolute Power.” Amherst. Prometheus Books, 1994
3. Kraepelin, E. “Manic Depressive Insanity and Paranoia.” 1921 Edinburgh. E&S Livingstone
4. Kubizek, August. “The Young Hitler I Knew.” Boston. Houghton Mifflin, 1955
5. Payne, Robert “The Life and Death of Adolf Hitler.” New York. Popular Library, 1973
6. Toland, John. “Adolf Hitler.” Garden City, N.Y. Doubleday and Co, Inc., 1976
7. Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (D.S.M-IV) 1994. American Psychiatric Association, Washington D.C.
9. Kohut, H. “Forms and transformations of narcissism.” J. Am Psychoanal Assoc. 1966 April; 14(2): 243-72
10. Kernberg, OH. “The narcissistic personality disorder and the differential diagnosis of antisocial behavior.” Psychiatr Clin North Am. 1989; 12(3): 553-70
11. Borger, J. “Saddam, tell me about your mum.” Guardian Unlimited. 2002 November 14.
12. Post, J. Review of, “A Brotherhood of Tyrants: Manic-Depression and Absolute Power.” J Nervous of Nervous and Mental Disease. 1996; 10: 647-648
Certain passages were excerpted for this article from “A Brotherhood of Tyrants: Manic Depression and Absolute Power.”
Julian Lieb, M.D is a retired Yale medical school psychiatry professor, now specializing in the immunopharmacology of infectious disorders and cancer. He has authored or coauthored forty-five professional articles and nine books.
