I recently attended the 11th Annual Mood Disorders: Research/Education Symposium, sponsored by the Johns Hopkins Affective Disorders Clinic & the Depression and Related Affective Disorders Association. Art Buchwald was the final speaker. Buchwald, in a magnificent style that showed he's still in charge of his life, had the most evolutionarily relevant things to say. He had a depressed interval in '63 and a manic interval in '85; he still takes lithium. His friends, Mike Wallace and William Styron had similar mood difficulties. Apparently all three of them used to sit on Martha's Vineyard and share stories about themselves and doctors. (My God, to have been a mouse!) Buchwald commented, with evident competitive themes in his humor and even about such personal experiences:
His Depression in '63: He was annoyed that Bill Styron made a million dollars off of his own depression Styron once remarked that he personally had a "9 of a Richter 10" depression whereas Buchwald's was only a rainy day at Disneyland. Buchwald worried he would not make the NY Times if he killed himself. DeGaulle would have died the same day and bumped him off the front page.
More seriously: He was frightened that anyone would find out. He would not be able to support his family if it were known he were depressed. "No one knew me" on the ward. His mother was hospitalized for 35 yrs; he was never allowed to see her from childhood. Would he see his own kids? Computer health reports meant that everyone will know about him.
While depressed, he liked the clinical "tricks" that doctors can't do "Staff" were there with him more and did more good than the doctors. The staff "cared more" than the doctors. He awoke one morning at 3am, determined to die. He wandered in the hall and was intercepted by a foreign medical resident who simply hugged Buchwald for 3 hrs. His wife countered his despondency one day by putting a picture of the children where he would see it.
His Mania in '85: "Loved the feeling of power" "Missed the feeling, so I quit taking my lithium" "The world has finally turned your way" "Taking medicine is a weakness; do it without medicine."
I was touched and fascinated by his presentation, given in a coffee table, interview format with Ray DePaolo, MD. Mr. Buchwald's comments about depression reflected so many concerns about loss of standing, personal effectiveness, and hopelessness. The attentions that he valued clustered around the themes of reassurance and acceptance, membership in a group. The fact of his mother's prolonged separation might have been a "trigger" for him that made group affiliation even more important. I understood as would have De Waal's chimps (De Waal F, 1996, Good Natured: The Origins of Right and Wrong in Humans and Other Animals, Cambridge, MA: Harvard Univ Press).
Buchwald was also highly consistent during his elated phase in that his mood and his cognitions were opposite the depressed interval. During manic euphoria, there is no challenge possible to your self esteem; indeed, you don't need sleep and you see so many possibilities that you never saw before. During these times, he felt little need for affiliation; he was Alpha.
His self-disclosures, in the company of Wallace and Styron as well as Kay Redfield Jamison, PhD, appear to have given him a different mission lately than he had as a cartoonist. He's still an Alpha but in a new domain. Buchwald has been a regular advocate for understanding of bipolar disorder; he seems to get a special boost from his wish (Psychological Adaptations?) to help others. After one television interview Buchwald was informed by a lady that the interview had saved her own life. She overdosed prior to the show but in passing out, rolled over the TV remote. Buchwald arose on the screen, commenting that if you kill yourself, your loved ones will have to live with it. She took his appearance as a "sign" and gagged up her medicine!
The Hopkins audience (about 700 of us) encouraged Buchwald to do a book about the clinical tricks that helped him most. I bet there will be a lot of ideas in it that can be tied to evolutionary psychology and even sociobiology. Although EP was in the shadows at this conference, no one acknowledged much about our past as species or as individuals. Frederick Goodwin & Kay Jamison's magnificent 800 pp text (1991, Manic-Depressive Illness, NY: Oxford) does not have "Darwin" or "Evolution" in the index. I understand that Thomas Wehr, MD, has some evolutionary interests that tie in to sleep, hibernation, and day length. Otherwise, there appears to be a very large intellectual meadow here for someone to explore.