TOUCHED WITH FIRE

Study of manic depression and inspiration that for many will be a hard read but that makes its points convincingly—if only fragmentarily—chapter by chapter. The relation between madness and genius is a fascinating subject, and Jamison (Psychiatry/Johns Hopkins University School of Medicine) has a rich lode of firsthand observers to quote from: Byron, Coleridge, van Gogh, Robert Lowell, John Berryman, Sylvia Plath, Theodore Roethke, Virginia Woolf, and many more, all of whom offer spellbinding words about their bouts with manic depression (paranoia and schizophrenia aren't covered). The basic argument here is ``not that all writers and artists are depressed, suicidal, or manic. It is, rather, that a greatly disproportionate number of them are; that the manic-depressive and artistic temperaments are, in many ways, overlapping ones; and that the two temperaments are causally related to one another.'' Genealogical studies of famed manic depressives show a definite genetic linkage, which is complemented by a seasonal one: Jamison includes seasonal tables of mood disorders, fluctuating productivity (``winter depression...summer hypomanias''), and peak times for suicide. Lithium and newer drugs, she explains, often dampen creative highs while relieving victims of turmoil and suicidal lows, but calm periods at optimum serum blood levels may allow longer, more productive periods of creativity. Some sufferers, however, choose to go with the lows for the rewards of the hypomanic state when it returns (hypomania is a middling state that gives a rich lift before the hyperactivity of mania or the colossal bleakness of melancholia). Jamison also finds a high incidence of manic depression among substance abusers, although she doesn't study the incidence of illness among abstinent drinkers or drug-abusers. Clear writing and research, but heavily clinical.