And his brain! That's what really set him apart. You could practically see
the ideas bursting out of it, one after another, each more offbeat, more
original, more promising than the last. The sheer profusion of ideas - and the
way he got excited as he described them - was a large part of his charisma.
The reason Bill Gross was still smiling was that his newest new idea was
"going to be unbelievably huge" and "revolutionize the Internet." Eight hundred
million. Eight hundred shmillion. Nothing could dim Gross's enthusiastic
confidence.
During the 1990s, I was paying attention to such behavior because I was
planning to write a book about religious movements started by manic prophets.
But I began to be distracted by messianic movements happening around me in real
time, particularly because, as an avid technology investor, I was a member of
one - the believers in the new economy. I was even a millionaire on paper for
one exhilarating day in March 2000 at the peak of the market, before my
portfolio lost 90 percent of its value. I began to suspect I was writing the
wrong book.
My new hypothesis became that American entrepreneurs are largely hypomanic. I
decided to undertake what social scientists call a pilot study: a small-scale,
inexpensive, informal investigation meant to test the waters. I placed
announcements on several Web sites devoted to the technology business,
expressing my interest in studying entrepreneurs and requesting volunteers. I
interviewed a small sample of ten Internet CEOs. After I read them each a list
of hypomanic traits that I had synthesized from the psychiatric literature, I
asked them if they agreed that these traits are typical of an entrepreneur:
He is filled with energy.
He is flooded with ideas.
He is driven, restless, and unable to keep still.
He channels his energy into the achievement of wildly grand ambitions.
He often works on little sleep.
He feels brilliant, special, chosen, perhaps even destined to change the
world.
He can be euphoric.
He becomes easily irritated by minor obstacles.
He is a risk taker.
He overspends in both his business and personal life.
He acts out sexually.
He sometimes acts impulsively, with poor judgment, in ways that can have
painful consequences.
He is fast-talking.
He is witty and gregarious.
His confidence can make him charismatic and persuasive.
He is also prone to making enemies and feels he is persecuted by those who do
not accept his vision and mission.
I feared they might find the questions insulting. I needn't have worried.
All of the entrepreneurs agreed that the overall description was
accurate, and they endorsed all the hypomanic traits, with the exceptions of
"paranoia" and "sexual acting out" (these traits in particular are viewed as
very negative and thus may be more difficult to admit to). Most expressed their
agreement with excitement: "Wow, that's right on target!" When I asked them to
rate their level of agreement for each trait on a standard 5-point scale, many
gave ratings that were literally off the chart: 5+s, 6s. One subject repeatedly
begged me to let him give a 7. I was startled by the respondents' enthusiasm,
though perhaps I shouldn't have been. As a psychotherapist, I am familiar with
the way people become energized when they feel understood, especially when it
helps them understand themselves better.
Having learned in our conversation that they were hypomanic, the CEOs wanted
to talk about it. One now understood better why he regularly rented palatial
office space he could not afford and why his wife hid the checkbook. Another
could finally explain what drove him to impulsively send broadcast e-mails at 3
A.M. to all his employees, radically revising the company's mission. It was as
if merely by asking these questions I had held up a mirror in which these men
could see themselves. After talking to them for just fifteen minutes, it seemed
as if I was the first person to truly understand them.
One respondent seemed to be in an intense hypomanic state when I interviewed
him. He responded to my Web site solicitation by e-mailing me in huge blue block
letters: "CALL ME IMMEDIATELY." When I did, he talked rapidly and loudly and
laughed quite often. At the same time he was charming, witty, and engaging. The
interview was a bit chaotic because he was driving and carrying on another phone
call at the same time. He was a serial entrepreneur. After founding one
successful company, he had felt he needed to quit his own corporation because he
couldn't "make things happen fast enough," leaving him frustrated and bored. Now
he was on to a new venture. He was very enthusiastic about my research and
volunteered to send me the phone numbers and e-mail addresses of half a dozen
well-known high-tech entrepreneurs (which I never received), who he claimed were
his "very close friends."
This was a small pilot study, but nonetheless, I was overwhelmed. I had never
seen data like this. Because humans are so complex, most effects in psychology
are modest and nearly drowned out by the great variability that exists naturally
between people. Not in this case. One hundred percent of the entrepreneurs I
interviewed were hypomanic! This couldn't be chance. The odds of flipping a coin
ten times and getting ten heads in a row is less than one in a thousand. It felt
as if I had tested the waters with my little pilot study and been hit with a
tidal wave. It was then that I knew I had stumbled onto something big that had
been hiding in plain sight.
Mania and Hypomania
A colleague of mine once told me about a manic inpatient he had treated for
many years at an Ivy League-affiliated psychiatric teaching hospital. The
patient's father was the CEO of a Fortune 500 company. Each time he visited his
son on the unit, he would behave in a dramatically hypomanic fashion. For
example, he would make numerous business phone calls around the world on the
patients' pay phone, while frantically yelling "Back off!" at patients or staff
who tried to interrupt him. Clearly, Dad was not normal, but he had made his
hypomania work for him. He was a very rich man.
This family's story illustrates the concrete relationship between mania and
hypomania. Manics and hypomanics are often blood relatives. Both conditions run
together in families at much higher rates than we would predict by chance. We
know that their genes overlap, though we don't know how.
This family's story also illustrates the most radical difference between
mania and hypomania. Mania is a severe illness. The son was disabled - a
long-term inpatient at a psychiatric hospital. Manic episodes almost always end
in hospitalization. People who are highly energized, and also in most cases
psychotic, do bizarre things that are dangerous, frightening, and disruptive.
They urgently require external control for everyone's safety, especially their
own. Most people who have experienced a manic episode remember it as a
nightmare.
By contrast, hypomania is not, in and of itself, an illness. It is a
temperament characterized by an elevated mood state that feels "highly
intoxicating, powerful, productive and desirable" to the hypomanic, according to
Frederick K. Goodwin and Kay Redfield Jamison, authors of the definitive
nine-hundred-page Manic-Depressive Illness. Most hypomanics describe it
as their happiest and healthiest state; they feel creative, energetic, and
alive. A hypomanic only has a bipolar disorder if hypomania alternates,
at some point in life, with major depression. This pattern, first
identified only in 1976, is called bipolar disorder type II to distinguish it
from bipolar disorder type I, the classic manic-depressive illness, which has
been well known since the time of the ancient Greeks. If a hypomanic seeks
outpatient treatment it is usually for depression, and he will define recovery
as a return to his old energetic self. Not all hypomanics cycle down into
depression. What goes up can stay up. Thus, we cannot conclude that someone has
a psychiatric disorder just because he may be hypomanic. The most we can say is
that hypomanics are at much greater risk for depression than the average
population. The things most likely to make them depressed are failure, loss, or
anything that prevents them from continuing at their preferred breakneck pace.
Given how radically different mania and hypomania are, it is perhaps
surprising that the diagnostic criteria for these two conditions are identical
according to the Diagnostic and Statistical Manual of Mental Disorders of
the American Psychiatric Association (usually referred to simply as
DSM-IV):
A. A distinct period of abnormally and persistently elevated,
expansive, or irritable mood, lasting at least one week.
B. And at least three of the following:
1. Inflated self-esteem or grandiosity
2. Decreased need for sleep (e.g., feels rested after only three hours of
sleep)
3. More talkative than usual or pressure to keep talking
4. Flight of ideas or subjective experience that thoughts are racing
5. Distractibility (i.e., attention too easily drawn to unimportant or
irrelevant external stimuli)
6. Increase in goal-directed activity (either socially, at work or school, or
sexually) or psychomotor agitation
7. Excessive involvement in pleasurable activities that have a high potential
for painful consequences (e.g., engaging in unrestrained buying sprees, sexual
indiscretions, or foolish business investments)
The only guideline offered to mental health professionals in distinguishing
between mania and hypomania is "degree of severity." Hypomania is "not
sufficiently severe to cause marked impairment in social or occupational
functioning or to require hospitalization." But DSM-IV tells us little
else, when there is so much more that could be said.
This relative neglect of hypomania by psychiatry is striking when we consider
that it affects many more people than does mania. We know from numerous
large-scale studies, replicated both nationally and internationally, that
classic manic depression exists in slightly less than 1 percent of the general
population. . . .
Excerpted from The Hypomanic Edge by John D. Gartner
Copyright © 2005 by John D. Gartner. Excerpted by permission.
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reserved. No part of this excerpt may be reproduced or reprinted without
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