Gail Saltz is a psychiatrist, columnist, and bestselling author of The Ripple Effect: How Better Sex Can Lead to a Better Life, Anatomy of a Secret Life: The Psychology of Living a Lie, and The Power of Different: The Link between Disorder and Genius. She recently joined Chuck Nice, stand-up comic and television and radio co-host whose many credits include StarTalk with Neil deGrasse Tyson and The Today Show, for a candid conversation on the role of mental illness in creative work. Chuck opened up about how bipolar disorder has affected his life as an artist, and together he and Gail dispelled misconceptions about the reality of mental illness.
This conversation has been edited and condensed.
Gail: I’ve known you a long time, and what I came to understand is that you actually had a lot of suffering earlier in life.
Chuck: Originally, I thought it was emotional. I would [have] these incredible bursts of energy, creativity, and feelings of euphoria. Imagine walking around high on your own brain. Sometimes it leads to rash decisions, capriciousness, risk-taking, because you’re like, “I’m invincible, everything works.”
Gail: This was in your late teens, early twenties?
Chuck: Yeah. I felt like I could do anything. During these periods of time, I would come up with incredible ideas, and they would work. Afterwards, it would be followed by a tremendous darkness. It’s not depression the way people think, “I’m sad.” I call it impression, not depression. You feel like there’s a deep heaviness that is crushing you from the inside out. Think if a hand were inside of an aluminum can, and the hand started to crush the can. From the outside, that can would look like it’s crushing itself. But really, there’s something inside that’s crushing it.
Gail: Did you have any insight at that time, like, “I don’t think other people go through this.”
Chuck: It’s not that I had an inkling that I was different, but people noticed me. They would say, “Look at you! You’re like shot out of a cannon!” Or they would accuse me of being high on something when I wasn’t. People would say, “Let me get some of that!”
Gail: Because you were infectious. I profiled you for The Power of Different because you are extraordinarily high achieving. You are a comedian, and people wouldn’t necessarily know that you struggled with these alternating mood states, some of which may have caused impulsive decision-making, and some of which accounted for periods of time where you felt downright miserable.
But at the same time, there is a neurologic link between those symptoms that you were experiencing and some of these strengths that you’re talking about: this charisma, this increased linguistic ability, which is a feature of being hypomanic. You have more words that come out faster, what’s called a flight of ideas.
Chuck: In that respect it feels as though the ideas are not coming from you. That’s what makes it so seductive, you feel like ideas are dropping into your head. There’s no pondering, there’s no thought process. The process is happening, just at a much faster speed. You conceive of things all at once.
Gail: You would get these fully-formed ideas that you could do something with?
Chuck: Yes. I’ll give you an example. During a period where I was manic, I was working for a company, we had a meeting, and we had to come up with an ad campaign. We [went] into the meeting, and I came up with the entire campaign on the spot.
At the time, I was young and kind of stupid. The vice president of marketing for the company was like, “That is a great idea, let me tell you why.” I didn’t realize that what you’re supposed to do is shut up and allow the person in charge to take credit for your idea.
So then they were like, “So what else do we have?” And I went, “I don’t understand why we’re going to continue this conversation. You’re not going to come up with anything better that that.”
Gail: Not only did you have these fully-formed ideas, but you had huge confidence about it. Which is very appealing to people, actually.
Chuck: Unless they’re your boss and they want the credit.
Gail: That can happen, too. People who are hypomanic do have some grandiosity. Sometimes it gets to be too much.
Chuck: Right. I went to see a doctor because the highs got shorter and the lows got longer.
Gail: The more you cycle, untreated, from high to low, the more [quickly] you cycle. That’s because in the brain you have this wiring going on that is like a country road, not very traveled. But the more you travel a country road, the more track that road gets, and eventually becomes like a superhighway. It’s very easy to speed down that road, which is why people who don’t get treated tend to be more and more symptomatic. You did go see a doctor?
Chuck: I did. It didn’t work out. His prescribed method of treatment was lithium. From what I hear now, that’s not a bad choice.
Gail: It’s not. Although, in the day that you saw the doctor, they used to prescribe really high doses of lithium that could have a lot of side effects, including squelching some of those creative feelings.
Chuck: That’s what happened to me.
“It feels as though the ideas are not coming from you. That’s what makes it so seductive.”
Gail: Today, doctors are much more inclined to prescribe low dose lithium. For bipolar disorder, the important thing we now understand is that while we don’t want to squelch those positive strengths that you’re getting from the hard-wiring of having this illness, we don’t want you to go so far off that you can’t utilize those effects.
Chuck: Yes. There are many individuals who suffer from bipolarism who become dysfunctional due to their bipolar condition. They become so manic, so hyper, that they can’t achieve anything. Their mind is all over the place.
Gail: What’s happening in your mind is really interesting when you’re hypomanic. Your frontal lobe, the rule-bound part, is a bit turned off compared to normal times. And the subcortical, or emotional and novelty part of your brain, is freer to express, and heightened. Because it’s not being squashed by the rule-bound part, you have the opportunity to produce really original, creative thoughts.
In fact, people in creative fields have a very high incidence of bipolar disorder. Some of the giants of history—Ernest Hemingway, Vincent Van Gogh—struggled with mental illness because they were also conferred this gift, in a way. This strength that came along with it. But comedy is a great choice for somebody who can think quickly, originally, out of the box.
Chuck: When I first started doing comedy, I would go on stage and do 15 minutes just off the top of my head. A comedian by the name of Ralph Harris came to me and said, “You’re really funny, but you’ve got to start writing material. I’ve seen you three weeks in a row, and every time was funny, but it was completely different. You’re never going to get any work, because a club owner has to see that your material works again and again.”
Gail: In order to do that, you want to be in the middle. That’s what I found in doing the research for this book, by talking to neuroscientists, and by talking with people like you: the power of being on the U-shaped curve. At one end of the U, people are really ill, so ill you can’t put all the thoughts together. You can’t write your material down and follow enough rules to excel. But when you are at the other end of the U, where you’re completely healthy, you don’t have necessarily the [creative] strength. It’s in that sweet spot of, “This makes a highly creative, original, charismatic person, but I want to treat it, so that I can use it. I can follow the rules.”
Chuck: I encourage everyone to seek treatment. For bipolarism, you need to see a doctor who is well-versed in the research, because these are all brain chemical disorders. Your brain is nothing more than a chemical factory. Even when you do drugs, what’s happening is your brain is releasing a flood of its own chemicals to get you high on what it already makes. Cocaine doesn’t make anybody high. It is the release of dopamine in your brain that causes you to go, “Whoa!” and be addicted.
Gail: It feels so good that you want more dopamine to be released.
Chuck: Right. It hijacks your brain, and you can break your brain that way.
That’s part of the problem when you have a disorder and you’re not really aware of what’s happening. You start to take actions to treat yourself, self-medicating. Ernest Hemingway was a raging alcoholic. Why? Because he was trying to find a coping mechanism for this roller coaster ride that his brain was on all the time.
Gail: When you’re that low, when you feel that depressed, you want to be checked out and disappear. That pushes people to use drugs or alcohol. But Hemingway talked about these periods of writing where he produced all of his books incredibly quickly. He called it “the juice.” He didn’t know that he was hypomanic in those times, but he had a reference: “I’m waiting for that period where I’ve got the juice.”
“What motivated me to research this link between disorder and genius was having patients who were high-achievers and looking at these past iconic figures—the Hemingways, Van Goghs, Lincolns, and Einsteins—and seeing that they had something significant going on from a mental health standpoint.”
Chuck: And you do wait for it. When you cycle through these things, you start to recognize the precursor to your hypomania. You know that this is coming on and start to get ready for it. You’re like, “I’m going to write some great stuff. I’m going to come up with the best comedy ever!” Then, you start to know when it’s going to tail off and when the depression starts. That’s normally when the drug use would happen.
Gail: You’ll try anything to feel better.
Chuck: Right, but you don’t realize drug use normally leads to depression, which leads to needing more drugs, which leads to depression. It’s a never-ending cycle. Your brain is being hijacked by these chemicals that you’re putting into your body, and addiction happens.
Gail: Part of what motivated me to research this link between disorder and genius was having patients who were high-achievers and looking at these past iconic figures—the Hemingways, Van Goghs, Lincolns, and Einsteins—and seeing that they had something significant going on from a mental health standpoint. Also, my brother is a Nobel Prize winner in the field of astrophysics for the discovery of the accelerating universe and dark energy. I grew up with a genius little brother.
Chuck: Does he suffer from any type of [disorder]?
Gail: Not in the sense of bipolar disorder, but my whole family has a lot of anxiety. Being a high anxiety person obviously can cause a lot of suffering. But, in my family, it also caused a lot of drive, perseverance. We’ve got to run as fast as we can, as hard as we can, and leave no stone unturned. He has some of the huge strengths that come along with anxiety, where you perform incredibly well because you are diligent.
You have anxiety, too?
Chuck: Are you kidding? It’s huge. People say to me, “Man, you’re such a hard worker.” I say to them, “I’m not. I’m scared.” That is the driving force that causes me to never stop.
Gail: Those are symptoms most people have. Over half of all Americans have a mental health diagnosis, whether they know it or not.
We talk about normal and not normal, but it’s kind a misnomer, because we all have different brains with different wiring. Half of us suffer as a result of something, but what we’re missing out on is that that very hard-wiring confers some particular strength, and most people are not looking for that strength. They’re not looking for the thing that may be their conferred gift, and playing to that. You stumbled into it.
You told me [once] that you had originally gone into business, and made a decision: “Maybe business isn’t the best place for me, because I feel tense all the time, and because impulsivity, money movement, and business is concerning to me.”
Chuck: Yeah. I knew that that’s not where I belonged. I still suffer from impulse problems, to be honest. An example: I’m working with some VR stuff right now that I’m producing, and last night I was doing some editing and was like, “I need VR headgear. I need to stop right now and go to Best Buy.” At the same time, there was a part of my mind saying, “You know that that’s the impulsive Chuck. Let that thought pass, and then get back to work.”
Gail: You could do that?
“I can’t imagine living without this unorthodox approach to life. It is part and parcel of who I am.”
Chuck: I have to. Otherwise I would be all over the place all the time. It works. That is why my newest venture into learning is cognitive behavioral therapy. It’s a huge boon in changing people’s lives, because they can change what they do, and changing what you do can sometimes change who you are.
Gail: About 60 studies have looked at the neurological effect of cognitive behavioral therapy, and found that indeed, when you change behavior and cognition, you are affecting very particular centers in the brain. You change wiring and neurotransmitter chemicals. It’s amazing that you can see brain change by doing psychotherapy. [But] the brain is still very mysterious. We know more about any other organ system. We’re working on it, and there are a lot of interesting, current breakthroughs in terms of imaging and understanding neuroscience. But we still have a long way to go.
In that vein: if I could take away your bipolar issues, and everything that goes with it, the positive and the negative, would you say. ‘Yeah, wave your magic wand?’
Chuck: No. I can’t imagine living without this unorthodox approach to life. It is part and parcel of who I am. I don’t think I would be where I am if I did not suffer from this malady. It has caused me a great deal of pain, but whose life doesn’t have pain? It has also brought me an immense amount of joy and satisfaction.