Manic Depression: The CEO's disease

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AIMLESS, RECKLESS AND POtentially dangerous whims used to be a fact of life for Pierre Peladeau. One day in 1972 the president and CEO of Quebecor Inc. decided he wanted to go to Tokyo. He took the flight, did some inconsequential business and returned home 24 hours later. Another time he flew off to make movies in Rome, although he had no prior interest in producing films. A similar impulse to launch a newspaper called the Philadelphia Journal in 1977 cost him about $14 million before he folded the doomed effort. "It's stupid. I didn't know what the hell I was doing," he says, looking back. "When I was drinking, it was worse."

Today, at 71, Peladeau is the picture of self-assured health and prosperity. Seated in his roomy corner office on the 13th floor of the Quebecor building in Montreal, he pulls a small pillbox from his breast pocket. With a shaking hand he selects one of the tiny pink and beige capsules that freed him from these disastrous impulses: lithium carbonate. Peladeau--the mercurial tycoon responsible for the second-largest commercial printing empire in North America and a personal fortune estimated at more than $350 million--has manic depression.

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He's not alone. Experts now say a startling number of CEOs and other high-achieving businesspeople have manic depression, a condition characterized by varying degrees of mental and physical hyperactivity alternating with periods of severe, prolonged depression. If you travel in hard-driving business circles or have a boss who does, chances are someone in your midst has the disorder. According to Dr. Sam Ozersky, a senior consultant at Toronto Hospital's Mood Disorders Clinic, manic depression "self-selects" to "any profession that requires stupendous effort, energy, confidence and the willingness to take risks." What's more, the important characteristics a manager needs to make a company sing--intelligence, confidence, clarity of thought, stamina, creativity and productivity--are the very traits heightened during mild manic episodes. "When you're in that state, things become extremely clear," says Julie, a young professional in the public sector who has manic depression (and who agreed to be interviewed only if she could use a pseudonym). "Seeing the big picture is a real asset. It's what takes you to the top."

Manic depression, also called bipolar affective disorder, has been a driving force behind some of themost colorful and ambitious business professionals of our times. Among them are US media mogul Ted Turner, Vancouver stock promoter Murray Pezim and former real estate magnate Robert Campeau. Similarly, some of the most accomplished people in history were manic depressives, including Abraham Lincoln, Winston Churchill, Leo Tolstoy and Vincent van Gogh. However, unlike Peladeau, Pezim, Turner and others, many high-achieving businesspeople don't realize they're manic depressive. On average, it takes 10 years from the onset of the illness for a manic depressive to receive a correct diagnosis. In the interim, some of them do very well in business. And as more and more such sufferers come forward, many psychiatrists are convinced that their good fortune is at least partly a result of their illness. Dr. Sagar Parikh, head of the Bipolar Clinic at the Clarke Institute of Psychiatry in Toronto, says 10% of those who have manic depression actually perform better in their jobs than a "healthy" individual. "[Manic depression] gives them that extra bit of panache to do the big deal," says Parikh.

But make no mistake: while manic depression can propel businesspeople to great heights, left unchecked it can also lead to wild, damaging behavior, with devastating consequences for a sufferer and his or her family, friends, partners, employees and even a sufferer's entire company. Untreated, about one in six manic depressives commits suicide; even with treatment, the mortality rate is 10%. Up to the time they reach that point, however, they are often among the most celebrated and envied people in business. If you are manic depressive, there are times "you can work with hardly any sleep," says Ozersky. "You can plan any business deal, seduce any man or woman or spend any amount of money." If it were possible to bottle its positive aspects in a safe, controlled compound, manic depression wouldn't be a sickness, he says, it would be a wonder drug.

PELADEAU IS LIVING TESTImony to the manic depressive's potential. From a single weekly newspaper purchased in 1950 with a $1,500 loan, he has built a formidable empire with annual revenue of $5 billion that includes 71 publications and 89 printing facilities, along with distribution and multimedia facilities operating in Canada, the US, Mexico, France and the UK. Despite being well past the age of retirement, Peladeau has no intention of stepping aside anytime soon. He starts off every morning at 6:30 a.m., swimming 50 laps in the pool at his home in the Laurentians before commuting to his Montreal office by helicopter. Ruffled sheaves of paperwork divide his desk into projects on the go.

Peladeau likes to think of himself as a street fighter. He was a drinker and carouser of epic proportions until he found God and Alcoholics Anonymous in the 1970s. "I could tell you many things," Peladeau says. "I was completely foolish." His first wife was taking "massive doses" of valium when she died in 1976. He has since married once more and divorced, and has seven children, who range in age from 41 to five (the youngest with a third woman). As always, Peladeau is a loose cannon and outrageous flirt who takes obvious delight in his checkered reputation: "I don't hide nothing. I say what I want to say, and I say it when I want to say it."

The few businesspeople like Peladeau who have gone public about being manic depressive tend to be unequivocal, controversial individuals. They've all held the brass ring firmly in hand, and they've all lost it from time to time. Turner's obsession with his own death for many years extended to his keeping on hand the gun his father had used to kill himself, according to one biographer; Pezim has had electroshock treatments; Campeau went on and off his medication to try to channel his moods, all the while dazzling the North American business community with his ill-fated, debt-propelled takeovers of Allied Stores Corp. and Federated Department Stores Inc. in the mid-'80s. That such people are able to say they're manic depressive and the world be damned is, essentially, a luxury few others can afford. For most manic depressives, their illness is more like a blight that would thwart their professional goals if revealed. Manic depression may be the reason they are among their companies' top performers, yet it is also their deepest, darkest secret.

Manic depressives only survive [professionally] if they have a lot of power--if they're Ted Turner," says Ozersky. He counsels his manic depressive patients not to tell employers about their illness unless they absolutely have to. Parikh's high-powered patients are also "extremely secretive" about their mood disorder. Parikh doesn't argue: "Would you go to a lawyer or, for that matter, a doctor or a businessman knowing that person has manic depressive illness?"

Carol, a vice-president in the financial services industry (she also requested a pseudonym), is certain that others would use the knowledge of her manic depressive illness to undermine her authority. She once confided her secret to a colleague. Next thing Carol knew, he had told his boss and, later when she disagreed with him during an important meeting, he snapped that maybe she should take a valium. It terrified her. "What he was doing was threatening me, [implying] that that information was going to come out," she says. "Both of those guys are gone [from the company], but I'm always worried, because others there are no better. I have no reason to trust that they're going to take the information in a sensitive manner."

In fact, employers and clients would be wise to worry more about manic depressives whose condition has not been diagnosed. Former lawyer Philip Upshall did an incredible amount of damage to himself, his family and his clients because no one knew about his illness--not even Upshall. Until 1990 he lived the busy but agreeable life of a prosperous corporate lawyer in the Toronto area. "I was just a person who needed very little sleep, who was very active in the community, highly involved--motoring right along," he says. A father of four, Upshall was a pillar of his town. He was involved in the Salvation Army and several social service clubs. He ran federal and municipal political campaigns and did some fund-raising for the local Conservatives. Then he began to lose control. "You're just marching on to your own little tune," Upshall says. "It's not until you have your big fall that you start to look back at what might have been an indication of an illness." Upshall loved golf and, over a two-year period beginning in 1990, sank $100,000 into golf club memberships and equipment. Yet he had time for only eight or nine games each year. His wife found sets of new clubs that he never used scattered around the house.

Far from suspecting something was wrong, Upshall felt happier and more self-confident than at any other time in his life. "When you're flying, you're flying," he says, with vigor (and a bit of longing.) "You feel like you're Jesus Christ. There isn't anything you can't do." Upshall invested his clients' money in the stock market--without telling them. "I don't know that you really realize that what you're doing is illegal," he says. "You really, honestly, believe that you are all-powerful and people would want you to do it." Of the approximately $3 million Upshall was alleged to have taken from his clients--most of whom were old friends--almost $1 million was lost. When his mood took a nosedive and the unvarnished realization of what he'd done hit him, Upshall plunged into a suicidal depression. "One of the gals I hurt, she called me up three days before I decided to commit suicide and asked me to officiate at the wedding of her eldest daughter," he says. "I'll never forget that." She would soon discover that Upshall had lost more than $100,000 of her retirement money.

Upshall's almost-successful suicide attempt landed him in hospital, where he was finally diagnosed as being manic depressive. Then the local police came to visit, and he was charged with numerous counts of fraud, breach of trust and misappropriation of funds. He was tried and sentenced to two years in jail and subsequently lost his licence to practise law. Paroled in June 1993, Upshall found that his marriage was over and he felt few of his old friends wanted anything to do with him: "Generally speaking, all of those people have said, 'Goodbye, I don't want to talk to you again because you're dirty.' And I can't say that I Name them."

ACROSS THE TOTAL POPULAtion, manic depression occurs in about one person in 100. Its cause is thought to be linked to protein abnormalities in the brain, probably of a genetic origin. The illness usually makes its first appearance when people are in their teens or 20s, during which time an individual can inexplicably slip into a period of giddy elation or a deep funk lasting weeks or months. The spell often passes as unexpectedly as it comes, and sufferers carry on normally, sometimes for long periods, before it happens again or they career off in the opposite direction. This rollercoaster ride from clinical depression to frenzied rapture can go on for years before sufferers realize something is amiss. When they're high, they feel anything but ill; when they're low, they believe they're personally inadequate, not sick. Many try to take the edge off with alcohol or drugs. Unfortunately, most people--doctors included--don't know what to look for, and manic depressives rarely receive a correct diagnosis the first time they seek help.

Psychiatrists sometimes refer to the business dynamos who have manic depression as "the lucky ones," because they tend to have a mild form of the illness, which allows them to enjoy its upside while remaining relatively untroubled by the lows that plague most of their colleagues. When they kick into what is called a "hypomanic" state, they become extremely energetic, ambitious people. Hypomania falls short of outright mania, in which manic depressives can become psychotic and lose control. Instead, hypomanic people just feel happy and vigorous, sticking to the most punishing of schedules for months without losing their edge. "They can be extremely jovial and a pleasure to be with," says Ozersky. "They're charismatic and in a good mood most of the time. They inspire a sense of confidence." Upshall compares a manic depressive professional to an athlete on steroids.

I absolutely exceed, in my opinion, the output of most of the people around me," says Carol, over a clandestine breakfast in a diner in Toronto's east end. Like many others who have manic depression, Carol doesn't sleep well, and has often ended up at the office in the middle of the night. She found out she was manic depressive nine years ago, after an extended period of insomnia wore her down to such a point that she began making mistakes at work--big ones. Her colleagues, who could see something was wrong, covered for her. Alarmed at her haggard appearance, her family convinced her to see a doctor, who referred her to a specialist who made the diagnosis. "I never did anything like walking into a room naked, but frequently I did have inappropriate use of the old mouth," she says. "People found me highly entertaining, great at a party, but a royal pain in the ass." Carol remains gregarious and painfully forthright. Her words sprint along and she punctuates her speech with startling, wide-flung gesticulations. She pauses, well aware of how it must look, and points out that she is not hypomanic--she's medicated.

The difference between Carol and a manic depressive who is not medicated is the difference between a personality type and an untreated illness. "How fast can you go without losing control?" says Ozersky. "That's the danger of these individuals. You don't know when they're going to lose control." He relates the story of a chief financial officer who slipped into a hypomanic state, and then went a little further. "It seemed as if he was extraordinarily energetic, capable and creative, and they really liked his ideas at work. Then he tried to sell them on this scheme to diversify well beyond their current business." Ozersky had a look at his plan. "It was gibberish," he says. "Grandiose, self-aggrandizing, limitless possibilities, hopelessly optimistic, impossibly optimistic."

So how do manic depressives so often get away with their behavior, even when things start to go wrong? Upshall says people questioned his behavior when he was manic, but he always had a quick and glib response that put them at ease. He was so sure of himself that he convinced everyone that everything was OK. Ozersky says it's also possible that others enjoy being caught up in the intensity of a manic depressive's upswing, without realizing the person is actually ill. "Sometimes people collude inadvertently," he says. "They don't want hypomanics to settle down."

LEAVING MANIC DEPRESSIVES to their own devices is a problem, however, because few seek help for themselves. Usually, they end up in jail or hospital when their manic phase gets them into trouble or when they get depressed and try to kill themselves.

For Peladeau, the road from the onset of his condition to his first treatment ran for more than five years. It started on Jan. 15, 1975, when he fell into what he remembers as his first clinical depression: "I've always been a boxer, a street guy. But that year I was knocked down. I couldn't get up." Yet he still dragged himself to the office. "There was a rumor going around town that I had had a heart attack and that I was lying in bed somewhere. So I had to go to the office, just so people saw me. I'd go to my office, I'd close the door and that was it. I couldn't read, I couldn't write letters, I couldn't answer the phone."

The blackness came back periodically as the years went by. Peladeau knew he was depressed, but didn't know how to make it go away. He tried megavitamins and dietary changes, but nothing seemed to work. "You want to die," he says. "I'm very lucky that I didn't try, because I would have succeeded."

Then, in 1980, a friend brought him a book called Moodswing, by Dr. Ronald Fieve. Peladeau's epiphany came when he hit the chapter about achievers with manic depression. "Churchill, Roosevelt, van Gogh, Handel, Schumann--ooohh," he cries, stretching it out. "These are people I know very well, friends of mine."

Despite finding the source of his trouble, Peladeau's realization came as a heavy blow: "I hated it. I would have preferred a heart attack. I thought it was a woman's illness." He was also reluctant to get treatment and didn't even want to know what lithium was. "My first wife died," Peladeau says, pausing to blow his nose. "Massive doses of valium. And I hated [drugs] because of that. So lithium was valium. It's stupid, because it has nothing to do with it, but that's the way I reasoned." A friend finally convinced him to take lithium and today he is one of its most outspoken proponents. (For centuries, people made pilgrimages to alkaline springs--lithium is an alkali metal--to soak away nervous complaints. But it was not until 1970 that doctors began widely prescribing it for manic depression.)

Not every manic depressive patient is as enthusiastic as Peladeau about lithium. Despite the fact that theirs is one of the most treatable mental illnesses, 70% of manic depressives resist taking medication. There are several reasons. Manic depressives have to take lithium for life, and many see it as a permanent reminder that they are somehow "flawed." If they're OK for a year or two, they begin to doubt they really do suffer from manic depression and stop taking their medication, as Turner did recently after informing his board of directors. While Turner appears to have remained healthy since going off his medication--and now even believes he was misdiagnosed--70% of manic depressives relapse within one year and 96% relapse within five years.

For others, the problem lies with lithium's side effects. While not debilitating, the drug can cause weight gain, shaky hands, stomach upset and a tinny taste in the mouth. Some manic depressives say lithium interferes with their concentration and makes them less creative. It also robs them of their periods of manic exhilaration. "All they wanted to do was to get me better and, really, when I was better, I wasn't as happy," says Julie, who is looking for an alternative to lithium. According to Ozersky, lithium is better at taking away the wonderful highs than eradicating the awful lows. It also makes manic depressives more realistic, which can be inhibiting for some.

There is, of course, a considerable upside. Peladeau says treating his manic depression taught him to delegate: "I would not have done that 20 years ago. I was doing everything myself. I was the only one that was bright, I was the only one that could do something, so I was knocking everybody down. Today, I've got two of my sons in the business who are doing a hell of a good job, whom I would have knocked down before. Same thing with my daughter."

Some professionals go off their lithium to try to slingshot themselves into a hypomanic episode in order to get more work done. Parikh calls it "riding the tiger." And it's risky. "They say, 'I've got a big contract to do something for three months,' and they go off their medication in the hope that they can go high and be productive," Parikh says. "If they see a low coming, they immediately go back on their medication. Once in a while, it works." More often, though, it backfires, spinning them in the opposite direction or destabilizing their systems' delicate balance. Parikh believes that, over time, riding the tiger makes manic depression worse.

Still, those who treat manic depressives understand the temptation. "People miss the hypomania," says Neasa Martin, executive director of the Mood Disorders Association of Metropolitan Toronto. "They miss the high. Who wouldn't want to feel invincible?" In this, Peladeau is one of the lucky ones, even on medication. "It's not up, up, up," he says gleefully, his hand flitting skyward like a plane taking off in steps. "But I still have the highs."