This month Australia plays host to Leonard Cohen, the world famous Canadian poet, novelist, singer, songwriter and professional manic-depressive. What many people do not know is that Leonard Cohen learned the Greek language in his twenties, loves the Greek way of life and carries the komboloi; his home for twenty years was on Hydra.
Opening paragraph of Leonard Cohen – The Greece Years by Harry Fatouros. Neokosmos: Dec 3, 2013.
As it turns out, I do know that “Leonard Cohen learned the Greek language in his twenties, loves the Greek way of life and carries the komboloi; his home for twenty years was on Hydra.”
What I’m puzzled by is the author’s identification of Leonard Cohen as a “professional manic-depressive.” (Come to think of it, I’m puzzled by the term “professional manic-depressive” itself in this context. Do career counselors advise clients to consider the fascinating profession of bipolar disorder?)
After a 30+ year career as a psychiatrist, I am leery of any diagnosis conjured up exclusively from media reports about entertainers, politicians, military leaders, writers, …
While the Diagnostic And Statistical Manual Of Mental Disorders, the official guide to psychiatric diagnoses, makes a commendable effort to establish objective criteria, it is a simple (and entertaining) task to find evidence of behavior that can be interpreted as fulfilling one or another diagnostic requirement. It is not a challenge, for example, to find posts on this site indicative of such bipolar disorder symptoms as “increased self-esteem or grandiosity,” “distractibility,” or “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).”
Further, even if one detects genuine signs and symptoms of a given psychiatric disorder, a diagnosis cannot be confirmed unless other possible causes of those symptoms are eliminated. Chest pain can be caused by musculoskeletal problem or by cardiac disorders. Clearly, treatment and risk vary depending on the etiology.
Leonard Cohen & Depression
Leonard Cohen has spoken frequently and explicitly about his long bout of depression (see, for example, Leonard Cohen’s List Of Pharmaceuticals Joke & His Not At All Funny Depression) which lifted several years ago. During this period, he being treated by physicians with standard anti-depressants. While nothing approaches the significance of personal examination of a patient and a review of that patient’s medical history, one can make a presumptive – and tentative – diagnosis of major depressive disorder from this information.
Making a diagnosis of bipolar disorder, however, requires more data than I have found or a leap into fantasy.
In any case, this issue has been considered previously by Sylvie Simmons in her biography of Leonard Cohen, who addressed this issue to her astute psychiatric consultant, Dr Showalter. The pertinent reference begins at the second paragraph. (click on image to enlarge)
Whatever “professional manic-depressive” has to do with Leonard Cohen, it certainly isn’t a well-supported medical diagnosis. And if it was meant to convey some other meaning, it’s at best sloppy journalism and smacks of cavalier use of medical terminology that may mislead readers.