Winston Churchill led England to victory in WWII. His physician, Lord Moran, treated him for depression (and likely had bipolar disorder).
The most accomplished people in history discovered the same antidepressant: total absorption in work that demands everything you have
STUDY: D’Agati DV et al, International Journal of Bipolar Disorders 2026
STUDY TYPE: Review
FUNDING: Independent
Background
The affective temperaments — hyperthymic, cyclothymic, irritable, and depressive — are common in mood disorders, especially bipolar II where nearly 50% have one. People with these temperaments carry outsized creative gifts, but also a persistent vulnerability to severe depression. This narrative review looks at six historical figures who likely lived with these temperaments:
- Robert Burton, Samuel Johnson, Meriwether Lewis, Winston Churchill, William Osler, and Jacques Barzun.
Though all suffered severe depressions, they also arrived at a common strategy to keep depression at bay.
A Summary
Here’s the strategy the converged on: Total immersion in a creative project that was all-consuming, spiritually satisfying, and commensurate with their gifts. Mere busyness wasn’t enough. The work had to possess them.
Robert Burton wrote the Anatomy of Melancholy, a sprawling textbook of depression, to cure his own melancholy. Samuel Johnson was most stable during the nine years he spent compiling the first true Dictionary of the English Language. Churchill switched between painting, masonry, and writing whenever fatigue threatened, never allowing a gap that depression could fill.
Meriwether Lewis, who explored the Western USA, thrived during his three-year expedition but collapsed into depression and alcoholism upon return to a sedentary government post. Jefferson’s epitaph for Lewis said it plainly: constant exertion had suspended his depressive tendencies; stasis brought them back “with redoubled vigor.” Barzun’s image for it: riding a bicycle. Keep pedaling, look straight ahead. The moment you stop and look down, you fall.
Though not covered in the article, Theodore Roosevelt, who had a hyperthymic temperament and a family history of manic-depression, claimed he could ward off depression — which he called “black care” — by keeping his mind and body active. He believed in “The Strenuous Life,” combating emotional distress through vigorous physical exertion, constant intellectual stimulation, and deep immersion in the wilderness.
Modern neuroscience offers a possible mechanism. Depression correlates with reversible hippocampal atrophy. In animal models, four things restore it: electrical stimulation, antidepressants, exercise, and environmental enrichment, the last defined as adding complexity and challenge to the creature’s environment.
Practice Implications
- Telling people with depression to just get busy can be invalidating and unrealistic.
- On the other hand, it is an effective preventative strategy, backed by trials of behavioral activation therapy. When done carefully and with a therapist, it treats even severe depressions.
- Learn how to recognize the affective temperaments with the TEMPS-A rating scale. They are also common in ADHD, as explained in our ADHD vs Bipolar podcast.
— Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
