CRAZY AMEERICANS. THE HYPOMANIC ENTREPRENEUR

The Hypomanic Entrepreneur
April 10, 2005

FIRST CHAPTER
'The Hypomanic Edge'

By JOHN D. GARTNER


The Hypomanic American
The Hypomanic Entrepreneur

The 1990s will be remembered as the age of Internet mania, a time when entrepreneurs making grandiose claims for their high-tech companies swept up millions of Americans with their irrational exuberance, inflating the biggest speculative bubble in history. The idea that some entrepreneurs may be a little manic is hardly new. A Google search for "manic" and "businessman" yields more than a million hits. Entrepreneurs, as well as the markets they energized, were commonly described in the media as "manic." Yet, until now, there has never been a serious suggestion that the talent for being an entrepreneur and mania, the genetically based psychiatric disorder, are actually linked. Perhaps because I am a clinical psychologist, it was clear to me that "manic" was more than a figure of speech in this case.

I called several reporters who had written profiles of these "manic" entrepreneurs and asked them, "Do you think he really was manic?" None said yes. "Not really manic; not clinically," was a typical response. They resisted applying the psychiatric diagnosis because the entrepreneurs they had interviewed were boastful, hyperenergized, and zany, but they "weren't crazy." And the journalists were right. Their subjects were not manic. They were hypomanic. Hypomania is a mild form of mania, often found in the relatives of manic depressives. Hypomanics are brimming with infectious energy, irrational confidence, and really big ideas. They think, talk, move, and make decisions quickly. Anyone who slows them down with questions "just doesn't get it." Hypomanics are not crazy, but "normal" is not the first word that comes to mind when describing them. Hypomanics live on the edge, betweeen normal and abnormal.

For example, Jim Clark, cofounder of Netscape, was described in Business Week by Netscape's other cofounder, Jim Barksdale, as "a maniac who has his mania only partly under control." In The New New Thing, Michael Lewis profiled Clark as a perpetual motion machine with a short attention span, forever hurtling at unsafe speeds in helicopters, planes, boats, and cars. When his forward motion is impeded, Clark becomes irritable and bored. In his search for the stimulation of the "new new thing," he quickly loses interest in the companies he founds and tosses them into the laps of his bewildered employees. His Netscape IPO is credited with starting the Internet gold rush. After that it seemed he could do no wrong. When he pitched a new company, Healtheon, a medical Web site, his only business plan was a diagram with five words. His "magic diamond" put Healtheon at the center of four vertices labeled "doctors, consumers, providers, and payers." That was it. His magic diamond, he claimed, was going to "fix the U.S. health care system." It was going to be "bigger than Microsoft, AOL, Netscape and Yahoo!" As Lewis wrote, "Any other human being would have been thrown into an asylum for thinking such grandiose thoughts." Those who followed Clark had faith in his messianic mission. "There was a feeling that we were about to change the world," said one of Healtheon's chief engineers.

Successful entrepreneurs are not just braggarts. They are highly creative people who quickly generate a tremendous number of ideas - some clever, others ridiculous. Their "flight of ideas," jumping from topic to topic in a rapid energized way, is a sign of hypomania. Consider Bill Gross, CEO of Idealab. Bill Gross's job was not to build or run companies, but just to think of ideas for them. Idealab was an "Internet incubator." On Fortune's cover, next to a picture of a cheerful Bill Gross, was the caption "I Lost $800 Million in Eight Months. Why Am I Still Smiling?" The author, Joseph Nocera, Fortune's managing editor, begins his article with an unusual mea culpa. He apologizes to his readers for his previous Fortune article that hyped Gross and Idealab just before the Nasdaq crash. He confesses that Gross converted him into a believer:

I believed him because I was dazzled by him. A small, wiry man, Gross had an infectious boyish enthusiasm that was charming and irresistible. He spoke so rapidly - jumping from topic to topic as if he were hyperlinking - that it was hard to keep up with him, and had so much energy he seemed constantly on the verge of jumping out of his skin. He bubbled over with irrepressible optimism.
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. .