The Tribune

By DR MIKE NEVILLE

Imagine one morning you arrive at work to find that your boss has gone completely mad.

Do you call the mental hospital or - if you suspect demon possession - call an exorcist?

The usual response is to see and hear nothing and decide it is not your problem.

It is much more common to be faced with this reality of mental illness in our own families; not nearly so easy to ignore and dangerous to do nothing.

Mental illness, like all other illnesses, can strike anyone, anywhere, impacting the life of the sick person and all those who love them. It is very important to reach out for the help that is available.

Once you can accept that mental illness is common in our society, it is clear that even our leaders are susceptible to illness - or madness to use the common term.

It is possible to convince oneself that the electoral process would prevent the election of a madman, but in the emotional vortex of an exciting campaign history would suggest that anything is possible.

Certainly there have been many leaders, both despotic and great, who have suffered from mental illness. Winston Churchill wrote about his terrible depression in his memoirs: he would stay in bed for days or weeks unable to function. There have been other great leaders with depression and it is suggested that whilst the illness causes great suffering to that person, it can also provide insights that help in the crisis of war but can cause them to struggle in times of peace and prosperity.

Adolf Hitler has been the subject of many a psychological profile and the anti-social, narcissistic personality disorder combined with stimulant and opioid addiction seem to be the best fit.

I have found the possible mental health problems of King Henry VIII fascinating. He was regarded as a handsome, athletic, intelligent prince who turned into a rather bizarre despot always remembered for his wives’ unhappy endings. He was infuriated by his wives’ inability to produce a male heir due to numerous miscarriages. He was paranoid, grandiose and bad tempered; he developed ulcers in his legs and found it difficult to walk. One explanation is that when he suffered a head injury whist jousting, the frontal lobe of his brain which caused later personality changes was damaged. This, however, cannot explain those frequent miscarriages which caused him so much fury. Another possibility is that he had a condition called Kell positive, a rare blood group which could explain all the miscarriages. It does not, however, explain the personality changes.

In Europe at that time, syphilis was spreading rapidly. The King was certainly popular with the ladies and whilst there is no record of him receiving any treatment for the “French Disease” it can explain the miscarriages, the bizarre personality changes (general paresis of the insane) and the leg problems (tabes dorsalis). I am not sure that the thought of a major religion having roots in an illness like syphilis would be well received but it really shows how mental illness can shape history.

Mental illness has a major impact on judgment. Wars can start if a leader feels slighted; economies are decimated by bad choices.

Many of us begin to have memory problems as we grow older and the more sinister Alzheimer’s Disease begins with memory and disinhibition problems. A leader may not even know what is happening around him or her.

How can we prevent these potential crises? A distinguished Bahamian politician once told me “countries get the government they deserve”. I have never been sure of that, but there is a vote so people do get some degree of choice. In times of crisis, the disaffected look for change and may be attracted to a leader who promises change. But is there any guarantee that they are telling us the truth?

Someone with severe personality disorder can pass a lie detector test and is able to feed us a constant diet of alternate facts, spin, truthful hyperbole or downright lies.

To quote Winston Churchill, “Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing ever happened.”

• Dr Mike Neville is a forensic psychiatrist who has practiced for more than 40 years in The Bahamas, working at Sandilands, the prison and in private practice. Comments and responses to mneville@tribunemedia.net