A retrospective analysis of genius Charles Darwin suggests that an adaptive response to panic disorder contributed to his development of the theory of evolution.

While such historical analyses are always highly speculative, psychiatrist Russell Noyes Jr., M.D., and radiologist Thomas Barloon, M.D., of the University of Iowa College of Medicine make a strong case that a diagnosis of panic disorder explains many disparate elements of Darwin's behavior.

Darwin exhibited many of the symptoms of panic disorder so well known to clinicians today. As Noyes and Barloon noted in the January 8 Journal of the American Medical Association, Darwin's illness had enormous bearing on his life and work.

The disorder "significantly changed his life style from that of a worldwide collector and traveler to a recluse. However, as a consequence of his illness, he was able to narrow the focus of his energies."

The authors quote Darwin himself as saying, "Even ill health, though it has annihilated several years of my life, has saved me from the distraction of society and its amusements."

If Darwin had not suffered from panic disorder, his theory of evolution might not have become "the all-consuming passion that produced On The Origin of Species," the authors speculate.

Although panic disorder is not associated with creativity, "any illness may have its secondary gains, and that may have been true for Darwin," Noyes observed in an interview. "Illness changes people's lives and often solves certain problems for them. And I think anyone treating people has to be aware of those factors. Others before us have commented on this sort of thing."

Peter Kramer, M.D., is best known as the author of Listening to Prozac. That book and other publications he has written explore the interplay between personality, creativity, and psychopharmacology in contemporary Western civilization. He spoke with Psychiatric News about the JAMA article.

"There are two issues. One is diagnosis. What does it mean to use 1990's diagnosis for the early 19th century? The other is how reasonable are our diagnostic distinctions? How culture specific is diagnosis?," Kramer wondered.

Even if the diagnosis is granted, the other issue is "to what extent can we attribute production to illness?" said Kramer. "Would Darwin have done something different if his illness were diminished? One could entertain a more psychoanalytic thought--that maybe both the illness and the writing are creative products of the imagination, and perhaps the person creates the illness to give himself space to write."

Such questions are fascinating in part because of "their science-fiction quality," said Kramer. Of course, no one will ever really know whether Darwin would have created his seminal theory had he received treatment for his condition. And therapists faced with treating creative patients must always weigh the costs of treatment against the benefits, recognizing that people value things in addition to creativity, Kramer added.

Speculation that "treating manic-depressive illness makes people less productive and less creative" is commonplace, observed Kramer. "But it is just an empirical question to which we don't have answers." It is hard to imagine how such a hypothesis could even be tested, he noted.

(Psychiatric News, March 7, 1997)