Tyson’s Choice

Medication could end his career–but save his life.

Who in their right mind would bite off a chunk of another person’s ear? Vincent van Gogh is famous for slicing off his own. But van Gogh was not in his “right mind.” He suffered from manic-depressive illness. It’s likely, from past revelations, that Mike Tyson may be similarly afflicted. This creates an interesting moral dilemma for Tyson, boxing officials, and the public.

A connection between mania and artistic achievement has been known since ancient times. Psychologist Kay Redfield Jamison, in Touched With Fire: Manic-Depressive Illness and the Artistic Temperament, maintains that mania is an essential driving force for many artists. “The fiery aspects of thought and feeling that initially compel the artistic voyage–fierce energy, high mood, and quick intelligence; a sense of the visionary and the grand; a restless and feverish temperament–commonly carry with them the capacity for vastly darker moods, grimmer energies, and, occasionally, bouts of ‘madness.’ ” Ernest Hemingway, Virginia Woolf, and Mark Rothko all suffered from manic depression. The disease fueled their artistic achievements even as it led to their suicides.

There may well be a similar relationship, for similar reasons, between manic depression and sporting achievement. Golfer Bert Yancey was the only well-known athlete to publicly acknowledge this affliction. But New York Mets pitcher Pete Harnisch made headlines this year when he became disabled because of unspecified depression. And Dr. Richard Wyatt, a psychiatrist who has worked with athletes, says there are many other cases.

In 1988 Tyson told an ABC television audience that he had had a psychiatric illness all his life, that he’d discussed manic depression with his psychiatrist, and that this illness caused him to do things he would normally never do. Tyson’s former wife, actress Robin Givens, said point-blank in the same joint interview, “Mike is a manic-depressive.”

Tyson’s well-publicized actions over the years are consistent with a manic-depressive illness. Tyson confessed to David Remnick of The New Yorker, “There’s no doubt about it; I’m a wild man.” According to Remnick, Tyson’s former trainer Teddy Atlas says, “[Tyson’s] like a double feature now, like you’re getting Heidi and Godzilla at the same time.”

Manic depression is not rooted in a Freudian childhood trauma. It’s a genetically determined, chronic, and incurable disease that affects about 1 percent of the adult population–striking people hardest in their 30s. The symptoms often can be contained by medication. Without medication, people suffering from manic depression face poor outcomes. Some studies report that 20 percent of untreated sufferers commit suicide, making untreated manic depression as lethal as many forms of cancer and heart disease. The disease also worsens over time, with both mania and depression becoming more pronounced and less responsive to medication. Victims are especially prone to drug and alcohol abuse, with all the attendant complications.

Would it make a difference if Tyson were not just a chump who chomped on the ear of a champ, but were suffering from an often fatal disease that can be effectively treated? It would.

Tyson faces a Hobson’s choice: he could seek treatment that could diminish his boxing skills or avoid treatment and become sicker. Treatment requires daily doses of lithium (or other mood-stabilizing drugs). The effect on his athletic performance might be severe. The medication–by design–diminishes many of the qualities that helped Tyson to reach the top of his game, including feelings of increased energy, invulnerability, elation, exhilaration, inflated self-esteem, hostility, and violence. Tyson acknowledged the risk in 1988 when he said, “I’m not taking any medicine because I feel medicine’s going to change me.”

For some patients, lithium also has undesirable side effects. Wyatt found that some athletes experienced tremors and reacted more slowly physically and mentally, while others improved their performance under drug maintenance. Going off lithium to prepare for a bout is not a way out of this dilemma, since in many cases lithium is not as effective the second time around.

All athletes are required to pass physicals to ensure that they do not place themselves or other participants at risk. A boxer cannot fight with a heart condition or dementia. So why should a boxer with manic-depressive illness–and a history of egregious conduct consistent with the disease–be licensed to fight without medical clearance?

Then there’s the public’s infatuation with train wrecks. We anticipate accidents at stock car races. We go to the “fights” and a hockey game breaks out. We egg on Dennis Rodman, watching him parade like a peacock and break down in tears on national TV. We goad baseball player Albert Belle so much that All-Star-game manager Joe Torre must confine him to the dugout. NBA forward Dennis Scott makes headlines for uncharacteristic rants. The press and public love it. Meanwhile, the adulation feeds a sense of invincibility–especially if the athlete already happens to suffer from manic depression. After a crash, the crowd’s silence feeds an athlete’s paranoia, depression, and despair.

Tyson’s choice is whether to save his life or save his career. The choice for others is whether to force him to make the right choice, or to continue deriving profit and entertainment from his illness.