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Kay Redfield Jamison was born into a military family and grew up around air-force bases from Florida to Puerto Rico. In her late twenties, a few months after becoming an assistant professor of psychiatry at the University of California, Los Angeles, she had her first episode of manic depression. Her account of the fight to gain control of the disorder 鈥� and accept the gruelling treatment regime 鈥� is told in An Unquiet Mind (Picador, 1997). She is now professor of psychiatry at Johns Hopkins University School of Medicine. Her latest book, Exuberance: The passion for life, is published in the US by Alfred A. Knopf

We all think we know what we mean by exuberance. But what do you mean by it?

Basically it comes from the Latin, 鈥渆x鈥�, out of, and 鈥渦berare鈥�, to be fruitful, to be abundant. So it鈥檚 from the natural world, and it meant an overflowing of abundant fertility. Think how a pair of poppies, given the right conditions over seven years, will produce 820,000 million million million descendants. Or how the universe is thought to contain 10²¹ stars. It has become a word to describe overflowing joy and energy.

I believe it is incomparably more important than we acknowledge. After all, if enthusiasm finds the opportunities and energy makes the most of them, then a mood that yokes the two has got to be formidable. Somehow exuberant people take in the world and act on it differently from the less lively and less engaged people. Also, exuberance is a very pleasurable state and in that pleasure is power.

Is that a tricky area for you? After all, it sounds not unlike what happens in the manic phase of manic depression.

Yes. I should know because I have had manic depression, or bipolar disorder as it is also called, for 30 years or so. Professionally, I have always been interested in the manic depressive state, in the role of high energy and high mood in different aspects of life. This time I decided that I wanted to focus particularly on a normal temperament that can veer into pathology. The pathology 鈥� mania and so on 鈥� has been well studied, but exuberance has not, so it was a challenge. It is like love in many respects: people have strong feelings about it and think they know what it means, but really there is no absolute definition of it.

What was the most surprising thing for you when you looked at exuberance?

It was riveting to find out just how hard it is to portray exuberance in words. It鈥檚 like portraying charm, something that tends not to get easily articulated but in some people it just comes flying off the pages. Reading descriptions of Theodore Roosevelt, for example, who is probably the US鈥檚 strongest candidate for exuberance, or reading his own writings, the exuberance literally leaps off the pages. It interested me as a teacher of clinical psychopathology because it is very hard to convey to young doctors what mania is. Same with exuberance.

Where do you draw the line between exuberance and mania?

It鈥檚 a puzzle. To me it is the most interesting thing about moods and disorders and always has been. The lines are not clear at all, they are often arbitrary. If it was absolutely clear-cut when the mood was pathological, then it would be interesting, but not nearly as interesting.

But there must be some way to tell them apart.

Well, a significant percentage of people who have manic depressive illnessalso have an underlying exuberant temperament. But most people who are exuberant do not have manic depressive illness. So exuberance is far from a pathological state for most people who have it 鈥� it is a highly valued and integral part of who they are. And if you understand the role of exuberance in manic depression then you do get a perspective on exuberance because extremes in behaviour will always illuminate normal behaviour. It鈥檚 just that there are limits to the comparisons.

Who would you describe as exuberant today?

You just have to see President Clinton walk into the room. He鈥檚 mesmerising. His energy is infectious, his love of the country is especially infectious and so is his capacity to put up with abuse and persecution day in day out. It was remarkable and it remains so after just coming off his surgical bed. He can still move a crowd in a way that few people can. He also has a constant curiosity that drives people mad. It鈥檚 3 am and he鈥檚 likely to call and be all buzzed up about some idea and want to know the answer to some question. But it is a delightful characteristic.

What about Bush and Kerry?

Neither of them is really exuberant. I think that John Kerry is probably a bit more exuberant than he looks because he is extremely reserved and very, very disciplined. But no, he鈥檚 not really exuberant.

Are American politicians more likely to be exuberant than British ones?

Tony Blair, the British prime minister, seems to me to be an enthusiast of some sort, but not exuberant. I do think that Americans are slightly more selected for exuberance. If you think how the country started 鈥� people left England to go to Massachusetts, then left the plains, crossed the mountains 鈥� it鈥檚 been a fairly questing sort of nation.

Do exuberant people make good leaders?

Sure. Being a great leader is really the capacity to fire infectious enthusiasm and I think that鈥檚 true for politics, business or scientific leadership where you need to get people on the same kind of emotional wavelength and get them very motivated and optimistic about what can be done.

You cite quite a few scientists in your book鈥�

Yes, Robert Gallo, the HIV pioneer, and James Watson among many others. I decided to include them partly because they are highly exuberant people but also because exuberant scientific leaders have this habit of choosing laboratories that are usually at the forefront of much of modern science, such as biology, virology or astrophysics.

Are scientists more likely to be exuberant?

Wherever you measure it, you find the exuberant temperament in about 8 to 10 per cent of the population. We can鈥檛 say that scientists are more exuberant for sure 鈥� and I wasn鈥檛 trying to lay down a scientific basis of exuberance. I focused on scientists partly because some of my friends and colleagues are scientists and I admire them enormously, but also because scientists are portrayed popularly as being rather passionless, dreary and monochromatic, and my experience was that really great scientists are often very colourful and very enthusiastic.

After your books about manic depression, suicide and psychosis, was it a relief doing this book?

Yes. And I鈥檝e been delighted with the response. I鈥檝e heard from lots of people who either wish they were more exuberant themselves, or who wish their husbands or wives were.

What about the reaction of your readers with bipolar disorder?

There are a lot of people who have bipolar illness who have been very interested in the overlap of exuberance with mania. One of the reasons is that they are more likely than the general public to have an underlying exuberant temperament, so they know the turf. Secondly, a lot of manic depressives become very conservative and cautious when they are first being treated. They get concerned when they start to feel really good that they are getting manic again. That鈥檚 one of the most difficult things about treating a young person with bipolar illness 鈥� and the average age of onset is about 18. When they start feeling enthusiastic again, the last thing you want to tell them is, 鈥測ou鈥檝e got to worry about being enthusiastic鈥�.

But you have to.

Sure, you want them to be aware of any indicators that they might be getting manic again. Mania is such a destructive state for the people who have it and the people who are around it. It鈥檚 like having a heart attack 鈥� you just don鈥檛 want people to undergo it. So you have to tread a fine line.

What do your colleagues think?

I鈥檝e had difficulty occasionally with my colleagues in psychiatry, because I have focused on some of the positive aspects of a very pathological illness. It is true, mania can become a destructive, potentially lethal, homicidal state, but there is a phase where people are highly productive, feel intensely alive, get a lot done and enjoy themselves immensely, and you don鈥檛 want to make something pathological that鈥檚 not.

鈥淚f you are really enthusiastic, you are likely to be taken down a peg by your colleagues鈥�

For sure, you don鈥檛 want to romanticise mental diseases. I am the last person to romanticise it. It nearly killed me and other members of my family. On the other hand, I think that at the intersection it is very, very interesting, and my hope is that people will start looking at how things like anxiety serve the public well. You know, we do have a diversity of temperaments for good cause.

This sounds a bit contradictory. Is this the rather difficult line between pathology and the human condition you were talking about earlier?

I don鈥檛 have a problem at all with the idea of bipolar illness being treated medically. It is not the human condition to be unable to get out of your bed for a year and a half as many people can鈥檛. But antidepressants can make people worse, particularly in bipolar. They can make people more agitated, trigger mania, all sorts of adverse effects. Does that mean that you don鈥檛 use them? No. It means that it behoves to doctors to be better educated than they tend to be.

Do you still have a daily fight with this condition?

I have been there, done that and run that particular experiment often enough. I have not seriously questioned not taking my medication for years and years. I just wouldn鈥檛. It鈥檚 not just on account of me, I see patients and people on the wards, and it is a really compelling argument.

Is it possible for someone to be 鈥渦p鈥� all the time?

There is a condition like this in the bipolar range of disorders, uniform mania. But there are also people who have what is known as a hyperthymic personality or temperament. It is pretty characteristic of the person most of the time, and some of them will become a little manic, but many of them stay that way without getting sick. Nobody truly knows why. Many people who have these hyperthymic temperaments do have family histories of bipolar illness, and so they are in some sort of continuum.

So many exuberant people are hyperthymic?

I鈥檓 sure they are but this wasn鈥檛 the point of my book. I鈥檓 more interested in the theology and literature rather than diagnosing people. Exuberance can have a downside. Everyone I interviewed said how annoying they knew they could be to others. People who are exuberant are not taken seriously enough 鈥� some scientists said they felt very vulnerable to ridicule. If you are really enthusiastic, you are likely to be taken down a peg by your colleagues because there is such demand for objectivity, and it is easy to mock someone who is enthusiastic.

Why?

Some of it is envy, some is probably to do with the fact that people who are exuberant do make other people uncomfortable after a certain point. They like being around them, enjoy the energy and the enthusiasm, but it is kind of exhausting. I think that in general people have a scepticism that the exuberant do not have. We all need to have that scepticism about ourselves.

Exuberance can be dangerous. If you have someone who is exuberant and doing great and wonderful things, that is terrific. But if you have somebody who is leading you into war because he or she is very enthusiastic about it, or into very bad business deals鈥�

Are we squeezing exuberance out of life?

Right. Exuberance doesn鈥檛 do well under structure. You鈥檝e got children in classrooms 鈥� it drives me wild just to look at it 鈥� who do hours of structured lessons and very few sports, and those they do are highly structured. Then they have structured music lessons, structured art lessons, then they go home and have structured homework. It鈥檚 really joyless. I think it makes kids much more passive. Exuberance allows you to go out and explore things on your own terms. If you鈥檙e used to somebody always providing your entertainment and stimulation, what happens when that goes away?

Did you run wild as a kid?

I absolutely roamed wild. They didn鈥檛 seem to care that much whether we did our homework. But we certainly were encouraged to go out and play and do sports without someone checking up on us every five minutes.