Many comments have been made on the creativity of persons with exceptional ability and of highly original kind. It is not possible to conclude that exceptional literary, musical or scientific work is the result of mental disorder. There are however some important or famous personalities about whom it is known or is presumed that they suffered with full or mild form of bipolar disorder. In such cases there are of course during the severe disturbances intermissions in their creative activities. Milder depression and hypomania usually do resemble in their literary or other work. In some writers, poets and dramatists, depression is thought to be the source of tragic or sad themes. Hypomanias on the other hand the inspiration for comedies and joyful plays.

Any judgment in this field is to be made with extreme caution, in particular if sufficient knowledge of circumstances is not known. Such informations are very scarce especially with historical personalities. Great care is required because it is a subject that for the general public carries a taste of sensationalism. Many people do not look for the explanation of influences that contribute to outstanding creative work. They are misusing such studies looking with selfsatisfying smirk for anything to denigrate the life and work of an outstanding personality. In this way they often bring injury to the living and damage to the memory of the deceased.

There has been a suggestion put forward[1] that Karl May might have suffered from manic-depressive illness known today under the name of bipolar disorder. It is difficult to see how anyone who had read and studied the books and life of Karl May would be able to agree with this thought.

 
(1)    Bipolar disorder – cause, general course and common treatment.

Bipolar disorder (manic-depressive illness) is a chronic disease that persists throughout one’s life. It is a mental illness involving episodes of serious mania and depression. Bipolar disorder is extremely distressing and disruptive not only for the patient, but also to people around him or her. It cannot be cured but can be well controlled nowadays through the use of psychotherapy and medication such as Lithium. Without treatment the symptoms will persist and worsen, and ultimately hospitalization may be required. If untreated bipolar affective disorder is associated with high suicide rate[2]. Eighty percent of patients with bipolar disorder presented with major depression and only developed a manic episode during their second or third episode of illness.[3]

The diagnostic features of bipolar mood disorder are outlined in ›The Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition‹ (Washington DC, 1994), known as DSM-IV.

In order to make a diagnosis of bipolar mood disorder the symptoms must »cause clinically significant distress or impairment in social, occupational, or other important areas of functioning«[4]. The symptoms must not be »due to the physiological effects of drug abuse, a medication, other treatment for depression, or toxin exposure. The episode must not be due to the direct physiological effects of a general medical condition.«[5]

Bipolar mood disorder is usually classified into subgroups: Bipolar I., Bipolar II. Cyclothymic Disorder, Hypomanic Episode, Manic Episode, Mixed Episode, and Major Depressive Episode.

Bipolar I. is characterized as the occurrence of one or more manic episodes or mixed episodes with duration of at least one week. Many such patients also experience at least one major depressive episode. Ten to 15% of bipolar affected people commit suicide or become violent during severe manic episodes. Job failure, divorce, substance (alcohol) abuse and antisocial behaviour are common. The most susceptible to this disorder are the first-degree biological relatives of bipolar I affected people.

Bipolar II. »The essential feature of bipolar II disorder is a clinical course that is characterized by the occurrence of one or more major depressive episodes accompanied by at least one hypomanic episode« [6]. The presence of manic or mixed episodes would nullify the diagnosis of bipolar II. Those with a first degree biological relative that is affected by bipolar II are at heightened risk for developing bipolar I, bipolar II, and for experiencing major depressive episode than the general population.

Cyclothymic disorder – »The essential feature of Cyclothymic disorder is a chronic, fluctuating mood disturbance involving numerous periods of hypomanic episodes and numerous periods of depressive symptoms« [7]. First degree biological relatives of those affected by cyclothymic disorder are at increased risk of being affected than the general population.

Manic episodes are characterized by »a distinct period of abnormally and persistently elevated, expansive or irritable mood«[8].

Hypomanic episode is characterized by a distinct period of »abnormally and persistently elevated, expansive, or irritable mood that lasts at least four days« [9]. The criteria are essentially the same as that for a manic episode except that delusions and hallucinations cannot occur. In addition, the person’s mood must be markedly different than their usual, nondepressed mood, and there must be an uncharacteristic change in their level of functioning.

Mixed episodes – people experiencing mixed episodes appear to meet the »criteria for a manic and for a major depressive episode nearly every day«[10].

Major depressive episode is defined as a »depressed mood or loss of interest in nearly all activities«[11]. Duration must be at least two weeks. Symptoms are inability to concentrate, difficulty in thinking and making decisions, decreased energy, and recurrent thoughts of death, suicide ideation, plans, or attempts.

What causes bipolar disorder? Not much is known about the causes of this disorder. A chemical imbalance (low or high level of specific neurotransmitters such as serotonin, norepinephrine or dopamine) in the brain (a link exists between neurotransmitters and mood disorder) is found in bipolar affected people. It is known that first-degree biological relatives of affected individuals are at heightened risk for bipolar disorder. However not everyone with a predisposition to bipolar is affected. A severe life stressor is needed to activate the disorder, such as physical, mental, environmental or emotional causes.

Considering the biological explanation, inheritability is to be addressed. This question has been researched via multiple family, adoption and twin studies. In families of persons with bipolar disorder, first-degree relatives, i.e. parents, children, siblings, are more likely to have bipolar disorder[12][13][14].

Medication in Bipolar Disorder.

The Australian psychiatrist John Cade discovered the therapeutic effects of Lithium carbonate against mania in 1949. In the early 1960’ period anti-depressant drugs were becoming available for general psychiatric use [15].

One important factor has to be kept in mind. During the time of Karl May’s life there was no effective treatment available for bipolar disorder. Even today the psychosocial outcomes are poor in many patients with bipolar disorder [16]. Latest findings challenged the view that bipolar disorder occurred in distinct episodes with little residual deficit once patient recovered. It appears that 30 – 60% of individuals with this disorder failed to regain full functioning in occupational and social domains. There was a significant level of unemployment, poor social contact and impaired social adjustment between episodes of acute illness. This would have been even more pronounced in Karl May’s lifetime when there was no efficient medication available.

 
(2)    Examples of people suffering from bipolar disorder.

Charles Burgess Fry, the remarkable sportsman, was born in 1872, captained the English cricket team, played soccer and rugby for England, broke world long jump record which he held for 21 years and was a deputy delegate at the League of Nations Assembly in 1919.

CB Fry won the Greek prize as an undergraduate at Oxford, where he topped the list of first class honours in classics. In 1919 he was offered the crown of Albania, but because there was no salary, he declined. To do all this must have taken not just talent, but a quite unusual hyperactivity.

The first odd thing to surface was in 1895, the year after all his university triumphs. Fry could only manage a fourth class in Literae Humaniores and played cricket very poorly. It was said he was depressed due to his mother’s illness, but Fry was withdrawn and depressed for five years! He bounced back in 1901 to score centuries in six consecutive cricket innings, a record never surpassed, but equaled 38 years later.

Fry was a great talker and bon vivant. He spoke with machine gun rapidity and dominated any conversation. Fry was at ease discussing anything from iambic pentameters to the niceties of long past cricket games. Then in 1929, aged 57, came the crash. On a visit to India Fry became paranoid, believing the locals were out to steal his possession. When brought home Fry was secretive, withdrawn and would not let his belongings out of sight – apart from one occasion when he was caught running naked down the beach. A full-time nurse was employed and for about three years Fry neither met people, offered opinions or discussed his feelings.

In 1933 he emerged and once more became the witty raconteur and racy commentator of old. He resumed his job of running the merchant naval training ship Mercury. The ship’s discipline attracted the attention of the emerging Adolf Hitler, and Fry was invited to advise on the organization of Germany’s youth. Little came out of it.

During World War II Fry was appearing on BBC radio’s discussion group The Brain Trust. The chairperson had difficulty shutting him up. At age 70 Fry stated he wanted to go in for horse racing and was asked: »What as – trainer, jockey or horse?«

Fry is regarded by many as the greatest sportsman England has produced. He showed all the stigmata of a quite severe bipolar affective disorder.

Manic Music Composers.

Handel was notorious for his major moodswings, and is known to have written his gigantic oratorio, ›The Messiah‹, in six weeks. Another composer, Rossini, spun out ›The Barber of Seville‹, one of the major operas of the nineteenth century, in thirteen days. Critics have computed it would be hardly enough simply to copy the opus in that time span. Rossini’s musical career peaked with ›The Barber of Seville‹ and he then went on to a dry spell that lasted some fourteen years. During this time he produced nothing. When he began to compose once again, the work was of inferior quality. The composer Robert Schumann was manic-depressive, and his cycles of creativity are documented. He was elated during the whole of 1840 and 1849 and these were the peak years of his musical output. When Schumann was in deep depression, he stopped composing altogether. In 1854, after his major creative phase, he tried to drown himself in the Rhine, but was rescued, only to spend his remaining two years of life in hospital.

 
(3)    Chart of Life – Literary Output and Events in Karl May’s Life. [17]

The life and work of Karl May have been documented elsewhere. Only events that might have influenced May’s mental state are noticed here. The record of May’s literary output year by year shows there was no period of deep pathological depression in which he would not have been able to concentrate on writing.

1874:
          Die Rose von Ernstthal

1875:
         Wanda
         Das Buch der Liebe
         Der Gitano
         In-nu-who
         Ein Stuecklein vom Alten Dessauer
         Die Fastnachsnarren
         Schaetze und Schaetzgraeber
         Old Firehand
         Geographische Predigten

May lived with his parents in Ernstthal. He accepted the position of an editor in Dresden.

1876:
         Auf den Nussbaeumen
         Leilet (Die Rose von Kahira)
         Im Wollteufel
         Der beiden Quitzows letzte Fahrten
         Ausgeraeuchert
        Unter den Werbern
        Im Wasserstaender

May leaves editor’s job with Muenchmeyer’s publishing company and became acquainted with his future wife Emma Lina Pollmer. He commuted between Dresden and Hohenstein. 

1877:
        Der Samiel
        Der Kaiserbauer
        Die verhaengnißvolle Neujahrsnacht
        Die Gum
        Der Oelprinz
        Ein Abenteuer auf Ceylon
        Die Kriegskasse
        Aqua benedetta
        Auf der See gefangen
        Ein Selfman

Emma Pollmer moves to Dresden. Their financial situation was poor and May has to borrow money. In Juni May finds another job as an editor.

1878:
        Der Ducatennest
        Der Afrikaander
        Husarenstreiche, Schwank
        Der Kaiserbauer
        Der Teufelsbauer
        Die drei Feldmarschalls
        Vom Tode erstanden
        Die Rache des Ehri
        Die verwuenschte Ziege
        Nach Sibirien
        Der Herrgottsengel
        Die Laubtaler
        Die Rose von Sokna
        Fuerst und Reitknecht
        Die falschen Exzellenzen

Rather impressive literary output. May lives in Dresden with Emma Pollmer. He finds time to make enquires into the death of Emma’s uncle (›Stollberg’s affair‹). The whole official protocol that includes May’s statements to the judge has been preserved and published [18]. May travels on business in Germany. In July May quits the editorial post and moves back to Hohenstein.

1879:
        Die Universalerben
        Des Kindes Ruf
        Der Waldkoenig
        Die beiden Nachtwaechter
        Der Gichtmueller
        Der Giftheiner
        Unter Wuergern
        Der Ehri
        Three carde monte
        Der Boer van her Roer
        Der Pflaumendieb
        Ziege oder Bock
        Scepter und Hammer
        Der Girl-Robber
        Fuerst und Leiermann
        Im fernen Westen
        Der Waldlaeufer (Free translation of the novel by Gabriel Ferry)

A quarrel with Emma Pollmer. Three weeks detention in Ernstthal (1–22 September) as the result of ›Stollberg’s Affair‹.

1880:
        Im Sonnenthau
        Deadly Dust
        Ein Fuerst des Schwindels
        Die Juweleninsel
        Tui Fanua
        Der Scherenschleifer
        Der Kiang-lu
        Der Brodnik

Emma Pollmer’s grandfather dies in May. In August Karl May and Emma Pollmer marry, church wedding follows in September. The couple moves into a house in Hohenstein.

1881:
        Ein Wuestenraub
        Die Both Shatters
        Giolgeda Padishanun: Abu el Nassr
                                            Die Tschikarma
                                            Abu Seif
                                            Eine Wuestenschlacht
                                            Der Merd-es-Scheitan
                                            Der Ruh’i Kulyan
        Reiseabenteuer in Kurdistan (2 End)
        Ein Fuerstmarschall als Baecker

The ›Deutscher Hausschatz‹ starts the ›Karl May legend‹. May is still a private person.

1882:
        Ein wohlgemeintes Wort        
        Robert Surcouf        
        Christi Blut und Gerechtigkeit
        Saiwa tjalem
        Der Krumir
        Die Todeskarawane
        In Damaskus und Baalbek
        Das Waldroeschen (1882–1884)

In summer Emma and Karl May meet H.G. Muenchmeyer. May agrees to write for his publishing firm, partly because of his wife’s insistence but also because of their poor financial situation.

1883:
        Die Liebe des Ulanen (1883–1885)
        Im »Wilden Westen« Nordamerika’s
        Stambul
        Ein Oelbrand
        Pandur und Grenadier        

The May’s move from Hohenstein to Dresden.

1884:
        Der verlorne Sohn (1884–1886)
        Der letzte Ritt (1884 u. 1885)

Karl May is fully occupied writing novels for Muenchmeyer’s publishing firm.

1885:
        Deutsche Herzen, deutsche Helden (1885–1888)

May’s mother died on the 15 April. In May his father suffered a stroke. Karl May went through a period of bereavement. He was able to continue writing by May. A major depression cannot be substantiated[19].

1886:
        Delila(h) (Fragment)
        Der Weg zum Glueck (1886–1888)
        Unter der Windhose

Still fully occupied writing novels for Muenchmeyer’s publishing house.

1887:
        Durch das Land der Skipetaren
        Der Sohn des Baerenjaegers
        Ein Phi-Phob
        Das Hamail
        Ibn el ’amm

1888:
        Maghreb-el-aksa
        Der Geist der Llano estakata
        Der Scout
        Kong-Kheou

May terminated his writing for Muenchmeyer. May’s father died in September. Emma and Karl May move several times to different addresses.

1889:
        El Sendador I: Lopez Jordan
        Die Sklavenkarawane
        Sklavenrache

May lives and writes in private. Other stories are being published in journals only. Emma and Karl May get to know Klara and Richard Ploehn.

1890:
        El Sendador II: Der Schatz der Inkas
        Der Schatz im Silbersee

May is unable to pay the rent »even if he hardly leaves the writing desk.«

1891:
        Der Mahdi
        Das Vermaechtnis des Inka
        Christus oder Muhammed
        Die beiden Kulledschi

The publisher Ernst Fehsenfeld visits May with the suggestion to bring on the market his stories in book’s editions. Agreement concluded in November. The money advance by Fehsenfeld enables May to pay outstanding debts. Because May was a chain smoker he suffered from frequent upper respiratory tract infection, influenza or exacerbation of bronchitis.

1892:
        Mater dolorosa
        Im Sudan
        Durch die Wueste
        Durchs wilde Kurdistan
        Von Bagdad nach Stambul
        In den Schluchten des Balkan
        Durch das Land der Skipetaren
        Der Schut (with a new chapter on Rih’s death)

May’s financial situation has improved through cooperation with Fehsenfeld. May feels more secure and wrote in a letter to a reader in December as part of public relation exercise: »I am telling what really happened, and the people I am talking about really did exist or are still alive today. F.e. I myself am Old Shatterhand.«

1893:
        Die Felsenburg
        Der Oelprinz
        Eine Ghasuah
        Nur es Sema – Himmelslicht
        Der Verfluchte
        Winnetou I.
        Winnetou II.
        Winnetou III.
                            Das Testament des Apachen
        Der Pedlar
        Orangen und Datteln
        Am Stillen Ozean
                                    An der Tigerbruecke

Karl May became extremely popular with the book edition of ›Winnetou‹. During a visit to Fehsenfeld in June the marital friction between Emma and Karl May came to fore in public.

1894:
        Krueger Bei
        Am Rio de la Plata
        In den Kordilleren
        Old Surehand I.
        Maria oder Fatima
        Christ ist erstanden!

May suffers from repeated bounds of bronchitis complicated with chest infection. Perhaps to avoid the tense situation with Emma at home the pair travels in Germany. In November May wrote to Carl Jung that he speaks 25 languages with some additional dialects. May later (1904) elaborated on what he meant[20]. May was in touch with his readers through letters mostly. His private life he kept to himself.

1895:
        Die Jagd auf den Millionendieb
        Old Surehand II.
        Im Lande des Mahdi I.
        Blutrache
        Der Kutb

Visit by Ferdinand Pfefferkorn from the US who introduced them to spiritism, then in vogue in America. The popularity of his books helped May financially. He bought in November a house in Radebeul, which he named »Villa Shatterhand.«

1896:
        Der schwarze Mustang
        Freuden und Leiden eines Vielgelesenen
        Im Lande des Mahdi II.
        Im Lande des Mahdi III.
        Tut wohl denen die euch hassen!
        Die letzte Sklavenjagd
        Old Surehand III.
        Satan und Ischariot I – III
        Er Raml el Helahk
        Der Kys-Kaptschiji

With the permanent address of »Villa Shatterhand Radebeul« Karl May became a public figure and could not any longer keep in touch with his readers by letters only. To keep in line with the image he created, and to cater for the curious and inquisitive public, Karl May bought the Silver gun and the Bear Killer gun from a Dresden gunsmith. He kept them on display in his Villa for the visitors to see. May also had 101 photos taken of himself in the costumes of Old Shatterhand and Kara ben Nemsi. The photos were on sale to his readers.

However when on holidays in August-September in Lorch am Rhein, staying with the family of wine merchant Jung, Karl May never talked about his books. When asked directly May – as Carl Jung junior reported later[21] – »…questions on details about his travel experiences he as a rule sidestepped with a short dismissive answer, so that I shortly found out that he did not wish to be very communicative in such matters.«

In this year Karl May also wrote ›The Joy and Suffering of a Popular Writer‹. This excellent self-description enables a unique view into Karl May’s mind[22].

1897:
        To-kei-chun
        Old Cursing-dry
        Im Reiche des Silbernen Loewen
        Auf fremden Pfaden
        Ein Blizzard
        Weihnacht!

Life became hectic for Emma and Karl May. The popularity of his books reached a cult status. The public at large identified Old Shatterhand with Karl May. More and more readers wished to see Old Shatterhand in his Villa, just as nowadays admirers of Elvis Presley flock to Graceland.

»Large crowds of visitors« wrote Emma May in a letter from 16. October, »the bell rings every three minutes, a servant girl has to stand at the gate all the time.« And later »We had again two American ladies visiting us; since we came home, we had so far no peace.« And again »Countess Jankovics for a couple of days, then a visit from Berlin, Hamburg, Warsaw … There were f.e. so many strange people here that in the evening we had, counting the local acquaintances, 26 people at the table.« »On the three X-mass days we had altogether 43 people at the table.«

May was his own public relations and business manager. What he used to write in letters to his readers May now was telling to his visitors. Dr. Fr. Amroth who visited May in January mentioned how the discussion touched mainly what was in the books and what the public wanted to hear from the author himself. The only way how to escape the visitors was to go travelling. This however showed to be no solution: »The word Karl May is here spread through the neighbourhood like a lightning…« (6 June at Koenigswinter). Karl May was aware of his role and of business obligations, when he did not want to be photographed at Komotau (13 July), claiming that the publisher of his books has the exclusive rights to his photos.

After return to Radebeul in August Emma May wrote in a letter: »… for as long as we are home, we had no peace.« Karl May became ›The darling of his readers‹[23]. The pair May escaped to Birnai in Bohemia (26.10-17.11), where May finished writing the »Weinacht« undisturbed.

1898:
        Scheba et Thar
        Im Reiche des silbernen Loewen
        Ein Raetsel
        Indianische Mutterliebe

The ›Prager Tagblatt‹ reports in February when Karl May visits on business the publisher Vilimek in Prague: »Dr.Carl May, the known globe trotter and writer, known to readers under the names Old Shatterhand and Kara ben Nemsi…« Certainly a good advertisement for May’s books. Karl May was in good control of himself when he declined the offer to try the famous organ at Emausy cloister in Prague! [May also declined to meet with a visiting group of Arabs.] Later that month May participated at a carnival in Vienna’s casino in a discussion with baron Vittinghoff-Schell, had a lecture on Winnetou, talked with the members of the Austrian imperial family, some of whom were avid readers of his books, met with members of his fan clubs.

1899:
        Am Jenseits
        Die »Um ed Dschamahl«

In March Karl May departed Radebeul for his Orient trip. The often-quoted »psychotic states« during his trip (in Padang and Istanbul) cannot be substantiated[24].

1900: In July May returned to Radebeul.

1901:
        Et in terra pax
        Der Zauberteppich
        Himmelsgedanken

On 14 February Richard Plohn died.

1902:
        Am Tode
        Im Reiche des silbernen Loewen III.
        Scheitans-Weib-Wueste

In March tense domestic situation, May stays overnight in a hotel. Klara Plohn becomes May’s secretary in April. In August Emma agrees to a divorce.

1903:
        Im Reiche des silbernen Loewen IV.
        Sonnenscheinchen
        Das Geldmaennle

In January divorce legally confirmed. In February Klara Plohn and Karl May marry. In March follows church wedding at Radebeul. In November May’s prison record released by court causing a severe stress reaction to him.

1904:
        Und Friede auf Erden
        Weltall – Menschheit – Krieg

»The lively, good natured stories of the famous, much appraised and maligned man and his spirited, faithful lady companion in life, captivated listeners in high degree« reported ›Donauwoerter Anzeigenblatt‹ on 27 October on a lecture May held at the local school.

1905:
        Ein Schundverlag

An article ›The King of Swindlers‹ appears in June in a Dresden newspaper.

1906:
        Babel und Bibel
        Kyros
        Briefe ueber Kunst

1907:
        Schamah
        Der Mir von Dschinnistan
        Bei den Aussaetzigen
        Frau Pollmer, eine psychologische Studie

May’s health deteriorates; stay at Bad Salzbrunn in May-June. In November house search by authorities in connection with court proceedings. In November the psychiatrist Dr. Paul Nacke pays a visit to May in Radebeul.

1908:
        Meine Beichte
        Abdahn Effendi

Klara and Karl May visit Prague; Berlin in June. In September travel to America, where May delivers a lecture in Lawrence on 18 October.

1909:
        Winnetou IV
        Ardistan und Dschinistan I/II
        Ein Schundverlag und seine Helfershelfer

In December delivers a lecture at an educational institute for English ladies.

1910:
        Mermameh
        Mein Leben und Streben
        An die 4. Strafkammer des Koenigl. Landgerichtes III in Berlin

Egon Erwin Kisch visits May in Radebeul[25].

1911: Stay at Joachimsthal.

1912: On 22nd March lecture in Vienna. Karl May dies at Radebeul on 30th March.

   
(4)    Could pathological depression or mania be documented in Karl May’s life?

Most people with bipolar disorder do have periods of depression at some time of their lives. There is no evidence Karl May had suffered from Major Depressive Episode that would be acceptable as a psychiatric diagnosis as outlined in DSM-IV.

Looking at the literary output year by year by Karl May there was one period in 1885 when he was not able to concentrate on writing. On 15 April 1885 May’s mother died. May was not able to deliver to the publisher the weekly contribution of articles until the middle of June. He was going through the stage of bereavement, a grief reaction[26].

The paper (1) quotes as a proof of May’s major depression a letter written by May to Fehsenfeld in 1893: »my nervousness … because of domestic discord … that I often look above my writing desk where a loaded revolver hangs«. However the year 1893 was a very successful year for Karl May. He was becoming very popular because of the book edition of ›Winnetou‹. The public was conditioned to match Old Shatterhand with Karl May in the tradition started by the ›Deutscher Hausschatz‹ publicity buildup. This was a year of May’s achievement and greatly improved financial situation when he had no reason to become depressed. But the relation between Emma and Karl was quickly deteriorating[27]. It was a time of marital clashes with his wife Emma, which were becoming more public. May also mentioned a revolver in a letter to Professor Dr.Paul Schuman in 1904[28]. May used this as a figure of speech, an act of dramatization, not as an expression of suicidal intention.

May’s clear description of his bodily pain in 1910[29] is interpreted in paper (1) as part of his life lasting cycles of depression. In fact the pain was of organic origin[30]. The statement from (1): »Sleep disturbances, which May in his old age interpreted as a symptom of his depressive ill-feeling, were permanently present in his creative and also hypomanic phases …«[31] incorrectly assumes mental illness. It was bodily pain that made May feel miserable in his last years. Many people study, concentrate and write better at night. This is simply a working habit and not a mental disease. Connecting old age and depression as part of May’s long lasting bipolar disorder is incorrect. The author of (1) did not take into consideration organic causes for depression including for example dementia, Huntington’s chorea, temporal lobe epilepsy and Parkinson’s disease. An organic cause should in particular be considered when the mood disorder is presenting in an elderly person[32]. In such way the author of (1) missed the cause of the chronic pain May suffered from.

The unsubstantiated psychotic condition Karl May was supposedly having during his Orient journey in Padang and Constantinopol, is presented in (1) as evidence of May’s bipolar disorder. Firstly the concept of ›psychosis‹ in itself is not diagnostic. Secondly the story of May’s psychotic breakdown has not been confirmed[33]. Another statement from (1) that May »was searching for an explanation of his cyclic mood swings that he did not understand«[34] is wrong. Clear description of manic-depressive states was part of all psychiatric textbooks during May’s lifetime.

In ›Meine Beichte‹ May wrote he suffered from ›Depression‹ during his ordeal in 1860s. The traumatic amnesia and hallucinations May described as experiencing himself at that time however speak against major depressive state. Other typical symptoms of major depression as ›changes in appetite and weight‹ described by May during his Orient voyage were in connection with his dysentery. ›Changes in sleep and psychomotor activity‹ – the sleep pattern of working during the night and sleeping longer into the day was May’s long life working habit. There was no prolonged period of ›decreased energy or inactivity‹ if we inspect the list of May’s yearly literary output. Nothing corresponds with the pattern of people with bipolar disorder who become incapacitated sometimes for years. This applies also to ›difficulty in thinking, concentrating or making decisions‹, and also for pathological ›feelings of worthlessness or guilt‹. The quoted poem in (1) by Karl May »I am so tired …« written during the Orient voyage was just that, an expression of loneliness, sad mood, and not a sign of deep incapacitating depressive state.

It seems that the main argument in (1) for Karl May’s bipolar disorder is May appearing in public in the years 1893-1900 and after. This is classified as ›hypomanic-manic episodes‹[35]. From the description given May supposedly suffered for whole of his life from ›long-lasting hypomania‹[36], even well into his old age[37]. That condition, it is claimed in (1), was faintly but distinctly overlaid with episodes of depression[38].

Such version given in (1) of Karl May’s mental state would be more accurately described by a psychiatrist as Cyclothymic Disorder: »The essential feature of Cyclothymic Disorder is a chronic, fluctuating mood disturbance involving numerous periods of Hypomanic Episodes and numerous periods of depressive symptoms«[39]. However the diagnosis offered in (1) is Hypomanic and Manic Episodes, characterized by a distinct periods of abnormally and persistently elevated, expansive, or irritable mood that lasts at least four days[40][41], and are interfering with daily life.

There are certain observations of Karl May’s conduct which speak against the classic symptoms of untreated mania:

1. There are no reports of manic behaviour as known from descriptions of untreated patients, when they become violent even suicidal and have to be restrained or hospitalized. The often quoted ›psychosis‹ during Karl May’s Oriental journey showed to be unsubstantiated. There are no documented periods of time during which Karl May would not have been able to work or function in the society because of severe depression, hypomanic or manic states.

2. No verbal garbage was ever recorded as it happens in acute mania, where there is a typical flight of ideas in which connection between one idea and the next is based on chance association including similar sounds (the clang association)[42]. In all preserved reports of Karl May’s public appearances his speech was coherent, even if multiloquacious.

3. It was the ›Deutscher Hausschatz‹ which started the build-up of Karl May’s public image, the ›Karl May legend‹, when the editor published the following: »The author of the adventure travel stories visited himself all the countries which are the scenes of his stories. He returned recently from a journey to Russia, Bulgaria, Constaninopel, etc., and even suffered a knife wound as a souvenir. He however does not enjoy to travel with the red Baedecker [travel guidebook] in hand and via railway compartment, but he seeks the less known routes«[43].

May continued later on in this tradition. Claus Roxin in his study ›Dr.Karl May called Old Shatterhand‹[44] put forward four possible reasons for May’s behaviour after 1890: (a) May played the role of Old Shatterhand to conceal his past. (b) May was more or less forced into the role of Old Shatterhand by his readers. (c) It was on the part of Karl May a business self-promotion. (d) May’s conduct was an expression of narcissistic neurosis. Lately (1) put forward a thesis of bipolar disorder as the cause of May’s performance.

The (b) and (c) reasons seem to explain Karl May’s conduct, as the diagnosis of hypomanic or manic psychiatric disturbance is not tenable.

The question of hereditary trait in Karl May’s ancestors.

The (1) mentions also the possibility of family history as a contributing factor to May’s bipolar disorder. May’s grandfather on mother’s side, one Christian Friedrich Weise, was found hanged in 1832. The cause of his death according to the official entry into records was »drunkenness and despair«.[45] In the absence of sufficient information about Ch.F.Weiss and the circumstances of his death, it is hardly justified to connect him with a psychiatric diagnosis.[46]

It is known that the first-degree relatives are more likely to have a genetic predisposition to bipolar disorder. Even if May’s father was known for his bad temper, he was not manic-depressive, never had been hospitalized or under psychiatric care.

In order to prove that genetic factors play a part it must be shown that near relatives of the mentally ill are more often also mentally ill than are the members of the general population, and that this cannot be explained by common environment. Both twin studies and the family studies, however, indicate that there really is often a genetic predisposition and that on the whole this predisposition is specific. One type of mental illness only tends to occur within one particular family[47]. In family studies it was found that the proportion of first degree relatives of manic-depressive patients who are also affected with manic-depressive insanity is of much the same order, though a little less than the proportion of like-sex fraternal twins. Stenstedt carried out one of the best studies[48] in Sweden. He took as his starting point all instances of manic-depressive psychosis from two areas of Sweden from 1919 to 1948. Stenstedt found that of the brothers and sisters 7 per cent were certainly affected and another 7 per cent possibly affected. For parents the proportions were 5 per cent and 7.5 per cent, for children 11 per cent and 17 per cent. The actual manifestation of the illness varied in different members of the same family. The family study suggested that patients with many attacks and patients with few attacks, patients with mainly manic symptoms and patients with mainly depressive symptoms, patients with an early onset and those with a late onset of the illness, all had varieties of essentially the same disorder, since all these varieties might occur within a single family.

To confirm the alleged manic-depressive illness in Karl May more studies of his family members would have to be done. If one examines the incidence of manic-depressive illness in the relatives, it is higher than in the general population. The incidence falls away dramatically as the degree of relationship, and the genetic resemblance, becomes more remote[49]. The first generation of offspring’s is at risk; the second generation carries less ›dominant‹ traits[50]. These facts have been recognized today and are included into the DSM-IV, where the first-degree biological relatives are named as being at heightened risk for developing Bipolar I, Bipolar II, and for experiencing Major Depressive Episode more than the general population. Studies on close relations, identical twins and adopted children whose natural parents have bipolar disorder strongly suggest that the illness is genetically transmitted, and that children of parents with bipolar mood disorder have a greater risk of developing the disorder.

What the paper (1) puts forward as support for May’s bipolar disorder[51] is insufficient to support the thesis. It certainly does not confirm the first-degree biological relatives known facts. More research into May’s family tree with particular attention to the incidents of mental abnormalities would be required before the expressed view in (1) could get any credit at all.

The author of (1) named his essay ›Author in Fabula – Karl Mays Psychopathologie …‹. Why the presumption of mental abnormality? Is it because it simply follows in the German tradition of maligning one of their most successful and popular writers? The blindness of May as a child is declared an »ophthalmologic impossibility«[52], even if this is not correct and cannot be substantiated. From such a false premise the author concurs with the view that Karl May was a psychopath, a pathological liar[53]. On the basis of May’s critics he is described as having a »bizarre personality structure«[54]. Again the negative damaging assessment of Karl May, based on what his critics and enemies said one hundred years ago. Karl May himself answered his critics[55] but his words are not mentioned in the essay.

Karl May correctly assessed his reaction to the trauma he suffered in his early manhood, as requiring medical attention and not prisons terms. This has been overlooked again. Almost all authors – including the (1) – did not pay attention to what May said himself, believing he was a liar, but tried to present May as a neurotic, narcissistic personality, psycho-neurotic, and finally even mentally imbalanced manic-depressive. Always the negative about Karl May, all the time an insistence that May was abnormal in some way.

The author of (1) does not see the period 1862–1874 in May’s life as the time of stress and May’s reaction to it. He calls it a period of »criminality and hoboeism of May as an expression of personality disorder«[56]. He considers it not to represent a reaction to life events, but to be an expression of May’s deviation of normal cognition[57], turning Karl May into a morally insane personality. The author of (1) also claims May was »lying as a rule in all the time new varieties«[58]. This should have been happening from May’s youth to his old age. To demonstrate May’s bad character the author of (1) creates a non-existent love affair with a married woman[59] to stress the moral insanity of a nineteen years old May.

Marital conflicts are the most difficult situations to deal with. What is not mentioned in (1) in connection with May’s ›Frau Pollmer, eine psychologische Studie …‹ is the fact that Emma Pollmer suffered from mental illness[60] and had to be hospitalized because of it later in life. Klara May’s diary describes Emma’s behaviour in some detail which is quite informative.

Episodes from the life of Karl May are presented in (1) as psychiatric symptoms, f.e. discussions with the readers of his books which were distorted and incorrectly reported, as May points out in his letter to a newspaper in Dresden[61]. Giving tips to waiters and domestics is presented as sign of megalomania – when charity by Karl May is not mentioned at all[62]. Sending postcards from May’s Oriental journey is classified in (1) as manic behaviour, when in fact it was a sound promotional public relation exercise.

In such way a psychiatric diagnosis was artificially created. There were no major incapacitating depressive episodes or significant hypomanic or manic impairments in important areas of functioning documented in Karl May’s life. A diagnosis of bipolar disorder as outlined in DSM-IV cannot be sustained. Karl May was a successful creative writer and his own business and public relations manager. He was an artist, not a certifiable mental case.
   

In this dignified old house of Porath family took rest in April 1898 the famous German writer Dr.Karl May from Radebeul. During his stay he helped a child of poor parents in their bitter need by filling up a basket with food at his own expense, and also gave the father of the child, who rushed in, some gold coins. We wish to honour herewith this spontaneous deed of human charity, as an example to others. The Shire of Kapern, February 1997

Photo: Hartmut Kühne

References
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