Writing can be compulsive

Hypergraphia: Several brain conditions involving the temporal lobe can spark an irresistible drive to write things down. Ideas and talent are optional.

Medicine & Science

September 27, 2004|By Erika Niedowski | Erika Niedowski,SUN STAFF

She would bolt upright in bed, hours before dawn, and jot her thoughts on tiny yellow sticky notes. She would scribble on her arm while bicycling home from the hospital where she worked.

Dr. Alice W. Flaherty simply could not stop writing.

After the death of her premature twin boys several years ago, the Boston neurologist lapsed into a postpartum mood disorder that prompted a peculiar syndrome: She was all but overtaken by the urge to write. And write. And write.

"I woke up one morning and I had a huge amount of energy. I had this pressure that I had to write everything down," said Flaherty, 41, director of Massachusetts General Hospital's mood disorders fellowship.

"I had this feeling that everything was meaningful. It felt like, `I've just been hit by a steamroller.'"

First described in the medical literature around the turn of the 20th century, the syndrome - known as hypergraphia - is thought to be triggered by several brain conditions that involve the temporal lobe. Among them: manic depression and a form of epilepsy.

Some hypergraphic patients keep voluminous journals, generously using exclamation points or different colored inks. Sometimes they write over what they've written before. One patient penned the sentences "Why can't a man live before he dies?" and "God bless the child that has its own" hundreds of times, using the pages of books or newspapers when he couldn't find blank paper.

He also spent hours writing aphorisms. "Men who can converse have more enjoyment and so do the women who can converse back," he wrote in looping cursive during a hospital stay. "Once I had everything I wanted. Now all I have is me, myself and I."

Professional observations

German psychiatrist Emil Kraepelin, co-discoverer of Alzheimer's disease, characterized hypergraphia among manic-depressive patients in a text in 1921. In 1974, neurologist Norman Geschwind and a resident at then-Boston City Hospital, Dr. Stephen G. Waxman, described the same condition in patients with temporal lobe epilepsy.

One woman, who kept writing paper with her at all times, would alternately describe her seizures in great detail and compile lists of seemingly mundane things: the furniture in her apartment, the songs her father played on the harmonica, the records she owned. According to Waxman's paper, she believed her writing might stop her seizures.

Hypergraphia often occurs in conjunction with other symptoms, which together were dubbed "Geschwind syndrome" in the 1980s. In addition to an overpowering urge to write, patients might exhibit heightened religious feelings, aggression, altered sexual behavior or so-called "stickiness," an inability to end a conversation or leave out even the dullest details.

Scientists aren't sure exactly what's going on in the brain to produce the compulsion to write: It's probably a complex combination of forces. But in temporal lobe epilepsy, they theorize, an electrical storm in the brain - which manifests itself outwardly as a seizure - interrupts the normal function of the temporal lobes, which are responsible for some speech and language functions.

Flaherty's hypergraphia had another genesis: a postpartum "mood break" that left her experiencing episodes of mania and, later, depression.

In her book The Midnight Disease: The Drive to Write, Writer's Block and the Creative Brain, Flaherty describes being seized by the urge to write 10 days after the death of her sons.

Much of her output wasn't in paragraphs or even sentences, but three- or four-word bursts. She penned theories about the nature of grief and what she called the "Kingdom of Sorrow." She jotted down thoughts about a friend who, she became convinced, was only posing as her friend.

She wrote ideas about her condition and other aspects of neurology, which led to the publication of her first book, The Massachusetts General Hospital Handbook of Neurology. "That book was what I wrote on my arm, minus about 800 pages of garbage," she said.

To Flaherty writing was, in essence, a drug.

"I wrote during department meetings, when I should have been doing experiments, when I could have been with friends," she recalled in The Midnight Disease. "The sight of a computer keyboard or a blank page gave me the same rush that drug addicts get from seeing their freebase paraphernalia."

Then, suddenly, four months after it arrived, her compulsion to write disappeared.

Scientists believe several renowned writers and painters suffered from - or perhaps reveled in - the condition. Vincent van Gogh likely had either temporal lobe epilepsy or manic depression. His hypergraphia manifested itself not only in the written word - he penned hundreds of letters, many to his brother Theo - but on canvas as well. During his most prolific period, he produced a painting every day and a half.

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