A First-Rate Madness (26 page)

On that point, Kubizek was wrong. Starting in the late 1930s, Hitler would begin abusing drugs in a way that would alter his habits and unhinge his mind.

 

 

WE WILL SOON SEE how these symptoms manifested themselves during Hitler's years in power, but now we'll examine his
family history,
which also supports a diagnosis of bipolar disorder
.

The identity of Adolf Hitler's paternal grandfather has long been open to question, which makes it hard to determine how closely related Adolf was to members of the Heidler clan (the family name before his father changed it), some of whom were insane. But Adolf's father, Alois, himself displayed manic symptoms, at least as hyperthymic personality. A civil servant with liberal political beliefs, he had a temper, beat his sons (though maybe not beyond the norms of his time), was obstinate and energetic (like his son Adolf), and hypersexual (unlike Adolf). Alois Hitler fathered at least two children out of wedlock, and had three marriages, the last to Klara, Adolf's mother, his second cousin and housekeeper. The father was restless, constantly moving his family; in one town, they had twelve different addresses. Even after he retired, he moved five times; Adolf attended five schools before dropping out as a teenager. Describing all this, Kubizek stumbled upon the likely cause: “[Alois Hitler] often moved from a decent dwelling to a poorer one. The house was not the important thing; rather the moving. How can one explain this strange mania?”

That Hitler's parents were cousins would intensify their children's susceptibility to illness, whether physical or mental. (Alois and Klara had to obtain a papal dispensation to marry.) They had much family tragedy: their first three children before Adolf died, as did a younger brother when Adolf was eleven. Hitler's only surviving full sibling was his younger sister Paula, a Vienna housemaid, who, under her married name, Wolf, lived without fanfare even during Hitler's rule. She was not known to be mentally ill.

Hitler had half siblings and relatives from Alois's other wives. One half brother, Alois Hitler Jr., was a petty criminal and moved frequently, like his father, living in England briefly and siring a child there (a British citizen, William Patrick Hitler). Adolf's half sister, Angela, had a daughter, Geli, to whom Hitler was quite attached; some historians infer a romantic relationship. Geli, then about twenty, died of a gunshot wound while living with Hitler in 1931. It was ruled a suicide, but some think Hitler shot her in a (lover's?) quarrel, others that he had her killed because she was planning to leave him.

In all, Hitler's family history supports mental illness, especially with the reasonably strong evidence for hyperthymic personality in his father, combined with inbreeding that would have heightened Hitler's risk for bipolar disorder.

REGARDING THE
COURSE
of Hitler's potential bipolar disorder, manic and depressive episodes began in his late teens and early twenties, as documented by his friend Kubizek. These symptoms were episodic, lasting days to weeks, and in some cases (with his most severe depressive periods) months. There are four lost years, beginning in 1910 at age twenty, when Kubizek lost contact with Hitler, until the outbreak of the First World War. These were Hitler's years of most dire poverty, when he lived in a men's hostel in Vienna and sold postcards for a living. There is little record of this period, during which some authors think he suffered from severe depression. Four years of war revived Hitler. He fought bravely, earning the Iron Cross, First Class, which was rarely given to enlisted men. He earned the respect, though not close friendship, of his fellow soldiers. After the war, he joined the new National Socialist Party, and by 1921 was elected its president. After a putsch attempt in 1923, Hitler spent five months in jail, which enhanced his political reputation, and wrote
Mein Kampf
. Though at times of great political risk, such as the putsch, he would repeatedly threaten to shoot himself, he in fact never tried to kill himself before his 1945 suicide. Hitler's influence grew as Germany wallowed in political and economic strife. He emerged with a strong national party that did well in the 1932 elections, and after some intrigue he became chancellor, and then dictator. The revival of the German economy earned him even greater plaudits and more power.

Hitler continued to have manic and depressive periods in the 1930s, though they were briefer than in previous decades. This was the period of his greatest success. A penniless nobody in peacetime, he had risen to the top during a period of great domestic crisis. In this period his close political aides describe him as intelligent, able to listen to others, endowed with a prodigious memory, flexible in thinking, and decisive.

If we had stopped with the prewar leader, Hitler's illness would not seem much more severe than Churchill's. Prewar Hitler was resilient and creative. He was an extremely astute, realistic politician, as historian Alan Bullock has shown in his classic work about Hitler's rise to power. Prewar Hitler wasn't particularly empathic, obviously (though even there he always viewed himself as siding with the oppressed masses of Germany). He was violent from the start (killing political opponents and even some allies), despotic (introducing a new absolutist state), and harshly anti-Semitic (from the beginning of his rule, he restricted the ability of Jews to live and work). But he had not yet invaded any other countries, nor had he turned genocidal.

 

 

IN 1937, Hitler began using amphetamines. Before then, his bipolar disorder seemed manageable; either his moods didn't affect him much in the 1930s, or they only added to his productivity and creativity. After that date, a gradual decline began, with worsening manic and depressive episodes that impaired his leadership. Hitler's psychotropic
treatment
history, his amphetamine use, combined with his bipolar disorder, has not been adequately described in previous attempts to “explain” him.

(This story was first fully revealed by the psychiatrist Leonard Heston, a prominent researcher in the genetics of schizophrenia, who along with his German-speaking wife, Renate, published a complete medical study of Hitler in 1980. At that time, the Hestons not only reviewed all available documentation of Hitler's medical records, but they also interviewed his still living doctors and many other people who knew about Hitler's medical care. Their personal interviews are important sources of documentation that, with the passage of time, will only increase in value.)

The year 1937 was when Hitler began treatment with the man who would remain his personal physician until his final days, Theodor Morell. Morell's exclusive practice catered to wealthy Berliners with nonspecific neurotic complaints who loved the doctor's magic injections. We now know these injections sometimes literally were placebos (diluted sugar—20 percent glucose in medical terms), and frequently were potent “natural” tissue extracts, like adrenal glands or ground bull testes. Morell liberally injected not only Hitler but many of the Nazi elite, such that Hermann Goering jokingly titled the doctor “
Herr Reich Injektion Minister
—the Injection Minister of the Reich. After he was captured by American forces, Morell admitted to giving Hitler twenty-eight different treatments, though he probably understated how frequently. A few stand out (and are similar to the injections that John Kennedy would later receive from Max Jacobsen): “Orchikrin,” described as “a combination of all hormones of males. Potency is increased by the addition of extracts of testis, seminal vesicles and prostate of young bulls . . . to combat fatigue and depression”; “Prostakrimum,” “an extract of seminal vesicles and prostate. Used to prevent depressive moods”; and a steroid derived from ground-up adrenal glands, “Cortiron,” “Desoxycoticosteronacetate [
sic
] . . . used for muscle weakness.” These descriptions are further proof, based on treatment, that Hitler experienced depression.

In the 1930s, Hitler (again like Kennedy) was racked with horrible gastrointestinal problems: eating produced sudden pain, followed by diarrhea. In retrospect these symptoms are consistent with gastritis, possibly ulcers, or perhaps irritable bowel syndrome (all of which are common in mood disorders). Hitler had already restricted his diet, becoming completely vegetarian, without avail. He called Morell, who eventually prescribed synthetic opiate narcotics and anticholinergic drugs, known to slow diarrhea. (The narcotic given was Eukodal, which is oxycodone, the same ingredient in the highly addictive drug Oxy-Contin.) Hitler improved, and Morell became part of the Führer's inner circle.

Hitler's chronic insomnia was the next target. With constant anxiety and frequent mood episodes, he had developed, like Churchill, reversed sleep cycles. He stayed awake late into the night, talking and working inordinately, but slept each morning until noon. Hitler wanted morning pep and evening sleep. Morell had just the thing.

The insomnia was easy to treat. Barbiturates were used extensively (Churchill also received them); in his American interrogation, Morell admitted to prescribing a barbiturate for sleep (Brom-Nervacit, which contained a bromide sedative, and Barbital, also called Veronal, the first commercially marketed barbiturate). He likely prescribed it to Hitler for nightly use from 1939 onward.

Morell had made progress: Hitler's stomach was quieted with an opiate; his sleep improved with a barbiturate. Now there was only the problem of pep. Amphetamine would be the solution.

 

 

AMPHETAMINES, first marketed in 1928 as Benzedrine (dl-amphetamine), were quite popular. Prescribed initially for narcolepsy, they quickly became the first widely used psychiatric treatment for depression. (By 1971, there were over thirty-one amphetamine preparations marketed in the United States, mostly used for depression.) Morell saw that his patient suffered from depression, anxiety, and insomnia—the kinds of symptoms he frequently saw in his rich Berlin clientele. He decided to prescribe a new antidepressant, methamphetamine.

Heston believes that Hitler's use began in 1937, based on the first reported changes in his behavior. Hitler was less friendly, more withdrawn, more suspicious of others. These changes weren't brief, as in his past depressive episodes, but more consistent. They were especially noted by Albert Speer, the Führer's confidant and a consultant to the Hestons, and by Heinrich Himmler, Hitler's close deputy, who, convinced that Hitler must have neurosyphilis, began collecting a medical file on him. (Hitler had repeated negative tests for syphilis.) Even the Italian king, Victor Emmanuel III, wondered aloud to his court, after seeing Hitler in May 1938, whether he was taking amphetamines.

More definitive evidence that Hitler received amphetamines dates to late 1941, right after the Germans' defeat at Stalingrad, when he became markedly depressed. In the 1970s, the Hestons interviewed Hitler's valet, Heinz Linge, who served him from 1935 onward, and who still admired his old leader. Linge described a daily morning intravenous injection, given by Morell, documented in Linge's appointment books. Morell admitted giving Hitler injections of “Vitamultin-Ca,” a mixture of vitamins. Linge describes results never associated with vitamins, though: “The effects were instantly apparent—not minutes later, but while the needle was still in the arm. The effect on Hitler was obviously alerting: he felt ‘fresh,' alert, active, and immediately ready for the day.” By the middle of 1943, Hitler began to have the injections, according to Linge, multiple times daily, with the same results. The Hestons interviewed other Hitler aides who described similar effects: Hitler was immediately rendered “extremely alert and talkative,” a “rejuvenating” effect; after the injections, he was “cheerful, talkative, physically active, and tended to stay awake long hours into the night.”

Morell kept the ingredients a jealously guarded secret; despite Himmler's repeated entreaties, Morell cited confidentiality, saying only that it was “a mixture specially compounded for the Führer.” Due to his link to Hitler, Morell now ran numerous pharmaceutical factories. Hitler's preparation was secretly made to Morell's specific order, with oral tablets wrapped in gold foil and intravenous injections delivered to Morell himself.

Hitler's other physicians were suspicious of Morell. Dr. Ernst-Günther Schenck, a nutrition inspector for the Waffen-SS, interviewed by the Hestons in the 1970s, reported that in 1943 he managed to obtain a gold-foil-wrapped tablet prepared for Hitler. He analyzed its chemical contents and found, besides vitamins, methamphetamine. Schenck gave the report to his superior, the Reich health minister, who showed it to Himmler. Schenck said that Himmler ordered him to drop the matter. Later assigned to the bunker after the Führer dismissed Morell in the final days, Schenck would be the last physician to see Hitler alive. After ten years in a Russian prison camp, Schenck revealed the story about methamphetamine, which he repeated in his own memoirs and in interviews until his death in 1998. According to Linge, Hitler took about five of these gold-foiled methamphetamine tablets daily, supplemented by continual sucking on over-the-counter candy, called “Cola-Dalmann,” which contained appreciable doses of caffeine. (Hitler did not drink alcohol, coffee, or tea, however.) Like Kennedy's doctors, some of Hitler's, such as the highly regarded Karl Brandt, tried to act to restrain the use of harmful drugs, attempting a medical coup d'état against Morell; unlike Kennedy's doctors, they failed.