A compelling psychological approach to explaining this and other puzzling features of the Mormon prophet’s behavior during this period was suggested to me by a Mormon psychiatrist, Dr. Jess Groesbeck. For nearly two years, I dismissed his suggestion as reductionistic, but gradually the explanatory power of the interpretation came to seem more and more compelling to me. Groesbeck argued that many aspects of Joseph Smith’s behavior, especially during the last years of his life, appeared strikingly similar to behavior that psychiatrists associate with manic-depressive syndromes. Although one could understand that any individual under the pressures Joseph Smith faced might have experienced substantial mood swings, in the Mormon prophet’s case those mood swings appear so severe that they may be clinically significant. Groesbeck also pointed out that there is substantial evidence that tendencies toward manic-depression tend to be inherited. Although many people are aware that one of Joseph Smith’s brightest and most appealing sons, David Hyrum, tragically lapsed into insanity and spent the last years of his life in a mental institution, few realize at least six other male descendants of the Mormon prophet also have suffered from psychological disorders, including manic-depression. The possibility that Joseph Smith himself may also have been subject to similar tendencies cannot be discounted.

What are some of the characteristics of psychological mania, and how do such states reflect themselves in behavior? According to Harold I. Kaplan and Benjamin J. Sadock’s Comprehensive Textbook of Psychiatry/IV:

The critical clinical feature for a manic episode is a mood that is elevated, expansive, or irritable. The associated symptoms include hyperactivity, pressure of speech, flight of ideas, diminished need for sleep, increased self-esteem to the point of grandiosity, extreme distractibility, short attention span, and extraordinarily poor judgment in the interpersonal and social area. . . .

The person speaks more rapidly, thinks more rapidly, or moves more rapidly. The person frequently requires much less sleep and has apparently limitless energy. Many people with a manic illness feel that they are highly creative during these attacks. The reason, in part, is because there is a flooding of consciousness with ideas and associations that at times are imaginative and creative but that at other times are idiosyncratic and of little artistic merit. . . .

Although the elevated mood is often described as euphoric and cheer­ful and having an infectious quality, it is characterized by an absence of selectivity and an unceasing driven quality. Mania is also characterized by an extremely poor frustration tolerance, with resulting heightened irritability. A manic patient may be quite humorous, good natured, and friendly until frustrated in some trivial way. The good humor then promptly disappears and is replaced by anger and even rage. . . .

The increased activity often takes the form of sexual promiscuity, political involvement, and religious concern. . . .

The manic episode may or may not include psychotic symptoms. The impairment of judgment may not be sufficiently severe· to justify a psychotic diagnosis. Delusions and hallucinations are not unusual. The-context is usually consistent with the dominant mood. It is quite common for the person to communicate with God and to have it revealed ·that he or she has a special purpose or mission. Patients frequently describe themselves as an “organ” of God through whom God speaks to the world.

In the various forms of manic-depressive illness, the manic highs alternate in bipolar fashion with periods of depression. Current diagnostic opinion, described by psychiatrists Frederick K. Goodwin and Kay Redfield Jamison in their synthetic study Manic-Depressive Illness (New York: Oxford University Press, 1990), emphasizes that manic-depressive illness expresses itself in an extraordinarily complex variety of forms, on a spectrum of intensity ranging from relatively mild, cyclothymic ups and downs that would be hard to distinguish from normal mood swings to extreme highs and lows that clearly display full-blown psychosis.

At the extreme end of the manic-depressive spectrum, the bipolar I form of the syndrome, individuals feel the full force of manic excitement or depressive despair. During their manic phases, they feel invincible and often do outrageous things. In full psychotic manias, individuals lose touch with reality, experience delusions and hallucinations, and lack any sense of judgment in interpersonal relations. At the other extreme, depression can become so severe that individuals can come to feel utterly hopeless and eventually may commit suicide if not treated.

A milder form of manic-depressive illness, bipolar II, typically involves recurrent depressions alternating with brief “hypomanic” (less than manic) periods of several days to a week or more when they feel mildly euphoric and full of self-confidence and energy.

It is often very hard to determine whether an individual is experiencing the bipolar II form of manic-depression needing treatment or just a normal period of enthusiasm or low spirits, but the recurrent nature of the experience is diagnostically important. In the mildest, cyclothymic forms of the manic-depressive spectrum, the distinction between normal expressions of enthusiasm or low spirits and those suggesting illness is particularly difficult to determine. [24]

. . .

In no area were Joseph Smith’s manic qualities more evident than in his efforts to introduce and practice polygamy during the last three years of his life. The point at which Joseph Smith began systematically to introduce polygamy to his closest associates has strong suggestions of mania. . . .

If the initial systematic attempt to introduce the concept of plural marriage among his closest associates bespeaks possible manic enthusiasm on Joseph Smith’s part, his subsequent surge of activity with the sixteen or more women with whom he appears to have sustained sexual relations as plural wives (the full number may have been much greater) is even more suggestive of the hypersexuality that often accompanies manic periods. . . .

. . .

Where does all this leave us with regard to understanding the dynamics of Joseph Smith’s psychology and its impact on his beliefs and practices? It must be emphasized again that the analysis presented here about Joseph Smith’s possible tendencies toward manic-depressive mental states is not intended as anything but an hypothesis. It is in no way intended to reduce the mystery—and the greatness—of Joseph Smith’s accomplishments. Even if this hypothesis be true, the ultimate question remains not the origin of Smith’s genius but the fruits of that genius.

. . .

[24] Even with living individuals, diagnosis of manic-depression is difficult because the symptoms can mimic other types of mental disorder. Reliable diagnosis of someone no longer living is even more difficult, particularly if the symptoms are mild. If Joseph Smith suffered relatively mild forms of manic-depression, knowing whether his behavior represented normal volatility of mood or possible illness would be difficult to determine with any degree of conclusiveness. I have, nevertheless, been encouraged to pursue the manic-depressive hypothesis by positive reactions from both Mormon and non-Mormon scholars.