08/14/2009 05:12 am ET Updated Nov 17, 2011

Late Bloomers?

Not so long ago the remarkable, and enormously successful, social commentator Malcolm Gladwell wrote a piece in the New Yorker called "Late Bloomers". I recently reread it wearing my psychiatrist lens, particularly the lens of believing that people with mental illnesses can and do recover.

Gladwell's thesis, in my view, is that the success of late bloomers depends on love. Love in the form of belief and support from those close to someone whose prospects don't seem so keen. One story he tells is that of the great painter Cezanne. As a young artist, a stranger from the provinces, Gladwell comments that Cezanne "couldn't draw." To make matters worse he had a habit of losing his patience, slashing paintings he had drawn, and subjecting others to painfully tolerate his tortured efforts and persistent delays. Still, his father and a number of Parisian supporters stayed with him, and after a while, a long while, his work reached the masterpiece level we recognize today.

Hmmm: Couldn't do the basics of his craft. An awkward outsider. Given to fits of anger and property destruction. Dependent on the endless patience of family and others. Does that sound familiar? While Cezanne was not mentally ill, or at least no one has claimed so, he certainly did sorely test the love and commitment of his greatest supporters -- for a number of decades. His story, though, sounds to me like the beginning of so many accounts I have heard about young and not so young people with a serious mental illness, like bipolar disorder, or schizophrenia, or severe and recurrent depression. Their problems often start as adolescents or by their early 20s; they are outsiders, or feel that way, wherever they go; their frustrations sometimes boil over into anger and once in a while into destructive behavior (usually to themselves); and they brutally test the generally boundless love of family.

Cezanne's story as a late bloomer is not unique. Matisse painted some of his greatest works in his 70s and 80s. Alfred Hitchcock directed his most spellbinding films after the age of 50. Mark Twain, too, bloomed late, as did Daniel Defoe the author of Robinson Crusoe. Even the icon of my field, Sigmund Freud, did not publish his first psychiatric theories until he was 40.

I do not mean to equate artistic or literary expression with mental illness. Nor do I seek to suggest that people who suffer with a serious mental illness for twenty or thirty years will emerge from a chrysalis and become butterflies. But those who would write them off, conclude they are fated to a life without contribution, are not seeing their prospects for recovery -- and thus put in peril the faith and support they need from their loved ones, their friends, and their doctors. Perhaps we might want to see these individuals as "late bloomers" since their illnesses have slowed them down, made emotional and vocational development difficult often since adolescence, and test not only our patience but theirs.

I know many now successful professionals, artists, trades people whose lives had been turned upside down from a serious mental illness as teenagers and young adults. They are on the faculty of Harvard or Columbia University, where I have and now have appointments, teaching law, business, medicine or literature; they are teachers, nurses, veterinarians, my psychiatric and medical colleagues; they are electricians, plumbers, events managers, salespeople, cabinet makers. They are your neighbors, people coming to work with you, sitting at a nearby desk or on line with you in the cafeteria. But they don't proclaim their history of mental illness, or for some, its persistence in their lives. That's because they have learned talking about being a "late bloomer" because of a mental illness (or working to remain well) will not help them lead normal lives, with equal opportunity -- despite all the anti-discrimination laws on the books.

Roy (identity is disguised) is the CEO of a small but nationally growing healthcare technology company. A very bright student and athlete in high school he developed a psychotic illness in college that resulted in multiple psychiatric hospitalizations for symptoms of hallucinations, delusions, and an inability to function. He spent his days sitting, staring and wondering what the purpose in living was. He was told he was schizophrenic and that he would have to come to terms with a life of disability and marginal existence. But his hopes, despite what he was told, were not crushed. Roy persisted, with the support of family, friends and enlightened professionals, and returned to college, then graduate school and finally to building the business that today, at age 40, is a testimony to his recovery -- and proof that people with mental illness can and do recover. Roy is one of many "late bloomers", and his life represents what we all want -- purpose and contribution to our society.

Gladwell concludes his article by saying "late bloomers stories are invariably love stories." Love is what fuels belief. Belief is what fuels patience and persistence -- in those with mental illness and their loved ones. Recovery, making a life of contribution despite and with a mental illness, is about hope and belief and patience and persistence. Recovery is all the more possible when faith and support from others are there, and really hard to come by when they are not.