Bipolar disorder struck me in 2003, when I was a 47-year-old colonel and brigade commander in Iraq. I served the next 11 years with an unrecognized, undiagnosed, and worsening mental illness.
By 2014, something was seriously wrong with my brain. After rocketing into full-blown mania and being removed from command in July 2014, I crashed into depression and psychosis. In November 2014, I was finally diagnosed. For two years I battled for my sanity and my life before beginning my recovery.
How did my bipolar go undiagnosed for 11 years? There were warning signs, but no one recognized them. I, and the people around me, were untrained in identifying the basic symptoms of bipolar disorder. I believe the military’s culture masked and incentivized my manic behavior. My mania helped me thrive, although it always bordered on dangerous. There are changes the military can make to improve recognition, prevention, and treatment of mental illness. In addition, there are things service members should know and do to deal with mental health disorders.
The Early Years
In retrospect, I displayed signs of latent bipolar disorder and what is called “hyperthymia” starting in my teens. After several discussions, psychiatrist Dr. Nassir Ghaemi, author of A First Rate Madness: Uncovering the Links Between Leadership and Mental Illness (Penguin Publishing Group, 2012), and I are convinced I had hyperthymia, up until the onset of bipolar in 2003. Hyperthymia is a form of “mini mania,” in which the person is continually “up”—happy, positive, energetic.1 It is a near constant state of mild mania.
The Army loved my energy, drive, and enthusiasm. I excelled in each assignment, ran marathons, earned the coveted Army Ranger tab, along with two master’s degrees and a PhD from MIT, commanded a battalion and brigade, was promoted early to colonel, then quickly to general officer.
As I advanced in my career, my behavior became increasingly abnormal—super “Hooah!” I earned nicknames such as “Mad Martin” and “the Energizer Bunny” and learned to elevate, unknowingly, into a manic-adjacent state, which raised my energy even more. My unrecognized hyperthymic, latent bipolar condition amplified my talents and helped me succeed—until it went too far.
Combat-Triggered Bipolar
In 2003, I commanded thousands of soldiers in Iraq. I felt fearless, required little sleep, and was “high” on the thrill of combat. I had always been aggressive, but not much of a risk-taker—until Iraq. I felt like Superman. My performance was rated as outstanding and above my peers; I now know this was, at least in part, because of my mania.
I later learned from Veterans Affairs (VA) and the Army Medical Department that the intense stress of combat, though exhilarating and euphoric, triggered my genetic predisposition for bipolar disorder. It caused my brain to produce and distribute an overabundance of dopamine and endorphins, propelling me into mania and damaging my brain circuitry.
In retrospect, several of my subordinates described my behavior as “unusual, strange, and extreme,” but they did not associate it with bipolar.
After redeploying in 2004, the excitement of war and combat-induced mania behind me, I fell into a months-long depression. I sought medical help, but doctors told me I was fine.
So, I turned to self-medication techniques such as intense workouts, religion, and off-duty alcohol, but they did not help. What saved me was the structure of Army life. I had to get up and keep going, until the depression naturally resolved itself. My forced military routine saved me from disaster. This completed my first full up/down, manic/depressive cycle.
Ascent Into Full-Blown Mania
Despite depression, and with help from mania, I kept getting results, so the Army kept advancing me. For the next decade-plus, my mania elevated higher, my depression sank lower, and my psychotic delusions and hallucinations grew. As my undiagnosed bipolar intensified, my behavior became more abnormal and extreme.
Although I was primarily manic, my depressions lasted for hours, days, or sometimes weeks. While depressed, I was tired, low energy, drank more alcohol off-duty, was socially withdrawn, indecisive, and sometimes confused. Again, the Army structure saved me, and I soon bounced back into high-performing mania: full of energy, enthusiasm, and great ideas.
I went into full-blown mania in 2014. After decades of mild mania, I was at higher risk for acute mania, and the stress of striving to transform the National Defense University into a more effective, efficient, and relevant institution—as charged by the Chairman of the Joint Chiefs General Martin Dempsey—triggered just that. My behavior became more erratic, disruptive, and bizarre. The stress supercharged my energy levels, poured fuel on the flames of my disorder, caused my mind to unravel, and my bipolar disorder to become unmanageable.
I was paranoid, delusional, and sometimes had hallucinations; I believed I was being watched, that people were out to get me, end my career, and put me in jail. I experienced flashbacks of Iraq and felt like Superman again.
My obsession with religion intensified. I slept less and emailed hundreds of people at night. I drank more and went on midnight, high-speed bike rides around D.C., hallucinating that I was flying. I spoke rapidly and pressurized; held impromptu meetings that lasted for hours, jumping from topic to topic; and was constantly late. I could not keep track of time, missing important events and sometimes talking nonstop for hours. I changed plans rapidly. My agitation and anger grew, while also bursting into extreme enthusiasm and happiness.
My boss, General Dempsey, began receiving anonymous complaints about me. An assessment from a senior official said: “Gregg has gone crazy, is extremely disruptive, and distracting from the mission in a major way. Moreover, he has become a religious zealot with abnormally high levels of energy, enthusiasm, and extroversion that border on the bizarre.”
General Dempsey investigated and correctly concluded I needed to go. In July 2014, he gave me the option to “resign or you’re fired . . . you did an amazing job . . . and go get a mental health evaluation.”
This was the right decision. I was fortunate to have a supervisor who cared enough to remove me from command and order me to be evaluated. He forced me to get medical help. That is exactly what I needed, because I believed I was okay and that everyone who thought otherwise was out to get me—but I was wrong.
I resigned that day but had been diagnosed as “fit for duty” three times that month. This underlines how difficult it is to recognize and diagnose bipolar disorder. Had my clinicians and chain of command discussed my symptoms, they could have reached an accurate diagnosis sooner and saved me mental anguish and risk of suicide.
I subsequently crashed into severe depression and psychosis, was diagnosed in November 2014, and spent two years fighting for my life. I underwent various therapies, including electro-convulsive therapy (ECT), and spent weeks in a VA hospital, battling to keep my passive suicidal ideations from becoming active. I finally stabilized with lithium and began my recovery in September 2016.
What To Do Institutionally
Training and education. The military has improved in recent years, particularly regarding depression, post-traumatic stress disorder, traumatic brain injury, and suicide awareness.2 People also must be able to recognize the symptoms of the most common mental health disorders.
Lead by example on mental wellness. Improvement is evident with the Army’s Holistic Health and Fitness field manual, FM 7-22.
Tell the truth about mental health. Everyone needs a battle buddy, or confidante, who gives it to them straight, without fear of retribution. A peer support system is key.
Reevaluate personnel policies. The military can enhance leadership and help uncover leaders harboring mental health conditions by:
• Adopting a 360-degree feedback program
• Keeping senior leaders in assignments long enough to be effective, enhance accountability, avoid masking detrimental behaviors, and reduce turbulence
• Developing a professionally certified coaching program for senior leaders
Stop perpetuating mental health stigma. If soldiers fear separation, many will not seek treatment. Mental health treatment should not be a source of stigma any more than a knee or back injury that precludes further military service.
Educate leaders to better understand mental health conditions. The Department of Defense (DoD) should increase research into the causes, prevention, and cures for brain maladies. In addition, military leaders should be taught to distinguish between essential and desirable behaviors/traits and consider and assess the possibility of mania being a factor in service member misconduct.
Increase the availability of mental health services. DoD should tighten its collaboration with VA and civilian mental health providers to improve continuity of care and push services down to the lowest levels.
Prioritize mental health. It cannot be an afterthought or addressed only when there is a problem or crisis. The brain is a service member’s most important weapon system.
What to Do Individually
Accept the truth. The first step to recovery is accepting that you might have a mental health disorder. When my boss ordered me to get a mental health exam, I considered the possibility I might be ill. When I was diagnosed with bipolar disorder, I embraced it and decided to do what it took to get well. I was grateful the doctors finally knew what was wrong with me and had ways to help.
Get help. Once you accept the painful truth, go get medical help. Be honest with your clinicians. Much of what they assess comes directly from you, the patient. Get family, friends, and colleagues to share what they have seen in you, so clinicians have a complete picture.
Build connections. When we acknowledge our condition and work to recover, people will want to help us. My wife and family stood by me throughout my diagnosis and treatment. An Army battle buddy helped get me into a great VA hospital, then followed up. Others encouraged, supported, and accepted me, without judgment.
Nourish yourself with hope. People are the most significant source of hope, so find people and activities that inspire you and lift you up. Human connection is one of the most powerful aspects of my recovery and new life of health, happiness, and prosperity.
Help stop the stigma. As mental wellness warriors, we each have a role to play in destroying the stigma that surrounds mental health—the biggest barrier to people seeking help. I am open, transparent, and honest about my bipolar story, and each relationship and conversation helps educate and chip away at the stigma.
In addition to the right medications, therapy and healthful living, anchor yourself on the social foundation of the 4P’s: People, Place, Purpose, and Perseverance. The right medications and healthful living are necessary, but not sufficient, for recovery. For a recovery that’s built to last, you must anchor it into the social foundation of the 4P’s. People: develop a network of happy, upbeat, interesting friends that you enjoy; make-a-friend and be-a-friend (MAF-BAF) every day. Place: live in a safe place that makes you feel good and energized. Purpose: discover and live your own mission and passion—make your life count for something greater than yourself! Perseverance: infuse and animate your life with the will to recover—never give up!3
If you are suffering from mental illness, you are not alone. Mental conditions are widespread; 25 percent of the global population are afflicted and virtually 100 percent are affected, through family members, friends, or colleagues. There is a vast network of potential support, within and outside the military. It is okay to not be okay.
I am a proud, thankful bipolar survivor, and I am thriving. I must live a life of disciplined vigilance to keep bipolarity at bay. I want people to know I have bipolar disorder, went through hell, am in recovery, and now live a happy, healthy, successful life—and they can too.
1. David N. Osser, “Hyperthymic Temperament,” Psychiatric Times 36, no 9 (13 September 2019).
2. Jane Gervasoni, “ACE Suicide Prevention Programs Wins National Recognition,” U.S. Army, 1 September 2010.
3. Gregg Martin, “The ‘4Ps’ of Mental Recovery: Medical Care and Healthfulness”, 7 July 2022, “Psychiatric Times”; and Thomas Insel, Healing: Our Path From Mental Illness to Mental Health (New York: Penguin Press; 2022).
