The anguished, volatile intensity we associate with the artistic temperament, often described as "a fine madness," has been thought of as a defining aspect of much artistic genius. Now, Kay Jamison's brilliant work, based on years of studies as a clinical psychologist and prominent researcher in mood disorders, reveals that many artists who were subject to alternatingly exultant and then melancholic moods were, in fact, engaged in a lifelong struggle with manic-depressive illness. Drawing on extraordinary recent advances in genetics, neuroscience, and psychopharmacology, Jamison presents the now incontrovertible proof of the biological foundations of this frequently misunderstood disease, and applies what is known about the illness, and its closely related temperaments, to the lives of some of the world's greatest artists - Byron, van Gogh, Shelley, Poe, Melville, Schumann, Coleridge, Virginia Woolf, Burns, and many others. Byron's life, discussed in considerable detail, is used as a particularly fascinating example of the complex interaction among heredity, mood, temperament, and poetic work. Jamison reviews the substantial, rapidly accumulating, and remarkably consistent findings from biographic and scientific studies that demonstrate a markedly increased rate of severe mood disorders and suicide in artists, writers, and composers. She then discusses reasons why this link between mania, depression, and artistic creativity might exist. Manic-depressive illness, a surprisingly common disease, is genetically transmitted. For the first time, the extensive family histories of psychiatric illness and suicide in many writers, artists, and composers are presented. In some instances - for example, Tennyson and Byron - these psychiatric pedigrees are traced back more than 150 years. Jamison discusses the complex ethical and cultural consequences of recent research in genetics, especially as they apply to manic-depressive illness, a disease that almost certainly confers both individual and evolutionary advantage, but often kills and destroys as it does so. Psychiatric treatment of artists remains a fiercely controversial issue. Dr. Jamison discusses both the advantages and problems with current treatments, and advocates a humanistic, flexible, and yet firmly medical approach. However, she strongly cautions against simplistic attempts to cure this most human and tragic of all diseases at the expense of destroying the artistic personality.