One of the popular historical pastimes of the 21st century is to guess what psychiatric disorder various famous people suffered from. Joan of Arc? At the very least she had severe migraines, based on her drawings of visions of the "City of God", which look remarkably like the fuzzy circular "scotomas" of these crippling headaches. Saint Paul? Temporal lobe epilepsy seems a likely diagnosis, based on that Road to Emmaus episode. Any famous Russian novelist? Clinical depression seems to be the norm for these writers. Abraham Lincoln and Winston Churchill? Depression, with a silver lining: depressed individuals often are at their best when a huge crisis looms.
Jazz musicians are a fertile subject for this post-humous mental diagnosis. In many, it is hard to tell if they had an underlying mental illness because they were primarily known for the abuse of hard drugs: Charlie Parker, Stan Getz, Chet Baker, and myriad others. Thelonius Monk was definitely a candidate for psychoactive medications; to me, his bizarre twirling during the solos of other musicians sounds like he was autistic, although other explanations have been offered. Monk's unique compositions even have some of the characteristics of drawings by autistic savants: angular, logical, and seeming to emerge in a finished, complete form rather than being gradually developed.
I am pondering these thoughts because I recently read Wynton Marsalis' new book, "Higher Ground". In his descriptions of famous jazz musicians, he laments the fact that John Coltrane, revered as the postmodern god of the tenor saxophone, was a severe obsessive/compulsive. According to Marsalis this was a tragedy, as it drove away other musicians that tired of his long, intense solos, and it alienated all but the most dedicated jazz listeners.
On the one hand, OCD seems to explain Coltrane's behavior. One of the reasons that he is so revered is that his practice habits were legendary. As a young man, he could be heard playing his scales even as he walked down the stairs to breakfast. He had a noiseless saxophone that he would take on airplanes so that he could practice in the restroom (try that now!). Even his soloing embodied a compulsion to express every melodic idea possible. When Miles Davis asked him why he soloed so long, Coltrane said "I still had something to say, and I didn't know how to stop". In his growly voice, Miles responded "Just take the #@*# horn out of your mouth".
If we accept the notion that this titan of Avant Garde jazz suffered from an obsessive/compulsive disorder, what does that mean to those of us who saw an aesthetic spirituality in his impossible dedication to practice and his endless melodies and "sheets of sound"? Many of those obsessive characteristics actually made him into the unique musician that he was, but labeling him with a psychiatric diagnoses somehow taints the legend. When we listen to his later recordings, are we hearing a transcendent genius, or simply witnessing the final train-wreck of a mental illness?
There is a concept that we should view all forms of mental illness as simply "neural diversity", similar to the racial and cultural diversity that makes our society richer and more complex. And yet when we know someone personally with mental illness the suffering seems to outweigh any beneficial side-effects that come with it. If nothing else, this conflict suggests that we should be more conservative about medicating away those behaviors that fall outside the norm.

Listening to Coltrane's beautiful ballad, "After the Rain", you can almost hear the peace that comes when the noise of an unquiet mind comes to rest. That may be enough of an answer.

Blueberries and Prozac
Worrying about our brains is part of getting older. Am I losing it? Or did I never actually have it? They tell us that we grow a whole skullful of neurons up until about 14 years of age, and from then on we start losing them. Initially this culling process makes you smarter, but at some point you find that you can't even remember which car belongs to you in the Starbucks parking lot.
The new watchword in neurophysiology is "neuroplasticity". Brain cells can apparently reorganize themselves to meet new challenges or old neural injuries. I found it particularly encouraging when I read in several sources, including a major Scientific American article and a new book on improving brain function by Dr Restak (if I remember correctly, it is called "Think Smart", but I might be wrong) that we do in fact make new brain cells, even as aging adults. But unless these new brain cells are put to use within 2 weeks, they die off, leaving you no smarter than you were.
It turns out that bursts of new brain cells are formed in response to three different stimuli: Exercise, eating blueberries, and antidepressants. Gaining a few young neurons is enough reason to get out of bed on a rainy morning and run 5 miles. Even walking three times a week may be enough to do it. Blueberries (and strawberries and a few other colorful fruits) apparently make you smarter, even at reasonable amounts, like 1/4 cup a day. A good reason to have a few blueberry muffins after your run. And antidepressants also spur the birth of a neuron. There is some thought that Prozac and other SSRIs actually improve depression by growing back neurons in those areas most damaged by stress, rather than simply increasing serotonin levels. Stroke patients, as well as some people with peripheral nerve or spinal damage, are receiving antidepressants to help replace lost nerve cells.
This is all good news, but this is still a "use it or lose it" proposition. These cells have a short lifespan unless they are put to use, and it takes certain types of demands to make them stay around. Specifically, it appears that the brain has to perform learning that anticipates near-future events. For rats, the task was to teach them to blink exactly 1/2 second after a tone sounds, to avoid a little puff of air directed at their face. What normal activities involve this kind of anticipation? Playing video games has actually been shown to have a significant effect, especially the shoot-em-up action games. Apparently activating the survival parts of the brain primes this type of learning better than Tetris or other puzzle-type games. Fortunately, you don't have to subject yourself to 2 hours a day playing Grand Theft Auto, because playing music involves the same type of skills. We might guess that playing improvised music with a group would work best: playing jazz forces you to think quickly, look forward to anticipate the next chord change or the next accent that the drummer lays down, and draw upon many different brain areas. And sometimes that slightly panicky feeling when it is your turn to take a solo activates those fight-or-flight survival areas to sensitize the learning center.
Go to the gym, throw a handful of blueberries on your oatmeal, and go sit in with some other musicians. Maybe those new brain cells will work even better than the old ones.