The Wrong Diagnosis?

His hands were trembling. He looked distraught. He was I dressed for the Iditarod, although the temperature was in the mid-80s. And he was crying.

Everybody who saw John Daly break down last Thursday in the first round of the Greater Vancouver Open agrees on those points. One minute Daly was O.K. The next minute he was not. He was able to finish, but not before scaring his playing partners, David Frost and Corey Pavin.

So what was it? Daly, the next day, dismissed the episode as a typical setback in the life of a recovering alcoholic. "The shakes are going to come and go," Daly said. "It's part of the program."

Is it? Doctors who treat alcoholism say that delirium tremens—the seizure symptoms that accompany withdrawal—ordinarily disappear within a month of quitting booze. ( Daly says he has not had a drink since March 1997, when he checked into the Betty Ford Clinic in Rancho Mirage, Calif.) What if Daly's disability is not alcoholism, but something deeper?

I raise the question because Daly's documented excesses, as bizarre as they seem, are familiar to me. I have a sister who suffers from a psychiatric ailment called major depressive disorder. In fact, we wrote a book about it (Story of "J", William Morrow & Co.). Until she was diagnosed and treated about 20 years ago, Terry pinballed between normal function and suicidal depression. For no discernible reason she plunged into deep funks. She ate and spent money compulsively, suffered from panic attacks and wallowed in self-reproach. John Daly's symptoms. That's why for years Terry and I have suspected that Daly suffers from a related condition called bipolar disorder, or manic-depressive illness. That would explain much about his behavior.

According to Dr. Fred Goodwin, former director of the National Institute of Mental Health, "Alcoholism is usually a fairly chronic condition, whereas manic-depressive illness has clear opposite extremes, and cycles from one extreme to another, sometimes with long normal periods in between." In his euphoric, manic phases, Daly wins tournaments, spends money recklessly, overeats, gambles, gets into fights and trashes hotel rooms. In his depressive moods he loses energy, sleeps fitfully, cries with remorse and thinks about driving his car off a cliff. Daly's history of substance abuse also fits Goodwin's profile. "Sixty percent of patients with manic-depressive illness will at some point meet the criteria for substance abuse," Goodwin says. "Alcohol can certainly obscure the diagnosis."

If Daly has been told he's manic-depressive, he hasn't acknowledged the diagnosis publicly, or perhaps he refuses to accept it. He could be resisting the label of mentally ill. Call him anything—drunk, deadbeat, junkie, dodo—but don't call him crazy.

"I can imagine exactly what he's going through," my sister told me by telephone last Saturday, having just watched televised highlights of Daly's panic attack. "You feel stigmatized by the diagnosis." She offered two other explanations for the possibility that Daly might have refused to accept bipolar disorder as the source of his torment: 1) "He assumes that the manic state is normal, when actually it's an unnatural and self-destructive high. It's only when he's depressed and in unbelievable pain that he's open to treatment." 2) "The usual treatment is lithium, and a common side effect of lithium is hand tremors. As an athlete Daly may fear the treatment more than the illness." The PGA Tour's Bert Yancey, who died in 1994, agonized because the lithium he took as a manic-depressive caused his hands to tremble. Goodwin, who treated Yancey late in his career, says the trembling is "one of the more treatable side effects [of lithium]."

A source close to Daly says that the golfer has been taking antidepression medicine since he left Betty Ford. His alcoholism could be more a symptom than the cause of his anguish. If he never takes another drink, he could still run the risk of death by sugar, slot machine or suicide.

That could explain why he was trembling and crying in Vancouver. He's 10 over par at the turn, and he may not have played the hardest holes.