If you are from the upper social classes and becoming manic, your illness is manifest in slightly more flamboyant ways; in 1908 Virginia Woolf and friends took part in the now famous Dreadnought Hoax. A telegram was sent to HMS Dreadnought, the flagship of the British home fleet then anchored at Weymouth, advising the Admiral of a visit by the Emperor of Abyssinia and four of his entourage. The group (Woolf et al) all disguised by dark greasepaint and wearing flowing robes, were met by a guard of honour at the station and escorted round the ship by the captain. Woolf's brother played the interpreter and used what one sailor called a ‘rum lingo’. Virginia remained silent, which is perhaps why they escaped detection. They got back safely and all would have been well, had not one of the party informed the press, whereupon a storm broke over their heads.

This anecdote comes from Peter Dally's biography of Virginia Woolf, with particular reference to her manic-depressive illness and the desperate attempts by her husband, Leonard, to cope with it. A retired consultant psychiatrist from the Westminster Hospital, Dally has painstakingly researched the inner dynamics of the dazzling Bloomsbury group. The gripping story that emerges is that some of the 20th century's brightest minds seemed curiously incapable of applying their intellects to the basic challenges of the emotional difficulties in their own lives.

Earlier in her life, Lytton Strachey, widely known to be a confirmed homosexual, proposed to Virginia and she accepted, to his shock and dismay, but they both managed to extricate themselves from the quagmire.

Leonard and Virginia's own married sex life seems to have been deeply unsatisfactory from an early stage, yet they appeared to have done little to use their vast educational resources to inform themselves about possible solutions. Despite Leonard taking over the publishing of the International Psycho-Analytical Library, he made almost no attempts to obtain any kind of ongoing therapeutic help for Virginia's manic depression. She read Freud ‘compulsively’ for a while, yet also seemed unable to attempt any psychological understanding of her moods. No doctor specialising in neurology or psychiatry was ever engaged for help by the Woolfs for any prolonged period.

Dally prefers dispassionate reporting of the facts rather than a polemic, but what emerges is a group of gifted individuals reduced to rather immature avoidances whenever in danger of confronting their own difficulties. There are some interesting clues here for the clinical psychiatrist of why sometimes the most intellectual patients are oddly the most difficult to treat.

Indeed, this eventually proved Virginia's undoing as Leonard took her to see a kind of family doctor inexperienced in mental illness, living miles away, for an inadequate consultation the day before her suicide. The ultimate tragedy of untreated manic depression is poignantly apparent in her suicide note — the deep loss to all of us when creativity and genius cannot be protected from the ravages of mental illness, or perhaps darkly inevitable insight. Her final lines ever include “… I am certain I am going mad again… I am always hearing voices, and I know I shan't get over it now.”