The course of modern world history has been critically shaped by the physical and mental illnesses of heads of state, sometimes in the public eye but usually in secrecy. Democratic politicians as diverse as Woodrow Wilson, Franklin D. Roosevelt, Churchill, Kennedy, Johnson, Nixon, Pompidou, Mitterrand, Blair, George W. Bush, Chirac, and Sharon all lied about their health. Between 1906 and 2008 seven Presidents are judged to have been mentally ill while in office: Theodore Roosevelt (bipolar disorder), Taft (breathing-related sleep disorder), Wilson (major depressive disorder), Coolidge (major depressive disorder), Hoover (major depressive disorder), Johnson (bipolar disorder), and Nixon (alcohol abuse). Many despots-such as Hitler, Stalin, Saddam Hussein, Pol Pot, Idi Amin, and Robert Mugabe-have been branded by the press and public opinion as suffering mental illnesses. Lord Owen argues neither Hitler nor Stalin were mad in any sense the medical profession recognizes (whereas Mussolini and Mao had depression, possibly bipolar disorder).
Something happens to some leaders' mental stability while in power that is captured by Bertrand Russell's phrase, the intoxication of power. Hubristic behavior with excessive self-confidence is almost an occupational hazard for heads of government, as it is for leaders in other fields, such as business and the military, for it feeds on isolation and excessive deference. Owen argues that a medically definable condition called Hubris Syndrome affects some heads of government the longer they stay in office or after a specific triggering event such as 9/11. Recent leaders such as George W. Bush, Tony Blair, and Margaret Thatcher have developed Hubris Syndrome. Symptoms include patterns of reckless behavior, bad judgment, and operational incompetence, often compounded by delusions of personal infallibility and divine exemption from political accountability. Lord Owen makes the cases that democratic societies need to implement new procedures for dealing with illness in their own heads of government, and that they need to empower the United Nations to use new procedures and means for removing despots whose behavior becomes so hubristic as to pose a grave threat to their own people or the world.