On February 3, 2009, two St. Bernard’s forced their way into a waterfowl breeding center outside Albany, N.Y, and slaughtered all one hundred and seventy of them. On April 4, Jiverly Voong gunned down fourteen people at an immigrant’s center in Binghampton.

It was a violent spring.

Kerby Trevelus decapitated one of his sisters, stabbed another to death, and injured a third. Robert Stewart slaughtered eight people in a nursing home, and wounded another three. In the days leading up to the massacre of four police officers, Lovelle Mixon told relatives that he felt depressed and angry, an uncle noticing that he was emotionally withdrawn.

Michael McLendon killed five family members and five other people before shooting himself.  In the days leading up to the massacre, he told a friend that he was depressed. Tim Kretschmer murdered fifteen people before shooting himself. Between April and September of 2008, Kretschmer had five outpatient “therapy” sessions for depression.

Devan Kalathat shot to death six family members, wounded his wife, and committed suicide, A few days before allegedly raping and murdering Sandra Cantu, Melissa Huckaby, who suffered recurrent bouts of depression, attempted suicide by trying to swallow three XActo-knife blades, but released from the hospital. An explanation for the violence is available, but ignored, while law enforcement, the judiciary, psychiatrists, psychologists, and media search for motives.    

Amok is remarkable not only for the numbers, but for the savagery, when the victims are raped, mutilated, cannibalized or beheaded It explains the atrocities that soldiers often inflict on civilians during and following battle. Episodes of police brutality and road rage are probably mini-amoks. Mood cycles have been observed in many species of domestic and wild animals, the vicious attack of chimp Travis having all of the markings of amok. The biological basis of amok must be recognized, and society educated so as to be sensitive to its warning signs. In referring to these attacks as “rampage” media are at odds with the medical literature, which for hundreds of years has used the word “amok.” After an amok, it is essential to review the charts of all prior contacts with the mental health system, to determine whether the diagnosis was correct, and the treatment appropriate. Suicidal intent is largely based on the lethality of the method, and one wonders whether Melissa Huckaby’s  discharge from the hospital was based on medical judgment, or managed care meddling. Amok is far more common than we realize, and often the result of misdiagnosis, not realizing that bipolar individuals are at risk, and allowing judges to make de facto medical diagnoses and treatment recommendations. 

Julian Lieb, M.D is a psychiatrist, and author or coauthor of forty -five articles and nine books. D Jablow Hershman and Dr Lieb coauthored: “Manic Depression and Creativity” and “A Brotherhood of Tyrants: Manic Depression and Absolute Power.” In these volumes, the authors showed that manic-depressive disorder is paradoxical, in gifting society with most of its creative geniuses, and inflicting many of its great destroyers. Dr Lieb’s article, ”Two manic-depressives, two tyrants, two world wars” was published by Medical Hypotheses.