In search of Aristotle: temperament, human nature, melancholia, creativity and eminence.

Is suffering associated with melancholia and "madness" necessary for artistic creativity and eminence? Or do creativity and leadership have something to do with the temperaments associated with affective disease? We integrate concepts dating back to Greek psychological medicine and philosophy--especially work attributed to Aristotle--with modern data-based examination of the role of cyclothymic and related temperaments in the interface between mixity, the bipolar spectrum and normality. We place our query within the general framework of evolutionary biology and human nature. In doing so, we propose that affective disease--including mania and associated psychotic states--exist because they serve as the genetic reservoir for adaptive temperaments and the genes for genius. Affective disorder can therefore be regarded as the price of exceptional greatness. Thus, creative and eminent individuals, by virtue of their being exceptional, occupy a somewhat unstable terrain between temperament and affective disease.