Creativity and bipolar disorder are linked, butnot by some mad genius21 August 2012, By Claudia Slegers

(Medical Xpress) -- Does some fine madness yieldgreat artists, writers and scientists? The evidenceis growing for a significant link between bipolardisorder and creative temperament andachievement.

People with bipolar disorder swing repeatedly fromdepression to euphoria and hyperactivity, orintensely irritable, mood states. Sometimes likenedto being on an emotional rollercoaster, each swingup then down affects one's behaviour, energylevels, thought patterns and sleep. Also known asmanic-depressive illness, bipolar disorder isstrongly genetically linked, passing down througheach generation of an affected family. It is fairlycommon and very treatable with modern medicinesand psychotherapy.

A seminal work in the field is Kay RedfieldJamison's book Touched with Fire: Manic-depressive Illness and the Artistic Temperament.The American psychologist combined currentdiagnostic criteria with biographical data, diaries,family trees and other historical information toclosely examine the lives of a sample of major 18thcentury British poets born between 1705 and 1805.Jamison found a rate of bipolar disorder 30 timesgreater in these poets than in the generalpopulation. Jamison's work also found that theperiods psychiatrists call hypomania - mild but notfull-blown mania - can also involve heightenedcreative thinking and expansiveness, high mentalspeed, cognitive flexibility, and ability to makeoriginal connections between otherwise disparateideas, all elements underlying creativity.

Other studies by Jamison established that anumber of speech components occur in individualswhen hypomanic: they are more likely to usealliterations, to rhyme, to use idiosyncratic words,and engage in a playful use of language. When

given drills, they can list synonyms or form wordassociations more rapidly than control groups. Andso they rate highly on tests of creativity. Jamison'sstudy of 47 eminent British writers and artists -selected on the basis of their having won at leastone of several major prestigious prizes or awards intheir fields - found 38 per cent of this group hadbeen treated for a mood disorder, a category whichincludes depression as well as bipolar disorder.

Recent, large-scale studies provide additionalscientific support to Jamison's work. A whole-population cohort study of all individuals in theSwedish national school register showed that thosewho demonstrated excellent school performanceswere nearly four times as likely to develop bipolardisorder as those who exhibited only averageperformance. Excellence in language or music wasparticularly correlated with an increased risk fordeveloping bipolar disorder. Other studies haveaddressed a different pattern of association, onebetween creative occupation and mental illness.These studies found a clear over-representation ofpeople with bipolar disorder (and their healthysiblings) in the most creative occupationalcategories, which included artists, musicians,writers and scientists.

While large, population-based studies provide uswith the scientific rigour to test the link betweenbipolar disorder and creativity, some of the moreinteresting studies have involved smaller-scale,reflexive approaches. Here, writers and artists withpersonal experience of bipolar disorder havereflected on their own and their peers' creativeprocesses, exploring how their mood states interactwith their productivity.

In 2010, Stephanie Stone Horton reflexively tracedher own and her colleagues' writing creativity anddysfunction as early career writers with bipolar

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disorder or depression. Horton described howhypomanic moods often facilitate writing periodscharacterised by fluency, flair and persuasivepower, whereas the periods of mild depression oreuthymia (even moods between the extremes) maybe better used for editing and proofing. OliviaSagan explored the experiences of mentally illdeveloping artists through longitudinal biographicalinterviews conducted with art students at twouniversity sites. Narratives involved complex storiesin which participants considered their illness to bepart of themselves, albeit one that they needed to'manage'.

One of the details of the narratives was thehypervigilance of health and ill-health on acontinuum which at times threatened to jeopardisethe dearly won achievement of becoming an artstudent. Here, participants often talked about thepotentially productive, but also potentiallydestabilising, role of hypomanic moods.

Let us be clear. To argue for a link between bipolardisorder and creative achievement is not to arguethat all, or even most, artists and writersautomatically have a mental illness: indeed, mostdo not. To make such simplistic generalisations canreinforce the idea of the "mad genius" and trivialisea serious medical condition that can end in suicide.Yet the evidence to date suggests that a highnumber of artists and writers, far more than couldbe expected by chance, meet the diagnostic criteriafor bipolar disorder.

What are the implications for treatment? First-linemedication for bipolar disorder, lithium, can causecognitive dulling and slowing, and limit emotionaland perceptual range for some individuals. This isespecially significant for those working in creativefields such as artists and writers, who draw on theiremotions for creating their work. It is not surprisingthen that some artists and writers with bipolardisorder choose not to take medications. However,unless an individual has a mild expression ofbipolar disorder, the consequences of the condition(suicide, for example) nearly always argue foractive treatment. More research is need tounderstand not only how mood experiences interact

with creative processes and artistic production, butto learn how mood episodes shape decisions aboutwhether or not to accept treatment and if so, thetreatment choices. We also need to learn moreabout how people with bipolar disorder can best besupported to make the most of their lives, with thehighest degree of satisfaction in theirachievements.

Society benefits from the achievements of itstalented writers, artists and scientists with mentalillness, yet those affected don't always judge theirmoments of brilliance to be worth theaccompanying pain and distress, and don't alwaysplace their personal wellbeing and adherence totaking medication ahead of the potential to expresstheir creativity.

Provided by Monash University

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