Creativity and mental illness

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Ludwig van Beethoven, widely considered one of the greatest composers in human history, may have been bipolar. Beethoven.jpg
Ludwig van Beethoven, widely considered one of the greatest composers in human history, may have been bipolar.

The concept of a link between creativity and mental illness has been extensively discussed and studied by psychologists and other researchers for centuries. Parallels can be drawn to connect creativity to major mental disorders including bipolar disorder, schizophrenia, major depressive disorder, anxiety disorder, and ADHD. For example, studies [3] have demonstrated correlations between creative occupations and people living with mental illness. There are cases that support the idea that mental illness can aid in creativity, but it is also generally agreed that mental illness does not have to be present for creativity to exist.

Mental disorder distressing thought or behavior pattern

A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitting, or occur as a single episode. Many disorders have been described, with signs and symptoms that vary widely between specific disorders. Such disorders may be diagnosed by a mental health professional.

Bipolar disorder mental disorder that causes periods of depression and periods of abnormally elevated mood

Bipolar disorder, previously known as manic depression, is a mental disorder that causes periods of depression and periods of abnormally elevated mood. The elevated mood is significant and is known as mania or hypomania, depending on its severity, or whether symptoms of psychosis are present. During mania, an individual behaves or feels abnormally energetic, happy, or irritable. Individuals often make poorly thought out decisions with little regard to the consequences. The need for sleep is usually reduced during manic phases. During periods of depression, there may be crying, a negative outlook on life, and poor eye contact with others. The risk of suicide among those with the illness is high at greater than 6 percent over 20 years, while self-harm occurs in 30–40 percent. Other mental health issues such as anxiety disorders and substance use disorder are commonly associated with bipolar disorder.

Schizophrenia Mental disorder characterized by abnormal behavior and misinterpretation of reality

Schizophrenia is a mental disorder characterized by abnormal behavior, strange speech, and a decreased ability to understand reality. Other symptoms include false beliefs, unclear or confused thinking, hearing voices that do not exist, reduced social engagement and emotional expression, and lack of motivation. People with schizophrenia often have additional mental health problems such as anxiety, depression, or substance-use disorders. Symptoms typically come on gradually, begin in young adulthood, and, in many cases, never resolve.

Contents

History

It has been proposed that there is a particular link between creativity and mental illness (e.g. bipolar disorder, whereas major depressive disorder appears to be significantly more common among playwrights, novelists, biographers, and artists). [4] Association between mental illness and creativity first appeared in literature in the 1970s, but the idea of a link between "madness" and "genius" is much older, dating back at least to the time of Aristotle. In order to comprehend how the connection between “madness” and “genius” correlate, first understand that there are different types of geniuses: literary geniuses, creative geniuses, scholarly geniuses, and “all around” geniuses. Since there are many different categories, this means that individuals can completely excel in one subject and know an average, or below average, amount of information about others. [5] The Ancient Greeks believed that creativity came from the gods, in particular the Muses (the mythical personifications of the arts and sciences, the nine daughters of Zeus). In the Aristotelian tradition, conversely, genius was viewed from a physiological standpoint, and it was believed that the same human quality was perhaps responsible for both extraordinary achievement and melancholy. [6] Romantic writers had similar ideals, with Lord Byron having pleasantly expressed, "We of the craft are all crazy. Some are affected by gaiety, others by melancholy, but all are more or less touched".

Major depressive disorder all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities.

Major depressive disorder (MDD), also known simply as depression, is a mental disorder characterized by at least two weeks of low mood that is present across most situations. It is often accompanied by low self-esteem, loss of interest in normally enjoyable activities, low energy, and pain without a clear cause. People may also occasionally have false beliefs or see or hear things that others cannot. Some people have periods of depression separated by years in which they are normal, while others nearly always have symptoms present. Major depressive disorder can negatively affect a person's personal life, work life, or education, as well as sleeping, eating habits, and general health. Between 2–8% of adults with major depression die by suicide, and about 50% of people who die by suicide had depression or another mood disorder.

Aristotle philosopher in ancient Greece

Aristotle was a Greek philosopher during the Classical period in Ancient Greece, the founder of the Lyceum and the Peripatetic school of philosophy and Aristotelian tradition. Along with his teacher Plato, he has been called the "Father of Western Philosophy". His writings cover many subjects – including physics, biology, zoology, metaphysics, logic, ethics, aesthetics, poetry, theatre, music, rhetoric, psychology, linguistics, economics, politics and government. Aristotle provided a complex synthesis of the various philosophies existing prior to him, and it was above all from his teachings that the West inherited its intellectual lexicon, as well as problems and methods of inquiry. As a result, his philosophy has exerted a unique influence on almost every form of knowledge in the West and it continues to be a subject of contemporary philosophical discussion.

Literature written work of art

Literature, most generically, is any body of written works. More restrictively, literature refers to writing considered to be an art form or any single writing deemed to have artistic or intellectual value, often due to deploying language in ways that differ from ordinary usage.

Individuals with mental illness are said to display a capacity to see the world in a novel and original way; literally, to see things that others cannot. [7]

Studies

For many years, the creative arts have been used in therapy for those recovering from mental illness or addiction. [8] [9]

Another study found creativity to be greater in schizotypal than in either normal or schizophrenic individuals. While divergent thinking was associated with bilateral activation of the prefrontal cortex, schizotypal individuals were found to have much greater activation of their right prefrontal cortex. [10] This study hypothesizes that such individuals are better at accessing both hemispheres, allowing them to make novel associations at a faster rate. In agreement with this hypothesis, ambidexterity is also associated with schizotypal and schizophrenic individuals.

Prefrontal cortex part of brain

In mammalian brain anatomy, the prefrontal cortex (PFC) is the cerebral cortex which covers the front part of the frontal lobe. The PFC contains the Brodmann areas BA8, BA9, BA10, BA11, BA12, BA13, BA14, BA24, BA25, BA32, BA44, BA45, BA46, and BA47.

Ambidexterity is the ability to use both the right and left hand equally well. When referring to objects, the concept indicates that the object is equally suitable for right-handed and left-handed people. When referring to humans, it indicates that a person has no marked preference for the use of the right or left hand.

Three recent studies by Mark Batey and Adrian Furnham have demonstrated the relationships between schizotypal [11] [12] and hypomanic personality [13] and several[ which? ] different measures of creativity.

Particularly strong links have been identified between creativity and mood disorders, particularly manic-depressive disorder (a.k.a. bipolar disorder) and depressive disorder (a.k.a. unipolar disorder). In Touched with Fire: Manic-Depressive Illness and the Artistic Temperament, Kay Redfield Jamison summarizes studies of mood-disorder rates in writers, poets and artists. She also explores research that identifies mood disorders in such famous writers and artists as Ernest Hemingway (who shot himself after electroconvulsive treatment), Virginia Woolf (who drowned herself when she felt a depressive episode coming on), composer Robert Schumann (who died in a mental institution), and even the famed visual artist Michelangelo.

A study looking at 300,000 persons with schizophrenia, bipolar disorder or unipolar depression, and their relatives, found overrepresentation in creative professions for those with bipolar disorder as well as for undiagnosed siblings of those with schizophrenia or bipolar disorder. There was no overall overrepresentation, but overrepresentation for artistic occupations, among those diagnosed with schizophrenia. There was no association for those with unipolar depression or their relatives. [14]

A study involving more than one million people, conducted by Swedish researchers at the Karolinska Institute, reported a number of correlations between creative occupations and mental illnesses. Writers had a higher risk of anxiety and bipolar disorders, schizophrenia, unipolar depression, and substance abuse, and were almost twice as likely as the general population to kill themselves. Dancers and photographers were also more likely to have bipolar disorder. [15] [ medical citation needed ]

However, as a group, those in the creative professions were no more likely to experience psychiatric disorders than other people, although they were more likely to have a close relative with a disorder, including anorexia and, to some extent, autism, the Journal of Psychiatric Research reports. [15] [ medical citation needed ]

Research in this area is usually constrained to cross-section data-sets. One of the few exceptions is an economic study of the well-being and creative output of three famous music composers over their entire lifetime. [16] The emotional indicators are obtained from letters written by Wolfgang Amadeus Mozart, Ludwig van Beethoven and Franz Liszt, and the results indicate that negative emotions had a causal impact on the creative production of the artists studied.

Psychological stress has also been found to impede spontaneous creativity. [17] [18]

A 2005 study at the Stanford University School of Medicine measured creativity by showing children figures of varying complexity and symmetry and asking whether they like or dislike them. The study showed for the first time that a sample of children who either have or are at high risk for bipolar disorder tend to dislike simple or symmetric symbols more. Children with bipolar parents who were not bipolar themselves also scored higher dislike scores. [19] [ medical citation needed ]

Mood and creativity

Mood-creativity research reveals that people are most creative when they are in a positive mood [20] [21] and that mental illnesses such as depression or schizophrenia actually decrease creativity. [22] [23] People who have worked in the field of arts throughout the history have had problems with poverty, persecution, social alienation, psychological trauma, substance abuse, high stress [24] [ medical citation needed ] and other such environmental factors which are associated with developing and perhaps causing mental illness. It is thus likely that when creativity itself is associated with positive moods, happiness, and mental health, pursuing a career in the arts may bring problems with stressful environment and income. Other factors such as the centuries-old stereotype of the suffering of a "mad artist" help to fuel the link by putting expectations on how an artist should act, or possibly making the field more attractive to those with mental illness. Additionally, where specific areas of the brain are less developed than others by nature or external influence, the spacial capacity to expand another increases beyond "the norm" allowing enhanced growth and development.

Bipolar disorder

Bipolar disorder is one of the main mental disorders said to inspire creativity, as the manic episodes are typically characterised by prolonged and elevated periods of energy. In her book Touched with Fire, American clinical psychologist Kay Redfield Jamison wrote that 38% of writers and poets had been treated for a type of mood disorder, and virtually all creative writers and artists (89%) had experienced "intense, highly productive, and creative episodes". These were characterised by "pronounced increases in enthusiasm, energy, self-confidence, speed of mental association, fluency of thought and elevated mood". [25] There is a range of types of bipolar disorder. Individuals with Bipolar I Disorder experience severe episodes of mania and depression with periods of wellness between episodes. The severity of the manic episodes can mean that the person is seriously disabled and unable to express the heightened perceptions and flight of thoughts and ideas in a practical way. Individuals with Bipolar II Disorder experience milder periods of hypomania during which the flight of ideas, faster thought processes and ability to take in more information can be converted to art, poetry or design. [26] Dutch artist Vincent Van Gogh is widely theorised to have suffered from bipolar disorder. Other notable creative people with bipolar disorder include Carrie Fisher, Demi Lovato, Stephen Fry (who suffers from cyclothimia, a milder and more chronic form of bipolar), [27] Mariah Carey, Catherine Zeta-Jones, Jean-Claude Van Damme, Ronald Braunstein [28] [29] , and Patty Duke [30]

Schizophrenia

People with schizophrenia live with positive, negative, and cognitive symptoms. Positive symptoms (psychotic behaviors that are not present in healthy people) include hallucinations, delusions, and thought and movement disorders. Negative symptoms (abnormal functioning of emotions and behavior) include "flat affect", anhedonia, reserved. Cognitive symptoms include problems with "executive functioning", attention, and memory. [31] One artist known for his schizophrenia was the Frenchman Antonin Artaud, founder of the Theatre of Cruelty movement. In Madness and Modernism (1992), clinical psychologist Louis A. Sass noted that many common traits of schizophrenia – especially fragmentation, defiance of authority, and multiple viewpoints – happen to also be defining features of modern art. [32] [ medical citation needed ]

In a 2002 conversation with Christopher Langan, educational psychologist Arthur Jensen stated that the relationship between creativity and mental disorder "has been well researched and is proven to be a fact", writing that schizothymic characteristics are somewhat more frequent in philosophers, mathematicians, and scientists than in the general population. [33] [ Unreliable fringe source? ] In a 2015 study, Iceland scientists found that people in creative professions are 25% more likely to have gene variants that increase the risk of bipolar disorder and schizophrenia, with deCODE Genetics co-founder Kári Stefánsson saying, "Often, when people are creating something new, they end up straddling between sanity and insanity. I think these results support the concept of the mad genius." [34] [ medical citation needed ]

Psychosis

Many famous historical figures gifted with creative talents may have been affected by bipolar disorder. Ludwig van Beethoven, Virginia Woolf, Ernest Hemingway, Isaac Newton, Judy Garland and Robert Schumann are some people whose lives have been researched to discover signs of mood disorder. [35] In many instances, creativity and psychosis share some common traits, such as a tendency for "thinking outside the box," flights of ideas, speeding up of thoughts and heightened perception of visual, auditory and somatic stimuli.

It has been found that the brains of creative people are more open to environmental stimuli due to smaller amounts of latent inhibition, an individual's unconscious capacity to ignore unimportant stimuli. While the absence of this ability is associated with psychosis, it has also been found to contribute to original thinking. [36] [ unreliable medical source? ]

Emotions

Many people with bipolar disorder may feel powerful emotions during both depressive and manic phases, potentially aiding in creativity. [37] [ unreliable medical source? ] Because (hypo)mania decreases social inhibition, performers are often daring and bold. As a consequence, creators commonly exhibit characteristics often associated with mental illness. The frequency and intensity of these symptoms appear to vary according to the magnitude and domain of creative achievement. At the same time, these symptoms are not equivalent to the full-blown psychopathology of a clinical manic episode which, by definition, entails significant impairment. [38] [ unreliable medical source? ]

Posthumous diagnosis

Some creative people have been posthumously diagnosed as experiencing bipolar or unipolar disorder based on biographies, letters, correspondence, contemporaneous accounts, or other anecdotal material, most notably in Kay Redfield Jamison's book Touched with Fire: Manic-Depressive Illness and the Artistic Temperament . [39] [ unreliable medical source? ]Touched with Fire presents the argument that bipolar disorder, and affective disorders more generally, [40] [ unreliable medical source? ] may be found in a disproportionate number of people in creative professions such as actors, artists, comedians, musicians, authors, performers and poets.

Positive correlation

Several recent clinical studies have also suggested that there is a positive correlation between creativity and bipolar disorder, although the relationship between the two is unclear. [41] [42] [43] Temperament may be an intervening variable. [42] Ambition has also been identified as being linked to creative output in people across the bipolar spectrum. [44]

Mental illness and divergent thinking

In 2017, associate professor of psychiatry Gail Saltz stated that the increased production of divergent thoughts in people with mild-to-moderate mental illnesses leads to greater creative capacities. Saltz argued that the "wavering attention and day-dreamy state" of ADHD, for example, "is also a source of highly original thinking. [...] CEOs of companies such as Ikea and Jetblue have ADHD. Their creativity, out-of-the-box thinking, high energy levels, and disinhibited manner could all be a positive result of their negative affliction." [45] Mania has also been credited with aiding in creativity because "when speed of thinking increases, word associations form more freely, as do flight of ideas, because the manic mind is less inclined to filtering details that, in a normal state, would be dismissed as irrelevant." [32] [ medical citation needed ]

Albert Rothenberg of Psychology Today noted that the "list of mentally ill creators who were successful [...] is dwarfed by the very large number of highly creative people both in modern times and throughout history without evidence of disorder", which includes figures such as William Shakespeare, Johann Sebastian Bach, and Jane Austen. [46] [ medical citation needed ] Rothenberg reported that when interviewing 45 science Nobel laureates for the book Flight from Wonder he had found no evidence of mental illness in any of them, and also stated, "The problem is that the criteria for being creative is never anything very creative. Belonging to an artistic society, or working in art or literature, does not prove a person is creative. But the fact is that many people who have mental illness do try to work in jobs that have to do with art and literature, not because they are good at it, but because they're attracted to it. And that can skew the data." [47] [ medical citation needed ]

Notable individuals

See also

Related Research Articles

Bipolar I disorder bipolar disorder that is characterized by at least one manic or mixed episode

Bipolar I disorder is a type of bipolar spectrum disorder characterized by the occurrence of at least one manic episode, with or without mixed or psychotic features. Most patients also, at other times, have one or more depressive episodes, and all experience a hypomanic stage before progressing to full mania.

Kay Redfield Jamison American bipolar disorder researcher

Kay Redfield Jamison is an American clinical psychologist and writer. Her work has centered on bipolar disorder, which she has had since her early adulthood. She holds the post of the Dalio Professor in Mood Disorders and Psychiatry at Johns Hopkins University School of Medicine and is an Honorary Professor of English at the University of St Andrews.

Mania state of abnormally elevated or irritable mood, arousal, and/or energy levels

Mania, also known as manic syndrome, is a state of abnormally elevated arousal, affect, and energy level, or "a state of heightened overall activation with enhanced affective expression together with lability of affect." Although mania is often conceived as a "mirror image" to depression, the heightened mood can be either euphoric or irritable; indeed, as the mania intensifies, irritability can be more pronounced and result in violence, or anxiety.

Psychosis abnormal condition of the mind that involves a loss of contact with reality

Psychosis is an abnormal condition of the mind that results in difficulties determining what is real and what is not. Symptoms may include false beliefs (delusions) and seeing or hearing things that others do not see or hear (hallucinations). Other symptoms may include incoherent speech and behavior that is inappropriate for the situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities.

Mood disorder mental disorders which have as their most predominant feature a disturbance in affect or mood to depression or to elation

Mood disorder, also known as mood affective disorders, is a group of conditions where a disturbance in the person's mood is the main underlying feature. The classification is in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD).

Schizoaffective disorder is a mental disorder characterized by abnormal thought processes and an unstable mood. The diagnosis is made when the person has symptoms of both schizophrenia and a mood disorder—either bipolar disorder or depression—but does not meet the diagnostic criteria for schizophrenia or a mood disorder individually. The main criterion for the schizoaffective disorder diagnosis is the presence of psychotic symptoms for at least two weeks without any mood symptoms present. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, psychotic bipolar disorder, schizophreniform disorder or schizophrenia. It is imperative for providers to accurately diagnose patients, as treatment and prognosis differs greatly for each of these diagnoses.

Depression (mood) state of low mood and aversion to activity

Depression is a state of low mood and aversion to activity. It can affect a person's thoughts, behavior, motivation, feelings, and sense of well-being. It may feature sadness, difficulty in thinking and concentration and a significant increase/decrease in appetite and time spent sleeping, and people experiencing depression may have feelings of dejection, hopelessness and, sometimes, suicidal thoughts. It can either be short term or long term. Depressed mood is a symptom of some mood disorders such as major depressive disorder or dysthymia; it is a normal temporary reaction to life events, such as the loss of a loved one; and it is also a symptom of some physical diseases and a side effect of some drugs and medical treatments.

A mixed affective state, formerly known as a mixed-manic or mixed episode, has been defined as a state wherein features unique to both depression and mania—such as despair, fatigue, morbid or suicidal ideation, racing thoughts, pressure of activity, and heightened irritability—occur either simultaneously or in very short succession.

<i>Touched with Fire</i> book by Kay Redfield Jamison

Touched with Fire: Manic-Depressive Illness and the Artistic Temperament is a book by the American psychologist Kay Redfield Jamison examining the relationship between bipolar disorder and artistic creativity. It contains extensive case studies of historic writers, artists, and composers assessed as probably having had Cyclothymia, Major Depressive Disorder, or Manic-Depressive/Bipolar Disorder.

Cyclical variations in moods and energy levels have been recorded at least as far back as several thousand years. The words "melancholia" and "mania" have their etymologies in Ancient Greek. The word melancholia is derived from melas/μελας, meaning "black", and chole/χολη, meaning "bile" or "gall", indicative of the term’s origins in pre-Hippocratic humoral theories. A man known as Aretaeus of Cappadocia has the first records of analyzing the symptoms of depression and mania in the 1st century of Greece. There is documentation that explains how bath salts were used to calm those with manic symptoms and also help those who are dealing with depression. Even today, lithium is used as a treatment to bipolar disorder which is significant because lithium could have been an ingredient in the Greek bath salt. Centuries passed and very little was studied or discovered. It wasn't until the mid-19th century that a French psychiatrist by the name of Jean-Pierre Falret wrote an article describing "circular insanity" and this is believed to be the first recorded diagnosis of bipolar disorder. Years later, in the early 1900s, Emil Kraepelin, a German psychiatrist, analyzed the influence of biology on mental disorders, including bipolar disorder. His studies are still used as the basis of classification of mental disorders today.

Bipolar II disorder bipolar disorder that is characterized by at least one hypomanic episode and at least one major depressive episode; with this disorder, depressive episodes are more frequent and more intense than manic episodes

Bipolar II disorder is a bipolar spectrum disorder characterized by at least one episode of hypomania and at least one episode of major depression. Diagnosis for bipolar II disorder requires that the individual must never have experienced a full manic episode, unless caused by an antidepressant. Otherwise, one manic episode meets the criteria for bipolar I disorder.

Grandiose delusions psychopathological condition (that is, when an individual believes that he has exceptional abilities, fame, wealth, or omnipotence)

Grandiose delusions (GD), delusions of grandeur, expansive delusions are a subtype of delusion that occur in patients suffering from a wide range of psychiatric diseases, including two-thirds of patients in manic state of bipolar disorder, half of those with schizophrenia, patients with the grandiose subtype of delusional disorder, and a substantial portion of those with substance abuse disorders. GDs are characterized by fantastical beliefs that one is famous, omnipotent, wealthy, or otherwise very powerful. The delusions are generally fantastic and typically have a religious, science fictional, or supernatural theme. There is a relative lack of research into GD, in contrast to persecutory delusions and auditory hallucinations. About 10% of healthy people experience grandiose thoughts but do not meet full criteria for a diagnosis of GD.

Frederick King Goodwin is an American psychiatrist and Clinical Professor of Psychiatry at the George Washington University Medical Center, where he is also director of the Center on Neuroscience, Medical Progress, and Society. He is a specialist in bipolar disorder and recurrent depression.

Persecutory delusions are a set of delusional conditions in which the affected persons believe they are being persecuted. Specifically, they have been defined as containing two central elements:

  1. The individual thinks that harm is occurring, or is going to occur.
  2. The individual thinks that the perceived persecutor has the intention to cause harm.
Cyclothymia persistent instability of mood that involves recurrent hypomanic and dysthymic episodes, but no full manic episodes or full major depressive episodes

Cyclothymia, also known as cyclothymic disorder, is a mental disorder that involves periods of symptoms of depression and periods of symptoms of hypomania. These symptoms, however, are not sufficient to be a major depressive episode or a hypomanic episode. Symptoms must last for more than one or two years.

The associated features of bipolar disorder are clinical phenomena that often accompany bipolar disorder (BD) but are not part of the diagnostic criteria for the disorder. There are several childhood precursors in children who later receive a diagnosis of bipolar disorder. They may show subtle early traits such as mood abnormalities, full major depressive episodes, and attention-deficit hyperactivity disorder. BD is also accompanied by changes in cognition processes and abilities. This includes reduced attentional and executive capabilities and impaired memory. How the individual processes the world also depends on the phase of the disorder, with differential characteristics between the manic, hypomanic and depressive states. Some studies have found a significant association between bipolar disorder and creativity.

Hypomania mood state characterized by persistent and pervasive elevated or irritable mood

Hypomania is a mood state characterized by persistent disinhibition and mood elevation (euphoria), with behavior that is noticeably different from the person's typical behavior when in a non-depressed state. It may involve irritability, but less severely than full mania. According to DSM-5 criteria, hypomania is distinct from mania in that there is no significant functional impairment; mania, by DSM-5 definition, does include significant functional impairment and may have psychotic features.

Lori L. Altshuler American psychiatrist

Lori Altshuler was a Professor at the University of California, Los Angeles (UCLA) Department of Psychiatry and Biobehavioral Sciences and held the Julia S. Gouw Endowed Chair for Mood Disorders. Dr. Altshuler was the Director of the UCLA Mood Disorders Research Program and the UCLA Women’s Life Center, each being part of the Neuropsychiatric Hospital at UCLA.

Sleep is known to play an important role in the etiology and maintenance of a bipolar disorder. Patients with a bipolar disorder often have for example a less stable and more variable circadian activity. This circadian activity disruption is often also apparent, even if the person concerned isn't currently ill.

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