Creativity and Bipolar Disorder

An analysis by Nicole Megatulski:

History has always held a place for the "mad genius", the kind who, in a bout of euphoric fervor, rattles off revolutionary ideas, incomprehensible to the general population, yet invaluable to the population's evolution into a better adapted species over time. Is this link between creativity and mental illness one of coincidence, or are the two actually related? If related, does heightened creative behavior alter the brain's neurochemistry such that one becomes more prone to a mental illness like bipolar disorder? Does bipolar disorder cause alterations in neurochemistry in the brain that increase creative behavior through elevated capacity for thought and expression? Is this link the result of some third factor which causes both of the two effects?

Centuries of literature and innumerable studies have supported strong cases relating creativity--particularly in the arts, music and literature--to bipolar disorder. Both creativity and bipolar disorder can be attributed to a genetic predisposition and environmental influences. Biographical studies, diagnostic and psychological studies and family studies provide different aspects for examining this relationship.

A 1949 study of 113 German artists, writers, architects, and composers was one of the first to undertake an extensive, in-depth investigation of both artists and their relatives. Although two-thirds of the 113 artists and writers were "psychically normal," there were more suicides and "insane and neurotic" individuals in the artistic group than could be expected in the general population, with the highest rates of psychiatric abnormality found in poets (50%) and musicians (38%). (1) Many other similar tests revealed this disproportionate occurrence of mental illness, specifically bipolar disorder, in artistic and creative people, including a recent study of individuals over a thirty-year period (1960 to 1990). Overall, when comparing individuals in the creative arts with those in other professions (such as businessmen, scientists, and public officials), the artistic group showed two to three times the rate of psychosis, suicide attempts, mood disorders, and substance abuse. (1)

Another recent study was the first to undertake scientific diagnostic inquiries into the relationship between creativity and psychopathology in living writers. Eighty percent of the study sample met formal diagnostic criteria for a major mood disorder versus thirty percent of the control sample. The statistical difference between these two rates is highly significant, where p<.001. This means that the odds of this difference occurring by chance alone are less than one in a thousand. Of particular interest, almost one-half the creative writers met the diagnostic criteria for full-blown manic-depressive illness. (1) This is not to say that the majority of artists are bipolar but rather that there is a considerably higher incidence in bipolar disorder among artists than among the general population.

Collectively, these studies and numerous others have clinically supported the existence of a link between bipolar disorder and creativity. Now the question applies: Is bipolar disorder the result of above-average creativity or is above-average creativity the result of bipolar disorder or are the two a result of some third factor which causes the two effects? From the sources I have encountered, I believe a stronger case is made for the latter, although it is impossible to scientifically or psychologically answer that question at this time.

Predisposition to bipolar disorder is genetically inherited and current studies suggest the same for predisposition to creativity but is there a common genetic factor, which determines the expression of both traits? If there were, neither creativity nor bipolar disorder would implicitly cause the other. A recent study hypothesized that a genetic vulnerability to manic-depressive illness would be accompanied by a predisposition to creativity, which, according to the investigators, might be more prominent among close relatives of manic-depressive patients than among the patients themselves. Significantly higher combined scores from a creativity assessment test were observed among the manic-depressive patients and their normal first-degree relatives than among the control subjects, suggesting a possible genetic link between the two characteristics, as both are prevalent in families with a history of bipolar disorder and not as evident in control families. (1) A wide variety of artistic and creative talents, ranging from music to art to mathematics, were exhibited among the family members of the bipolar patients as well. The varied manifestations of creativity within the same family suggest that whatever is transmitted within families is a general factor that predisposes them to a creative mentality, rather than a specific giftedness in a single area. The coexistence of creativity accompanied by manic depression, whether expressed in bipolar patients or not expressed in their predisposed family members, suggests that a third factor, yet unidentified, may be orchestrating the expression of the two.

Assuming both creativity and bipolar disorder, or at least predisposition to the illness, are expressed simultaneously, what accounts for heightened creativity in people upon onset of bipolar disorder? A deficit in normal information-processing could be manifested in a severe behavioral disorder, but it could also favor creative associations between information units or a propensity toward innovation and originality. (2) The altered neurological structure and functioning in the frontal lobe, prefrontal cortex, hippocampus, hypothalamus and cerebellum associated with bipolar disorder may also allow for more creative thought.

People with bipolar mood disorders tend to be more emotionally reactive, which gives them greater sensitivity and acuteness. This, coupled with a lack of inhibition due to compromised frontal lobe processes, permits them unrestrained and unconventional forms of expressions, less limited by accepted norms and customs. They are more open to experimentation and risk-taking behavior, and, as a consequence, more assertive and resourceful than the mean. (2) (3) Characteristics of the bipolar disorder, such as lowered inhibition, allow for freer expression of previously contained ideas and the constant flux between manic and depressive states also gives an unusual kaleidoscopic perspective of the world. All of these factors can account for increased creativity once the illness erupts. (5)