ABSTRACT | PDF
Faculty Forum II
Relationship between creativity and mood disorders
Prosenjit Ghosh
Registrar of Psychiatry
Silchar Medical College and Hospital
Anecdotally, there are many examples of striking associations between creativity and mood disorders, and particularly bipolar disorder. For example, Vincent Van Gogh suffered from mood disorder during much of his adult life, prior to committing suicide at age 37. Martin Luther suffered periods of intense despair, but also periods of extremely high energy. After his Ninety-five these unexpectedly launched the Reformation, he devoted enormous energy to writing theological tracts to defend his position. There are many other well-known creative people who suffered from mood disorders, many of them bipolar: Ernest Hemingway, Winston Churchill, and Theodore Roosevelt, to mention only a few.
Anecdotal accounts of the lives of creative people are fascinating, however, the real test of whether there is any association between Mood disorders and Creativity can only be determined by rigorous empirical research. Such studies are rare, as research on creativity presents a variety of challenges.
Challenges in studying creativity
One of the greatest challenges faced by the researchers is defining the sample to be studied. The use of the term “creativity” to refer to individuals who make creative contribution is relatively modern. Until recently creativity was thought to be equivalent to having high intelligence. But the landmark study of Lewis Terman, “Genetic Study of Genius”, where the researchers followed a group of high-intelligence quotient (IQ) individuals into adulthood and found that, although the subjects were generally more successful than average but very few made significant creative contribution, thereby documenting that having a high IQ is a different mental trait than being creative. This suggests that a better definition of creativity is of paramount importance in identifying the appropriate sample. Various researchers have put forward different perspectives on defining creativity.
Gardner: He argues that there are multiple types of creativity; people can make creative contribution in various fields such as – Art, Engineering, Biology, Mathematics and Music etc.
Csikszentmihalyi: He stresses the importance of making original contributions and of being recognised for these contributions by one's peers.
Although there are some differences between those currently pursuing researches on creativity, a definition that would embrace is one that emphasises that creativity is the ability to produce something that is novel and also useful or beautiful in a very general use.
Given this definition of creativity, how then should an investigator identify a sample to study? One approach is to select a very homogenous group of creative people, such as group of writers, or musicians, or mathematicians. Another approach is to sample more broadly and to study a mixture of creative individuals from multiple disciplines.
An alternative approach is to identify a group of people for whom written histories are available and to use this information as the basis for study. Examples of this type of approach are the studies of Ellis, Juda, Post, Ludwig, and Schildkraut. But the major problem with this approach is that the historical, biographical and autobiographical material may not be complete or accurate.
In studying the relationship between creativity and psychopathology, several other challenges must also be met. First is to use a standard and widely accepted set of definitions of mental illness, and to assess its presence or absence using a structured interview of some type. A second challenge is to identify an appropriate comparison or control group, in order to determine whether rates of any given illness in the creative people are different from rates in a “normal” comparison group. Selecting the comparison group is also a challenge. Should one select a profession not notable for nurturing creativity, such as lawyers? Should one select a varied group of people not known to be creative, who are equivalent in age, gender, and educational level to the creative group? There is no easy answer, but the latter alternative is probably preferable, since it averages out whatever bias might exist if a single field or profession were chosen.
Is there an association between mood disorders and creativity?
The earliest study to examine the relationship between creativity and mental illness was conducted by using thirty Writers from Iowa Writers’ Workshop and thirty control subjects of equivalent age, gender and educational achievement. Diagnoses were made using the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria. Rates of mood disorders were extremely high in writers: 80% had some type of mood disorders and 43% had bipolar disorder, whereas only 30% of control subjects had any mood disorder. The writer (30%) also had higher rates of alcohol abuse than controls (7%). In 1989 Jamison reported high rate (63%) of treatment for mood disorder among British writers and artists. In this study subjects were classified as having mood disorder based on whether they received treatment for mood disorder .This study did not include a control group.
A subsequent study by Ludwig in 1994, where 59 women writers and 59 age and educationally matched controls from members of several different women clubs within the state. Evaluations included a screening questionnaire to find out presence of psychiatric syndromes and a personal interview based on the revised DSM-III (DSM-III-R). The two groups differed significantly in rates of a variety of diagnoses – depression, mania, panic attacks, generalized anxiety, and drug abuse. Rates of depression (56%) and mania (19%) were relatively very high.
These three studies are the primary ones to investigate rates of mood disorders in creative individuals using personal interviews of the subjects and a diagnosis that reflects modern concepts of depression and bipolar disorder. Thus it seems likely that creative individuals do have higher rates of mood disorder in general and bipolar disorder in particular. An obvious limitation of the work to date, however, is that it has focused primarily writers.
Psychiatric treatment of creative individuals suffering from bipolar disorder
Given that there appears to be a clear association between creativity and mood disorder, what are the implications for the clinician who is caring for a creative individual who suffers from mania or depression? Specifically how does the treatment affect an individual’s creativity? Some feel that the high energy level and euphoria associated with mania or hypomania states enhance creativity and may be reluctant to have their euphoria blunted by psychotropic medications. There are also many examples indicating that creative individuals who have suffered from mood disorders find them to be disruptive and counterproductive. Mogens Schou studied a group of 24 artists by using measures of productivity and quality of work; he found that the suffering from severe bipolar illness (50%) showed great improvement in creativity. Overall these results suggest that adequate and appropriate treatment is likely to be helpful for majority of creative people suffering from bipolar disorder.
Summary
There appears to be a strong association between creativity and mood disorders. However, the overall literature supporting this link is relatively weak. A great deal of the work reported so far suffers from inadequate definition of both creativity and mood disorders, reliance on autobiography, and lack of a control group. The study of the relationship between creativity and mood disorder is still an open territory, with much remaining to be done.
References:
1. The relationship between creativity and mood disorder, Nancy C. Andreasen; Dialogues in clinical neuroscience, 2009, 10: 251-255.
2. Genetic studies of Genius, Terman L, Cox C; Stanford University Press, 1925 – 1959.
3. Intelligence reframed: Multiple intelligence of twenty-first century, H. Gardener; Basic Books 1999.
4. Creativity: Flow and the psychology of Discovery and invention, M Csikzentmihalyi; Harper Collins 1996.
5. The relationship between high mental capacity and psychic abnormalities, A Juda; American Journal of Psychiatry, 1949, 106:296-307.
6. A study of British Genius, H A Ellis; Houghton-Mifflin,1926.
7. The Creative Writer: Psychiatric Symptoms and Family History, N C Andreasen; Comp. Psychiatry,1974,15:123-131.
8. Creativity and Mental Illness: Prevalence Rate in Writers and their First Degree Relatives, N C Andreasen, Am. J. Psych,1987,144:1288-1292.
9. Mood disorders and Patterns of Creativity in British Writers and Artists, K R Jamison, Psychiatry, 1989,52:125-134.
10. Mental Illness and Creative activity in female writers, A M Ludwig, Am. J. Psych, 1994, 151: 1650-1656.
11. Artistic Productivity and Lithium Prophylaxis in Manic-Depressive Illness, M Schou, Br. J. Psych., 1979, 135: 56-65.
12. Bipolar Affective Disorder and Creativity: Implications and Clinical Management, N C Andreasen, Comp. Psychiatry, 1988, 29: 207-217.
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