Demons and muses: Debunking the myth of the mad genius: CrossCurrents Spring 2003

CrossCurrents

"It's a mistake to think because you are mentally ill you will have access to the unconscious more than other people. I deny it. I think it is the artist that has the access. Creativity is the artist at work, not the illness at work."

"There's simply no question in my mind, having treated hundreds of people with bipolar disorder, that there is a link between manic depression and creativity."

These comments, the first by a painter and poet with bipolar disorder, the second by a psychiatrist, reflect the debate over the age-old notion that there is a link between mental illness and creativity. Who among us can't picture an impassioned Vincent Van Gogh, soul on fire, painting his sunflowers? Who doesn't see the artist's pain and isolation trapped on canvas in Edvard Munsch's "The Scream"?

For decades, scientists have known that eminently creative individuals have a higher rate of bipolar disorder than does the general population. Indeed, the list of artists, past and present, diagnosed with bipolar disorder is impressive: Ernest Hemingway, Jackson Pollock, Edvard Munsch, Francis Ford Coppolla. The hypothetical list is even longer, including Michelangelo, Virginia Woolf, Edgar Allen Poe and Hans Christian Andersen.

Today, researchers say they have convincing evidence that bipolar disorder, which features extreme mood swings from mania to depression, is inextricably linked to creativity.

The modern debate began in 1974, when Dr. Nancy Andreasen, currently editor-in-chief of the American Journal of Psychiatry, interviewed a group of writers at the University of Iowa Program in Creative Writing. She tested them against a group of controls and followed the participants for 15 years. Among the writer group, 43 per cent were found to have bipolar disorder, compared with just 10 per cent of controls.

More recently, Johns Hopkins University psychologist Dr. Kay Redfield Jamison studied 47 British artists and found that 38 per cent had sought treatment for mood disorders. (In the United Kingdom, bipolar disorder affects one per cent of the general population.) Jamison, who herself has bipolar disorder, says that with lithium to help her control it, she wouldn't wish her illness away. In fact, she claims it has enriched her life.

Just last year, a Stanford University study found healthy artists to be more similar in personality to individuals with bipolar disorder than to healthy people in the general population.

But critics of the link are unconvinced. "Scientifically, it's simply not true that mental illness is linked to creativity," says Dr. Albert Rothenberg, a psychiatrist at Harvard University. In a 2001 issue of Psychiatric Quarterly, he enumerates various problems with the studies. Andreasen did not have proper control group matches and did all the interviewing herself with no independent evaluations. Jamison used no control group, interviewed only self-selected artists, did not conduct blind interviews and made no attempt at differential diagnosis. And the Stanford data are preliminary.

Beyond bad science, Rothenberg is philosophically opposed to the idea of a connection, claiming it romanticizes a sometimes-crippling disease and doesn't give credit to those whose genius some people simply refuse to accept. "Let's recognize that great literature and great art contain some of the most important experiences and greatest wisdom about life that we can experience," says Rothenberg. "To recognize that, we have to recognize that mental illness is on the other side of the spectrum. It's about suffering, sometimes a lack of wisdom about life. Instead of novelty, it's about the most repetitious and banal types of feelings possible. It's the antithesis of creativity."

It is certainly true that bipolar disorder is anything but sexy. Periods of mania can include severe hallucinations, and the lows can be debilitating. And 10 to 15 per cent of people with bipolar disorder commit suicide, compared with less than one per cent of the general population.

Pascale Reboul, a Toronto artist and poet, wants to debunk the myth of the mad genius. When she is feeling well, Reboul paints colourful, energetic canvases. She also facilitates a poetry group for people dealing with mental illness, encouraging participants to free themselves and their creativity. Reboul was diagnosed with bipolar disorder eight years ago, after suffering for more than 25 years. Calling her medication "the drill," she describes her exhausting daily routine, where she reacts like a pinball to various medications taken for mania, depression, panic attacks and restless leg syndrome, a side-effect of Prozac.

"It's like the military. I start at six in the morning and end at one in the morning. I try to put my painting on a schedule, but it rarely works because of the moods," says Reboul. "I don't know how I'm going to wake up. I say, 'OK, I'm going to paint tomorrow,' but I might wake up really down."

Reboul scoffs at the notion of trying to create during a manic episode. "You're so high you cannot process thoughts. It's very uncomfortable. Thoughts go at such a rapid rate that you cannot put them on paper with brushes or a pen. If I do write, it's automatic writing, a form of writing that sometimes is just a succession of words that make no sense."

Toronto photographer Marko Polakiwsky had his first manic episode in 1983, but his beautiful, serene photographs defy the tempests that can rage in his head for months at a time. His landscapes are restful and idyllic, and his sweet, intimate portraits reveal an artist's sensitive eye. He describes his experiences with mania differently than Reboul.

"When I have a manic episode, my levels of consciousness are way expanded," says Polakiwsky. "It blows my mind, almost literally. The mania enhances my mental ability to comprehend. It's very mystical and a very surreal experience that I can use toward my photography."

Mild manic states may indeed facilitate creativity, but Polakiwsky is careful to point out that without stability and medication, he can't produce anything at all. "That's the Catch-22. Yes, I think that my illness has helped my creativity, but if I'm suffering from a manic or depressive episode, I can't work at all."

This is one place where Rothenberg says scientists have missed the boat, mistaking what may be described as "insight" gleaned from bouts of depression or mania for an intricate cerebral process like creativity. Creativity, he insists, requires a healthy, functioning mind.

What researchers do agree on is that artists who have bipolar disorder need effective psychiatric treatment to restore stability. The challenge is to treat the illness without hindering creativity.

Harvard University psychiatrist Dr. Harrison G. Pope, Jr. says that medications have come a long way since the days when lithium, an effective mood stabilizer but one that can hinder cognition, creativity and productivity, was the only option. "Lithium is still widely prescribed, but the range of medications available is much greater than 10 years ago." Pope says each medication has its own side-effects, but he is excited about breakthroughs made with anticonvulsants like lamotrigine.

Rothenberg says doctors need to be sensitive to the complexities of the creative process to properly treat a creative person who suffers from bipolar disorder. But they must be careful not to overestimate clients who are highly creative or withhold needed interventions for fear of undermining creative work. Rothenberg recalls Ernest Hemingway, who was apparently prematurely discharged from the Mayo Clinic when staff overestimated his judgment and capacities. Shortly afterward, he shot himself.

Too many people refuse treatment altogether, Rothenberg says, for fear of losing their creativity. "Mental illness is not something people very willingly go in to treat, and the notion that it's linked to creativity is a great barrier."

Reboul offers these words of wisdom: "We must remember: mental illness doesn't define one's character."

For more information about Pascale Reboul's poetry group, Wild Mind, contact her at wildmind@attcanada.ca.

Cindy McGlynn

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