Bipolar illness, creativity, and treatment

Self-perceived relations between artistic creativity and mental illness: a study into lived experiences

Aim

To explore the self-perceived relationships between experiences of creativity and mental illness and to understand the meanings behind these relationships.

Background

The idea that mental illness and artistic creativity are somehow related dates back to ancient times. There is some evidence for an actual correlation, but many questions remain unanswered on the nature and direction of the relationship. Qualitative contributions to the debate are scarce, and mainly focus on the potential benefits of participation in the arts for people with mental illness.

Design

An explorative, interpretive study.

Methods

Twenty-four professional and semi-professional artists with self-reported experience with mental illness, were recruited purposively. Unstructured in-depth interviews were conducted and transcripts were subjected to interpretive analysis, guided by a hermeneutic phenomenological frame.

Results

Participants experience a range of interactions between artistic creativity and mental illness. Three constitutive patterns describe what these interactions look like: "flow as a powerful force"; "ambiguous self-manifestation"; and "narrating experiences of suffering."

Conclusion

The findings show that both the concept of creativity and the concept of mental illness, as well as their interrelationships, are layered and complex phenomena that can take on different meanings in people's lives. The findings provide starting points for further research that goes beyond the polarized academic debate. Understanding the experiences of artists with mental illness can help shape the role of art in public mental health and mental health care.

A shared novelty-seeking basis for creativity and curiosity

Curiosity and creativity are central pillars of human growth and invention. Although they have been studied extensively in isolation, the relationship between them has not yet been established. We propose that both curiosity and creativity emanate from the same mechanism of novelty seeking. We first present a synthesis showing that curiosity and creativity are affected similarly by a number of key cognitive faculties such as memory, cognitive control, attention, and reward. We then review empirical evidence from neuroscience research, indicating that the same brain regions are involved in both curiosity and creativity, focusing on the interplay between three major brain networks: the default mode network, the salience network, and the executive control network. After substantiating the link between curiosity and creativity, we propose a novelty-seeking model (NSM) that underlies them and suggests that the manifestation of the NSM is governed by one's state of mind.

The Relationship Between Creativity and Intrusive Rumination Among Chinese Teenagers During the COVID-19 Pandemic: Emotional Resilience as a Moderator

Coronavirus disease 2019 (COVID-19) has not only resulted in immeasurable life and property losses worldwide but has also impacted individuals' development, especially teenagers. After the COVID-19 pandemic, individual rumination as an important cognitive process should be given more attention because of its close associations with physical and mental health. Previous studies have shown that creativity as an antecedent variable can predict people's mental health or adaptation. However, few studies have focused on the relationship between creativity and individual cognitive rumination after traumatic events, and the mechanism underlying this relationship remains unclear. By using the Runco Ideational Behavior Scale (RIBS), the Event Related Rumination Inventory, and the Questionnaire of Adolescent Emotional Resilience, the current study explored the relationship between creativity and intrusive rumination among 1488 Chinese teenagers during the COVID-19 pandemic and analyzed the moderating effect of emotional resilience on the relationship. The results showed that creativity, as assessed by the RIBS, was positively related to teenagers' intrusive rumination, which implied that a higher level of creative performance could predict more intrusive rumination. Moreover, emotional resilience acted as a moderator in the relationship between creativity and intrusive rumination; the correlation was stronger when emotional resilience was low. These findings provide more evidence of the relationship between creativity and mental health and show the effect of this traumatic event on teenagers.

Creativity and psychopathology: Two sides of the same coin?

The Mad Genius is a recurring stereotype of contemporary cultural expression, and many famous personalities and creators have suffered from psychopathology. Creativity and genius may be a sought-after trait; however, it is also commonly believed to be associated with psychopathology. This has been examined, starting with Lombroso's investigation of genius and madness in 1800s followed by a dearth of literature debating the association between the two. This evidence for this polarizing issue ranges from psychometric to neuroscientific disciplines and creates ambiguity neither refuting nor accepting this association completely. Through this article, we briefly review the literature on this subject and try to decipher what is written in between the lines, how creativity and psychopathology may fuel each other, and what may be its clinical implications.

Creativity and Mood Disorder: A Systematic Review and Meta-Analysis

Although the belief that creativity is related to psychopathology is prevalent, empirical evidence is limited. Research findings relating to mood disorder in particular are mixed, possibly as a result of differing research approaches (e.g., assessing the creativity of individuals with versus without mood disorder opposed to the prevalence of mood disorder in creative versus noncreative individuals). Therefore, a systematic review and meta-analysis were conducted to investigate prior research examining the link between mood disorder and creativity from three distinct research approaches. Multilevel random effects models were used to calculate the overall effect size for studies that assessed (a) creativity in a clinical versus nonclinical sample ( k = 13), (b) mood disorder in a creative versus noncreative sample ( k = 10), and (c) the correlation between dimensional measures of creativity and mood disorder symptoms ( k = 15). Potential moderators were examined using meta-regression and subgroup analyses, as significant heterogeneity was detected among the effects in all three analyses. Results reveal a differential strength and pattern of effects across the three analyses, suggesting that the relationship between creativity and mood disorder differs according to the research approach. The theoretical implications of results and potential mechanisms responsible for the relationship between creativity and mood disorder are discussed.

Creativity and Bipolar Disorder: Igniting a Dialogue

Bipolar disorder (BD) has been related to heightened creativity, yet core questions remain unaddressed about this association. We used qualitative methods to investigate how highly creative individuals with BD understand the role of symptoms and treatment in their creativity, and possible mechanisms underpinning this link. Twenty-two individuals self-identified as highly creative and living with BD took part in focus groups and completed quantitative measures of symptoms, quality of life (QoL), and creativity. Using thematic analysis, five themes emerged: the pros and cons of mania for creativity, benefits of altered thinking, the relationship between creativity and medication, creativity as central to one's identity, and creativity's importance in stigma reduction and treatment. Despite reliance on a small sample who self-identified as having BD, findings shed light on previously mixed results regarding the influence of mania and treatment and suggest new directions for the study of mechanisms driving the creative advantage in BD.

Self-reported creativity in bipolar disorder: prevalence, types and associated outcomes in mania versus hypomania

BACKGROUND

Bipolar (BP) disorder has been linked to creativity following investigation of prominent artists and controlled trials of creativity in BP disorder patients. However, it is unclear whether creativity is differentially expressed across the BP I and BP II subtypes.

METHODS

219 patients (aged 19-63 years) diagnosed with BP disorder by clinical interview and DSM-IV criteria were asked whether they tended to be more creative during hypo/manic episodes, and answered five questions about personality styles associated with creativity. Qualitative analyses were performed on a smaller subset of 69 BP patients (n=19 BP I, n=50 BP II) who provided written responses of the types of creative activities engaged in when hypo/manic and any perceived advantages or disadvantages of their creative pursuits.

RESULTS

82% of BP patients affirmed being creative when hypo/manic, with comparable results for the BP I and BP II subtypes (84% and 81% respectively). Both BP subtypes engaged mostly in writing, painting, work or business ideas and 'other' forms of art; however BP II patients were more likely to draw and be musical. Both subgroups reported the consequences of feeling good, being productive or quitting their project. BP I patients were more likely to overspend during their creative highs while BP II patients were more likely to experience improved focus and clarity. BP patients affirming creative highs were significantly more likely to report creative personality styles more generally outside of a mood episode.

LIMITATIONS

BP patients' self-reported creative activities were not retrospectively judged for quality or originality and so may reflect common creative abilities rather than exceptional quality. The impact of depressive episodes on creativity was not assessed. Uneven sample sizes in the BP I and BP II subgroups may have compromised statistical power.

CONCLUSION

Creativity during hypo/manic episodes was extremely common in both BP subtypes. While some nuances in activity type and outcomes were observed, no significant creative phenotype specific to BP I or BP II disorder emerged.

Positive Affect Enhances the Association of Hypomanic Personality and Cognitive Flexibility

Several lines of research have suggested a link between mania and creativity, The goal of the present study was to test whether positive affect moderated the relationship between risk for mania (assessed with the Hypomanic Personality Scale [HPS]) and a variable postulated to be a cognitive component of creativity: cognitive flexibility. Fifty-three undergraduate students were randomly assigned to either a neutral or positive mood induction condition. They then completed the Delis-Kaplan Executive Function System (DKEFS) Sorting Test as a measure of cognitive flexibility. Consistent with our hypothesis, higher HPS scores were associated with greater cognitive flexibility among participants in the positive mood induction condition. Covariate analyses revealed that results were not confounded by verbal intelligence or the presence of current depression symptoms. Our findings suggest a mood-dependent link between hypomanic personality and one potential component of creative cognition.

[Creativity and Character Traits of University Students: Transversal Association Study]

INTRODUCTION

This study was carried out to assess the relationship between character traits and creativity in a sample of students from a public university in Bogotá.

METHODOLOGY

A random sample of 157 students from the Universidad Nacional de Colombia. The two instruments used for measuring character traits and creativity were the International Personality Disorder Examination (IPDE) and the Abbreviated Torrance Test for Adults (ATTA). Additional information about gender, psychopathological antecedents, current academic period and academic average have been recorded. Robust regression methods have been used to analyze the relationship between creativity and character traits.

RESULTS

Creativity and narcissistic traits were associated. In a multivariate model, other variables showing a relationship with creativity were found, i.e., male gender, mental illness family antecedents, number of academic periods completed, and a high academic average.

CONCLUSIONS

Relationship between creativity and narcissistic traits had not been reported in previous. Longitudinal studies using more accurate scales should be undertaken to determine the validity of these findings.

Creativity and executive function across manic, mixed and depressive episodes in bipolar I disorder

INTRODUCTION

Creativity is a complex construct involving affective and cognitive components. Bipolar Disorder (BD) has been associated with creativity and is characterized by a wide range of affective and cognitive symptoms. Although studies of creativity in BD have tended to focus on creativity as a trait variable in medicated euthymic patients, it probably fluctuates during symptomatic states of BD. Since creativity is known to involve key affective and cognitive components, it is plausible to speculate that cognitive deficits and symptoms present in symptomatic BD could interfere with creativity.

MATERIAL AND METHODS

Sixty-seven BD type I patients medication free, age 18-35 years and experiencing a maniac, mixed, or depressive episodes, were assessed for creativity, executive functioning, and intelligence.

RESULTS

Manic and mixed state patients had higher creativity scores than depressive individuals. Creativity was influenced by executive function measures only in manic patients. Intelligence did not influence creativity for any of the mood episode types.

CONCLUSION

We propose that creativity in BD might be linked to the putative hyperdopaminergic state of mania and be dependent on intact executive function. Future studies should further explore the role of dopaminergic mechanisms in creativity in BD.

Creativity and bipolar disorder: touched by fire or burning with questions?

Substantial literature has linked bipolar disorder with creative accomplishment. Much of the thinking in this area has been inspired by biographical accounts of poets, musicians, and other highly accomplished groups, which frequently document signs of bipolar disorder in these samples. A smaller literature has examined quantitative measures of creativity among people with bipolar disorder or at risk for the disorder. In this paper, we provide a critical review of such evidence. We then consider putative mechanisms related to the link of bipolar disorder with creativity, by drawing on literature outside of bipolar disorder on personality, motivational, and affective predictors of creativity. Because so little research has directly evaluated whether these factors could help explain the elevations of creativity in bipolar disorder, we conclude with an agenda for future research on the theoretically and clinically compelling topic of creativity in bipolar disorder.

Positive aspects of mental illness: a review in bipolar disorder

INTRODUCTION

There is growing interest to understand the role of positive psychological features on the outcomes of medical illnesses. Unfortunately this topic is less studied in relation to mental health, and almost completely neglected in relation to one of the most common severe psychiatric illnesses, bipolar disorder. Certain specific psychological characteristics, that are generally viewed as valuable and beneficial morally or socially, may grow out of the experience of having this affective disorder.

OBJECTIVE

We describe the sources, research and impact of these positive psychological traits in the lives of persons with bipolar disorder based on the few published literature available to date. These include, but are not limited to: spirituality, empathy, creativity, realism, and resilience.

METHODS

After an extensive search in the literature, we found 81 articles that involve descriptions of positive psychological characteristics of bipolar disorder.

RESULTS

We found evidence for enhancement of the five above positive psychological traits in persons with bipolar disorder.

CONCLUSIONS

Bipolar disorder is associated with the positive psychological traits of spirituality, empathy, creativity, realism, and resilience. Clinical and research attention to preserving and enhancing these traits may improve outcomes in bipolar disorder.

The clinical significance of creativity in bipolar disorder

Clinical implications of the high rates of creativity within bipolar disorder (BD) have not been explored. The aim of this review is to outline these implications by (i) reviewing evidence for the link between creativity and BD, (ii) developing a provisional model of mechanisms underpinning the creativity-BD link, (iii) describing unique challenges faced by creative-BD populations, and (iv) systematically considering evidence-based psychosocial treatments in the light of this review. While more research into the creativity-BD nexus is urgently required, treatment outcomes will benefit from consideration of this commonly occurring phenotype.

Family background and genius II: Nobel laureates in science

OBJECTIVE

In a previous study of literary creative achievement, we presented evidence refuting the still-influential statistical studies of Frances Galton on the inheritance of genius and also described a family background constellation of creativity. This study aims to assess empirically the hereditary transmission hypothesis with respect to creative achievement in the natural sciences.

METHODS

Family background data were collected on 435 of all 488 Nobel laureates in chemistry, physics, and medicine and physiology, from 1901 through 2003. These were compared with a matching group of 548 eminent nonscientists for incidence of occupational inheritance (that is, same parent-offspring occupations) and with 560 high-IQ nonprizewinners for predominant type of occupation.

RESULTS

The incidence of one or both parents having the same occupation was only 2% for science Nobel laureates but 20% for eminent nonscientists (P < 0.001). The predominant family background constellation (63%) for science Nobel laureates consisted of the same-sex parent either having a performance-equivalent occupation involving applied science, technology, or a natural-world focus and skills (P < 0.001, compared with the matching group) or having an unrelated occupation with unfulfilled scientific interests and wishes for creative expression.

CONCLUSIONS

Nobel laureates in the natural sciences do not manifest direct inheritance of creativity from their parents; instead, congruent-sex parents are predominantly in applied or performance-equivalent occupations, with unfulfilled creative and scientific wishes. Early developmental influences on motivation involving identification and competition with the congruent-sex parent are suggested.

The cognitive neuroscience of creativity

This article outlines a framework of creativity based on functional neuroanatomy. Recent advances in the field of cognitive neuroscience have identified distinct brain circuits that are involved in specific higher brain functions. To date, these findings have not been applied to research on creativity. It is proposed that there are four basic types of creative insights, each mediated by a distinctive neural circuit. By definition, creative insights occur in consciousness. Given the view that the working memory buffer of the prefrontal cortex holds the content of consciousness, each of the four distinctive neural loops terminates there. When creativity is the result of deliberate control, as opposed to spontaneous generation, the prefrontal cortex also instigates the creative process. Both processing modes, deliberate and spontaneous, can guide neural computation in structures that contribute emotional content and in structures that provide cognitive analysis, yielding the four basic types of creativity. Supportive evidence from psychological, cognitive, and neuroscientific studies is presented and integrated in this article. The new theoretical framework systematizes the interaction between knowledge and creative thinking, and how the nature of this relationship changes as a function of domain and age. Implications for the arts and sciences are briefly discussed.

Family background and genius

OBJECTIVE

It is widely believed among professionals and laity that genius is born and not made. However, the early and still-influential statistical studies of Frances Galton on the inheritance of genius have neither been supported nor definitively refuted. This study empirically assesses the hereditary transmission hypothesis.

METHODS

We collected family background data on 50 Nobel Prize laureates in literature, 31 Booker Prize awardees, 135 Pulitzer Prize winners, and 20 National Book and National Book Critics Circle awardees. We compared these for incidence of occupational inheritance (that is, same parent-child occupations) with a matching group of 392 eminent persons in noncreative occupations; for predominant occupation type, we also compared subject data with data for 560 high-IQ nonprizewinners, as well as with general population occupational data.

RESULTS

Incidence of one or both parents in the same occupation was only 1% for literary prizewinners but 16% for eminent noncreative persons (P < 0.0001). The predominant (76%) family background constellation for prizewinners consisted of parent-child sex congruency either in applied-equivalent occupations requiring language, persuasion, or artisan skills (P < 0.0001, compared with control subjects) or in unrelated occupations with unfulfilled wishes for creative expression.

CONCLUSIONS

Outstanding literary prizewinners do not manifest direct inheritance of creativity from their parents; instead, parents and children of the same sex are predominantly in applied-equivalent or performance occupations and have unfulfilled creative wishes. We suggest that early developmental influences on child motivation involve identification and competition with the parent of the same sex.