Bipolar Creativity: The Evidence and the Gaps

Dr. Sheri JohnsonProfessor, Department of Psychology

Director of the Cal Mania (Calm) program,University of California Berkeley

Dr. Erin MichalakAssociate Professor, Department of Psychiatry

University of British ColumbiaNetwork Lead, CREST.BD

Debbie Ann SmithSean Costello Memorial Fund

for Bipolar Research

Objectives

1. Review prior research on the relationship between creativity and bipolar disorder

2. Share results from two new studies exploring creativity and BD

twitter.com/CREST_BD - @CREST_BD twitter.com/erin_michalak - @erin_michalak twitter.com/seansfund - @seansfund

facebook.com/CRESTBDBipolarResearch facebook.com/seancostellomemorialfund

Mission:The purpose of The Sean Costello Memorial Fund for Bipolar Research is to apply Sean’s celebrity and music to address the connection between creativity and bipolar disorder in three ways: Research, Advocacy and Reduction of Stigma.

Longstanding recognition of possible relationship between heightened creativity and bipolar disorder….

• Hans Christian Andersen• Honore de Balzac• William Faulkner (H)• F. Scott Fitzgerald (H)• Graham Greene• Ernest Hemingway (H, S)• Hermann Hesse (H, SA)• Henrik Ibsen• Henry James• William James• Samuel Clemens (Mark

Twain)• Joseph Conrad (SA)• Charles Dickens

• Isak Dinesen (SA)• Ralph Waldo Emerson• Robert Lowell (H)• Herman Melville• Eugene O'Neill (H, SA)• Francis Parkman• John Ruskin (H)• Mary Shelley• Robert Louis Stevenson• August Strindberg• Leo Tolstoy• Tennessee Williams (H)• Virginia Woolf (H, S)• Emile Zola

Authors believed to have manic episodes (from Jamison, 1993)

Authors believed to have mood disorders• William Blake• George Gordon, Lord Byron• Harley Coleridge• Samuel Taylor Coleridge• Emily Dickinson • T.S. Eliot (H)• Victor Hugo• Samuel Johnson• John Keats• Edna St. Vincent Millay (H)• Sylvia Plath (H, S)• Edgar Allan Poe (SA)• Ezra Pound (H)• Laura Riding (SA)• Theodore Roethke (H)

• Percy Bysshe Shelley (SA)• Alfred Lord Tennyson• Walt Whitman

Musicians and composers believed to have manic episodes

• Anton Arensky• Hector Berlioz (SA)• George Frederic Handel• Gustav Holst

• Charles Ives• Gustav Mahler• Modest Mussorgsky• Sergey Rachmaninoff• Robert Schumann (H, SA)• Peter Tchaikovsky• Irving Berlin (H)• Noel Coward• Charles Mingus (H)• Charles Parker (H, SA)• Cole Porter (H)• Kurt Cobain, musician

(Nirvana) (S)

Artists believed to have bipolar disorder

• Paul Gauguin (SA)• Vincent van Gogh (H, S) • Arshile Gorky (S)• Edvard Munch (H)• Georgia O'Keeffe (H)• Jackson Pollock (H)• Mark Rothko (S)

Many famousartists have bipolardisorder.

Conclusion 1:

Does the pattern hold

up in research?

Creativity

Bipolar Disorder

Bipolar disorder

Diagnosis

Minor symptoms of mania(Not at a diagnostic level)

Family history

Creativity

Creative accomplishment

and fame

Engagement in creative occupation

Creative thought: divergent

thinking

Study Sample Rates of maniaLudwig, 1992 1005 recognized artists,

writers, actors8.2% had some history of mania, compared to 2.8% of non-artists

Wills, 2003 40 famous Jazz Bepop musicians

28.5% some form of mood disorder

Czeizel, 2001 Famous Hungarian poets

67.5% had some form of bipolar disorder

Jamison, 1989 47 British 18th century writers

26% elated moods, 6.5% treated for mania

Juda, 1994 113 highly creative artists

No diagnosable bipolar disorder, but 22% of offspring had bipolar spectrum traits

Biographical studies of famous artists

Problem: biographies may be biased…

Highly prestigious writers’ workshop

43% met criteria for some form of mania:• 30% bipolar II disorder• 13% bipolar I disorder

Iowa Writers Workshop (Andreasen)

Problem: Fame might relate to strengths other than creativity.

Bipolar disorder relates to creative fame

Akiskal (2005) Artists and those in non-artistic occupations

43% of artists endorsed cyclothymic traits, compared to about 10% of controls

Colvin (1995) 40 conservatory students; 40 students in non-creative areas

GBI mania and cyclothymia scores were higher among the conservatory students

Studies of artistic samples

What about samples that aren’t famous or eminent?

DOES THIS HOLD UP IN THE GENERAL POPULATION?

Aims: Is creativity tied to psychopathologyamong family members?

Methods:• Swedish population registries of

mental health treatment and occupation

• 54,042 people with schizophrenia 29,644 with bipolar disorder

• 217,771 with unipolar depression• Family members of the patients

Creativity and mental disorder: family study of 300,000 people with severe mental disorder

Findings:• Individuals with bipolar disorder and healthy siblings of people with

schizophrenia or bipolar disorder overrepresented in creative professions

• People with schizophrenia had no increased rate of overall creative professions compared with controls

• Neither individuals with unipolar depression nor their siblings differed from controls regarding creative professions

Creativity and mental disorder: family study of 300,000 people with severe mental disorder

Creativity and mental disorder: family study of 300,000 people with severe mental disorder

schizophrenia

Bipolar disorder

Unipolar depression

Aims: (1) Consider family and personal history(2) Distinguish being an author versus

other creative occupationsMethod:• In Sweden, extensive records

available for personal and family mental health treatment.

• 1,173,763 Swedish adults

Mental illness, suicide and creativity: 40-Year prospective total population study

Personal History:Authors had higher rates of schizophrenia, bipolar disorder, unipolar depression, anxiety disorders, substance abuse, and suicide than did those in non-creative professions.

Bipolar disorder, but not other disorders, related to greater likelihood of being in other creative occupations.

Family History:• First-degree family members of patients with schizophrenia, bipolar

disorder, anorexia nervosa were more likely to be in creative occupations.

Mental illness, suicide and creativity: 40-Year prospective total population study

Mental illness, suicide and creativity: 40-Year prospective total population study

Kyaga,S. , Landén, M., Boman, M., Hultman, C., Långström, N., Lichtenstein, P. (2013). Mental illness, suicide and creativity: 40-Year prospective total population study. Journal of Psychiatric Research, 47(1), 83-90. http://dx.doi.org/10.1016/j.jpsychires.2012.09.010.

Among people in creative occupations, bipolar disorder and family history of bipolar disorder are more common.

This may be unique to bipolar disorder.

Conclusion 2:

Even if artists have a higher likelihood of bipolar qualities, many with bipolar disorder might not be creative.

Among those with bipolar disorder, how many are creative?

A different sampling approach

Tremblay et al. (2010) 13,700 participants in the ECA study (84 with DSM-IIIR diagnosis of bipolar I disorder)

Creativity ratings of occupations were higher among those with bipolar disorder (4.54) than those without bipolar disorder (3.07)

Among those with bipolar disorder, how common is it to be an artist?

Bipolar disorder relates to creative occupations

Problem: People might choose occupations that allow for less structure or fit their personality.But are people really more creative? What about the level of creative accomplishment?

Lifetime accomplishment (Richards et al, 1988)

Creative accomplishment is enhanced among those with milder forms of bipolar disorder,but not among those with severe forms.

Carrie McGrath

Conclusion 3:

Study Sample Findings

Furnham et al. (1988) Students at risk for mania +

Schuldberg, 2001 Students at risk for mania +

Shapiro & Weisberg, 1999 Students at risk for mania +

Frantom et al., 1999 Risk for mania among graduate students and faculty studying art

No effect

Frantom et al., 1999, second analysis

Family history of mania +

Santosa et al., 2007 People diagnosed with bipolar disorder

No effect

Self-Ratings of Creativity

Those with milder forms of bipolar disorder see themselves as creative.

Conclusion 4:

Creativity paradigm Bipolar I disorder

Bipolar spectrum

Family members

Risk for mania

Biographical studies of eminence

+ + +

Interview studies of famous creative persons

+ + +

Occupational choice + + + + Creative accomplishment - + + Self-rated creativity - +

Creative persons?

People with bipolar disorder are to be likely to be creative.Particularly true for milder and at-risk variants.

What advantages of bipolar disorder fuel creativity?

Study Sample Findings Score Card

Furnham et al., 2008

Students at risk for mania

Higher scores on the Unusual Uses Test

+

Santosa et al., 2007

Adults diagnosed with bipolar disorder

No differences from controls on the Torrance verbal or nonverbal creativity subtests

-

Johnson et al. (2015)

Adults diagnosed with bipolar I disorder

No advantages on standard measures of divergent thinking

-

Measures of Divergent Thinking

Creative (divergent) thinking is observed in those at risk for the disorder, but not within bipolar I disorder– at least without considering mood.

Conclusion:

• In interviews with eminent artists and in undergraduates who varied in creativity and manic risk• enthusiasm, energy, and less need for sleep related

to level of creativity • other symptoms did not

• Jamison (1989)• Shapiro & Weisberg (1999)

Could mild mood changes be more beneficial?

Aims: (1) To evaluate whether ambition is

related to creativity among those with bipolar spectrum conditions.

Methods:• Examined correlations between a

validated self-report measure of ambition (the WASSUP) and creativity.

• Study 1: Individuals with BD who self-identified as highly creative (n=22) completed the WASSUP and a measure of lifetime creative accomplishment.

• Study 2: Undergraduates (n=221) completed the WASSUP, a measure of mania risk and a measure designed to assess creativity in business projects and tasks.

Creativity and ambition

Findings:Study 1 (artistic bipolar sample):• Ambition (WASSUP scores) was high in bipolar disorder.• Ambition was correlated with lifetime creative accomplishment.Study 2 (undergraduates, correlations within mania risk and creativity):

Mania risk was related to greater ambition and creativity Ambition was also directly related to greater creativity.

Conclusion:• Ambition could be one important part of creative success across the bipolar spectrum.

Johnson , S., Murray, G., Hou, S., Staudenmaier, P., Freeman, M., Michalak, E., CREST.BD. (2015). Creativity is linked to ambition across the bipolar spectrum. Journal of Affective Disorders, 178, 160-164. doi: 10.1016/j.jad.2015.02.02

Creativity and ambition

Aim:

Investigate how highly creative individuals with BD understand role of symptoms and treatment in their creativity, and possible mechanisms underpinning this link

Creativity and Bipolar Disorder: Igniting a Dialogue

Methods

22 participants, 50% BD type I, 50% BD type II/NOS, mean age 42.7 years, 17 women, 5 men

Quantitative data collected

Divided into four focus groups, 1.5 hours

Tape recorded, thematic analysis

How does BD enhance/add to creativity? Do different mood states have different impacts on your creativity? How does creativity relate to treatment? Do BD medications help or hinder creativity? Are there ways of tailoring treatments for BD that could help you express your creativity?

Results

Five themes identified:

1. Pros and cons of mania for creativity2. Benefits of altered thinking3. Relationship between creativity and medication4. Creativity as central to one's identity5. Creativity's importance in stigma reduction and treatment

Johnson , S., Moezpoor, M., Murray, G., Hole, R., Barnes, S., CREST.BD, Michalak, E. (2015). Creativity and bipolar disorder: Igniting a dialogue. Qualitative Health Research. DOI: 10.1177/1049732315578403

Creativity and Bipolar Disorder: Igniting a Dialogue

• Substantial evidence: bipolar disorder is related to being a “creative person”

• Particularly true of milder forms of bipolar disorder, and even vulnerability to the disorder

Summary

• Less is known about the “creative process” that supports this pattern

• Some early evidence suggests that mood plays a role• Happiness might bolster fluency and divergent

thinking• Moods that are too high might interfere with creative

accomplishments• This dovetails with findings in the quantitative

literature– more severe mania history may interfere with creative outcomes, while good moods may help.

Summary

Acknowledgments

web: www.crestbd.catwitter.com/CREST_BD - @CREST_BDfacebook.com/CRESTBDBipolarResearchyoutube.com/CRESTBDslideshare.net/CRESTBDinstagram.com/crest.bd/ - @CREST.BD

www.bdqol.com

www.bdwellness.com

Follow us on social mediaTo stay current with CREST.BD research, news, events, and other resources, follow us on: