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Bipolar disorder

Bi-Polar Disorder and Creativity

Bi-polar disorder, also known as manic-depression, is a mood disorder recognized by its periods of mania and depression. These periods can last hours, days, weeks or months. Often, there are periods of wellness between these episodes where there are few to no symptoms present. People with bi-polar disorder actually experience four types of mental states which are depression, hypomania, mania and mixed-state. Sometimes when a person is in extreme mania or depression they will also experience psychosis.

Depression is characterized by on-going sadness; loss of interest in things you normally enjoy; difficulty sleeping or oversleeping; changes in body weight; physical slowing or agitation; loss of energy; feelings of worthlessness or inappropriate guilt; difficulty thinking or concentrating; and recurrent thoughts of death or suicide.

(March 30, http://www.nimh.nih.gov/publicat/bipolarrestfact.cfm)

Hypomania is not as intense or overwhelming a feeling as mania, but it shares many of the same characteristics with actual mania. It can be summarized by the following quote: "At first when I’m high, it’s tremendous...ideas are fast...like shooting stars you follow until brighter ones appear....all shyness disappears, the right words and gestures are suddenly there...uninteresting people, things, become intensely interesting. Sensuality is pervasive; the desire to seduce and be seduced is irresistible. Your marrow is infused with unbelievable feelings of ease, power, well-being, omnipotence, euphoria....you can do anything...but, somewhere this changes." (March 15, 2002,

http://www.molbio.princeton.edu/courses/mb427/2000/projects/0002/index3.html)

Mania is often said to be a step beyond hypomania. Symptoms include abnormally and persistently elevated (high) mood, or irritability, occurring with at least three of the following: overly-inflated self-esteem; decreased need for sleep; increased talkativeness; racing thoughts; distractibility, increased goal-directed activity or physical agitation; and excessive involvement in risky behaviors or activities (e.g. unwise spending sprees, reckless driving, sexual affairs).

(March 30,2002, http://www.nimh.nih.gov/publicat/bipolarrestfact.cfm)

"Mixed" state is where symptoms of mania and depression are present at the same time. The symptom picture frequently includes agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking. Depressed mood accompanies manic activation.

(March 30, 2002, http://www.nimh.nih.gov/publicat/bipolarrestfact.cfm)

Sometimes severe mania or depression is accompanied by periods of psychosis. Psychotic symptoms include hallucinations (hearing, seeing or otherwise sensing the presence of stimuli that is not there) and delusions (false fixed beliefs that are not subject to reason or contradictory evidence and are not explained by a person’s usual cultural concepts). Psychotic symptoms associated with bi-polar disorder typically reflect the extreme mood state at the time (e.g. grandiosity during mania, worthlessness during depression).

(March 30, 2002, http://www.nimh.nih.gov/publicat/bipolarrestfact.cfm)

There are three different diagnosis of bi-polar disorder. They are bi-polar I, bi-polar II and cyclothymic. Bi-polar I is based on a person having at least one period of mania. Bi-polar II is based on having at least one hypomania experience that does not escalate to a manic episode. Cyclothymic disorder is the mildest diagnosis and is where a person, over the course of two years, cycles between hypomania and mild depression but does not escalate to the severe states of mania or depression.

Bi-polar disorder affects 2.3 million adults in the U.S. – about 1 percent of the population. The illness is genetic. Three out of four patients diagnosed with bi-polar disorder have a family member with an affective disorder. It is an illness that is cyclic in nature and some have what is known as rapid-cycling. This means that four or more episodes of the illness are seen within a 12 month period. This form of the illness tends to be more resistant to treatment than non-rapid-cycling bi-polar disorder. Fortunately, in most cases, the intense and disabling symptoms can often be relieved through treatment involving combinations of medication and psychotherapy. Bi-polar disorder usually becomes evident in late adolescence or early adulthood. Episodes of depression and mania flare up across a person’s lifetime, often disrupting work, school, family and social life. Without effective treatment, the illness can lead to suicide in nearly 20 percent of cases. (March 15, 2002, http://www.molbio.princeton.edu/courses/mb427/2000/projects/0002/index3.html)

An increasingly asked question concerning bi-polar disorder is whether there is a link between the illness and creativity. Many creative people, both historically and currently, are known to have bi-polar disorder. Vincent Van Gogh, who produced all of his artistic works in a 10 year period, was hospitalized numerous times for the illness and eventually shot himself to death at the age of 37. During one of his manic episodes, Van Gogh cut off his ear. Many people remember this as a part of who he was but probably did not know the cause of his mania. There are many others, such as Edgar Allan Poe – who attempted suicide in his lifetime; Georgia O’Keefe – who was hospitalized for her illness; Janis Joplin and Kurt Cobain – both who died of suicide. The list is long and growing. Today, there are numerous celebrities, artists and musicians who are doing interviews, writing articles and writing books to talk about their experiences with the illness.

Kay Redfield Jamison, considered by many to be one of, if not, the leading expert on bi-polar disorder, has written three books on the subject; one of which is an autobiography of her battle with the illness. She also co-wrote the standard medical text on the illness with Frederic Goodwin and has written over a hundred papers on the subject of bi-polar disorder and mood disorders. Ms. Jamison is currently a Professor of Psychiatry at John Hopkins University. She is obviously an individual who has been very successful in her life, but she also admits that it has been a life of struggle.

It has long been thought that there is a connection between the mania and depression of bi-polar disorder and creative output. Historically, researchers used written documents from the individuals being studied, physician’s records and comments from friends and relatives on the behaviors and moods of the individuals as the basis for subjective theories about the issue.

In the 1970’s, Nancy C. Andreason, from the University of Iowa, conducted the first studies of the connection between bi-polar disorder and creativity. In this study, she used structured interviews, matched control groups (consisting of 30 creative writers against 30 persons in mostly uncreative jobs) and rigid diagnostic criteria for her baseline. From this study she found that among the creative writers there was a high incidence of mood disorders and alcoholism among them. Alcoholism and drug addiction have been known to be highly evident in persons with bi-polar disorder. She found that 80 percent of the writers said they have experienced either bi-polar disorder or severe depression, while only 30 percent of the people in non-creative jobs said that they had. (Andreason, 1288-1292)

In 1983, Kay Redfield Jamison also did a study to examine the link. Ms. Jamison, then at the University of California at Los Angeles, surveyed 47 of the top British artists and writers, questioning them about their mood states and their treatment history. Thirty-eight percent of the total had sought treatment for mood disorders – a rate about 30 times that of the general population. Writers experienced the most problems, and of these, poets topped the list – with half of them reporting psychiatric intervention (drugs and /or hospitalization) for depression and /or mania. Almost two-thirds of the playwrights had been treated for mood disorders. The rate for biographers was 20 percent, and for artists the incidence rate was 13 percent. One-third of the 47 reported that they suffered from severe mood swings, particularly the poets and novelists. (Holden, 9-10)

In a third study, Arnold M. Ludwig,of the University of Kentucky, published an extensive biographical survey of 1,005 famous 20th century artists, writers and other professionals. Some of these individuals had been in treatment for mood disorders. The study lasted approximately 10 years. From the study, he discovered that the artist and writers experienced two to three times the rate of psychosis, suicide attempts, mood disorders and substance abuse than did comparably successful people in business, science and the general public. It was found that the poets had most often been manic or psychotic and hospitalized; they also proved to be some 18 times more likely to commit suicide than the general public. Ludwig concluded that "members of the artistic professions or creative arts as a whole suffer from more types of mental difficulties and do so over longer periods of their lives than members of other professions." (Ludwig, 38-42)

These studies have shown a strong correlation to the theory that there is a link between bi-polar illness and creativity. Historically, the behaviors and words of many great artisans, musicians and writers help to add to the evidence of a link between the two. There are also more persons in the creative fields who are willing to openly discuss their struggles and experiences with the disorder.

Patty Duke, a well-known actress, co-wrote a book with Gloria Hochman in July of 1992 entitled "A Brilliant Madness – Living with Manic-Depressive Illness". In this book, Patty relates her story of her symptoms, diagnosis and day-to-day living with the disorder. Patty says, in her book, "I have known from a very young age that there was something very wrong with me, but I thought it was just that I was not a good person, that I didn’t try hard enough. As with many people, the overt symptoms of manic-depressive illness didn’t show themselves until my late teens. And that was with a manic episode. From that time on, until I was diagnosed at the age of thirty-five, I rode a wild roller coaster, from agitated, out-of-control highs to disabling, often suicidal lows" (Duke, 1)

In 1998, Danielle Steele, a well-known writer, published a book about the life of her son, Nick Traina. Nick suffered from bi-polar disorder and his creative and inspiring life ended in his suicide at the age of nineteen. Nick was a writer, a poet, a song-writer, a musician and a person ravaged with the affects of bi-polar disorder. His life was filled with mood swings, drugs, alcohol and restlessness until the time of his death.

In conclusion, based on the many books, papers, articles and web sites I have reviewed, I believe there is definitely a link between creativity and bi-polar disorder. I don’t think you have to be bi-polar to be creative or that being creative will make you bi-polar. I do believe that creative persons whom are bi-polar have a heightened level of creativity when the illness is not stifling them with the depression. I believe that people in artistic and creative fields are of a certain temperament and emotional make-up. Persons who are more closely in touch with the emotional sides of themselves are usually known to be better at creative pursuits. The severe depression associated with bi-polar disorder has been known to stop artist in their tracks, but during times of hypomania and mania they have also been known to produce at unbelievable rates. This was exemplified in the case of Van Gogh. During the depressive states, the motivation to create is lost and during manic episodes, an explosive desire to create has shown to manifest. People with bi-polar disorder wrestle with their emotional turmoil from both a positive and negative approach; surely this introspection and feeling of extreme highs and lows in emotion provide a deeper well from which to draw and use in the creative process.

Bibliography:

Andreason, Nancy C. "Creativity and Mental Illness: Prevelance rates in writers and their first-degree relatives." American Journal of Psychiatry October, 1987: 1288-1292.

Duke, Patty and Hochman, Gloria. A Brilliant Madness-Living with Manic Depressive Illness. New York; Bantam Books, 1992.

Holden, Constance. "Creativity and the Troubled Mind." Psychology Today April 1987: 9-10.

Ludwig, Arnold A. "Method and Madness in the Arts and Sciences." Creativity Research Journal 1998: 38-42.

NJMH-National Institute of Mental Health. NIMH publication no. 00-4502. Printed 2000. Updated Aug. 24, 2000. 30 March 2002. .

Manic Depression and Creativity. Princeton University. Biotechnology and it’s social impact web project. Ed. Kit Delgado, Valerie Gutmann, Sarah Muntinsky, Ben Roman, Hillary Young. 15 March 2002 .



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