For generations, there’s been a cultural assumption that creative people are more mentally unstable than everybody else. In his 1936 essay, The Crack-Up, F. Scott Fitzgerald detailed his own personal battles with depression and alcoholism. Just four years prior, German psychiatrist Wilhelm Lang-Eichbaum examined 800 "geniuses," and found that they showed higher tendencies toward "nervous tensions" than the general population.
In 2005, a study of 30 writers from the prestigious Iowa Writer’s Workshop were compared with 30 people of similar IQ and comparable educational advancement. The writers—and their immediate relatives—had a higher rate of mood disorders than the controls. And, for added measure, let’s throw in the fact that of America’s 11 Nobel laureates in literature, four of them were "clearly alcoholics" (Sinclair Lewis, Eugene O’Neill, William Faulkner, and Ernest Hemingway), and one of them (Steinbeck) "probably was," according to Donald W. Goodwin, MD, who wrote a book on the subject.
This fall, the first statistically significant study linking creativity and mental illness was published in the Journal of Psychiatric Research. "Mental Illness, Suicide, And Creativity: 40-Year Prospective Total Population Study," examined 1.2 million Swedish patients from the country’s national registry and compared this sample against the entire Swedish population.
Here’s what they found:
Overall, creative professionals were about 8% more likely to suffer from bipolar disorder than the general population. The study found this to be true for artists (practitioners of everything from photography to choreography) and scientists (professors and researchers). The most startling results, however, related to authors. Writers were a whopping 121% more likely to suffer from bipolar disorder than the general population. Moreover, Simon Kyaga, the study’s lead researcher, says that authors had a "statistically significant increase" in anxiety disorders—38% to be exact. Rates of alcoholism, drug addiction, and suicide also increased among writers.
So what, exactly, is going on here? And why the particular increase in bipolar? Simon Kyaga, the study’s lead author, explains that first you have to address the tricky problem of defining creativity. He does so by examining three aspects: personality (traits like curiosity that are associated with creativity), process (what actually happens in the brain during a creative act), and product. In short, he says that creativity is the production of something new and meaningful. Sure, these terms are subjective. But research has shown that the greater the creative person’s output, the more likely she is to hit on something innovative or revolutionary.
"When you’re manic, you get more things done, but you also get more and wider ideas. And the more ideas you have, the more creative you are," says Kyaga. It’s certainly possible for a manic person to create an excess of crappy art. But Kyaga’s team has also seen a link between bipolar disorder and ambition. If you’re truly ambitious, then you’re actively trying to create new and meaningful work. In other words, your art is more than a by-product of your inability to sit still.
But this doesn’t explain why the rates of bipolar disorder are so much higher for authors. Kyaga’s study discovered that authors are really overrun with psychological illness—from anxiety disorders to alcoholism. In fact, this was the opposite of what Kyaga found among other creative professionals. Visual artists, dancers, directors, and scientists suffered from these disorders at significantly lower rates than the general population. Kyaga theorizes that writers are particularly plagued by environmental factors. "It takes a long time before you get something published and a long time to get feedback," he says. "That waiting isn’t present to the same extent in other occupations."
(As an author, I will attest to the truth of Kyaga’s observation about the agony of waiting, but I’m not sure the struggling painters, dancers, or, for that matter, the scientists who work for years without a breakthrough, fare any better.)
In any case, the important question raised by the Swedish study relates to treatment. Can this new diagnosis change the way that doctors help their patients? Kyaga says absolutely. "Patients cannot be reduced to a diagnosis, and these results point to that."
He argues against the tendency to look at patients as either sick or well, because even "sickness" has its upsides. "The underlying traits [of these illnesses] might confer advantages, e.g. creativity," he says. And because of this, Kyaga says that doctors need to think twice before administering standard drug treatments. Drugs can stabilize but in so doing, they can alter a creative person’s personality, process, and product. On the flip side, Kyaga says that some studies have shown an increase in creative output among patients who are taking lithium, a common treatment for bipolar disorder. He points to an old one (1979) in the British Journal of Psychiatry, which examined the effects of Lithium treatment on 24 manic-depressive artists. Half of the sample reported an increase in artistic productivity.
"Treatments need to be based on sound clinical trails," says Kyaga. "And this calls for using large databases of information." Say, 1.2 million Swedes.