"Our hospital was famous and had housed many great poets and singers. Did the hospital specialize in poets and singers, or was it that poets and singers specialized in madness? ... What is it about meter and cadence and rhythm that makes their makers mad?" (1)

The link between madness and creativity is one that has been hotly debated in both medical and literary circles for a long time. The two most common types of mental illness theorized to be an influence on creative people such as writers, artists, and poets were schizophrenia and bipolar disorder (2). However, various studies comparing the characteristics of schizophrenics, bipolars, and writers have concluded that schizophrenics do not share a common thought process with writers (2). In comparison, a study conducted at the University of Iowa declared that while both bipolar patients and writers tended to "sort in large groups... arbitrarily change starting points, or use vague distantly related concepts as categorizing principles" (p 107), the two differed in their abilities to control their thoughts (2). Where the exactly this line of control is located – or indeed if there is a line at all – is the debate in question.

Bipolar disorder, also called manic depression, is a complex and often cruel illness that takes sufferers on a rollercoaster ride of emotional highs and deep depressions. During the mania period, either euphoria or irritability manifest themselves, and sometimes a combination of the two, called "mixed mania"(3). A person in a manic phase can also exhibit symptoms known to physicians as the DIGFAST symptoms: distractibility is heightened; insomnia is present due to increased energy; grandiosity occurs in delusions of godliness or omnipotence; flight of ideas speeds up thought processes; activity is greatly increased; and thoughtlessness results in sexual promiscuity and/or shopping sprees (3).

The other half of bipolar disorder is that which accounts for the great number of suicides among the ranks of bipolar patients: depression (3). Roughly 20% of bipolars committed suicide before effective treatments for the ailment became available (2). Depression is characterized by such symptoms as feelings of exhaustion, sleeping either much more or much less than usual, lowered self-worth, lowered enthusiasm for life, and contemplation of suicide (3). These depressions can last as long as six months to a year. They are frustrating and frightening to deal with, for unlike other forms of depression there is often no cause for the reversal in mood (3). Patients can cycle rapidly through depressive and manic phases, from four times a year to as often as three or four times a day (3).

Manic depression can also be associated with such behavioral problems such as attention deficit disorder (3). Other problems that can appear as a result of the disease are addiction to drugs and alcohol as an attempt to "self-medicate," using depressants like alcohol to slow down the manic thought process or using stimulants such as cocaine to attempt to prolong the sense of euphoria also associated with a manic phase (2). Most frightening of all, the disease has been found to be genetic; if one identical twin is bipolar, the other is 80% likely to suffer from it, whether the two are raised together or apart (4). While some people become violent while they are manic, these are usually patients with a very severe form of bipolar disorder (4). Most artists and writers diagnosed with bipolar disorder have a milder form of the disease, sometimes called hypomania (4). Patients with hypomania are subject to the same symptoms as mania except at a much lower intensity; combined with mild depression, these two result in a condition called cyclothymia, itself a milder form of the fully formed manic-depression that often follows it later in the patient’s life (2).

Artists and writers are often subject to these fluctuations in mood, accompanied by sudden periods of productivity. Nancy C. Andreason, a psychiatrist at the University of Iowa, conducted a study that began in the 1970’s to discover the link between bipolar disorder and writers (4). For the next 15 years she collected data on a group of 30 writers; as of the time of publication of the article, 43% of the writers had been diagnosed with manic depression, as opposed to 10% of the control group (4). More unsettling still, two of the 30 writers in the sample group had committed suicide during the time of the study (4). A similar study found that 33% of artists and writers said that they experienced acute mood swings; this subgroup was made up mainly of poets and novelists (4).

Writers have reported these rapid changes in mood in their own works. As Robert Burns wrote, "Day follows night, and night comes after day, only to curse him with life which gives him no pleasure" (2). William Cowper, a poet who in the 1700’s was thrown into an asylum due to the severity of his illness, describes his depression as if "a thick fog envelops every thing, and at the same time it freezes intensely" (2). Equally compelling are the descriptions of the mania that is twin to this deep depression, the irrational urges and speeding thoughts that wreak havoc on both mind and body of sufferers such as Theodore Roethke: "Suddenly I knew how to enter into the life of everything around me... All of a sudden I knew what it felt like to be a lion. I went into the diner and said to the counter-man, "Bring me a steak. Don’t cook it. Just bring it." So he brought me this raw steak and I started eating it" (2). Yet those who suffered this swiftly flowing madness could describe their experiences so beautifully, as John Ruskin did: "I saw the stars rushing at each other...Nothing was more notable to me through the illness than the nerves... and their power of making colour and sound harmonious as well as intense" (2).

There are lists upon lists of those artists and writers who experienced the glorious highs and lethargic lows of bipolar illness. Virginia Woolf, John Berryman, and Robert Lowell are just a few on a long list of well-known writers (5); Tchaikovsky, van Gogh, and Pollock add composers and painters to the list of bipolar sufferers (6). This extensive documentation of writers’ own experiences with mood fluctuation is highly convincing of the link between bipolar illness and a creative temperament. Combine those writings with the overwhelming results of studies that find a far greater incidence of manic depression among artists and writers than among the general population, and the link is as well-established as a scientific truth can ever be.

This conclusion, however, leaves us with a few very pressing questions. These days, the automatic response to a diagnosis of manic-depression is to medicate the patient (3). While doubtless this creates a calmer life for both the patient and those around him or her, it is often doubtful whether the patient leads a happier life while on medication. As is described by a bipolar teenage girl on lithium: "How can I tell them I LIKE being high? ...I feel dull. I feel robbed of my creativity. I feel robbed of who I am, or rather who I was" (7). From a slightly different perspective, is society better off with these artists and writers medicated? Psychiatist Joseph J. Schildkraut of Harvard Medical School studied the lives of 15 artists in the mid-1900’s; at least four had committed suicide (8). Even with these casualties, Schildkraut maintains, "Yet depression in the artist may be of adaptive value to society at large" (8). How would the literary world have changed without the mad genius of Virginia Woolf, Sylvia Plath, F. Scott Fitzgerald? Is it fair to allow a writer or artist to sacrifice their emotional stability or even their lives for the creation of new art? Where do we draw these lines between the public and the private good?

Written by Sarah Eberhardt

References
1) Kaysen, Susanna. Girl, Interrupted. Vintage Books: New York, 1993.
2) Jamison, Kay Redfield. Touched with Fire: Manic-Depressive Illness and the Artistic Temperament. The Free Press: New York, 1993.
3)Medscape article, facts on bipolar disorder
4)An article on the Pendulum website, about the possible links between bipolar disorder and creative personalities
5)A website to support those with bipolar illness, with a list of famous manic-depressives
6)The Serendip webpage, an article entitled "Creativity and Psychopathology"
7)A website to support those with bipolar disorder, with an essay by a teenage girl about her bipolar illness
8)An article posted from the Science News, about the relationship between creativity and bipolar illness