Medicine

Is there a connection between Bipolar and creativity?

Is there a connection between Bipolar and creativity?

Abstract:

There has been lots of research both into the psychopathology of creative people, as well as the neuroscience of people living with Bipolar disorder. However, there has not as of yet been sufficient investigation into why there appears to be this link between creative individuals and individuals with Bipolar. In this article I will examine various studies that have been made of people in creative industries and the frequency of mood disorder within these groups, before progressing to highlight the elements of shared neuroscience and brain activity between creative people and people with Bipolar. Following this I will propose that it could be the quality of having a less active prefrontal cortex, responsible amongst other things for self-censoring and inhibition, which leads creative people and especially people with Bipolar to take risks and produce original work.

Introduction:

Connections between artistic capability and mental illness have been rumoured in popular culture and in philosophy from times all the way back to Ancient Greece. Aristotle himself remarked that “No excellent mind has ever existed without a touch of madness.” History is littered with similar sentiments from similarly revered thinkers, right up to the present day: Steve Jobs once suggested that “Creation is messy. You want genius you get madness; two sides of the same coin.” Numerous titans of history have been, or were very much suspected to have been Bipolar, from Albert Einstein, Lord Byron, Vincent Van Gogh and Beethoven, to today with figures such as Tennessee Williams, Winton Churchill, Mark Twain, Sylvia Plath, and even Marshall Mathers (Eminem). But we still must be wary of anecdotal evidence, and thus enquire what scientific background there is to bolster these claims. And if there is the evidence to back up the idea, then it is helpful to delve into the neuroscientific traits of the “creative brain” and a Bipolar brain, and then propose what common features there are that might contribute to the link.

Middle:


First, it is useful to make a distinction between what Hans J. Eysenck describes as “everyday creativity” and “eminent creativity” (Eysenck, 1993. “Creativity and Personality: Suggestions for a Theory”. In Psychological Inquiry, Vol.4, No.3, 147-178. Oxfordshire: Taylor and Francis, Ltd.) He suggests it is important to consider them as separate concerns, and so in this article we shall be focusing on eminent creativity, which Eysenck defines as superlative, visionary creativity in a field. Everyday creativity is considered to be the ability to problem-solve or use initiative to find solutions in day-to-day challenges. This is referenced by Professor of Psychology at Saybrook University Ruth Richards in her summation of research on this subject (Ruth Richards, 1993. “Everyday creativity, eminent creativity, and psychopathology”. In Psychological Inquiry, Vol.4, No.3, 212-217.Oxfordshire: Taylor and Francis, Ltd.) More specifically, I will be studying what I will term as “eminent linguistic creativity”, that is eminent creativity in fields of creative writing and manipulation of language.

Richards (1993) draws our attention to studies which suggest that the prevalence of Bipolar in the world population being far above what we would normally expect for an average mutated gene, must surely establish that there is some kind of upside to the condition which natural selection has therefore not eliminated (F.K Goodwin & K.R Jamison, 1990. Manic-Depressive Illness. New York: Oxford. In addition: P.H Wender, S.S Kety, D. Rosenthal, F Schulsinger, J.Ortmann & I. Lunde, 1986. “Psychiatric disorders in the biological and adoptive families of adopted individuals with affective disorders.” Archives of General Psychiatry, 43. 923-929)

Richards then points to N.C Andreasen’s study which began in 1987, where Andreasen assessed two groups of people for creativity: 30 people taken from the University of Iowa’s Writers’ Workshop and 30 people as controls who were not from the workshop but who had similar academic acumen, age and education (N.C Andreasen, 1987. “Creativity and mental illness: Prevalence rates in writers and their first-degree relatives.” In American Journal of Psychiatry, 144, 1288-92). Andreasen found that not only was mood instability more common among the writers, but far further than this, 80% of the writers experienced some form of Bipolar, an immensely higher portion of the group than in the controls (N.C Andreasen, 1987). The relatively small number of people examined in this study must of course be considered as a limitation, but equally seemingly stark evidence in other studies does add credibility to these results. Richards references two studies by K.R Jamison which appear to direct to the same conclusion. In her psychopathological assessment of a group of eminent creative writers and artists, she found that in 90% of her subjects there were many features of hypomania present, particularly in times of their greatest and most prolific output (K.R Jamison, 1989. “Mood disorders and patterns of creativity in British writers and artists.” In Psychiatry, 52, 125-134) . Hypomania is the state of elevated mood that characterises Type 2 Bipolar, where heightened energy, talkativeness and propensity for goal-directed behaviour is normally exhibited. Reflecting on writers in history who certainly were or who are highly suspected to have been Bipolar, Jamison in a 1995 article refers to her study published in her 1993 book. (K.R Jamison, 1995. “Manic-Depressive illness and creativity” In Scientific American, Vol.272, No.2, 62-67. In addition, K.R Jamison, 1993. Touched with fire: Manic-Depressive Illness and the Artistic Temperament. Chapter 3, New York: The Free press.) Jamison explains that “In a comprehensive biological study of 36 major British poets born between 1705 and 1805… these poets were 30 times more likely to have had manic-depressive illness than were their contemporaries.”(Jamison, 1993) So again, the case for a link between linguistic eminent creativity and Bipolar does seem to be reasonably well founded, and while the research on the subject is limited by the small cohorts examined, the particularly strong and clear results do help to overcome this difficulty.

If we work on the premise that the link between Bipolar and linguistic talent seems at the very least probable, then perhaps taking an alternative approach and comparing the neuroscience of creative individuals and Bipolar individuals should proffer new insight. In definitions of creativity, the recurring theme and word that always resurfaces is “originality”. If one considers that innovation or new concepts are intrinsic to originality, then it follows that creativity must involve presenting new ideas and ideas that are contrary to the status quo. Relevant to consider then is what part of the brain may aid or hinder this process. One of the most important roles of the pre-frontal cortex of the brain is what is called “executive functioning”. This includes the brain’s working memory, attentional control, and crucially self-regulation or inhibition, as well as judging of what is considered normal social behaviour. Studies have shown that in creative individuals, and especially during creative tasks, that the pre-frontal cortex experiences deactivation and suppression (e.g Evangelia G. Chrysikou, Roy H. Hamilton, H. Branch Coslett, Abhishek Datta, Marom Bikson, Sharon L. Thompson-Schill. “Non-invasive transcranial direct current stimulation over the left prefrontal cortex facilitates cognitive flexibility in tool use.” In Cognitive Neuroscience, 2013; 1 DOI: 10.1080/17588928.2013.768221.). This might be called the “silencing of the inner critic” notion, in that by suppression of the pre-frontal cortex one is suppressing the brain’s instinct to filter and to try to fit into social norms, thus allowing creative originality. In a Livestrong.com article (https://www.livestrong.com/article/81868-parts-brain-influence-creativity/) a study is referenced which recorded brain activity through the use of fMRI (Functional Magnetic Resonance Imaging) in jazz musicians as they improvised (Charles J. Limb and Allen R. Braun, 2008. “Neural substrates of spontaneous musical performance: An fMRI study of Jazz Improvisation.” https://doi.org/10.1371/journal.pone.0001679). As above, Figure 2 in the article reveals that “spontaneous improvisation was associated with widespread deactivation in prefrontal cortex.” (Limb and Braun, 2008). Of course this is not linguistic creativity, so we must see whether it is the same case in a linguistic setting. A nature.com article (https://www.nature.com/news/brain-scans-of-rappers-shed-light-on-creativity-1.11835#/b1) summarises a similar study of professional rappers who were asked to “freestyle” or improvise lyrics entirely in the moment, while in a fMRI scanner. Again, the results were the same, and the investigators found that when spontaneously creating lyrics there was widespread deactivation and suppression in the pre-frontal cortex (Siyuan Liu, Ho Ming Chow, Yisheng Xu, Michael G. Erkkinen, Katherine E. Swett, Michael W. Eagle, Daniel A. Rizik-Baer & Allen R. Braun, 2012. “Neural Correlates of Lyrical Improvisation: An fMRI Study of Freestyle Rap” In Scientific Reports 2, Article number: 834.).

So there is certainly strong evidence that a less active pre-frontal cortex might aid creativity, but we must establish whether this gives us any clue as to why the Bipolar brain holds linguistically creative potential. Luke Clarke and Barbara J Sahakian draw attention to studies which ague that in both the depressed and elevated mood states in Bipolar the pre-frontal cortex is suppressed (Luke Clarke, Barbara J Sahakian, 2008. “Cognitive neuroscience and brain imaging in Bipolar disorder.” In Dialogues Clin Neurosci, 153-165). J. McGrath, S Scheldt, J. Welham, A. Clair in 1997 found that this was the case in elevated mood states (“Performance in tests sensitive to impaired executive ability in schizophrenia, mania and well controls: acute and subacute phases.” In Schizophrenia Research, 127-37). Their method involved classic tests for executive function, such as word association and the Wisconsin Card Sorting Test (a task requiring participants to classify and group different cards together), and their subjects consisted of a small group of patients who experienced mania, and a small control group. Meanwhile J.S Rubinsztein, A Michael, B.R Underwood, M Tempest and B.J Sahakian found in 2006 that it was also the case in depressed mood states that the prefrontal cortex was less active (“Impaired cognition and decision-making in Bipolar depression but no “affective bias” evident.” In Psychological Medicine, 629-39). They established this through subjecting a group of 24 depressed patients, and 26 controls, to computerised tests to measure executive function.

Further evidence for an abnormal pre-frontal cortex in Bipolar people was found in “Reductions in neuronal and glial density characterise the dorsolateral prefrontal cortex in Bipolar disorder”, in which a study found there was “reduced neuronal density” and “reduced pyramidal cell density” in areas of the prefrontal cortex (G. Rajkowska, A. Halaris, L.D. Selemon, 2001. In Biological Psychiatry, 741-752). This effectively equates to a lower functioning in the cortex than there would be in an average, typical prefrontal cortex. Finally “hypofrontality” is a factor that must be considered. This is the term describing reduced cerebellum blood flow (CBF), the blood quantity delivered to the brain in a given time period, to the prefrontal cortex. The severity and extent of this varies in Bipolar disorder, but can range from mild to significant, and therefore must not be discounted in our considerations, as decreased blood flow will again reduce functioning in the prefrontal cortex.

These different elements all contribute to make the Bipolar brain have a less active prefrontal cortex, which as discussed is in common with creative brains in general, possibly accounting for the linguistically creative quality in Bipolar people.

Conclusions:

Andreasen (1987) and Jamison’s (1989, 1995) studies of groups of writers and their psychopathology does seem pretty strongly to point to the conclusion that mood instability does enhance creativity. More research in this area and of bigger groups is necessary, and more detailed analysis and experimental work is needed to establish if the “correlation may not be causation” trap is present here. However, Bipolar people do seem often to possess a creative linguistic quality, and it is my conjecture that it is the reduced functioning in the prefrontal cortex of Bipolar people, allowing them a greater confidence to be original and not subscribe to the norm, which is also seen in creative people who are not Bipolar, that gives Bipolar people a particularly advantageous neuroscience for creative endeavours. Finally, more research into how other parts of the brain contribute to this is needed, for the prefrontal cortex is just one area and it is simplistic to assign creativity to just one section of the brain, when creativity also relies on cooperation between brain sections.

Bibliography:

N.C. Andreasen, 1987. “Creativity and mental illness: Prevalence rates in writers and their first-degree relatives.” In American Journal of Psychiatry, 144, 1288-92

Evangelia G. Chrysikou, Roy H. Hamilton, H. Branch Coslett, Abhishek Datta, Marom Bikson, Sharon L. Thompson-Schill. “Non-invasive transcranial direct current stimulation over the left prefrontal cortex facilitates cognitive flexibility in tool use.” In Cognitive Neuroscience, 2013; 1 DOI: 10.1080/17588928.2013.768221.

Luke Clarke, Barbara J Sahakian, 2008. “Cognitive neuroscience and brain imaging in Bipolar disorder.” In Dialogues Clin Neurosci, 153-165

Hans J. Eysenck, 1993. “Creativity and Personality: Suggestions for a Theory”. In Psychological Inquiry, Vol.4, No.3, 147-178. Oxfordshire: Taylor and Francis, Ltd

F.K. Goodwin & K.R. Jamison, 1990. Manic-Depressive Illness. New York: Oxford.

K.R. Jamison, 1989. “Mood disorders and patterns of creativity in British writers and artists.” In Psychiatry, 52, 125-134

K.R. Jamison, 1993. Touched with fire: Manic-Depressive Illness and the Artistic Temperament. Chapter 3, New York: The Free press.

K.R. Jamison, 1995. “Manic-Depressive illness and creativity” In Scientific American, Vol.272, No.2, 62-67.

Charles J. Limb and Allen R. Braun, 2008. “Neural substrates of spontaneous musical performance: An fMRI study of Jazz Improvisation.” https://doi.org/10.1371/journal.pone.0001679

J. McGrath, S Scheldt, J. Welham, A. Clair, 1997. In Schizophrenia Research, 127-37

Siyuan Liu, Ho Ming Chow, Yisheng Xu, Michael G. Erkkinen, Katherine E. Swett, Michael W. Eagle, Daniel A. Rizik-Baer & Allen R. Braun, 2012. “Neural Correlates of Lyrical Improvisation: An fMRI Study of Freestyle Rap” In Scientific Reports 2, Article number: 834

G. Rajkowska, A. Halaris, L.D. Selemon, 2001. “Reductions in neuronal and glial density characterise the dorsolateral prefrontal cortex in Bipolar disorder” In Biological Psychiatry, 741-752

J.S. Rubinsztein, A. Michael, B.R. Underwood, M. Tempest & B.J. Sahakian “Impaired cognition and decision-making in Bipolar depression but no “affective bias” evident.” In Psychological Medicine, 629-39

Ruth Richards, 1993. “Everyday creativity, eminent creativity, and psychopathology”. In Psychological Inquiry, Vol.4, No.3, 212-217.Oxfordshire: Taylor and Francis, Ltd.

P.H. Wender, S.S. Kety, D. Rosenthal, F. Schulsinger, J.Ortmann & I. Lunde, 1986. “Psychiatric disorders in the biological and adoptive families of adopted indivudals with affective disorders.” Archives of General Psychiatry, 43. 923-929

Webography:

https://www.livestrong.com/article/81868-parts-brain-influence-creativity/

https://www.nature.com/news/brain-scans-of-rappers-shed-light-on-creativity-1.11835#/b1

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