Maybe you are familiar with the famous Dutch painter Vincent van Gogh. Vincent is most famous for his painting called ‘The Starry Night’, however, the story behind him creating this painting is somewhat cruel. Van Gogh cut off the lobe of his left ear in an apparent psychotic state and consequently offered it to a prostitute. Without having any recollection of what happened he was admitted to the hospital the next day where he remained suffering from intense visual and auditory hallucinations described as ‘acute mania’ by the doctors. These recurrent episodes led to various hospitalizations, however, strikingly, he produced about 150 paintings in this time period, including his most famous work ‘The Starry Night’.
Van Gogh received almost 30 different diagnoses from different doctors that potentially could explain his condition. However, this article is not meant to dive into these possible disorders that van Gogh actually could have had. We are trying to shed light on a different question; is it possible that a specific mental illness could go hand in hand with increasing the creativity of such individuals? In this article, the focus will be on two of the 30 diagnoses proposed for Vincent’s condition; bipolar disorder and schizophrenia.
To get us all on the same page, we should pose ourselves the question, what is creativity? To be honest, it is hard to answer this question, and I think there should still be room for debate regarding its definite meaning. However, the most common explanation is the ability or act of producing ideas that are at the same time novel (original, unique, inventive) and useful (appropriate, adaptive, valuable). Interestingly, back in the day, Cesare Lombroso, an Italian doctor, interpreted being creative as a form of moral insanity that could be spotted in various disorders. So it seems that in history already the link between creativity and mental illness was established, but is this truly the case?
Let us first focus on bipolar affective disorder. You might be thinking, 'Hold on, I've never heard of this disorder. What does it mean? Bipolar affective disorder comes in two types. For the sake of this article, only type I will be covered in this article, since patients with this type experience manic episodes which becomes relevant when talking about creativity. When we look at the brain, we see that frontolimbic structures and dopamine circuits are disturbed in the case of bipolar type I disorder. Moreover, dopamine and frontolimbic structures also come into play during creative activities. However, I would like to point out that the brain is connected as a whole and many more brain regions will be involved as well. This link between creativity and bipolar disorder has attracted the interest of clinicians and neuroscientists since a lot of case stories are present in the literature. Namely, bipolar patients express themselves during a manic period, that they feel inspired, and imaginative, both being fruitful for creativity. Patients often describe themselves as ‘very artistic and creative’ during such an event and colors and smells become more intense to them.
At this point, you may be thinking, 'But isn't all of this subjective? What about the black-and-white objective evidence that exists?' Well, we got you covered; several studies looking at creativity in patients with mood disturbances showed that even by applying a wide definition of creativity, no more than 8% of patients with bipolar could be considered creative. Moreover, a study by Srivastava and colleagues compared bipolar disorder patients to creative controls and healthy controls during the euthymic state . Since bipolar type I patients alternate between manic states, depressive states, and stable mental states, the latter being called ‘euthymia’, they compared the three groups during this ‘baseline’ state to find out what was underlying their increased creativity. Different kinds of creative tasks were completed by these groups, together with a couple of questionnaires assessing different personality characteristics (neuroticism (related to experiencing a lot of negative emotions, such as anxiety or self-doubt among others), cyclothymia (changeability of mood), openness to experience, and intuition), all personality characteristics that bipolar type I patients score high upon. This study showed that the bipolar disorder type I itself potentially is not underlying creativity since when compared to creative controls they scored similarly on 5 out of the 6 tests measuring creativity. What was interesting though, is that there were strong correlations between the personality characteristics as mentioned above and the outcome of these creative tasks. This means that people scoring high on for example openness to experience, would score higher on creative tasks. Therefore, it seems that it’s not the full-blown psychiatric disorder that seems to be the underlying factor enhancing creativity, but rather personality characteristics which are also high in bipolar type I patients.
Schizophrenia is a mental disorder with the following major symptoms: hallucinations, delusions, flat affect, and disorganized thinking.
Just as in the manic phase of bipolar type I patients, people with schizophrenia can have unusual experiences and versatile thinking. To come back to our discussion, the unusual experiences and versatile thinking that are the result of the delusions and hallucinations resulted in the idea that schizophrenic patients can step out of the conventional way of thinking and use their full imagination in order to be creative. On the contrary, other theories suggest that creative ideas come with increased cognitive flexibility and persistence together with the capability to plan, organize, etc. (all mostly orchestrated by the (pre) frontal cortex) seem to be important when it comes to creative thinking, which is lacking in schizophrenic patients.
So what’s the deal with that? A meta-analysis pulled the evidence from 32 studies together and showed that schizophrenia and creativity were negatively correlated. What does this mean? Schizophrenia comes in different degrees of severity, so you can see it as a spectrum with common abnormalities such as delusions and hallucinations underlying this spectrum. The most extreme side of this spectrum is characterized by the full expression of schizophrenic symptoms, while the other extreme side is characterized by the absence of symptoms (e.g. doing good for one another). Somebody with a mild expression of psychotic symptoms, but not ending up on the full positive (extreme) side of the spectrum shows to score high on creativity. However, if you increase on this scale more towards the positive side of this spectrum we spot the reverse effect, namely a decline in creativity. In literature this relationship is also called an inverted U-shape. This means that when applied to this example, there is a maximum amount of creativity found in people who are exactly at the middle of this spectrum of schizophrenic symptoms. When you flip the U, you will see that the middle of the letter is exactly the highest point, representing the highest level of creativity in this case!
It seems that it is not the disorder (in this case bipolar type I and schizophrenia) that underlies creativity. Personality characteristics and the severity of the disorder give a more realistic outlook on this relationship. Moreover, since Vicent van Gogh was a painter and we have seen that creativity can express itself in many different ways, this relationship between mental disorders and the concept of creativity becomes vague. So all in all, researchers have to find creative ways to further figure out this relationship.
Author: Joyce Burger