Creativity and Mental Illness

The relationship between creativity and psychopathology has been the focus of considerable interest and research in psychiatry. Plato, Aristotle, Shakespeare, Proust, and Freud alleged a connection, as have the anecdotal accounts of many writers and visual artists. The lives of Sylvia Plath and Jackson Pollock, for instance, exemplify how thin the line can be between destruction and creation. Three questions are the focus of hundreds of studies: Do some kinds of psychopathologies enhance creative achievement? Are creatively gifted people more likely to be mentally ill? What is the nature of the connection between creative and pathological thought processes? The research has obvious implications for the development of talent, particularly in the arts.

Diagnostic analyses of the works or lives of well-known artists and writers are often used to explore the relationship between creativity and mental illness. All of this research has been done with adults. We know next to nothing about the mental health of creatively gifted adolescents. The psychoanalytic clinical literature in particular has put forth several theories explaining the connection between creativity and psychopathology. Findings, however, are equivocal and have been controversial since the first quarter of the 19th century.

Studies that examine what creativity and psychopathology have in common observe three shared characteristics: mood disturbance, tolerance for irrationality, and certain types of thinking processes. The incidence of mental illness among gifted visual artists, writers, and poets is higher than in the population at large. Significantly higher rates of depression and suicide are reported among eminent writers, poets, and visual artists, and some studies link creativity with bipolar disorders specifically, usually finding about 10 times as many diagnoses of bipolar disorders among creative individuals as in the general population. We know that psychotic thinking rarely turns into creative production without some abatement of the psychosis, but creative processes sometimes turn into psychotic ones.

Within the field of academic psychiatry, there has been serious acceptance of the association between creativity and hypomania. In recent years, however, it has been noted that these findings are often based on retrospective analyses of biographical material of eminent creative individuals, many of whom lived and worked during the Romantic Period when strong cultural assumptions alleged a divine “madness” associated with creative giftedness. There is now some question as to whether the self-reports of these individuals may have been, in fact, self-serving projections of cultural expectations. Were they really struggling with mental illness? Or did they relate emotional problems because that was the expected public persona of a great artist in their time? The self-report of some contemporary gifted artists and writers of elevated levels of creativity during periods of moderate mental illness does find support in the literature.

The work of several investigators, including Kay Jamison and Nancy Andreasen, suggests that creative production varies with mood states. Specifically, greater production seems to be generally preceded by an elevated mood, perhaps by opening up thought processes. Depression, however, may also enhance the creative process by slowing down rapid thought processes, putting thoughts and feelings into perspective, sharpening focus, and eliminate extraneous ideas.

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