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Creativity and Depression
CBS CARES:
Van Gogh, Churchill and Tolstoy were all depressive personalities. Is there a relationship between a depressive personality and brilliance and creativity?
DR. ANDREASEN:
There is very definitely a relationship. I did the first empirical study of creativity and mental illness at the University of Iowa Writers Workshop. I studied thirty very prominent writers who had been on the faculty at the Iowa Writers' Workshop and a control group. The rate of mood disorder in those writers was just incredibly high. Something like seventy percent of the writers had cumulative depression that would now meet DSM3 or DSM4 criteria, (criteria from the Diagnostic and Statistical Manual of Mental Disorders).
There are different types of creativity but the people you mention, van Gogh and Tolstoy, are creative writers and painters who have very human forms of creativity. There is a profile of a person who is creative. First, a creative person is open to experience, exploratory, risk taking and tolerant of ambiguity. And those kinds of traits make you see and feel more, but they also make you more easily hurt and more prone to experience suffering. If you do that enough, it can make you feel depressed.
CBS CARES:
Can it get to a point where the depression is too much and then stifles creativity?
DR. ANDREASEN:
That was something that I interviewed the writers about. And most of them said that they could not write when they were depressed. I think that's a fairly universal observation. Now, I mean, significant depression in general is an episodic disorder so people have periods when they are depressed and withdrawn and so on and then they improve and are ready to interact with the world again. So, it impairs creativity during periods of depression, but then after the person comes out of a depression the experiences during depression become a reservoir upon which a creative person draws in order to produce whatever they are going to produce, a novel, a poem, a play, whatever.
CBS CARES:
Do you find that creative people are less inclined to take medication because they think it might stifle their creativity? For example, could the genius of Virginia Woolf have been lost if she'd been on lithium?
DR. ANDREASEN:
Some people worry about that. It depends to some extent on how ill the person is. One of the examples I've used is the author, Robert Lowell, who had really, really severe bipolar illness. He was hospitalized once or twice a year at McClean for years and years. He was doing psychotherapy a couple of times a week and then was put on Lithium. There is a quotation where he says, " I'm doing so much better. I'm so much more productive. I received a little gift from Denmark. My problem was a deficiency in salt. And now that I'm taking this Lithium salt, I'm very stable."
Most creative people say they can't produce something that is really worthwhile if they're psychotic-if they're experiencing mania, psychotic inner-depression or just severely depressed and immobile. The jury is out a little bit, but I think in general that most creative people who have at least significant depression feel that having the depression treated enhances their creativity rather than reduces it.
CBS CARES:
So, there's a danger of glamorizing depression by associating it with creativity?
DR. ANDREASEN:
Yes. The 20th century is tragically filled with writers who have committed suicide, such as Sylvia Plath, Anne Sexton, Virginia Woolf, John Barryman. One definitely shouldn't romanticize mental illness. Given that so many creative people have committed suicide, I do not believe that medication, which saves lives, should be seen as impairing creativity-it could have enabled them to live much longer and create so much more. I think it's a really serious argument to say that creative people should not be treated for their depression. In fact, if left untreated, these people are likely to die.
Most real mental illness is painful and unappealing, hardly appropriate for romantic idealism and certainly not worth pursuing as a personal goal because it might increase one's insights and make one an artist. In addition to being unsound for medical reasons, in that mental illness is unpleasant or drab rather than enriching and interesting, this romanticism of suffering and suicide is wrong on the psychological grounds as well. I think it is a terrible mistake to romanticize mental illness. And I think most people who have had mental illness would agree.
CBS CARES:
Is there a difference in the way people with bipolar disorder and people who experience periods of depression see their conditions?
DR. ANDREASEN:
Bipolar illness in a creative person is more difficult to treat because when you're bipolar, you have these periods of extreme high-where you feel that you can do anything. You're just completely on top of the world. Mania is sort of the ultimate in terms of happiness but when you're manic you spend a lot of money and travel around the world and you're excessively friendly and you do things that will ruin your marriage and destroy your business and so on. But you don't know that you're doing those things because you just feel like you're the greatest.
Well, when you have the experience of feeling that great, it usually takes you a couple of episodes to come down from it and realize how much damage you've caused and recognize that maybe you do need to be treated. A person in his or her first bipolar episode or first manic episode is really harder to convince to seek treatment or to convince that there's anything wrong with them.
CBS CARES:
Are the manic periods the more prolific time for the artists?
DR. ANDREASEN:
No. Again, they are so disorganized. When they're at an ultimate high, they generally can't do anything productive. Somebody who's in the midst of a mania is usually running around, having a great idea, writing it on a sheet of paper. And then going on to something else, writing a bunch more stuff down and after a week or two of being in a mania he'll be sitting in the middle of the room surrounded by piles of disorganized sheets of paper that don't say anything that makes any sense. But a person in mania has very little insight into the nature of the problem.
CBS CARES:
Are there other mental illnesses that spawn creativity?
DR. ANDREASEN: The other illness that perhaps has some links to creativity is schizophrenia. I was an English professor who became a psychiatrist and a driving force behind it was my awareness that James Joyce had a daughter who had schizophrenia. I also knew that Bertrand Russell had a family that was full of schizophrenia and Einstein had a son who had schizophrenia. I began my Iowa workshop study expecting the writers to be essentially normal but to have schizophrenia in their first-degree relatives, which refers to parents, brothers and sisters and children. What I found was this very high rate of mood disorder, both bipolar and unipolar, but absolutely not schizophrenic and absolutely no schizophrenia in their family members.
The fact remains that Einstein, Joyce, Bertrand Russell, Isaac Newton and several other people had a psychotic illness that was schizophrenia like. And there are other very famous people, basically in math, physics and other scientific fields that are more abstract and less personal, who have a connection with schizophrenia. A project that I want to do is an empirical study just like the one that I did at the Writer's Workshop, but selecting very creative scientists, to determine whether they have schizophrenic traits, what the rate of schizophrenia is in their first degree relatives, and so on.
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