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Bipolar and creativity

Vincent van Gogh was diagnosed with bipolar disorder (manic-depression at the time) after his tragic death in 1890. He produced over 2,000 artworks, including such iconic paintings as Vase with 15 Sunflowers shown here.

Vincent van Gogh and his extraordinary creativity and artistic productivity featured prominently in my previous blog post on World Bipolar Day.

In my 2022 bipolar anthology, Navigating Bipolar Country: Personal and Professional Perspectives on Living with Bipolar Disorder, an eminent Montreal psychiatrist and professor emeritus from McGill University, Dr. Abdu’l-Missagh Ghadirian, contributed an essay titled Bipolar Disorder and Creative Expression. He has kindly given me permission to quote some excerpts from it here.

Interspersed and offset throughout, I have phrased some questions for you to reflect on.

Dr. Ghadirian’s introduction begins:

“My interest in creativity began when I was very young. It grew through my observation of the work of visual artists. When I began my practice of psychiatry, I was interested to note that some patients with emotional disorders who had difficulty expressing their thoughts and feelings verbally could express them through the arts such as drawing, painting, writing, poetry, and music. For some, this became a second language of expression and communication and was therapeutic. I also realized how gifted some of them were whether they were depressed or elated. I developed art therapy for individuals and groups as a complement to conventional psychiatric treatment when appropriate.”

​Q1: If you live with bipolar disorder (or have an affected loved one), do you find it easier to communicate through the arts rather than verbally? If so, does this tend to increase during (hypo)mania, or depression, or both?

The cover of Dr. Ghadirian’s 2009 book.

In 2009, Dr. Ghadirian published a book, Creative Dimensions of Suffering (Wilmette: Baha’i Publishing). In it, he explains that creativity can be a useful catalyst for healing, but it can also be misused and can cause emotional and psychological damage. For example, some ambitious, creative people sometimes drive themselves to their limit, trying to maximize creative productivity. They may neglect basic needs for sleep, nutrition, exercise, family, and social contact in an excessive creative frenzy day after day. This of course often results in serious consequences for the individual, their family, and their employers and colleagues.

Q2: Do some or all of these behaviours sound familiar to you? Which one(s) have caused you and your family the greatest difficulty over time? What strategies and tools can you use to “maximize creative productivity” without neglecting your basic needs? Who could you ask to help you with achieving a healthier balance?

Dr. Benjamin Rush, painted by Charles Wilson Peale, 1783. Source: Wikipedia

In his book (2009:75), Dr. Ghadirian quotes Dr. Benjamin Rush (1746–1813), considered to be the father of American psychiatry, who explained the relation between mental illness and creativity using this metaphor: “The disease which thus evolves these new and wonderful talents and operations of the mind may be compared to an earthquake which by convulsing the upper strata of our globe (brain) throws upon its surface precious and splendid fossils, the existence of which was unknown to the proprietors of the soil in which they were buried.”

Q3: Do you find Dr. Rush’s earthquake metaphor useful in your own case? Have you ever been surprised by any “precious and splendid fossils” that were unearthed after a bipolar episode? If so, were you able to make creative and/or productive use of them?

The 2022 essay by Dr. Ghadirian continues:

“For centuries, there was an assumption that a connection might exist between having a mood disorder such as melancholia (depression) or mania and possessing a high degree of creativity. However, since there were no psychiatrists to validate this impression, biographers of certain gifted individuals (prominent writers, poets, artists, and others) noted the possibility of a relationship between what they had observed in the creative life of such people and their mental problems. It was not until a few decades ago that researchers began to purposefully explore and study this relationship.”

Q4: Apart from van Gogh, who I have considered at some length in my blog posts over the years, are you aware of other visual artists, poets, writers, musicians, dancers, choreographers, actors, directors, comedians, etc. who have (or had) bipolar disorder?

Dr. Ghadirian writes:

“Recent research shows that there is a connection between creativity and bipolar, especially during the hypomanic state of the disorder, but not for every patient. Some people seem to have a particular susceptibility to this development. Our understanding of the connection between creativity and patients with bipolar illness is growing, but the precise nature and the mechanism of this connection remains a mystery.”

Q5: Do you think there is a connection between creativity and bipolar in your case? If so, what form does your creativity take? How do you express it? How does Dr. Ghadirian’s statement about “remains a mystery” make you feel, and why?

Dr. Ghadirian then includes some thought-provoking reflections on treating bipolar disorder in creative people, including both clinical and ethical considerations. He writes:

“The importance of research findings about the relationship between bipolar illness and creativity may have ethical implications for the current pharmacological treatment of patients with these disorders. Many visual artists, writers, musicians, and others make their living through their art while, at the same time, receiving treatment for their psychiatric disorders. Some of them, during their ongoing treatment, whether by not complying in taking their medication or by consuming alcohol and/or psychoactive drugs and without informing their therapist, may develop a (hypo)manic or depressive state. The consequences can be serious and costly. For example, during a manic episode, individuals are at much higher risk for destructive behavior, family conflicts, significant financial loss through overspending, or moral indiscretions that could damage their credibility and well-being.

“One of my bipolar patients was a gifted artist who from time to time would miss her appointment for weeks. Then she would show up at the emergency room in a relapse. When I inquired about her periods of absence from treatment, she told me that she had stopped her medication in order to regain her excitement and elation to be productive and thus better able to earn her living. She would work hard but unfortunately would also neglect her sleep. This, in addition to her non-compliance with treatment led to her relapse. Nevertheless, she felt that she had no choice for otherwise she was unable to work, a situation that would result in financial difficulties and accumulation of debt. Relapse was the price she paid for non-compliance with her mood stabilizing treatment.

“… Treating a creative bipolar patient is a daunting intervention both clinically and ethically. A patient’s agitation, delusional thoughts, mood changes and other symptoms are believed to stem from biological disturbances in brain function. All these factors point to a crucial need for adequate treatment. The challenge for a physician is to find the right balance between using a medication such as lithium and other mood stabilizers that regulates mood swings and enabling a patient to maintain their creativity. Occupational therapy including art therapy can be beneficial, especially for those who have artistic interest and background. Depending on the stability of the patient, art therapy may be combined with other therapeutic approaches such as supportive or interpersonal therapy.”

Q6: Which sections of the above extract resonate with you, and why? (As a health worker who is living with bipolar myself, I was struck by Dr. Ghadirian’s clinical and ethical concerns with trying to achieve an appropriate balance between prescribing potentially life-saving mood stabilizers on the one hand and respectfully supporting a client’s unique creativity on the other.)

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Many thanks to Dr. Ghadirian for allowing me to excerpt from his essay in the Navigating Bipolar Country anthology here.

Do you have any other thoughts about bipolar and creativity? Or any additional questions to consider after reading this? Please share in the comments below.

Thanks as always for making time to read this.


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