Roman philosopher Seneca once penned, “There is no great genius without a tincture of madness.” For centuries, philosophers and scientists have wondered about the nature of the relationship between creativity, a trait critical to genius, and psychiatric disorders like schizophrenia and bipolar disorder. A recent study in the journal PLoS One suggests that the density of a certain type of dopamine receptor on the thalamus, a brain area linked to passing sensory information to the cerebral cortex, may play a role.
Linking creativity to mental illness
Most studies of creativity have focused on eminent creativity, or the creativity of famous geniuses and artists. While there is a fair amount of anectdocal evidence suggesting that eminent creatives are likely to suffer from disturbances of mood, there is not much direct evidence to link the two.
“It’s long been an observation that some of the greatest creative individuals in the world experienced emotional distress,” says Michael Crawford, a psychiatrist at Imperial College in the United Kingdom. “When you look at famous artists, musicians, and other creatives, high levels of mental illness has been noted.”
In 1995, Arnold M. Ludwig, a psychiatrist at Brown University, published The Price of Greatness: Resolving the Creativity and Madness Controversy (Guilford Press). In the book, he examined more than 1,000 people who were important enough to have their biographies reviewed in the New York Times Book Review. He assessed each for mood disorders and then clustered the different occupations based on his findings.
“Ludwig found a clustering of creative endeavors at the highest rate of mood disorders. That is, individuals who were poets, fiction writers, visual artists, musicians, and theater performers,” says Terence Ketter, a psychiatrist at Stanford University. “That group was much more likely to show signs of mood disorders than military figures, sports figures, or people prominent in the natural sciences.”
But this ad-hoc analysis, though interesting, isn’t conclusive. And Ketter is quick to point out that when you study only the most eminent individuals, there’s a limit to what you can learn about the true relationship between mental illness and the creative process.
To that end, Ketter and his colleagues compared people with bipolar disorder, those with unipolar depression, a creative control group made up of graduate students in the Fine Arts at Stanford, and normal individuals on a battery of creativity measures. In one of the creative metrics, the Barron Welsh Art Scale, people with bipolar disorder scored 50 percent higher than healthy controls. People with unipolar depression showed a slight advantage on the test – as did the creative control group. This, Ketter argues, suggests a link between bipolar disorder and creative thinking.
What might be behind this creative advantage? Anna Abraham, a researcher at the Justus Liebig University in Giessen, Germany, suggests that the attention system may be involved.
“One classic idea that has been around for a long time is to link greater creative ability to populations such as patients with bipolar disorder or schizophrenics who have impaired attention systems,” she says. “If you use the spotlight metaphor of attention: As these groups can’t stay focused on one thing, they have other items of information available in that focus and then have more possibilities to combine that information in original ways.”
The role of dopamine
Other studies suggest that the dopaminergic system may be involved, particularly a specific receptor for the neurotransmitter dopamine called D2.
“There’s new data that there may be a common set of genes involved in major psychiatric diseases like schizophrenia and bipolar disorder,” says Fredrik Ullén, a researcher at the Karolinska Institute in Stockholm, Sweden. “It appears that some of these genes are related to creativity—and also related to the D2 receptor system.”
Ullén and colleagues used positron emission tomography (PET) to measure the density of D2 receptors on brain areas traditionally associated with schizophrenia’s hallmark psychotic symptoms in healthy individuals. The group then correlated those densities with each participant’s score on a creativity task. In the study published in the May 17 issue of PloS One, Ullén and colleagues demonstrated that people who scored higher on the creative tasks showed a schizo-typical pattern of D2 receptor density on the thalamus, the part of the brain responsible for transmitting sensory information to the cerebral cortex. This area shows a reduced number of D2 receptors in schizophrenia, too.
“The thalamus gates information: Lots of different information that comes in from the senses and the thalamus selects what is relevant,” says Ullén. “Having reduced D2 receptors in the thalamus means that more signals are going through the thalamus to the cortex. This might result in the kind of bizarre, positive symptoms you see in schizophrenia. But in a healthy mind, the lack of D2 receptors may give individuals more information to play with and make creative associations from.”
Treatment and next steps
The link between creativity and psychiatric disorders may also help with treatment. Crawford, who studies evidence-based therapies, has completed a clinical trial showing that creative therapy programs are beneficial to inpatient schizophrenic patients, improving overall emotional health and reducing some of the negative symptoms of the disease, including social withdrawal and lack of motivation.
“If you have delusions about the world being very different from the way anyone else sees it, it can be quite hard to communicate. If you are psychotic and want to talk about things others don’t, your expression is going to be reduced,” says Crawford. “Maybe art allows individuals to express themselves without inhibition and convey how they are feeling in a way that is therapeutic.”
Abraham believes that there’s still much to learn about normal creativity. Though the studies on people with illnesses are exciting, there’s still a need to examine the cognitive processes underlying creativity in normal brains, too. It’s a topic that is not well understood and critical to our overall understanding of cognitive function.
“Everyone is creative to some extent,” she says. “You have to understand normal creativity to fathom extraordinary creativity.”