The Affect of Affective Shifts

A closer look at the link between creativity and bipolar disorder

This essay will attempt a close examination of the link between bipolar disorder (BD) and creativity. Research on the subject dates back to as early as the 1970’s. Some researchers studied the lives of famous historical figures, looking more specifically at artists’ biographies, medical records, personal correspondence etc. From this, they were able to establish whether or not famous artists could possibly have suffered from BD or similar mental illnesses. Similarly, a lot of research is currently done on individuals known to suffer from BD, measuring their creativity against control groups without any form of the illness. This essay takes a different approach, and aims to explore the affective states, or moods, that influence both the creative process and BD, respectively, to see if there are any similarities.

Creativity is a very ambiguous term and cannot be singularly defined or understood. One definition suggests that it is “the creation of new and useful products, including ideas as well as concrete objects” (Piffer 2012). If only new and useful products are considered to be creative, does this mean that no aesthetic work can originate from creativity? It was, after all, the artist Oscar Wilde (1994, p.6) who said that “all art is quite useless.” To better accommodate the artist, the definition of creativity can be expanded to a “phenomenon whereby something new and valuable is created” (Creativity 2013), or better yet, “the use of the imagination or original ideas, esp. in the production of an artistic work” (Define Creativity 2013). Etymology suggests that the word creativity derived from the Latin word creō, which literally means to create (Creativity 2013). The word create, however, did not find its way into the English language until the 14th century, and was then associated only with divinity; only the gods could create something out of nothing (Creativity 2013). It was not until the Enlightenment in the 17th and 18th centuries that humans were deemed worthy of creation.

The creative person has the ability to make remote associations between distinct ideas, to generate many possible solutions to a single problem, and to actively conceive two or more opposite ideas simultaneously (Johns Hopkins 2012). They are typically open to new experiences, have a diversity of interest in hobbies, prefer complexity and novelty, and tolerate ambiguity (Johns Hopkins 2012). Put simply, the creative individual has a remarkable ability to create.

BD is a mental illness that is classified by psychiatrists as a mood disorder, since patients typically experience frenzied changes in affective states, or moods, alternating between episodes of mania and depression (Bipolar disorder 2013). During minor episodes of mania, patients appear to be excited and energetic, and often experience high levels of productivity (Bipolar disorder 2013). In more severe cases of mania, patients are prone to experience psychosis, a mental state that is often described as a ‘loss of contact with reality,’ during which hallucinations and delusions are common (Psychosis 2013). Manic and depressive episodes can last from between a few days to several months, with some patients reporting mixed states where both mania and depression are present at the same time (Bipolar disorder 2013).

BD can be described as a spectrum of disorders, rather than a single, defined illness, ranging from mild expressions of the disorder to severe manic-depressive behaviours. Recognised in the spectrum of disorders are (Shapiro, Weisberg 1999):

· Bipolar I

Bipolar I is full-blown manic-depression and is the most severe form of the illness. It is characterised by recurring episodes of mania and major depression.

· Bipolar II

Patients still experience recurring episodes of major depression, but hypomania and impairing mood elevations are less severe.

· Bipolar III

Bipolar III is a predominately depressive disorder, and patients typically only experience symptoms of hypomania or elevated mood after medical intervention.

· Cyclothemia

Cyclothemia literally means ‘cycling mind.’ Patients report cycles of mild depression and hypomania.

· Hyperthemia

Hyperthemia patients suffer from repeated hypomania and elevated moods, but no depression is reported.

The same sources suggest that during episodes of mania, BD patients often have a tendency toward punning, rhyming, sound associations and writing spontaneous poetry; intellectual functioning increases according to the Wechsler Adult Intelligence Scale (WAIS), and the number of original responses during word association tasks increase by as much as threefold.

Neuropsychological studies in BD patients found:

· Marked deficits in performance IQ. These deficits are independent of mood states and may often predate the onset of illness (Johns Hopkins 2012).

· A profound disturbance in attention. In fact, attention deficits in BD patients are significantly higher than in those patients suffering from actual Attention Deficit Disorder (Johns Hopkins 2012).

· BD patients suffer marked deficits in short term memory, which might be a secondary cause of attention deficits (Johns Hopkins 2012).

· Executive performance and overall functioning also suffer deficits (Johns Hopkins 2012).

· Cognitive functions that are heavily dependent on language appear to be among those functions that are least affected (Johns Hopkins 2012).

· Verbal IQ is not only normal, but is believed to be higher in BD patients (Johns Hopkins 2012).

· Reasoning remains mostly intact and logical (Johns Hopkins 2012).

How, the question is begged, can such a debilitating illness, which dramatically effects memory, attention, concentration and energy, yield any form of creativity? We know that the very nature of the illness is its significant changes in mood and affect, but what do we know about the creative process? Can there be drawn any similarities between the creative process and BD? What affect does affective states have on creativity?

Bledow, Rosing and Frese (2013, p.432) argue that “creativity is influenced by the dynamic interplay of positive and negative affect,” and that high creativity results when an episode of negative affect is followed directly by increased positive affect. They refer to this process as an “affective shift,” an all too familiar occurrence in the lives of BD patients. For their argument, they use, as analogy, the metaphor of the phoenix. Much like the phoenix that rises out from the ashes to become once more a beautiful and colourful bird, the creative person must, too, rise from an episode of negative affect before a creative period can be experienced.

In their study, they identified two types of positive and negative affect: high and low positive affect and high and low negative affect.

Low positive affect regulates whether cognition proceeds in a controlled, slow and sequential mode, while high positive affect regulates whether cognition proceeds in an automatic, fast and parallel mode (Bledow et al. 2013, p.433). When positive affect is low, a problem can be analysed closely, objectively and deliberately. When an increase in positive affect is experienced, behavioural activation occurs, and previously conceived ideas can be implemented. When behavioural activation does occur as a result of high positive affect, “cognitive processing broadens and includes exploratory thoughts and actions” (Bledow et al. 2014 p.433).

This brings to mind the ‘edge of chaos’ theory, which suggests that circumstances that present widely disparate ideas and perspectives, that cannot be perfectly coordinated, can stimulate creative thought. (Fodor, Laird 2004). The edge of chaos theory does not, despite the term, imply chaos. It implies rather a certain sensitivity to complexity and nonlinearity (Fodor, Laird 2004).

Some studies found that persons with mania tend to merge seemingly unrelated ideas and make connections according to criteria that other persons normally would not, and that they would often allow categories of thought to intrude on each other, meaning that they would entertain different ideas, that are completely unrelated, in search of a single solution (Fodor, Laird 2004.) It is thought that the elevated mood states experienced with mania create a defocused state of attention which allows for a wider range of interpretations and associations in thought processing. Again, this relates to the theory of high positive affect and behavioural activation.

Low negative affect regulates whether attention is narrowed and focused on isolated elements, where high negative affect, on the other hand, regulates whether attention is focused on broader elements, but not exclusive of the context of those particular elements (Bledow et al. 2014 p.433).

In his work, The Creative Personality, Mihaly Csikszentmihalyi (1996) talks about convergent and divergent thinking. Both, according to him, are crucial elements in the creative process. Divergent thinking does not result in any agreed-upon solution, but “involves fluency … the ability to generate a great quantity of ideas; flexibility … to switch from one perspective to another; and originality in picking unusual associations of ideas” (Csikszentmihalyi 1996). Does this not sound remarkably similar to behavioural activation and to the edge of chaos theory?

Convergent thinking, on the other hand, is measured by IQ tests, where well-defined problems with only one correct answer are presented, strongly relating to low negative affect, where attention is narrowed and focused on isolated elements. It also relates to the depressive states as experienced by BD patients. Csikszentmihalyi (1996) furthermore states that it is important for all creative persons to be able to distinguish a good idea from a bad one, and that is why a balance between convergent and divergent thinking is necessary.

It is, in many cases, possible that the mood variations reported by creative individuals are merely a result of their creativity, and not a result of any underlining mood disorders. It is important that a clear distinction can be made between the normal mood variations of a creative person, and the mood variations that are experienced in BD.

In studying the relation between specific symptoms of mood disorders and creative productivity, it was found that 89% of the artists and writers in a study group reported “Intense, highly productive and creative episodes … characterised by an increase in enthusiasm, energy, self-confidence, speed of mental association, fluency of thoughts, elevated mood, and a strong sense of well being” (Jamison 1989 p. 128). These are specific traits of hypomania as experienced by BD patients. It should be noted, however, that other extreme behavioural traits of hypomania were reported less frequently. Increased sex-drive and increased talkativeness are key recognisers of BD, yet only 30% of the study group reported these symptoms (Shapiro, Weisberg 1999). Likewise, only 10% of the respondents reported an impulse for excessive spending, or similar risk-taking behaviour, which is typically associated with hypomania (Shapiro, Weisberg 1999). However, as noted earlier, BD is defined as a range of disorders with a range of symptoms, some more severe than others. It is evident that there is a clear similarity between symptoms of hypomania and the creative process, but it should not be assumed that these are all underlining symptoms of BD. The elevations in mood reported by the test subjects could very well be symptoms of the creative process alone.

Nevertheless, these reported changes in mood, motivation and cognition are remarkably similar to the critical symptoms of hypomania as put forth by both the Research Diagnostic Criteria (RDC) for psychiatric diagnosis and the American Psychiatric Association (Shapiro, Weisberg 1999).

Studies on affect and creativity suggest that goal-directed motivation increases creativity, whereas avoidance motivation, such as fear or anxiety, is known to impede the creative process (Flaherty 2011, p.135). But there are different types of goal-directed motivation, and they affect creativity in different ways. These goal-directed motivations can be referred to as ‘intrinsic’ motivation. Intrinsic motivation, such as finding pleasure and joy in performing tasks, has a positive effect on mood, and indeed, on creativity. At the same time, intrinsic motivation, such as deadlines or working towards a goal or a monetary reward, might have a more negative effect on creativity. Much research has been focused on the effect that positive mood has on creativity, but the intensity of mood also plays a significant factor. Even negative drives like anger and frustration can encourage positive outcomes. High-energy negative moods are more effective for creativity than low-energy positive moods (Flaherty 2011, p.135). This is especially true in the case BD patients. Hypomania, despite being a hyperactive state, is thought to have negative psychomotor activation as its central feature, rather than being a hyper-positive mood (Flaherty 2011, p.135). In many patients, increased creativity might be a secondary cause from the affect that the disorder has on their mood and motivation (Flaherty 2011, p.135).

Evidence to support this can be found in the works of artists known to suffer/have suffered from BD. The German composer Robert Schuman, 1810–1856, was one such artist (Robert Schumann 2013). A close examination of his biographical information, medical records and his personal correspondence, in correlation with his compositions and collective works, shows clearly that Schumann produced, on average, four times as many compositions during episodes of mania, than he did during episodes of neutral or depressive states (Weisberg 1994, p.363). Schumann was indeed a phoenix.

The American poet, Robert Lowell, 1917–1977, who has been hospitalised for manic episodes twenty times, described mania as “a magical orange grove in a nightmare” (John Hopkins 2013). In this letter to fellow poet and friend, T.S Elliot, Lowell refers to increased creativity as the ‘magical orange grove,’ and the more serious and temperamental symptoms of mania as ‘a nightmare’ (Becker n.d).

Edgar Allan Poe, 1809–1849, wrote some of his best work while experiencing episodes of mania, the poet himself said: “Men have called me mad; but the question is not yet settled, whether madness is or is not the loftiest intelligence — whether much that is glorious — whether all that is profound — does not spring from disease of thought — from moods of mind exalted at the expense of the general intellect” (McGrath 2013).

In the paintings of artist Vincent van Gogh, 1853–1890, clear patterns of moods and psychosis align with the artist’s productivity (McGrath 2013).

In his documentary, The secret Life of the Manic Depressive, actor, author and comedian, Stephen Fry (2006), discusses in detail his experience with BD. His observation of the illness, its alternating moods and its affect on creativity, hold true to the discussions as highlighted thus far. Fry agrees that there is, indeed, a clear link between affective states and the creative process.

There are significant similarities between affective states as experienced by creative persons during high states of creativity, and that of the effective states as experienced by bipolar patients. Csikszentmihalyi (1996) is of the opinion that the creative personality can control their moods, and is able to bring on a state of creativity, a state of “ fluency … the ability to generate a great quantity of ideas; flexibility … to switch from one perspective to another; and originality in picking unusual associations of ideas.” The bipolar patient, however, is not always in control of their mood. It may very well be that creative episodes experienced by bipolar patients are as a secondary result of their uncontrollable, and often extreme, effective shifts.

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