The “tortured artist”: Is mental illness linked to creativity?
The idea of a “tortured artist” is well engrained in our society. It almost seems like a requirement for great artists to also struggle with mental illness. A fascinating series from JAMA Psychiatry explores the idea of famous paintings being linked to their artists’ struggles with different mental disorders.
As a double art history and psychology major, I have many times flirted with the idea of a link between creativity and mental disorders. For some artists, this is well documented: Vincent van Gogh perhaps being one of the best examples. It is widely suggested that van Gogh struggled with what was called manic depression, and is now called bipolar disorder. These waves of mania and depression led to his hospitalization at St Paul. The view out van Gogh’s window in his hospital room is the subject of the famed Starry Night and the lesser known daylight equivalent (my personal preference) Olive Trees. Sadly, van Gogh succumbed to his illness, dying by suicide at age 37. Van Gogh’s last painting, Tree Roots and Trunks, appears to be unfinished before his death.
Other artists known to have struggle with mental illness include Frida Kahlo, Edvard Munch, and Paul Gaugin, to name a few. Is mental illness a requirement of exceptional creativity? I would like to think not and argue that there is some level of the availability heuristic at play. That is, we look at cases that are easily available (eg: famous artists who are well known for mental illness) and form our estimates from these cases.
But does this hold association hold true for the normal population? Are more creative people more likely to struggle with mental illness? Or even, can creativity cause mental illness? Researchers in Sweden made it their mission to find out. The goal of this study was to better differentiate between confounding variables (outside variables with a potential influence on the connection of interest) to the association between creativity and three mental disorders: schizophrenia, bipolar disorder, and unipolar depression (commonly just called depression). Confounding variables include highest level of education, familial influence, and intelligence.
These researchers decided to measure creativity as studying a “creative” subject in college or high school. They made the choice to differentiate between “artistic” and “scientific” creativity because people who study science may have “a more logical or analytical cognitive style.” They chose to look at a measure collected in young adulthood as opposed to those with artistic occupations because according to their article, these disorders typically arise after secondary education. Additionally, having these disorders might affect an individual’s ability to keep or perform at their job. Two levels of creativity were identified: (1) the broader definition included a wider array of coursework related to artistic creativity (although not art history, which I found interesting) and (2) a narrow definition with more directly related courses. The researchers also categorized courses into those relating to the visual or performing arts. This information is represented in the table below.
Researchers took advantage of the wealth of information publicly available about Swedish citizens to obtain information about psychiatric hospitalizations, first-degree relatives (parents, siblings, or children), level of education, and intelligence. Intelligence information was only available for men due to previously compulsory military conscription for males that included IQ evaluations. For individuals with multiple diagnoses, schizophrenic diagnoses took precedence over bipolar or depression diagnoses, and bipolar diagnoses took precedence over diagnoses of depression.
The researchers created three models to better identify the confounding variables in this association. They represented their results by identifying the values that would make them 95% certain of their results (called a confidence interval (CI) and represented by [minimum value, maximum value]) and the value (called an odds ratio (OR)) that represents the association statistically. These values will be reported as (OR, [min value for CI, max value for CI]) in this blogpost. The first model only controlled for age and gender. Here, they identified a “moderate” link between the broad definition of creativity and bipolar disorder and unipolar depression (bipolar disorder: 1.29 [1.22; 1.36], unipolar depression: 1.22 [0.92; 1.01]). Schizophrenia was only “borderline” associated with this definition (1.09 [1.00; 1.19]). When researchers used this model (only controlling for age and gender) with the narrow definition of creativity, these associations became stronger (bipolar disorder: 1.53 [1.42; 1.66], schizophrenia: 1.50 [1.34; 1.68], unipolar depression: 1.29 [1.24; 1.34]).
In this second model, the researchers controlled for the highest level of education reached (and age/gender) to account for the possibility of university attendance affecting the link between artistic creativity and mental disorder. With this model, the link appeared to be even stronger. This suggests there is likely a minimal if any effect of university attendance on this association.
The third model controlled for the same things as the second model while also controlling for sibling pairs. This would reveal if there was some influence of the family on the link between artistic creativity and mental disorders. In fact, the odds ratios here decreased, meaning that there likely is some influence of the family on this connection, for the broad definition: (bipolar disorder: 1.26 [1.15; 1.39], schizophrenia: 1.19 [1.02; 1.37], unipolar depression: 1.20 [1.15; 1.25]).
The researchers found no effect of intelligence on this association. When they further categorized the narrow definition into visual or performing arts coursework, they found that all mental health outcomes were more strongly associated with those in the visual arts.
All in all, I think these researchers did a good job at looking at a complicated research question. Psychologists can target those in artistically creative fields (especially visual arts) for early identification, treatment, and resources relating to these disorders. I do have a couple points that I think could be incorporated into future research in this field. First, I found that this article went back-and-forth on using causal-type language. Sometimes, it felt as if the researchers were almost suggesting that being involved in creative courses made individuals more likely to develop these disorders. On the same vein, the researchers mentioned they chose secondary education coursework because these disorders generally develop later in life. This is true, but also erases the cases of pediatric and adolescent schizophrenia, bipolar disorder, and depression. Additionally, I found it hard to understand whether being creative was defined as taking one course in an artistic field or majoring in the field.
I think it would be interesting if the researchers created a study to look at these factors in a lab setting. For example, they could recruit individuals with these disorders and a healthy control group. Here, they could measure creativity through a validated task instead of using coursework. They could use a more diverse group than just Swedish residents who are generally very similar. It would also be cool if the researchers looked at comorbidity (having more than one disorder at once) and if this is relevant to the discussion.
Want to read this article yourself? Check it out here.
Citation for article discussed:
MacCabe, J. H., Sariaslan, A., Almqvist, C., Lichtenstein, P., Larsson, H., & Kyaga, S. (2018). Artistic creativity and risk for schizophrenia, bipolar disorder and unipolar depression: A Swedish population-based case–control study and sib-pair analysis. The British Journal of Psychiatry, 212(6), 370–376.
