Creativity and mental illness

Dec 1 JDN 2458819

There is some truth to the stereotype that artistic people are crazy. Mental illnesses, particularly bipolar disorder, are overrepresented among artists, writers, and musicians. Creative people score highly on literally all five of the Big Five personality traits: They are higher in Openness, higher in Conscientiousness, higher in Extraversion (that one actually surprised me), higher in Agreeableness, and higher in Neuroticism. Creative people just have more personality, it seems.

But in fact mental illness is not as overrepresented among creative people as most people think, and the highest probability of being a successful artist occurs when you have close relatives with mental illness, but are not yourself mentally ill. Those with mental illness actually tend to be most creative when their symptoms are in remission. This suggests that the apparent link between creativity and mental illness may actually increase over time, as treatments improve and remission becomes easier.

One possible source of the link is that artistic expression may be a form of self-medication: Art therapy does seem to have some promise in treating a variety of mental disorders (though it is not nearly as effective as therapy and medication). And that wouldn’t explain why family history of mental illness is actually a better predictor of creativity than mental illness itself.

My guess is that in order to be creative, you need to think differently than other people. You need to see the world in a way that others do not see it. Mental illness is surely not the only way to do that, but it’s definitely one way.

But creativity also requires basic functioning: If you are totally crippled by a mental illness, you’re not going to be very creative. So the people who are most creative have just enough craziness to think differently, but not so much that it takes over their lives.

This might even help explain how mental illness persisted in our population, despite its obvious survival disadvantages. It could be some form of heterozygote advantage.

The classic example of heterozygote advantage is sickle-cell anemia: If you have no copies of the sickle-cell gene, you’re normal. If you have two copies, you have sickle-cell anemia, which is very bad. But if you have only one copy, you’re healthy—and you’re resistant to malaria. Thus, high risk of malaria—as we certainly had, living in central Africa—creates a selection pressure that keeps sickle-cell genes in the population, even though having two copies is much worse than having none at all.

Mental illness might function something like this. I suspect it’s far more complicated than sickle-cell anemia, which is literally just two alleles of a single gene; but the overall process may be similar. If having just a little bit of bipolar disorder or schizophrenia makes you see the world differently than other people and makes you more creative, there are lots of reasons why that might improve the survival of your genes: There are the obvious problem-solving benefits, but also the simple fact that artists are sexy.

The downside of such “weird-thinking” genes is that they can go too far and make you mentally ill, perhaps if you have too many copies of them, or if you face an environmental trigger that sets them off. Sometimes the reason you see the world differently than everyone else is that you’re just seeing it wrong. But if the benefits of creativity are high enough—and they surely are—this could offset the risks, in an evolutionary sense.

But one thing is quite clear: If you are mentally ill, don’t avoid treatment for fear it will damage your creativity. Quite the opposite: A mental illness that is well treated and in remission is the optimal state for creativity. Go seek treatment, so that your creativity may blossom.