Creativity and bipolar illness

Stigmatising Mania in Both Ways:
Either as Genius or Nuts?

E. Timuçin Oral
Bakırköy State Hospital for Psychiatric & Neurological Diseases
Mood Disorders Outpatient Unit

Rasit Tahsin

duygudurum
merkezi

06 Eylül 2010 Pazartesi

Funny Political Pictures:

“not all of them necessarily
have psychiatric diagnoses
of course”


BMW


Robert
Schumann Gordon
Sumner

Charles
Sylvia
Parker
Plath

Stigma is still an
important problem
for people, and not
only mentally
handicapped people
but everybody may
need help against it in
his entire life…


Public attitudes today – worse than in the 1950s
Proportion of respondents in a public survey that
described a mentally ill person as being violent

1950 1996
13% 31%

“the perception of people with psychosis as being
dangerous is stronger today than in the past”
Phelan et al 1997


Power and confusion surrounds stigmatising
terms in the media

Early edition Later edition

23 September 2003


Metaphors in mental illness:
influence on public attitudes

A study of German language newspapers
examined use of the term ‘schizophrenia’

 In 40-60% of newspapers the term was
used metaphorically
 In no case of use was the connotation
positive

Finken 1997


Albright: Whitehouse is Manic Depressive


A manic depressive night:
Evaluation of the 2003 Oscar Results


• Science has not so far found a way
to prevent all mental illness or cure it

• Stigma is not only a pernicious
consequence of mental illness, it is also
a risk factor for disease and a direct
cause of disability & handicap


Does the ‘mental illness’ label have any help?
YES NO
Provides orientation for patients Stresses the negative effects
and families of mental illness

Improves patients’ understanding
Negative stereotypes prevalent
of the problem and improves
among the public will be triggered
access to help

Patients not held responsible for Discrimination against those
their illness, leading to more with a mental disorder increases
accepting attitudes in society in society


Steps of social distance

Have the
Trust the
Start work Make friends Rent a person
person to
with the with the room to the marry
take care of
person person person into your
your child
family

Lauber et al 2004

Attitude Against Mental Illness
Substance use
in University Students (n= 325) Alcohol use
Schizophrenia
60 Depression
Bipolar
50

40

30

20

10

0
Against being Against being Can not work Should not marry Should not be
friens neighbors a parent

Alkan et al 2004


“With whom you shared your illness and what did they do?”
% 55 Bipolar Patients
100
90
80
70
Who knows illness
60
Staying away
50
40
30
20
10
0
1° Relatives 2° Relatives Close friends Friends Close collegues Collegues Neighbors

Alkan-Vahip-Çam 2004


If God created human in his own image, does this
mean that God has a mental illness? If not so,
who created mentally handicapped people?
Norman Sartorius


I want to know God’s thougts;
rest are details

Albert Einstein


Are all creative artists Bipolar?


Writers
Hans Christian Andersen Honore de Balzac
James Barrie Arthur Benson (H)
William Faulkner (H) F. Scott Fitzgerald (H)
Lewis Grassic Gibbon (SA) Nikolai Gogl
Maxim Gorky (SA) Kenneth Graham
Graham Greene Ernest Hemingway (H, S)
Hermann Hesse (H, SA) Henrik Ibsen
William Inge (H, S) Henry James
William James Charles Lamb (H)
Malcolm Lowry (H, S) John Bunyan
Samuel Clemens (Mark Twain) Joseph Conrad (SA)
Charles Dickens Isak Dinesen (SA)
Ralph Waldo Emerson Herman Melville
Eugene O'Neill (H, SA) John Ruskin (H)
Mary Shelley Jean Stafford (H)
Robert Louis Stevenson Leo Tolstoy
Ivan Turgenev Tennessee Wiilliams (H)
Mary Wollstonecraft (SA) Emile Zola
Virginia Woolf (H, S)

Poets
Antonin Artaud (H) Konstantin Batyushkov (H, SA)
Charles Baudlaire (SA) Thomas Lovell Beddoes (S)
John Berryman(H, S) William Blake
Aleksandr Blok Barcroft Boake (S)
Louis Bogan (H) Rupert Brooke
Robert Burns George Gordon (Lord Byron)
Thomas Campbell Paul Celan (S)
Thomas Chatterton (S) John Clare (H)
Harley Coleridge Samuel T Coleridge
William Collins (H) William Cowper (H, SA)
Hart Crane (S) George Darley
John Davidson (S) Emily Dickinson
Ernest Dowson T S Eliot (H)
Sergey Esenin (S) Robert Fergusson (H)
Afanasy Fet (SA) Anne Finch, Countess of Winchilsea
Edward FitzGerald John Gould Fletcher (S)
Gustaf Froding (SA, H) Oliver Goldsmith
Adam Lindsay Gordon (S) Thomas Gray
Nikolai Gumilyov (SA) Robert Stephen Hawker
Friedrich Holderlin (H) Gerard Manley Hopkins
Victor Hugo Randal Jarrell (H, S)


Poets II
Samuel Johnson John Keats
Henry Kendall (H) Velimir Khlebnikov (H)
Heinrich Von Kleist (S) Walter Savage Landor
Nikolaus Lenau (H) J.M.R. Lenz (SA)
Mikhail Lermontov Vachel Lindsay (S)
James Russell Lowell Robert Lowell (H)
Hugh MacDiarmid (H) Louis MacNeice
Osip Mandelstam (H, SA) James Clarence Mangan
Vladimir Mayakovsky (S) Edna St Vincent Millay (H)
Alfred de Musset Gerard de Nerval (H, S)
Boris Pasternak (H) Cesare Pavese (S)
Edgar Allan Poe (SA) Ezra Pound (H)
Alexander Pushkin Laura Riding (SA)
Theodore Roethke (H) Delmore Schwartz (H)
Anne Sexton (H, S) Percy Bysshe Shelley - (SA)
Christopher Smart (H) Torquato Tasso (H)
Sara Teasdale (H, S) Alfred, Lord tennyson
Dylan Thomas Edward Thomas
Francis Thompson George Trakl (H, S)
Marina Tsvetayeva (S) Walt Whitman
Sylvia Plath (H, S)


Painters
Ralph Barton (S) Francesco Bassano (S)
Ralph Blakelock (H) Francesco Borromini(S)
Richard Dadd (H) Edward Dayes (S)
Paul Gauguin (SA) Theodore Gericault
Vincent van Gogh (H,S) Arshile Gorky (S)
Philip Guston (H) Benjamin Haydon (S)
Carl Hill (H) Ernst Josephson (H)
George Innes (SA) Ernst Ludwig Kirchner (H, S) Edwin
Landseer (H) Wilhelm Lehmbruck (S)
John Martin Charles Meryon (H)
Michaelangelo Buonarroti Adolphe Monticelli
Edvard Munch (H) Jules Pascin (S)
Georgia O’Keefe (H) Raphaelle Peal (H)
Jackson Pollock (H) George Romney
Dante Gabriel Rossetti (SA) Mark Rothko (S)
Nicolas de Stael (S) Pietro Testa (S)
Henry Tilson (S) George Frederic Watts
Sir David Wilkie Anders Zorn


Musicians

Anton Arensky Hector Berlioz (SA)
Anton Bruckner (H) Jeremiah Clarke (S)
John Dowland Edward Elgar
Carlo Gesualdo Mikhail Glinka
George Frederic Handel Gustav Holst
Charles Ives Otto Klemperer (H)
Orlando de Lassus Gustav Mahler
Modest Mussorgsky Sergey Rachmaninoff
Giocchino Rossini Alexander Scriagbin
Peter Tchaikovsky Peter Warlock (S)
Hugo Wolf (H, SA) Bernd Alois Zimmerman (S)

Robert Schumann (H, SA)

Irving Berlin (H) Noel Coward
Stephen Foster Charles Mingus (H)
Charles Parker (H, SA) Cole Porter (H)
Bud Powell (H) Kurt Cobain (S 1994)


Living BP

Buzz Aldrin
Francis Ford Coppola Patty Duke
Larry Flynt Linda Hamilton
Peter Gabriel Peter Nolan Lawrence
Kate Millett Ilie Nastase
Charley Pride Axl Rose
Ted Turner Jean-Claude Van Damme
Gordon Sumner


Are all creative artists Bipolar?

ALMOST

but it is not necessary
to named as Bipolar
to be certified as creative


You have some
Prof
Shrink
schizophrenia and
some psychological
depressions and
much more sir

Yihhouuou I became an
artist. I’ll paint, carve, Prof
write poems, novels Shrink
now


If somebody has any idea about
depression or bipolar illness, you can
easily understand it from his/her work


Sylvia Plath

Lady Lazarus
I have done it again.
One year in every ten
I manage it-----

The nose, the eye pits, the full set of teeth?
The sour breath
Will vanish in a day.
Soon, soon the flesh
The grave cave ate will be
At home on me

And I a smiling woman.
I am only thirty.
And like the cat I have nine times to die.

This is Number Three.
………………………………………………………


………………………………………………………
The first time it happened I was ten.
It was an accident.

The second time I meant
To last it out and not come back at all.
I rocked shut

As a seashell.
They had to call and call
And pick the worms off me like sticky pearls.

Dying
Is an art, like everything else.
I do it exceptionally well.

I do it so it feels like hell.


Is it necessary to be in the manic or
depressive episode to create in
BPD; if so which episode is it?


54 artists and 33 healthy volunteers
 Mood Disorders in artists and in their relatives
is significantly higher than the control group
(p < 0.001)

 A significant positive correlation was found
between artistic creativity and mood episodes
(p < 0.001)

The Relationship Between Mood and Artistic Creativity (Mumcu et al 1998)


Diagnosis Control Artist

No Rx 25 % 75.8 5 % 9.3

Adjustment Disorder with Anxiety 1 % 3.0

BP I 12 % 22.2

BP II 21 % 38.9

Adjustment Disorder with Depression 2 % 6.1

Dysthymia 1 % 1.9

Alcohol-Substance Abuse 1 % 1.9

Schizo-affective 3 % 5.6

Cyclothymia 2 % 3.7

Somatoform Disorder 1 % 3.0 1 % 1.9
UP-D 3 % 9.1 8 % 14.8

GAD 1%3


%2
No correlation

% 15 increase in euthymia
increase in depression/mania
% 15

increase in depression
increase in mania /hypomania
% 23
% 45

decrease in mania /hypomania No correlation
% 11 % 15

decrease in depression decrease in euthymia

% 44 % 30

Mumcu et al, 1998


Creativity in Mood Disorders:
Limited only to art?


Fill my eyes
O Lithium sunset
And take this lonesome burden
Of worry from my mind

Take this heartache
Of obsidian darkness
And fold my darkness
Into your yellow light
I've been scattered I've been
shattered
I've been knocked out of the race
But I'll get better
I feel your light upon my face

Heal my soul
O Lithium sunset
And I'll ride the turning world
Into another night

See mercury falling...


Take Home Message

Bipolar Disorder is very
important like all other
mental disorders, but
avoid stigmatising it
either ways


Creativity and bipolar illness

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