Is this why the research on creativity and mental illness is so contradictory?

From Van Gogh to Poe, history is littered with famous cases of creative geniuses plagued by inner turmoil. But going beyond the anecdotal, are creative people really more prone to mental health difficulties?

Past studies have led to conflicting results – for every one that uncovered a link, another has come along with the opposite result. In a new paper in Psychological Bulletin, a Netherlands-based team led by Matthijs Baas takes us through a tour of this earlier work and they propose a brain-based explanation for why the results are so messy.

Baas's team begin with findings from earlier meta-analyses – studies that pool data from prior research. These reviews show that "positive schizotypic symptoms" such as impulsivity, hallucinations and superstitious beliefs are more common among creative people, but "negative schizotypic symptoms" – such as cognitive disorganisation and forms of anhedonia, a reduced capacity to enjoy pleasure – are actually less common.

Baas and his colleagues suggest this is because of the relationship between positive and negative schizotypic symptoms and our brain's two basic motivational systems – the approach system and the avoidance system. The approach system is creativity friendly, as the neurotransmitter dopamine encourages exploration and the pursuit of rewarding stimuli. It is linked to high mood, exploration, and even to difficulties inhibiting 'irrelevant experience' – not unlike positive schizotypy. Meanwhile, the serotonin-charged avoidance system deals with threat, and leads to reduced flexibility and focused rather than open information processing – which links with the low mood and disrupted attention that characterises negative schizotypy. So this taxonomy makes sense of the different results: approach system symptoms are more frequent in creative people who have more dominant approach systems, whereas avoidance-related symptoms are less frequent. Supporting this, another avoidance-like condition – trait anxiety – has been shown to be slightly less common among more creative people.

Baas's team wanted to see if this pattern generalises beyond schizophrenia-related symptoms to the approach-like condition of bipolar disorder and to depression – avoidance's black dog. They gathered nearly 2000 scholarly citations that referenced creativity and these two conditions, and then shaved them down to 39 depression studies, 28 bipolar, mostly peer reviewed work, together with some theses and unpublished work. Note, these studies dealt with non-clinical instances – so depressive mood or manic tendencies, rather than formal diagnoses.

The relationship between bipolar tendencies and creativity was clear and positive (an overall correlation of .224 where 1 would be a perfect match). This correlation was strongest when considering self-report studies, rather than those that actually tested creativity; this suggests an association between bipolar and an inflated sense of creativity. But still, a significant correlation remained when stripping out the self-report.

Meanwhile, depression showed the expected negative relationship with creativity. However, this association it was very small (the correlation was -.064). The previous findings with negative schizotypy were also small which could suggest that the avoidance system is only a minor impediment to creativity, or that the picture is more complicated. Supporting the latter position, the data suggest that the relationship is stronger in certain social groups – non artists – and in older adults.

We should note that the data discussed in this new study is all from healthy people whose symptoms were not serious enough to warrant a clinical diagnosis. There may be different factors at work among creative people who have more serious mental health problems, as was the case for Van Gogh and Poe. One possibility here is that being highly creative is a risk factor for mental health because it pits people against rigid societal boundaries. Another may be that atypical experiences – such as committal to a mental institution – may kindle different ways of looking at the world. But this study suggests that sitting underneath these complex dynamics are deeply grounded tendencies: to follow our flights of fancy or stay close to home.

Further reading

Baas, M., Nijstad, B., Boot, N., & De Dreu, C. (2016). Mad Genius Revisited: Vulnerability to Psychopathology, Biobehavioral Approach-Avoidance, and Creativity. Psychological Bulletin DOI: 10.1037/bul0000049