Creativity in Bipolar Disorder

Introduction
Evidence that high creativity and achievement can result from manic episodes of bipolar disorder is not only interesting but beneficial for society because it can positively influence a predominantly negative general narrative the public has on bipolar disorder. Research on the link between bipolar disorder and creativity also can provide insight on how to treat bipolar disorder by focusing on the advantages of manic episodes such as creative power by harnessing the positive emotions and functioning elicited from it to be used in evidence based therapy for treatment of bipolar disorder.

The relationship of creativity and extreme mood states or "madness" is a general ancient narrative that Socrates, Plato and Aristotle discuss in length. This madness that Plato and Socrates believed to be the essence of creating art, was a combination altered states of mind, awareness and emotions. Aristotle even pointed out that Plato and Socrates both are melancholic but gifted with inspiration in their insanity.

History/Distinguished Figures with High Levels of Creativity and Bipolar Disorder
A large amount of evidence for the link between manic-depressive illness and creativity is found in biographical studies of famous creative individuals such as artists, poets, musicians, philosophers, authors etc. The excessive number of creative well-known figures with bipolar spectrum disorders does not suggest that their creative power was a result of their bipolar spectrum disorder but that their already present creative ability was enhanced and harnessed by their manic-depressive disorder. Autobiographical studies on famous artists, who were suspected or diagnosed with a type of Bipolar Disorder, not only provided insight into the creative enthusiasm predominately occurring during hypomanic states but also a description of their well-being during it.

Writers
Virginia Woolf is recognized as one of the greatest writers to date. In her writings, her emotional turbulence is evident. This is, however, by no means a bipolar diagnosis. It is within her diary and her family history that we see the real evidence warranting her diagnosis. Virginia’s great-grandfather on her father’s side was cyclothymic, along with her father and three of her siblings. Her half-sister suffered from a form of psychosis and was institutionalized throughout her life, and her mother battled with depression. Woolf was sexually abused by two of her half-brothers throughout her childhood; experts suggest that her case of bipolar disorder could have been less severe if she were not subject to this trauma. Her mental illness even reached the point to where her doctor requested she refrain from bearing children. At age 22, Woolf attempted suicide for the first time; this leads to an extended period of suicide attempts broken up by stays in an institution. Until finally, at age 59, Virginia Woolf stuffed her pockets full of stones and walked into a river; successfully killing herself. Woolf spent her life battling her illness and knew that the only method of helping herself was through her writing. She could never decide if her illness impeded her writing abilities or a factor that gave her typically unattainable ideas.

What are some reasons that can explain the link between creativity and manic-depressive disorder?
Broadly speaking, many studies have established that the co-occurrence of bipolar disorder (BD) and creativity could be explained by variables such as: personality, affective, and cognitive characteristics such as openness to experience, positive affect, cyclothymia, divergent thinking, risk-taking, ambition and drive.

The manic episode of bipolar spectrum disorders is linked to creativity likely because it increases involvement in pleasurable activities and if that person is a creative individual those activities are usually ones that provide a creative outlet for their energy.

A recent study investigated the relationship between bipolar disorder and creativity in a nonclinical sample of 543 undergraduates in an introduction to psychology class from three universities in South Korea. The study relied on the the self-reported measures to come to the conclusion that heightened behavioral activation system (BAS) sensitivity has a mediation effect on the relationship between bipolar disorder and creativity. After informed consent, each participant completed the following 6 measures:
 * 1) The Hypomanic Personality Scale (HPS) to identify if they were at risk for hypomania and to assess for personality variant vulnerability of BD.
 * 2) The validated Korean version of the Behavioral Activation System/Behavioral Inhibition System Scale (BAS/BIS Scale) which measures the dispositional sensitivities of the neurological aversive motivational system called the behavioral inhibition system (BIS) and the other physiological mechanism which controls the appetitive motivation called the behavioral approach/activation system (BAS). The BIS subscale successfully predicts level of nervousness in response to an impending punishment and the BAS subscale successfully predicted happiness in response to an impending reward. This study focused on the BAS Scale because it had been traditionally used as an index of BAS sensitivity in people with BD and used BAS subscale's composite score and it's three subfactor scores: reward responsiveness, drive, and fun seeking to correlate with hypomania risks, hypomanic symptoms and creativity.
 * 3) The self-reported creative measure, Adjective Checklist Creative Personality Scale (ACL-CPS),  creative adjectives correlated with