Bipolar Disorder
Studies have found that those who met criteria for the disorder have higher levels of creativity (Burkhardt et al., 2018). Like major depression, this is likely due to art's therapeutic effects on the distress caused by mental disorders - as opposed to art causing the mental distress.
Bipolar disorders are mental disorders, characterized by cycles of depressive and manic episodes. Depressive episodes are like those discussed on the MDE page. They entail persistent low mood, low self-worth, and/or a loss of pleasure/interest in activities. Manic episodes are characterized by an extreme higher mood, so to speak. Common signs of a manic episode include euphoria, intense motivation, sleeplessness, irritability, and hyperactivity.Bipolar I is characterized by a depressive episode, followed by a manic episode (or vice versa). Bipolar II is characterized by a depressive episode, followed by a hypomanic episode (or vice versa). Hypomania is a more mild form of mania.It is important to note the longer-term nature of these episodes. A common misconception is that a volatile mood is a sign of bipolar disorder. Sudden changes in mood are not a symptom of the disorder; episodes of depression and (hypo)mania are longer-term.
Bipolar Disorder Diagnostic Criteria (APA, 2013)
(Hypo)manic Episode
A distinct period of persistent, abnormal high mood, energy, and/or irritability for most of the day, nearly every day, for at least one (1) week. If hospitalized, symptoms can present for any amount of time.
1. Exaggerated self-esteem or sense of self importance.
2. Decreased need for sleep (i.e., feeling rested after short periods of sleep).
3. Abnormal talkativeness or pressure/need to talk.
4. Racing thoughts.
5. Easily distracted.
6. Excessive engagement in risky behavior, such as unprotected sex or rash financial decisions.
7. Increase in goal-oriented behavior (i.e., extreme levels of work towards one's goals).
Symptoms must cause distress, hospitalization, and/or impairment in everyday functioning.
Symptoms are not better explained by substance use.
Symptoms for a depressive episode are the same as outlined in major depressive disorder.
Treatment: Lithium
Lithium is a mood stabilizer drug, widely used to treat manic and depressive episodes in bipolar disorder. It works by limiting the production of neurotransmitters such as dopamine and glutamate; excessive levels of these are linked with development of the disorder. Meanwhile, lithium also stimulates production of GABA, a neurotransmitter that regulates mood and slows down brain activity (Guzman, 2016).
Bipolar Disorder in the Media: Pat Solitano
Pat Solitano (left) is the protagonist of the romantic comedy film, Silver Linings Playbook. Pat catches his (now ex) wife cheating on him, and beats up her affair partner. He is then hospitalized and diagnosed with bipolar disorder. Throughout the film, he exhibits manic symptoms. He displays an irritable mood when grilling his parents over the whereabouts of his wedding video. He devises elaborate plans to win back his wife. His speech is often rapid and animated, and he spends little time sleeping. While a limitation of this representation is that they do not specify which form of bipolar disorder Pat has (I or II), manic symptoms are accurately depicted and he is shown as being supported by his friends and family.
Neurobiology
As mentioned previously, levels of dopamine in the brain influence the development of bipolar disorder.
Dopamine has roles in: pleasure and reward, attention, psychological arousal, and movement (Cleveland Clinic, 2022). Recall that symptoms of the disorder include risky pleasure-seeking activities and higher levels of energy.
Excess levels of dopamine are associated with the development of bipolar disorder.
Bipolar Disorder and Art
A meta-analysis of multiple studies found people with bipolar disorder to be no more or less creative than those without bipolar disorder (Cruz et al., 2022).
1. Patients experiencing depressive episodes performed relatively poorly on measures of creativity, likely due to the fact that motivation and pleasure in activities decreases when depressed.
2. Patients experiencing manic episodes did not perform better than patients not experiencing a manic or depressive episode. This is likely due to the fact that in mania, thoughts can be racing and disjointed, thus inhibiting patterns of clear thought that are conducive to creation.
3. A limitation of the study is that in the studies analyzed, there lacked information on hypomania's impact on creativity.
4. These findings can be helpful in dissuading the "tortured artist" myth. The study found that mania and depression hindered creative output instead of stimulating it. This can indicate to artists that not only is suffering unnecessary to artistic creation; it is also harmful to artistic creation.
Background: album cover for Hopeless Fountain Kingdom, by singer/songwriter Halsey, who has spoken openly about her diagnosis with bipolar disorder.
Works Cited (in order of appearance)
Burkhardt, E., et al. (2018). Creativity in persons at-risk for bipolar disorder—A pilot study. Early Intervention in Psychiatry, 13, 1165-1172. doi.org/10.1111/eip.12748
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American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
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Guzman, F. (2016, November 13). Lithium's Mechanism of Action: An Illustrated Review. Psychopharmacology Institute. https://psychopharmacologyinstitute.com/publication/lithiums-mechanism-of-action-an-illustrated-review-2212
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Cleveland Clinic. (2022, March 23). Dopamine: What It Is, Function & Symptoms. Cleveland Clinic. URL
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Cruz, T. N., et al. (2022). Creativity in bipolar disorder: a systematic review. Trends in Psychiatry and Psychotherapy, 44. https://doi.org/10.47626/2237-6089-2021-0196
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