ഇന്ത്യ
7 months ago
Friday, October 10, 2008
Creativity and mood disorders.
The present understanding is that Type II bipolar disorder is the underlying disorder in creative persons. When depressed people tend to look back at life and the world with a philosophical outlook. Mind goes into an introspective attitude, analyzing everything with detachment. Such mental state may give rise to profound insight about everything. Later when they become hypomanic, there is increased energy and activity, thoughts race through the mind with extreme clarity and pace. Such state helps the writer to complete the creative work. It has to be emphasized that the severe form of mania is not compatible with this ability to control one's mind and produce works of art. This is why Type II Bipolar disorder is found to be more prevalent. Alcoholism could also be related to this. When depressed they may self medicate with this to improve mood state. During the hypomania it may be used to curb the excess energy and obtain sleep. Other than this, excess use of alcohol may occur as a hazard of being a celebrity. Many of these creative persons are as vulnerable to vices as any of us, if not more. Some think they have a licence to get away with any sort of behaviors, like some of our professional politicians.
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6 comments:
Thank you Sashi. It is true that classifications in psychiatry (of mood disorders or others) keep changing over time. But the basic level of understanding reached is not lost. Emil Kraepelin described MDP or Manic depressive psychosis. The current term Bipolar disorder still includes those original MDP cases as one of the subtype. So these changes are not a problem. Your second point confuses between creativity and originality. Copying Mona Lisa or Yesudas's song can still be creative if you add some improviastions (or sangathis to use the technical term in music). In my discussions I only meant a very broad concept of creativity. A friend who comes up with a new brilliant befitting one liner can be considered creative in this sense. Same is the case of a rishi or yogi. Some of the fantasies narrated by psychotics have creative qualities, but we have to consider the total picture. I have some difficulty regarding abtract art which does not communicate anything to me. I am not ashamed to state that I have difficulty in understanding a Picasso work. But I should listen to an expert in that area before labelling it as trash or a masterpiece. Obviously, the evaluation of any art is based on subjective opinion of a handful of experts. But psychiatrists need not bother about such nuances as long as there is general agreement about a person's creative talent.
"But psychiatrists need not bother about such nuances as long as there is general agreement about a person's creative talent."
Was there a general agreement with Copernicus or Socrates at their time? A lot of creative talent came to light only after their (creative people's) death. Isn't it true that lay people, may be including mental health practitioners take years or generations to understand creativity? It is like a post mortem diagnosis of Alzheimer’s! When you* treat thousands of psychotic people, some people or some delusions may have creative value. These may come from any subjects and nobody is supposed to be a master of all subjects.
In psychiatry, treatment has improved a lot but diagnosis is still in its infancy. We need diagnostic methods that no Rosenhan wants to play with. Sometimes I wish I could make such bold statements those current classifications of mind/brain disorders are pseudoscience!?
* ‘you’ is not personal, I am referring to all psychiatrists. I know many and you are the best so far I have seen.
Thank you
I think the whole issue of grading the abnormality should be better discarded than discussed. We should have a different approach. We must try to grade the ’quality of life’ instead of trying to grade the abnormality. The problems of insanity vs. creativity get worse when we try to grade the abnormality of people. Buddha may perform badly on an ‘abnormality grading scale’ but he will outperform all others in the world if we test him on a ‘quality of life grading scale’. Suppose in a scale ranging from 0 to 10, Buddha may get -3 for abnormality and +9 for quality of life with a definite winning advantage of +6. A schizophrenic John Nash is more deserved or qualified to live here on the earth than a dumb politician without any mental illness. Gandhi or Buddha becomes a problem when we try to analyse them with DSM or ICD. It is my opinion that the current direction of diagnosis and classification of mental disorders should be changed. It should integrate the positive elements of spiritual, philosophical or artistic life. It may not be a pleasing suggestion to the drug mafia though we need it. Mental problems tend to co-exist, it may be difficult to find a person with a single mental illness only. It is like either there are many problems or there are not any. Am I right? A psychiatrist has to rely on a patient’s narration of his problems up to a large extent. When a patient becomes more realistic or good at explaining his symptoms, the chances that he might be normal also increases. The difficulty to explain problems increases with the severity of the psychosis. Outsiders will not be of any help to know the inner feelings of a patient but you have to listen to the patient and the patient have difficulty recalling, disorganized speech and thoughts, poor cognition etc… Patients may also filter out some information, he may hide his egosyntonic problems and explain only the egodystonic nature of the disorder to the psychiatrist. Patient will be happier to get treated for his particular problems that he seems disgusting than solving all basic problems. Patients tend to change psychiatrist regularly, they get interested in a new psychiatrist and lose the interest after some visits, starts looking for a new one. You need to regularly appreciate them otherwise they are going to ditch you. A really challenging profession but you have a lucky time because of drugs that work for a wide range of problems. A combination of an SSRI with a new atypical antipsychotic may cover from generlised anxiety disorders to schizophrenia or OCD, Bipolar, PTSD, Panic attacks etc… If there were different drugs for different problems every psychiatrist had to spend hard time finding the right classification for each patient.
Waiting for your valuable comments.
Thank you.
Are delusions and hallucinations relative? A person believing that a magnetic field around his cow can control this world is having a delusion. But if there are thousands of people to follow his ideas he can make a religion and we will not consider him having delusions anymore. A ‘velichapadu’ or a pope talking with god or hearing voices from heaven as not considered hallucinating by the society. Is it irrationality of the belief or the context of the belief that makes a belief a delusion?
Hi Sashi,
I disagree with what you said "if he thought what he had was a delusion he would disown it for its spuriousness". It may not be always possible for a person to act against his belief even if he is well aware of its irrationality. Dr.Harish may comment about it. Almost all people have some kind of delusions, some times it become pathological.
I agree that creative people in our society are safer than ever before in history but this statement is true for any particular period. Is Buddha safer now? I do not know. The problem is that we all lag behind a genius. That's what a genius is.
I am aware of the limitations of psychiatrists so I said it is one of the challenging professions.
Thank you.
Reply to Ajeesh's comments
1) Oct 12th - I agree that psychiatric diagnoses have a certain degree of arbitrariness. This is because they are not based on objective biochemical, histopathological or radiological criteria. But this does not warrant lebelling as pseudoscience. Pseudoscience is something that goes against the basic tenets of science. Here the difficulty is because we have not been able to evolve any objective criteria based on symptoms ot their desriptions. Looking carefully at the current criteria shows that the diagnostic names are nothing but shorhand versions for a long list of symptoms. I would humbly suggest you to read my posts on these issues in the first 2 weeks that is 20th July to 3rd August where these are disucssed.
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