For all its disadvantages, mental illness may have one thing in its favour. Some say it makes you more creative. A recent case-control study by MacCabe et al examined this relationship by using the formal study of a creative subject at secondary school or university as a proxy for creativity and then determining whether it was associated with the later development of a psychiatric disorder.¹ This Swedish study was both large (over 4.45 million people) and epidemiological. Age, gender, highest educational level achieved and creative subjects studied were cross-referenced with data for cases of schizophrenia, bipolar disorder or unipolar depression requiring hospitalisation from 1973 to 2009. Individuals completing a course in visual arts, music, dance, theatre and drama, film, radio and TV production, fashion design, art and media were defined as having studied a creative subject. The authors found that, compared with the general population, people with an artistic education had a significantly greater likelihood of developing mental illness.

When we think about severe mental illness, some very talented names spring to mind. The painter Vincent van Gogh, the writer Ernest Hemingway, the composer Robert Schumann, the musician Syd Barrett and the Nobel-Prize-winning economist John Nash are but a few highly creative individuals who also contended with serious psychiatric problems. There are other examples, but perhaps the most notable is Vaslav Nijinsky, a Russian ballet dancer and choreographer who is said to be the greatest male dancer of the early 20th century.  

Nijinsky was born in 1889. His talent was spotted at an early age and he joined the Imperial Ballet School in St Petersburg at the tender age of nine. By 1907, he was a graduate and member of the Imperial Ballet with the rank of coryphée whereupon he began taking starring roles. His poise and athletic ability were considered remarkable, while he was among the few male dancers who could perform en pointe. By 1912, Nijinsky was choreographing his own shows, including L’après-midi d’un faune (1912), Jeux (1913) and Till Eulenspiegel (1916). Around 1917, he became psychotic and was ultimately diagnosed with schizophrenia. He was initially treated in Switzerland by the psychiatrist Eugen Bleuler (who coined the term ‘schizophrenia’ in 1911) but the treatment was largely unsuccessful. Nijinsky mostly spent the rest of his life in and out of psychiatric hospitals and rarely danced in public again. He died in London in 1950.  

Of the creative minds we have mentioned, few had any reason to thank mental illness for their talent. Yet Kyaga et al found an overrepresentation of creative professions among people with bipolar disorder and the undiagnosed siblings of people with schizophrenia or bipolar disorder.²

So, might early or mild mental illness correlate with creativity? Perhaps they share common themes such as a heightened perception of stimuli, a speeding up of thought and the tendency to ‘think outside the box’. Such divergent thinking might generate more plentiful ideas. Or does the grandiosity of mania confer both ambition and disinhibition leading to a degree of fame where creativity also happens to exist?

As Lord Byron once remarked: “We of the craft are all crazy; some are affected by gaiety, others by melancholy, but all are more or less touched.” Perhaps he was right.  

References

1. MacCabe JH et al. Artistic creativity and risk for schizophrenia, bipolar disorder and unipolar depression: a Swedish population-based case-control study and sib-pair analysis. Br J Psychiatry (2018); 212(6):370-6
2. Kyaga S et al. Creativity and mental disorder: Family study of 300,000 people with severe mental disorder. Br J Psychiatry (2011); 199(5):373-9