What Neuroscience Has To Say About The 'Tortured Genius'

09/02/2014 08:27 am ET | Updated Sep 10, 2014
  • Sarah Klein Senior Editor, Health & Fitness; Certified Personal Trainer

Every suicide leaves behind mourners grasping for answers, but when the person in question is a high-profile celebrity known to have struggled with mental health issues, it's tempting to fall back on the age-old trope of the "tortured genius." It's an idea deeply embedded in our culture: the artist, musician, poet, novelist or comedian who excels in his or her field, but is tormented by inner demons. By this logic, the coexistence of creativity and mental illness is not a coincidence: The talent and the demons are thought to be inextricably linked. The torment is part of the gift.

The World Health Organization estimates there are 350 million people on the planet living with depression. And the recent death of Robin Williams has stirred up the old question of whether creative genius carries with it an elevated risk of mental illness. "It stands to reason that some of those people are going to be creative," Harvard University's Shelley H. Carson, Ph.D., author of Your Creative Brain, told The Huffington Post. "Certainly enough to form public opinion."

The idea that "great art comes from great pain" has long-standing roots in public opinion, rumored to date back to ancient philosophers and poets, but our modern idea of the tortured genius likely stems from a glamorization of mental illness that took hold during the Romantic Era. At that time, so-called "madness" was seen as "voyaging into new planes of reality," according to psychiatrist Allan Beveridge. And while it's easy enough to believe that pain helped to fuel the work of Kurt Cobain, Sylvia Plath, David Foster Wallace or Alexander McQueen -- to name just a few of the brilliant, creative, successful people who took their own lives after battling mental illness -- there is also great art that comes from no pain whatsoever.

A photograph of American writer and poet Sylvia Plath on her grave in Heptonstall, England. Plath committed suicide in 1963.

"There are plenty of geniuses who are not mentally ill, and there are plenty of mentally ill people who aren't geniuses," said HuffPost Mental Health Medical Editor Lloyd Sederer, M.D., medical director of the New York State Office of Mental Health.

"Sometimes you have the two combined. When you have geniuses who have such prominence, like Philip Seymour Hoffman or Robin Williams or John Nash, they make you think that this is more common than it is," said Sederer. "One in four people annually in this country has a mental illness that impairs their function. That's pretty common. The illness is pervasive. Genius is much more rare."

The cognitive-neuroscience community is divided on whether a scientific link between creativity and mental illness actually exists. The earliest cited investigation into the issue came from the Italian clinician Cesare Lombroso, who argued in 1888 that "genius and madness were closely connected manifestations of an underlying degenerative neurological disorder," according to the Psychiatric Times.

In recent decades, there have been a number of attempts to find a firm empirical basis for that idea. Some correlative points have emerged: There is research suggesting that people with bipolar disorder, as well as the healthy siblings of people with bipolar disorder or schizophrenia, are more likely to have creative occupations. People with certain genetic risk factors for schizophrenia have been found to be more creative. In 1989, Kay Redfield Jamison, Ph.D., who herself has bipolar disorder, found a high prevalence of mood disorders among a group of British writers and artists. And in 1987, Nancy C. Andreasen, M.D., Ph.D., found a higher rate of mental illness among 30 creative writers than among 30 equally educated non-writers.

Past research, like Andreasen's, relied heavily upon hours of interviewing and application of the diagnostic criteria of the time to identify mental illness. Today, researchers have moved toward administering creativity tests to subjects while monitoring their brain activity with a procedure known as fMRI, or functional magnetic resonance imaging.

But other experts say that results showing a link between creativity and mental illness are unconvincing. They point to small sample sizes and a dependence on self-reported biographical data from subjects. In fact, even research with large sample sizes is routinely called into question for failing to establish objective measures of creativity.

DEFINING CREATIVITY

Part of the problem in determining whether or not this link exists is that creativity has proven difficult to quantify in research. Andreasen, director of the Neuroimaging Research Center and the Mental Health Research Center at the University of Iowa's Carver College of Medicine, acknowledged that limitation in a recent column for The Atlantic. Measuring creativity is "a necessarily controversial task," she wrote, "given that it requires settling on what creativity actually is."

The general consensus in the field is that a creative idea or product is new or original and useful or adaptive, Carson told The Huffington Post, and that a creative person is able to take pieces of information and "recombine them in novel or original ways that are somehow useful or adaptive." Carson's research explores what she calls the middle ground between the researchers who believe a link exists between creativity and mental illness, and the researchers who don't. She espouses what she calls a shared vulnerability model -- the idea that a person's chances of mental illness and her chances of being creative may stem from the same place, but that neither one causes the other. The outcome -- creativity, mental illness or both -- ultimately depends on other factors, like high IQ or strong memory.

Recent research from Austria builds upon this idea. A 2013 study found that people who scored high for creativity and people who scored high for schizotypy -- that is, behavior suggestive of schizophrenia but not diagnosable as such -- "share an inability to filter out extraneous or irrelevant material," Fast Company reported.

This would allow more information into the minds of both creative people and people at risk for mental illness, and "if you have more bits of information [coming in], it stands to reason you may come up with more connections," said Carson.

But the problem with defining creativity in this way, argues Keith Sawyer, Ph.D., professor at the University of North Carolina at Chapel Hill and author of Explaining Creativity: The Science of Human Innovation, is that "usefulness" and "adaptability" also need to be defined -- meaning researchers often have to use other measures to determine who or what is creative. Some studies administer creativity tests to subjects, while other studies choose participants according to their occupation, like writer or artist, or their achievements, like Nobel or Pulitzer Prizes.

Singer-songwriter and guitarist Kurt Cobain performing with Nirvana in 1994. Cobain committed suicide in April of that year.

Another challenge in studying the link between creativity and mental illness is that it's difficult to pinpoint where creativity actually "happens" within the brain. Researchers once thought that each of us had one dominant hemisphere of the brain, and that right-brained individuals were more creative while left-brained thinkers were more analytical. But while certain functions do take place in particular regions of the brain, research now shows that one side is never entirely dominant.

"Imaging studies typically focus on the precise brain region where some activity is located, but there doesn't seem to be just one with creativity," Sawyer wrote in a 2011 review of creativity research. "It follows that associating [creativity] with the area in the brain affected by mental illness would be difficult."

Andreasen told HuffPost that she is currently working on an imaging study using fMRI. She emphasized that the idea of the "tortured genius" is oversimplified, and not one she's pursuing. "People who are highly creative are intrinsically curious, exploratory, risk-taking, adventurous, and they're also persistent and somewhat rebellious or unconventional," she said. "When you have all of those traits, it makes you more vulnerable to rejection ... There's an underlying fundamental way of approaching life and the world that leads to both creativity and vulnerability to mental illness. But things like innate resilience and social support are what help these curious, adventurous, exploratory people not develop mental illness."

In fact, Andreasen's own 2008 review of creativity research acknowledges many of the same problems with the body of literature supporting a potential link that Sawyer's does, including poorly defined measures of both creativity and mental illness and heavy reliance on self-reported data.

POPULAR PERCEPTION

In Sawyer's mind, the case is closed: There is no link between creativity and mental illness, and researchers should stop looking for one. He wonders if perhaps researchers are still searching for a link so they'll be able to provide a patient with at least a bit of good news. "I think if you're treating people it can be helpful in therapy to tell your patient that their mental illness has a silver lining" -- namely, the gift of creativity, he said. "[I think] that's where their willingness to believe in a link comes from."

Still, outside of the research community, many remain open to the idea, as seen in the weeks following Williams' death. The bigger question now, says Sawyer, is why the general public is so receptive to this belief.

The trope of the tormented artist is so widespread that for some people, it's almost something to be taken for granted. "As an artist in an artsy community, in some ways it seems intuitive that there is that correlation," said Ellen Forney, an artist who detailed her diagnosis with bipolar disorder in the graphic memoir Marbles: Mania, Depression, Michelangelo, and Me. Maybe, she hypothesized, artists can be more outspoken about mental illness than is accepted in other professions, or maybe mental illness somehow gives an advantage to people who work in creative fields.

Historically, there have been creative thinkers who spoke about mental illness giving them their edge. "My fear of life is necessary to me, as is my illness," the artist Edvard Munch, thought to have had bipolar disorder, once wrote, according to Smithsonian magazine. "Without anxiety and illness, I am a ship without a rudder ... My sufferings are part of my self and my art. They are indistinguishable from me, and their destruction would destroy my art."

Forney said she had similar reservations about treatment when she was diagnosed with bipolar disorder shortly before her 30th birthday. "I was terrified to go on any sort of meds [and] even questioning if I wanted to be a stable person, because I had the same romantic idea that a lot of people do about artists," she said. "That whole 'crazy' artist was definitely part of my perception of the field, and what I thought was creative in myself."

Stability sounded "bland" to her, and many medications had a reputation for "flattening" creativity, Forney said. But after falling into a deep depression following the manic period during which she was diagnosed, she realized she needed help. Today, her treatment involves medication, therapy and lifestyle changes, and even stability has become important to her. "I found that stability was good for my creativity, because a part of creativity is productivity," she said. "When I was manic, I didn't have enough focus. When I was depressed, I was so squashed." In both cases, she said, "I couldn't get much done."

Pam Dawber and Robin Williams in a 1981 episode of "Mork & Mindy." Williams took his own life in August 2014.

It's important to remember that in no way do cultural beliefs, anecdotal interviews or rigorous research suggest that being creative is cause for concern. Andreasen said that most of the creative thinkers she has studied -- with and without mental illness -- have spoken of the joy they derive from their creative pursuits. In fact, there's plenty of research indicating that creative endeavors can boost happiness and promote relaxation.

"The more I've studied [creativity], the more I've realized we all have these amazing creative capacities in our brains," said Carson. "The ability to imagine things, to be able to see things in your mind that don't actually exist -- everybody can do that. You don't need to be mentally ill for that to occur."

Have a story about depression that you'd like to share? Email strongertogether@huffingtonpost.com, or give us a call at 860-348-3376, and you can record your story in your own words. Please be sure to include your name and phone number.

Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.

Also on HuffPost:

  • Summer Weather
    Thinkstock
  • Seasonal Affective Disorder (SAD) is most commonly associated with winter blues, and it afflicts about 5 percent of Americans. But for less than 1 percent of those people, this form of depression strikes in the summer. Warm weather depression arises when the body experiences a "delay adjusting to new seasons," says Alfred Lewy, MD, professor of psychiatry at Oregon Health and Science University, in Portland. Instead of waking and enjoying dawn, the body has a hard time adjusting, he says, which could be due to imbalances in brain chemistry and the hormone melatonin. More from Health.com: 10 Tips for Dating With Depression The Most Depressing States in the U.S. Depressing Jobs: Career Fields With Hight Rates of Depression
  • Smoking
    Thinkstock
  • Smoking has long been linked with depression, though it's a chicken-or-egg scenario: People who are depression-prone may be more likely to take up the habit. However, nicotine is known to affect neurotransmitter activity in the brain, resulting in higher levels of dopamine and serotonin (which is also the mechanism of action for antidepressant drugs). This may explain the addictive nature of the drug, and the mood swings that come with withdrawal, as well as why depression is associated with smoking cessation. Avoiding cigarettes -- and staying smoke free -- could help balance your brain chemicals.
  • Thyroid Disease
    Thinkstock
  • When the thyroid, a butterfly-shaped gland in the neck, doesn't produce enough thyroid hormone, it's known as hypothyroidism, and depression is one of its symptoms. This hormone is multifunctional, but one of its main tasks is to act as a neurotransmitter and regulate serotonin levels. If you experience new depression symptoms -- particularly along with cold sensitivity, constipation and fatigue -- a thyroid test couldn't hurt. Hypothyroidism is treatable with medication.
  • Poor Sleep Habits
    Thinkstock
  • It's no surprise that sleep deprivation can lead to irritability, but it could also increase the risk of depression. A 2007 study found that when healthy participants were deprived of sleep, they had greater brain activity after viewing upsetting images than their well-rested counterparts, which is similar to the reaction that depressed patients have, noted one of the study authors. "If you don't sleep, you don't have time to replenish [brain cells], the brain stops functioning well, and one of the many factors that could lead to is depression," says Matthew Edlund, M.D., director of the Center for Circadian Medicine, in Sarasota, Fla., and author of "The Power of Rest."
  • Facebook Overload
    Thinkstock
  • Spending too much time in chat rooms and on social-networking sites? A number of studies now suggest that this can be associated with depression, particularly in teens and preteens. Internet addicts may struggle with real-life human interaction and a lack of companionship, and they may have an unrealistic view of the world. Some experts even call it "Facebook depression." In a 2010 study, researchers found that about 1.2 percent of people ages 16 to 51 spent an inordinate amount of time online, and that they had a higher rate of moderate to severe depression. However, the researchers noted that it is not clear if Internet overuse leads to depression or if depressed people are more likely to use the Internet.
  • End Of A TV Show Or Movie
    Thinkstock
  • When something important comes to an end, like a TV show, movie, or a big home renovation, it can trigger depression in some people. In 2009, some "Avatar" fans reported feeling depressed and even suicidal because the movie's fictional world wasn't real. There was a similar reaction to the final installments of the Harry Potter movies. "People experience distress when they're watching primarily for companionship," said Emily Moyer-Gusé, Ph.D., assistant professor of communication at Ohio State University, in Columbus. With "Avatar," Moyer-Gusé suspects people were "swept up in a narrative forgetting about real life and [their] own problems."
  • Where You Live
    Thinkstock
  • You can endlessly debate whether city or country life is better. But research has found that people living in urban settings do have a 39 percent higher risk of mood disorders than those in rural regions. A 2011 study in the journal Nature offers an explanation for this trend: City dwellers have more activity in the part of the brain that regulates stress. And higher levels of stress could lead to psychotic disorders. Depression rates also vary by country and state. Some states have higher rates of depression and affluent nations having higher rates than low-income nations. Even altitude may play a role, with suicide risk going up with altitude.
  • Too Many Choices
    Thinkstock
  • The sheer number of options available -- whether it's face cream, breakfast cereal or appliances -- can be overwhelming. That's not a problem for shoppers who pick the first thing that meets their needs, according to some psychologists. However, some people respond to choice overload by maximizing, or exhaustively reviewing their options in the search for the very best item. Research suggests that this coping style is linked to perfectionism and depression.
  • Lack Of Fish In The Diet
    Thinkstock
  • Low intake of omega-3 fatty acids, found in salmon and vegetable oils, may be associated with a greater risk of depression. A 2004 Finnish study found an association between eating less fish and depression in women, but not in men. These fatty acids regulate neurotransmitters like serotonin, which could explain the link. Fish oil supplements may work too; at least one study found they helped depression in people with bipolar disorder.
  • Poor Sibling Relationships
    Thinkstock
  • Although unhappy relationships with anyone can cause depression, a 2007 study in the American Journal of Psychiatry found that men who didn't get along with their siblings before age 20 were more likely to be depressed later in life than those who did. Although it's not clear what's so significant about sibling relationships (the same wasn't true for relationships with parents), researchers suggest that they could help children develop the ability to relate with peers and socialize. Regardless of the reason, too much squabbling is associated with a greater risk of developing depression before age 50.
  • Birth Control Pills
    Thinkstock
  • Like any medication, the pill can have side effects. Oral contraceptives contain a synthetic version of progesterone, which studies suggest can lead to depression in some women. "The reason is still unknown," says Hilda Hutcherson, M.D., clinical professor of obstetrics and gynecology at Columbia University, in New York. "It doesn't happen to everyone, but if women have a history of depression or are prone to depression, they have an increased chance of experiencing depression symptoms while taking birth control pills," Dr. Hutcherson says. "Some women just can't take the pill; that's when we start looking into alternative contraception, like a diaphragm, which doesn't contain hormones."
  • Rx Medications
    Thinkstock
  • Depression is a side effect of many medications. For example, Accutane and its generic version (isotretinoin) are prescribed to clear up severe acne, but depression and suicidal thoughts are a potential risk for some people. Depression is a possible side effect for anxiety and insomnia drugs, including Valium and Xanax; Lopressor, prescribed to treat high blood pressure; cholesterol-lowering drugs including Lipitor; and Premarin for menopausal symptoms. Read the potential side effects when you take a new medication, and always check with your doctor to see if you might be at risk. More from Health.com: 10 Tips for Dating With Depression The Most Depressing States in the U.S. Depressing Jobs: Career Fields With Hight Rates of Depression

CONVERSATIONS