For nearly twenty years I have resisted the idea that there may be a link between bipolar disorder and creativity. Yet everyone I know with a psychiatric diagnosis, tells me about the link between their diagnosis and their creativity. A couple of years ago I took part in a debate at the Institute of psychiatry where I took the view that creativity and madness were not linked. In my view poor mental health is inextricably linked to poverty, ill-health and adverse life events.
I now think that there is a difference between poor mental health and madness. The two are related yet separate. In many ways poor mental health is akin to being physically unhealthy. Just as eating a junk food diet and not exercising affects one's physical health it also affects mental health, with the result that people cannot enjoy life to the full. Improving mental health helps somebody feel better in the same way as improving their physical health does. It is impossible to be a world class athlete while at the same time failing to train and not looking after once body.
Most poor mental health is a result of poor mood management. this leads to anxiety and depression, as well as impulsive behaviour and lethargy.
Madness on the other hand, more than poor mood management. it is likely to be as much due to the hyper specialisation of the brain in particular areas to a failure to live a balanced life. Madness in its extreme form is as much a talent has the ability to play the violin beautifully or take mathematics beyond the edge of the known universe.
Poor self management, which is largely poor mood management and a failure to properly manage one's mind means that it is impossible to take advantage of the mental gifts that are on occasions called madness.
A pianist must learn their scales, and so must any creative artist learn the vehicle by which they express themselves. The poet must learn to speak a language and use that language to give expression to their gift.
In the same way, someone the gift of schizophrenia bipolar disorder, and autism needs to learn the basics of living in order to give expression to their gifts. Self management and the ability to live within normal society are the musical scales of living through which these gifts must be expressed. Unless the unique insights that madness brings can be enjoyed by other people there are meaningless and self-indulgent. There is no point in Rachmaninov living on his own or a desert island playing his piano to the ocean. The scientist's insights are is only meaningful within the framework of our current understanding.
The debate between mental health and madness is still ongoing. The reason that I debated that mental health is the result of poverty, adverse life events and stress is because this is true for the majority of people who receive psychiatric medications. On the other hand, the ivory tower psychiatrists at the Institute of psychiatry deal with people with severe madness. These are people with highly specialised brains, whose difficulty in managing their genius is in being able to find expression for their exceptional abilities.
At the fringes of this debate, Goldman Sachs has already started employing autistic people to help them with their computer algorithms. Their problem is in managing such people. I had one patient who was a obsessional compulsive abattoir inspector. His abattoirs were the cleanest in north-east England. On the other hand other days when he could not leave his front door for the severe anxiety and number of checks that he had to make. In the modern failing economy such inconsistency is inefficient, regardless of the talent that he brought to his work.
I have changed my position because after 10 years of intensive self management, I now feel that I have a healthy mind. And yet my mind is still different, if anything I fit in less with society than I did before I cleaned up my act. I have learnt communicate to talk effectively, I am learning structures by which to write plays by which to write comic scripts and I am learning the way to express that creativity. None of this gets round the need for me to be able to manage my moods and manage my mind. Yet I am beginning to see the difference between feeling ill because I have not exercised and those deeper feelings which provide insights into the human condition. just as if I were a great Javelin Thrower I would need to have a healthy working body to express that talent, I am beginning to believe that I have talent for writing and communication and that in order to express it I needed to develop a healthy mind.
In conclusion today, mental illness as a combination of poor mental health and severe maladjustment. yet that maladjustment stems from a genius of specialisation and such creativity is essential if we are to come through the 21st-century largely unscathed.