"Touched With Fire"
Moods and the Creative Mind
I've stolen the title of this chapter from
the book "Touched with Fire: Manic-Depressive Illness and the Artistic
Temperament," by Kay Redfield Jamison.
Lots of people ask me whether there is a
relationship between various mood disorders and ADD. There most definitely is. Big mood
swings in particular seem to be the norm, at least for those who I speak to on this site.
Some ADDers are misdiagnosed with manic depression because ADHD looks similar to mild
manic episodes. A very high percentage of diagnosed ADDers experience bouts of
depression and/or anxiety, and a few have been diagnosed as ADD with manic depression.
Since Born To Explore is about positive and alternative views of ADD, I want to focus on
why these conditions may be present in populations. A very high percentage of eminent
writers, artists, inventors, explorers and other people which have changed the course of
human history were considered either extremely moody, were manic depressive, or suffered
from bouts of unipolar depression. There is not, however, any link between schizophrenia
and such people. In the past, extreme episodes of mania were often confused with
schizophrenia, leading some to believe there was a connection.
| "If a man comes
to the door of poetry untouched by the madness of the Muses, believing that technique
alone will make him a good poet, he and his sane compositions never reach perfection, but
are utterly eclipsed by the performances of the inspired madman" - Socrates |
Here's a hierarchy of
moodiness, ranging from normal to a full blown disorder:
- Normal mood variations
- Unusual mood cycles or ranges of moods
- Cyclothymia (Bipolar Type II)
- Manic Depression (Bipolar Type I)
I'm guessing that many ADDers are somewhere
between #2 and #3. One of the most common experiences ADDers online seem to share is that
of mood swings generally lasting days or weeks. This is marked by periods of high
intensity involving lots of ideas, plans, midnight email sessions, and lack of sleep,
followed by a period of recovery consisting of fogginess and fatigue. ADDers can also go
into or come out of bad moods very quickly, even in a matter of a few minutes.
Cyclothymia (Bipolar Type II) is a mild
version of manic depression marked by periods of "hypomania" alternating with
periods of mildly depressed mood. The mood swings typically last on the order of days and
cycle very rapidly compared to manic depression. Hypomania is a state of mind which is
mildly manic and marked by lots of ideas, enthusiasm and creativity. It is a fast mind,
switching from thought to thought, and full of energy. It is believed that a significant
percentage of great artwork was completed by artists while they were in a hypomanic state.
Note the similarity between the description of hypomania and ADD.
Manic depression (Bipolor Type I) is marked
by periods of normalcy, interrupted by extreme depressions and episodes of mania. The
mania often starts out as hypomania, which is not too bad, but may increase in intensity
until the person can talk non-stop for two hours and not complete a single sentence. At
this point, the manic depressive is delusional and may even experience psychosis. Manic
depression is typically treated with Lithium, and sometimes antidepressants.
People who have "strong
emotional responses" have a greater likelihood of developing a bipolar condition. If
they do, it may first present as cyclothymia which may or may not progress to manic
depression. They also have "more elaborate and generalizing cognitive
operations" (Jamison). There's that theme of sensitivities or overexcitabilities
again! I think it would be fair to say that ADDers as a group have stronger emotional
responses compared to others. And, as a group, it would therefore not be surprising if
ADDers also have a significantly higher rate of developing cyclothymia and/or manic
depression.
This is not to say that ADD and cyclothymia
are the same. Bipolar disorders are successfully treated with drugs like lithium, while
ADDers respond most often to stimulants like Ritalin. Even so, I wonder about the
relationship between the two and whether most medical professionals have a clear
understanding of both conditions. For example, I stumbled across a web page discussing how
professionals can tell the difference between bipolar disorders and ADHD, but the
information on ADHD was seriously wrong. The author thought of ADD primarily as an
inability to concentrate, and was apparently unaware that speeding thoughts and ideas are
also typical of the ADD mind, especially for those with ADHD. Therefore, if a patient
described fast thoughts they were likely to be diagnosed with bipolar, even though they
may have been ADD.
The Link Between Mood Disorders and
Creativity
What's interesting to me is the link
between mood disorders and creativity. In "Touched With Fire," the author Kay
Jamison argues quite convincingly that artists and writers have suffered
disproportionately from Manic Depression and Cyclothymia (the weaker version of manic
depression), and that these conditions contributed significantly to their talents. Even if
bipolar disorders and ADD are two completely unrelated conditions (which I doubt), the
description of hypomania may just as well be ADD. Therefore, it seems that the same
arguments for why bipolar disorders increase creativity can be used for ADD as well.
It is the hypomanic state in which artists
feel most inspired and creative.
"Two aspects of thinking in particular
are pronounced in both creative and hypomanic thought: fluency, rapidity, and flexibility
of thought on the one hand, and the ability to combine ideas or categories of thought in
order to form new and original connections on the other. The importance of rapid, fluid,
and divergent thought in the creative process has been described by most psychologists and
writers who have studied human imagination. The increase in the speed of thinking may
exert its influence in different ways...the sheer volume of thought can produce unique
ideas and associations." - Kay Jamison
In one study, the rate of psychiatric
conditions, primarily depression (including bipolar), were compared within different
fields:
- Poets - 50%
- Musicians - 38%
- Painters - 20%
- Sculptors - 18%
- Architects - 17%
And study after study of famous writers and
artists shows a clear pattern of mood disorders and even hospitalizations and suicides.
These artists were not consistently productive, but created much of their best work during
hypomanic or, less often, manic phases. During these times they were enthusiastic and
inspired. At other times, they slipped into depressive states and created almost nothing.
Hospitalizations were sometimes needed because of severe episodes of mania and psychosis,
or suicidal depressions. Van Gogh created some of his best paintings from a sanitarium.
A link between ADHD and creativity has been
established; so has a link between bipolar depression and creativity. ADHD folks often
described themselves as unusually moody, with periods of high energy and enthusiasm
lasting several days or weeks, followed by a lethargic state and the ADD "fog."
Many of the terms used to describe the artist in the "inspired," or hypomanic
state, are the same words used to describe ADHD. There is even confusion in diagnoses,
with some ADDers being incorrectly diagnosed with bipolar disorder. The relationship
between these conditions is intriguing.
Mood Swings and Manic Depression
This was a reoccurring topic on the
Explorer mail group. Many ADDers wonder if they are also manic depressive, and others
diagnosed manic depressive wonder if they might really be ADD. Or both.
ADDers are definitely subject to more mood
swings than the average bear. Moods can change on a dime, within only a few minutes, so
that an ADDer can go from low to high several times a day.
Many, if not most ADDers I converse with
also talk about going through days, or even weeks, of high energy and little sleep.
Insomnia is common, and I receive plenty of mail written at 2:00 in the morning. Some say
this occurs frequently when the ADDer is worked up about a project or something of
interest. The periods of intense activity are typically broken apart by periods of
lethargy, when ADDers speak of "being in a fog" or just not being able to wake
up.
So is it Manic Depression? Because
people so frequently ask about this, I'm going to provide an excerpt from "Driven to
Distraction" by Edward M. Hallowell, M.D., and John J. Ratey, M.D.:
"ADD with Agitation or Mania
"Sometimes ADD can look like manic
depressive illness due to the high energy level involved in both syndromes.
Manic-depressive illness is characterized by periodic momentous mood swings, from very
high to very low. The very high moods, called periods of mania, can resemble ADD in that
they include highly active behavior, easy distractibility, impulsivity, and an apparent
disregard for personal safety.
"One can distinguish mania from the
high energy of ADD by the level of intensity. An average person could simulate the
energized state of ADD, but could not voluntarily reproduce the energy level of mania.
Mania is the most extreme from of non-drug-induced drivenness that we know. The manic
person can go without sleep for days, traveling the globe or spending his life's savings
on wild schemes or making grandiose claims of self-importance or talking nonstop from
morning until night.
"The manic individual is truly out of
control. He cannot slow down. He does not just talk fast, he talks as if the words were
being propelled from his mouth, a disconcerting symptom referred to as "pressured
speech." Listening to someone who is in the grip of mania gives one the feeling of
wanting to duck; the words seem to be thrown at you. A manic's mind leaps from topic to
topic, like a frog jumping lily pads, alighting for a moment here only to spring away to
another place. This symptom is aptly called "flight of ideas." It makes logical
conversation of any length just about impossible. Let me give an example, taken from my
days working on a psychiatric inpatient unit:
"'Good morning, Mr. Jones.'
"'Why good morning, Doctor, and good
morning to all the lovely little squiggles you have on your tie, and to squiggles
everywhere, who, by the way, are outward representations of chaos, a soon-to-be-quantified
branch of physics and mathematics, which, if you haven't boned up on your integrals, will
leave you without much hope of doing more than passing over the topic, as the cow passes
over the moon in the ditty which you may have heard when you were a child. You were once a
child, Doctor? It is safe to assume that we all were children once, that is a safe
assumption, the first three letters of which are a-s-s so don't be an ass and assume
anything, as my old teacher used to say. Sound advice, especially for a planetary
stargazer, wouldn't you say? There is more in the stars than there is in every brain put
together, like link sausages, a delicious breakfast at that!'
"While the individual with ADD can
branch from topic to topic, he does not do so with the suddenness or pressuredness that
the manic does. And while the person with ADD may be restless and full of energy, he is
not driven by nearly the same horsepower as the manic.
"The two syndromes can actually
coexist...On the other hand, the person who has ADD with a high degree of agitation may be
incorrectly diagnosed as having manic-depressive illness. This has practical significance
in that the drug most commonly used to treat mania, lithium, usually does not help ADD.
Indeed, it may make ADD worse."
To be continued.....
