Manic Depression and Creativity

Perhaps the book Touched With Fire by Kay Redfield Jamison (1) has set the crossbar so high that few can approach it. This book was not among the few. To its credit, however, it appears directed outside the hard-core academic psychiatric audience that Jamison addressed, with user-friendliness as a major objective for a nonprofessional audience. As such, the writing flows well and the content is entertaining as well as instructive. The symptoms and inner experiences of manic and depressive states are well described for the layperson in colorful, informative anecdotes. Importantly, the book actively dispels pervasive myths that mania and depression function to drive creative genius.

There are some unfortunate aspects of the work. People in various phases of the disorder are repeatedly called “manics” or “depressives,” serving to propagate mistaken ideas of mania and depression as lifetime states or personality characteristics, as well as to promote a conceptualization of people as disease states or “cases.”

A central criticism of the book lies with its general lack of concern for diagnostic validation. Many historical figures are said to be manic-depressive, and a number of classic symptoms of the disorder are invoked, appearing to validate the diagnosis. Verification of the diagnosis in individuals portrayed, however, does not appear to constitute a serious concern of the text. Many people—including Elvis—are assumed to have been manic-depressive, but more confirmation of the diagnosis is needed before pursuing more extensive discussions of the individual’s condition. It would have been especially helpful if differential diagnosis of depression from substance abuse, particularly alcohol use disorders, which are well documented among artists, could have been better delineated for readers who may not appreciate how alcohol and drug abuse can create states that mimic affective disorders.

Less well-known individuals are described with unfounded allegations and claims, such as, “Many high-ranking executives and people successful in politics are hypomanics” (p. 25). Credibility could have been improved by citation of sources for sweeping statements. For example, twice it was said that compromised immune function is a frequent accompaniment or even a part of depression (pp. 31 and 181), with no attempt to qualify this popular idea with scientific evidence. It is also said that success and fame can not only increase mania but precipitate psychosis in people with manic-depression (p. 195). This is a statement that begs for supporting data.

The book’s cover promises that the authors will “explode the popular myth that suffering is essential to creativity and suggest ways that can alleviate the extreme ‘highs’ and ‘lows’ of the disease.” Given the lack of professional readership targeted by the text, it would have been a bonus if the authors had educated the public on the victories of treatment over disease. I couldn’t find this material presented anywhere besides suggestions in a few brief sentences.