The idea that highly creative or intelligent individuals are especially vulnerable to mental ill health has been around for a long time. “No great genius has ever existed without some touch of madness” is attributed to Aristotle in 350BC, and more recent examples of creative types describing their afflictions with great clarity are not hard to find.

Sylvia Plath’s The Bell Jar and David Foster Wallace’s Infinite Jest are both achingly vivid portrayals of mental ill health; and both make uncomfortable reading in light of their author’s untimely deaths.

New study claims to find genetic link between creativity and mental illness Read more

Bipolar disorder, previously referred to as manic depression, is a psychiatric disorder in which individuals oscillate between periods of mania and depression. It is one of the rarer psychiatric conditions, affecting less than 1% of the population (compare that with major depressive disorder, which affects closer to 20% of us).

In popular culture, the manic phase of bipolar disorder is often portrayed as being characterised by elevated mood and creativity. As the psychologist Kay Redfield Jamison puts it in her autobiography about her own experiences of bipolar disorder, An Unquiet Mind: “When you’re high it’s tremendous. The ideas and feelings are fast and frequent like shooting stars, and you follow them until you find better and brighter ones.”

A paper published this week in the British Journal of Psychiatry reports that in a sample of 1,881 individuals, those who demonstrate the top 10% of “manic features” (measured at age 22-23 by a questionnaire known as the HCL-32) had IQ scores (measured when they were eight years old) nearly 10 points higher than those in the bottom 10% of manic traits. In other words, if you have a higher IQ when young, you may report higher manic traits as an adult.

It is therefore seductive to speculate, as the article does, that “in evolutionary terms … there may be some selective advantage associated with propensity to serious recurrent disorders of mood such as bipolar disorder”. Indeed, one of the authors is quoted as saying: “One possibility is that serious disorders of mood – such as bipolar disorder – are the price that human beings have had to pay for more adaptive traits such as intelligence, creativity and verbal proficiency.”

While this may hold for some sufferers, some of the time, we must also wonder how helpful this trope is for the majority of those who suffer from these disorders.

In truth sufferers are as diverse as the society in which they live. That is to say, there are many who suffer from serious mood disorders who aren’t especially creative or pushing the upper reaches of IQ. And even if they were, as a recent review in the British Journal of Psychiatry puts it: “By my reckoning if it was possible to remove all bipolar disorder in the population, creativity would only be reduced by 0.23%.”

We should also be particularly careful extrapolating a relatively standardised metric such as IQ on to something as flighty and ill defined as “creativity”. IQ does not map easily on to better life outcomes and is subject to cultural differences.

Perhaps more importantly, however, mania is just as readily associated with disordered thinking, irritability, and even psychotic experiences as it is with euphoric highs. As Kay Redfield Jamison puts it, “Somewhere, this changes. The fast ideas are far too fast, and there are far too many; overwhelming confusion replaces clarity”, and ultimately “you are irritable, angry, frightened, uncontrollable”.

As with all disorders of the mind, the reality is never truly black and white. It should also be noted that there is a gulf between “manic traits” in healthy individuals and a full-blown manic disorder (the paper does not report if any of these individuals actually meet criteria for a disorder) and, as the authors of the present study are quick to point out, high IQ in and of itself does not confer a direct risk for manic traits, but perhaps in combination with other factors “such as exposure to maternal influenza in the womb or childhood sexual abuse”.

Psychiatric disorders are massively, intimidatingly, complicated

Psychiatric disorders are massively, intimidatingly complicated. As Tom Insel, head of the US National Institute of Mental Health says: “Mental disorders are among the most complex problems in medicine, with challenges at every level from neurons to neighbourhoods. Yet, we know so little about mechanisms at each level.”

Currently, a diagnosis of most psychiatric disorders is based on self-reported symptoms (similar to the questionnaire used in this study) but it is becoming increasingly recognised that the same set of symptoms may be caused by myriad underlying mechanisms, all of which may require fundamentally different treatments.

Unlike practitioners in most branches of medicine, mental health professionals have no truly objective tools with which to diagnose psychiatric disorders. This is perhaps unsurprising, given the complex interplay between environment, society and underlying biology in provoking mental ill health.

In the UK, £9.75 is invested in research per person affected by mental illness – over

100 times less than the amount spent on cancer research per patient (£1,571), yet an urgent need to improve treatment and diagnosis remains. “The sooner we can intervene in bipolar the better the outcome,” the authors of the present study say. There is little to disagree with here. But we are still a long way off.