Are the mentally ill especially creative? If so (or if not), should afflicted writers and artists undergo treatment?

Readers of Against Depression (and, previously, Listening to Prozac) will know my answer. The quick summary: Suggestive studies link bipolar disorder to accomplishment in the arts — and a number of other fields as well. Major depression on its own seems to have no special links to creativity, or only very weak ones. Actually, the case for epilepsy and even alcoholism may be easier to make. The “modern,” that is, nineteenth century, case for linkage begins with an interest in schizophrenia; there the question is highly confused, because the disease was so poorly diagnosed and is so disabling at an early age. In Against Depression I also pose an ancillary question, whether our aesthetics have been shaped by the ubiquity of mental illness.

Correlations aside, the problem remains, if you are creative and you suffer mental illness, should you undergo treatment and, in particular, treatment with medication? In its science section today, the New York Times reviews two books that bear on the subject, Madness: A Bipolar Life, by Marya Hornbacher, and Poets on Prozac: Mental Illness, Treatment and the Creative Process, edited by Richard M. Berlin. I have read neither, but the Times reports that both reach the same conclusion. If treatment works, the work benefits. Even partial responses to quite difficult drug regimens seem to result in more and better writing.

In my practice (where any prescribing tends to be more moderate), I find that the same rule holds. Like other diseases, the mental illnesses may lend perspective to art. But the disorders are destructive in dozens of ways. Medications have their problems. In particular, virtually any psychoactive substance can, over time, induce apathy. But by and large, if my patients do well on medication, they write, paint, compose, and sculpt better. The same holds for successful psychotherapy, another modality that (see the Peter Schaffer play or movie “Equus”) people used to worry over when thinking about the fine arts.

Incidentally, the Times also makes note of a study in Neurology that links early depression to later Alzheimer’s disease . . . another reason to consider prompt, vigorous treatment. In more general terms, the link between depression and dementia had been documented in the past.

Postscript: Those who like creative wordplay — or who believe that brain exercise wards off dementia — might glance at my prior post about Frank W. Lewis, the puzzle-master for the Nation.