In the October issue of the Journal of Psychiatric Research, Dr. Simon Kyaga and his colleagues examined the relationship between various psychiatric disorders and the creative occupations. They used Swedish census data as well as the medical and mortality registry information of more than 1.1 million subjects involved in either scientific or traditional creative professions. A scientific occupation was considered creative if it involved academic research and teaching at a university level. The traditional creative professions were defined as visual or non-visual artists, with particular attention paid to writers.
An additional control group was added for comparison to a “lesser creative” occupation, specifically accountants and auditors. First degree relatives of each subject were also included. The authors considered a wide variety of disorders, including schizophrenia, bipolar disorder, depression, anxiety, autism, anorexia nervosa, ADHD, and substance use disorders.
The study showed that there was no overall difference between the creative and lesser creative occupations with regard to any psychiatric disorder other than bipolar disorder, which was more prevalent among scientific creatives.
Participation in a creative occupation appeared to be protective for the development of most disorders, and decreased the likelihood of suicide.
Being in a creative profession was associated with a family history of schizophrenia and bipolar disorder. The authors speculated that creativity and unconventional thinking exist along a spectrum with psychopathology, and that there is an overall evolutionary benefit. Some degree of pathology leads to productivity, while too much is pathological.
Writers were an exception to these findings. Authors were twice as likely as other creative professionals to have schizophrenia and bipolar disorder, and were at increased risk of both depression and substance abuse. Writers, and poets in particular, were at an increased risk of suicide even in the absence of a psychiatric diagnosis.
There were several unique aspects to this study: the extremely large number of subjects, the 40-year follow-up period, and the extensive list of psychiatric disorders that were included. It was also unique because it included “everyday” artists – creative individuals who were not celebrity figures or award-winning authors. Thus, the study may be more reflective of the real-world experience of most visual and verbal artistic professionals.
While I found the research fascinating, it was not designed to answer the question of why creativity may protect against mental illness for most professions or why writers may be particularly vulnerable. Certainly, there are aspects of an artist’s life that would affect emotional functioning: living in a society were artistic accomplishments are less valued or rewarded, being professionally isolated or being involved in an activity that requires a considerable investment of one’s identity or some degree of public personal disclosure. The creative endeavor itself may compensate for all this.
The study also isn’t able to answer the question of how best to care for the mentally ill artist or the role of the creative process in recovery from mental illness. Nevertheless, this paper will hopefully put to rest the myth of the mad but tragic artistic genius. While creativity and madness may make for a compelling narrative, the reality of serious mental illness and suicide is a much uglier picture.
—Annette Hanson, M.D.
DR. HANSON is a forensic psychiatrist and co-author of Shrink Rap: Three Psychiatrists Explain Their Work. The opinions expressed are those of the author only, and do not represent those of any of Dr. Hanson’s employers or consultees, including the Maryland Department of Health and Mental Hygiene or the Maryland Division of Correction.