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Creativity in Bipolar Disorder: Fabulous or Fatal?

When I’m providing therapy for people with bipolar disorder, one of the greatest concerns they have is losing their creative abilities. People with a bipolar condition adapt to mood swings by getting as much accomplished while manic, knowing that a period of depression may be right around the corner.

During manic episodes, an individual can feel tremendous energy and form intense ideas towards extreme productivity. The prospect of blunting creativity with mood stabilizing medications is troubling for them, even when they recognize how mania can also be a destructive force in their lives. The creativity issue is inevitable in bipolar therapy—so it’s important to know ahead of time what the perceived loss of creativity really means in the life of someone with bipolar disorder, and what therapy can do to help.

In understanding what creativity means to someone with bipolar, consider this: Much of what you may have heard about great inventors, entertainers, artists, and leaders who have had bipolar disorder is probably true. For example, van Gogh, Newton, Mozart, and Poe are believed by many to have suffered the disorder. But is it also true that without bipolar in their lives, they still would have been the great and celebrated innovators of all civilization?

Winston Churchill, believed by some to have had Bipolar II Disorder, called his intense bouts of depression the “Black Dog.” However, he also experienced periods of hypomania that vaulted him to historical immortality. Psychoanalyst and author Anthony Storr (1997) said of Churchill, “Had he been a stable and equable man, he could never have inspired the nation. In 1940, when all the odds were against Britain, a leader of sober judgment might well have concluded that we were finished."

I believe that people with bipolar can relate to that assessment. To be stable and equable may mean what they do creatively might well be finished, too. And not just do they fear a loss of their creative juices, but also their entire sense of identity. Bipolar disorder is genetic in its foundations, so it is vital to understand that individuals with bipolar, to one extent or another, have regarded themselves and the world around them in extreme ways for much of their lives. Stability through bipolar treatment is often feared to be so neutral a position, that they would actually feel nothing—not energized and alive, or for that matter, sad and wanting.

Though the prospect of doing away with depression may sound terrific, they will more likely fear becoming zombies in the process. The perceived loss of creativity and sense of identity through mania often keeps people away from bipolar treatment.

But the avoidance of care for bipolar disorder brings with it an array of terrible consequences, including a dramatic increase in suicidal risk, which is 20 to 30 times higher than the general population (Berk, et al, 2013). Neglecting treatment in order to preserve manic creativity and productivity often leads to an inevitable crash that threatens every aspect of the person’s well-being.

Therefore, bipolar therapy must always include a therapeutic discussion of all creative issues, and a developed plan to help people maintain mood stability while retaining and ultimately enhancing their creative abilities. This starts with redefining what the creative process is all about.

First of all, it’s important to note how people often confuse the intense rise of manic energy with a sudden surge of creative skill. But this really isn’t how creativity works. Indeed, someone flush with energy may feel creative, with boundless excitement to “get things done;” but this can also lead to a disorganized and reckless path, which the person in mania will brazenly justify through denial.

It's necessary to assess one's own talents that may be seen as raw or innate. Essentially, they are possible desires or pursuits that have some genuine attachment to that person's life and experience. Just because mania might make you believe you can write the great American novel, that doesn’t mean you can. Mania often deludes the person into believing they are greater than their skills can produce. But if you actually desire to become a creative writer, and you show some promise in that regard, you can steadily harness your innate abilities following mood stabilization, and without the delusion or excessive strain of mania.

After understanding talents and desires in the creative pursuit, it's necessary to develop an organized strategy. Energy alone is not creativity. It’s simply the body's fuel that's being used up at an accelerated pace.

The concept of the creative process acknowledges the need for a developing skill set and a formulated plan using the plotting of time as an essential ingredient. It also requires ongoing learning and skill-refinement towards an appropriate level of success. This is best achieved through bipolar therapy in the post-stabilization phase when medications and overall treatment is set for long-term maintenance.

Now, the thought of time for people with bipolar can be aggravating. The bipolar mindset often views time as the enemy. The very temporal nature of a manic episode, whether it lasts a few days or a few weeks, makes the person believe everything has to get done at once, and there’s no room for “planning” anything into the future. And what’s the point of planning anyway, especially when you’re feeling on top of the world? Time is a drag that fundamentally threatens perceived success and all those great feelings mania provides. This gets wrapped into the person’s sense of self—their identity—and is difficult to envision any other method of creativity, or even the ultimate purpose of developing a strategy at all.

So bipolar therapy recognizes how hard it may be to grieve the perceived beneficial aspects of mania, and how trust in therapy and the therapist is needed to go forward with a better organizational plan for sustained creative output. This is especially true when the person comes to a certain point of struggle within an authentic creative method. True success often involves trial-and-error, failure, self-doubt, and simply a lot of undesirable and repetitious work.

Going through failure may entice a person with bipolar to abandon treatment, avoid feeling the struggle and return to relying on manic energy. Therefore, the astute therapist can anticipate and address these feelings and conflicts before trouble hits, and help keep the person on track along the new creative pathway.

And as success develops in smaller pieces for the person in post-stabilization, confidence builds steadily. But when it comes to success for people with bipolar disorder, the story doesn’t just end with a pat on the back. Interestingly, attaining goals for people with bipolar may actually increase the further risk of mania (Miklowitz and Johnson, 2009). I think this phenomenon is similar to a gambler who scores a big win at the racetrack. Instead of taking his money home and relaxing in the moment, he cannot contain the rush—and instead parlays his winnings again and again, until he gets further behind than when he started.

Apparently, the rush of success through goal attainment in people who are stabilized on bipolar medication may be too exciting to maintain. Perhaps the memory of how good it feels to be creative, productive and high on life, can force a manic response in the brain that can break through barriers imposed by medication and previous cognitive changes brought by therapy.

So it’s crucial to consider proceeding with therapy through the good times as well as the bad times, especially as the person with bipolar lives through challenges of all kinds. I find that when people with bipolar disorder experience various challenges to their newfound sense of identity and creativity, their opportunities for a life of fulfillment is plenty available and sustainable. This becomes the new rhythm of their lives, and they discover how to be creative in their work, their play, and their relationships without undue risk to overall health and well-being.

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