Friday, July 29, 2011

Mental Illness or Muse? Amy Winehouse and Historic Artists with Bipolar Disorder

By Mohammad Alsuwaidan, MD 

We have no doubt lost a profound musical talent in the tragic death of Amy Winehouse this week.  Her public struggle with substance abuse and bipolar disorder (commonly known as manic depression) has reignited curiosity about possible links between creativity and mental illness. In such unfortunate circumstances, it serves well to draw upon the lessons of history in making meaning out of sorrow.

A little more than 120 years ago, a misfortune befell another budding talent. A young painter entered a psychiatric hospital in Saint-Rémy-de-Provence, Southern France. Known by his neighbors in town as “fou roux" (the crazy redhead), he had been troubled with mental illness throughout his life. A few months prior, he had reached a crisis point and during his breakdown, he rushed to a brothel to see his friend - a prostitute named Rachel. He handed her a small wrapping of newspaper - telling her to “keep this object carefully” and ran off. Unwrapping it, she was shocked to find the freshly cut and still bloody lower portion of his left ear!

Vincent van Gogh holds legendary status in Art and his influence has crossed cultures and eras. To gaze onto the vivid colors and hypnotic swirls in his work is to be transported into another world - a morphed view of reality that can only be seen through his eyes. There is a tendency to romanticize van Gogh’s mental illness – which most respected psycho-biographers believe to have been bipolar disorder.

The notion that there is a fine line between creative genius and “craziness” is not new and has existed since ancient times. Most of this interest has focused on bipolar disorder; many famous figures have been speculated to have suffered from this mental illness: Beethoven, Edgar Allan Poe, Emily Dickinson, Victor Hugo, Charles Dickens, Edvard Munch, and many more. We continue to see this pattern in the modern day among celebrated actors, poets, painters, and musicians like Ms. Winehouse. Yet, despite our modern methods, illuminating the “line” or “link” between mental illness and creativity remains elusive.  Studies show that a certain level of melancholy or mixed emotions may be needed to access the creative spring. Unfortunately this negative emotion may also underlie some of the symptoms seen in bipolar disorder. 

Herein lies the eternal dilemma in the field of medicine – balancing benefits of treatments against their risks. Could some bipolar treatments dampen the creative drive? The evidence, both anecdotal and empirical, says yes.

Yet research also reveals that when individuals with bipolar disorder receive treatment, their overall productivity, focus, and organization improve. We know that the poet Robert Lowell produced the largest portion of his work after receiving lithium treatment for his bipolar disorder. And though some critics argue that his “pre-lithium” work is more striking in its poetic beauty, they admit that had it not been for the stabilizing effects of his treatment leading to many more – still beautiful – poems, we may have never known Lowell and his artistic mastery at all.

The message to mental health professionals is clear in my mind; we should attempt to treat highly-creative individuals with mood disorders with all the latest advancements including medications. BUT we should listen carefully and work with our patients to understand what effect treatment is having on their creative drive. Perhaps some individuals need some degree of discontent to “kindle the creative fire,” and we should step up to the challenge of helping them achieve a tolerable and productive balance.

At the young age of 37, after a manic episode of creating many paintings, Vincent van Gogh walked into an empty field outside his home, aimed a loaded revolver into his chest, and pulled the trigger. His famous last words, as he lay dying in his brother Theo’s arms, were "La tristesse durera toujours" (the sadness will last forever).

Perhaps had he not suffered some degree of sadness, you and I would have never heard of van Gogh. Perhaps had he lived longer, his influence would have been even greater. Perhaps the next van Gogh or Poe or Winehouse will walk into a mental health clinic next week suffocated by their sadness, yet possessed by creative inspiration. The questions are complex scientifically, ethically, and philosophically. But I believe that a balance can and should be reached (or at least approached) and that tragic endings can be re-written. 

Dr. Mohammad Alsuwaidan is a psychiatrist with expertise in Mood Disorders at the University of Toronto and a Master of Public Health candidate at Johns Hopkins University. Learn more:

KR Jamison, Touched with Fire: Manic Depressive Illness and the Artistic Temparment, Free Press Paperbacks (New York 1993). p.85
AW Flaherty, Frontotemporal and Dopaminergic Control of Idea Generation and Creative Drive. Journal of Comp. Neurology 493:147-153 (2005).
Santosa C.M. et al. Enhanced creativity in bipolar disorder patients: A controlled study. J. Affect. Disord. (2006), doi:10.1016/j.jad.2006.10.013
Flaherty, A. (2011). Brain illness and creativity: mechanisms and treatment risks. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 56(3), 132.


  1. great article, had to share it with others. thanks!

  2. This is thoughtfully written and presents an interesting dilemma that is worth pondering a bit. It interests me particularly because there are well known artists in my husband's family. A treatment to normalize the neurotransmitters in the patient's brain, yet allow whole brain or improved communication across the corpus collosum is an interesting problem to try to solve. Perhaps this might be part of what occurs in highly creative individuals who suffer from Bi-polar illness, the increased communication they may possess, would make it more problematic to target specific areas and treat.

  3. What a great article! I'm writing my thesis on this subject, and came across this article while doing research on the correlation between mental illness and creativity. I completely agree that there is a fine balance between medicating an individual so they can lead as normal an existence as possible, and over-medicating them to where they lose their motivation and creative essence. The artistic material produced by people suffering from schizophrenia and bipolar disorder can be truly amazing, not only affecting those it touches, but offering insight into the individual's mindset and existence, their 'reality.'I think it can only be beneficial that more research is being done in this area.

  4. As a Clinical therapist working w/ a vast population of clients who manifest several different diagnoses - a large % being diagnosed w/ Bipolar D/O and Chronic Major Depression w/ Generalized Anxiety D/O; AND being a spouse of someone who is dx'd w/ BP Disorder, and the mother of a very creative daughter w/ the same diagnosis, I believe that I can see many different sides to this. I can say that we certainly don't want to blunt anyone's artistic ability. However, if they do not have any medication regimen or at least therapeutic assistance & monitoring, the creative person will probably not be well enough to focus and produce their works, know how to get them seen, and become known, in their lifetime at least, as the great artist of whatever kind that they are. If a person is bordering that cusp of a psychotic break with reality, that is going to consume them, on all levels, as well as if the person has to endure long or quickly spiking episodes of mania, (especially Type I Bipolar D/O where the mania usually lands the person in the hospitl), or if they suffer a deep depression...leaving them without the ability to do much more than concentrate on trying to maintain equilibrium. A learned & respectable doctor in psychiatry should always be aiming for the lowest dose of medication to keep the person asymptomatic. I do know that my ex-husband of 15 yrs was just as talented and produced some great visual art while at his most dysfunctional times, BUT the illness could be definitely seen in his artwork. He always used charcoal & pencil as his medium, and the abstracts were dark, and somewhere between looking at someone's delusion and their nightmare. But as he got therapeutic help, and onto medication, his artwork changed moods and venues - going first to acrylics and water-colors mostly of scenes of females and children that he photographed first or just conceptualized, then onto oils on canvas of landscapes that he would draw on location. He is one of the lucky ones b/c he was eventually able to continue to be stabilized w/o meds, but his affect is very flat. That is the trade-off. ALL his emotions are muted and expressed through his art, but very little is expressed in words, gestures, or mannerisms. That led to an unfortunate divorce. My daughter on the other hand was a wonderful poet w/ a vast command of the English language and was able to write about experiences far out of her range of experience. This was all through her childhood, and adolescence. Some of it was so dark though, that I did seek counseling for her. But then when she had her 1st psychotic break in college and we had to remove her and get her treated for her own safety, she began to lose interest in writing at all. Years later on no medication at all, seemingly happily married with babies, she is totally unmotivated to write. I think that possibly writing was her outlet for all the repressed emotions that she couldn't express, but then when everything culminated to a major change in her personality and inability to maintain her own self-care, with distortions of the truth, pathological lying.....she perhaps didn't need it anymore? She "seems to be" a happy person today, but she suffers with a lot of anxiety and rage, and w/o gaining any insight into her behavior, her passive-aggressiveness will always be there, and she'll never understand how her additional dx. of Borderline Personality Disorder really fractures her relationships with others. So it's a thing of the past. I don't believe we will ever see anymore original writings from her anytime soon in the future. She is refusing any meds (except a light dose of anti-depressants for postpartum depression). But she is not open to any therapy, and that's where she is stuck. Her father continues w/ his gift, but I believe that her's is out of reach, at least for now.


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