Reviewing my old Medium account, I found this gem amongst articles that would probably not fit well here. This was originally published August 20, 2021, but I still stand by everything I said; in fact, it echoes much of what I wrote in a newer piece, “The Myth of the Martyr-Artist.” Enjoy this cleaned-up representation of an older piece that still resonates strongly with me.
That familiar feeling began to creep over me, like a fever emanating from deep in my bones. A mix-up at my pharmacy forced to miss a few days of my antipsychotic medication, a life-saving drug that has kept mania at bay.
Life seemed to speed up.
Days and nights blurred into one another as I stayed cemented to my computer, typing up dozens of pages. At night, I continually awoke to scribble down a thought that could germinate into some project.
I spent hours bouncing ideas off a friend; our conversation leapt from Indigenous rights to otherkin identities. Our discussion resembled two misfiring chatbots fed an endless stream of Wikipedia articles.
This is awesome, right? As a writer, there’s no better feeling than having a full queue of work ahead and all the energy in the world to do it. Writing isn’t just work to me: it’s my reason for living. Getting a preternatural boost in my work speed seems like a dream.
It’s not — at least not for me.
What I was experiencing was a hallmark symptom of hypomania, a milder version of the classic bipolar mania. Racing thoughts are frequently reported by bipolar patients and are one of the criteria to diagnose a manic episode. They can be deeply frustrating and debilitating: as Marcia Purse notes,
Racing thoughts are more than just thinking fast. Rather, they are a rapid succession of thoughts that cannot be quieted and continue without restraint. They can progressively take over a person’s functional consciousness and gallop out of control to a point where daily life can be affected. This symptom can become so severe that it interferes with the ability to sleep.
With racing thoughts, it’s nearly impossible to get anything done. I dream up remarkable ideas, but none of them are completed because I am immediately swept up in some new interest.
I don’t just go down one rabbit hole: I nosedive into the whole burrow and can’t find my way back out. Every entrance has no exit and I’m forced to seek a new tunnel. It’s an exhausting mental exercise, but occasionally it turns up some truly great gems. Sometimes these discoveries make the struggle seem worthwhile — after all, don’t we love originality in a world of imitators?
Sure, I suppose. This phenomenon has been credited with influencing some of the greatest artists of all time. It’s no wonder that people assume that bipolar people must be innovators in their chosen field: it so often turns out to be true.
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Mental illness has influenced the work of many creatives
You don’t have to look far throughout history to find bipolar individuals who mastered their craft, pioneering entirely new ways of thinking. Virginia Woolf wrote that “as an experience, madness is terrific I can assure you, and not to be sniffed at; and in its lava I still find most of the things I write about.” She saw her disease as the genesis of her art, something many others have asserted as well.
Woolf’s tortured life, which most likely contributed to her emotional lability, enabled her to create remarkable novels that furthered feminism and illuminated a more expansive vision of women’s role in society. Sounds like an awesome life path — if you forget that she ended her life by walking into the River Ouse.
Fame poet Sylvia Plath, also famously struggled with mental illness. Her works resonate so deeply because they are raw, oozing wounds, blood-soaked fingers pressed onto the page.
Like many other bipolar individuals, she had tortuously difficult relationships: her husband Ted Hughes was physically and emotionally abusive, beating her until she miscarried and cheating on her with the German poet Assia Wevill. Both Plath and Wevill committed suicide by carbon monoxide poisoning, reflecting how interpersonal issues, combined with neurotransmitter failures, lead to tragic ends.
Beyond these anecdotes, there is at least some evidence that bipolar may have a link with creativity. Work by researchers at Johns Hopkins University acknowledges the high overlap between creative individuals and mood disorders, while Stanford University research suggests that a particular creative temperament may correlate with bipolar tendencies.
This intriguing work offers a number of different hypotheses for a well-recognized phenomenon, but there’s a catch. The reality for most of us is that mania only provides the illusion of creativity.
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Bipolar mania is more about quantity than quality
Most artists, no matter their medium, have sought some way to boost their creativity, from drugs to hardcore meditation. Those who struggle with productivity might find themselves jealous that bipolar individuals can experience a rush of creativity by just not taking their pills.
However, many don’t realize that mania helps you generate a lot of work – not necessary good work. Virginia Woolf pointed out that during mania, the words would emerge, “everything shaped, final, not in mere driblets, as sanity does.” I suspect much of it was relegated to the trash bin when she recovered.
Disorganized thoughts is a hallmark of mania and it deeply affects the quality of one’s writing. Kay Redfield Jamison describes it thus: “for those who are manic, or those who have a history of mania, words move about in all directions possible, in a three-dimensional ‘soup’, making retrieval more fluid, less predictable.”
A 2019 study published in Scientific Reports confirms this observation. In a study that compared the word usage of bipolar individuals across the mood spectrum, those experiencing mania or mixed episodes had greater “flight of ideas,” meaning that their words do not follow any coherent narrative but scatter across the mental landscape like buckshot.
I certainly found this to be true. During my episode of psychosis, I churned out four or five poems every single day; I was working on at least three different novels and raced through nearly a whole manuscript within only a few months. I thought it was all brilliant, that I was a true savant who would soon be famous.
One of the novels I was working on was written with an interlaced secret code which could only be deciphered using one particular version of the dictionary. I was sure this book, with its lackluster plot, would cement me in the halls of the greats.
Looking back on the work after recovery, I was aghast at how terrible this work was: not the diamond I expected, but faceted plastic, a cheap child’s toy. It doesn’t take a genius to realize that a novel which is only enjoyed when partnered with a single edition of Webster’s will not be a bestseller. I focused more on the reference book scavenger hunt than creating likeable characters or interesting scenes.
Likewise, the poems were more world salad than ballad, simply a jumble of phrases that sounded nice together but didn’t create a narrative. Just as Weiner et al found, my work had increased phonological association: I was pairing words with complementary sounds. It also demonstrated semantic overaction, where I assigned more meanings to a word than are expected in normal language. Here is an example of a work from that era:
I am the roasted one that toasts
to the burnt fragments of myself
endlessly, dropping crumbs of my body
all along the riverfront
for angry ducks to destroy.Remember when I bewitched squirrels
for you, drew dog food from my backpack
and fed a hungry animal because I know
how the gnaw feels? There was a smile
across those gauntlet lips
and I thought perhaps I’d won you.
Now I know I’m wrong.Again again I draw myself back
and rush over you. Perhaps this
version of me, a dumb doll smile
wrapped around my weeping face,
will seduce you enough
that I can take off
my bandages and succumb
to blood poisoning.My veins are made of iron;
I have a sword for a spine.
And as it is the last piece
to make it out of me alive,
make it a memento and bury me
in your well.
In the memorable words of one of my creative writing professors, my work had no plot, more interested in sounding good than being good.
Over a decade later, I am still slowly picking through the poetry boulder fields, polishing the pebbles for a new decoupage. While it’s nice to have an enormous backlog of writing to develop, it is also depressing to see how sick I truly was and how little I recognized it. I would give up these thousand lines to get that year of my life back. Each word came at a cost far beyond its value.
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Mania is too high a price to pay
If an individual with bipolar gets swept up in the joy of creativity and chooses not to treat their mania, things can go downhill fast. The burst of energy and innovation will be quickly replaced with the other, more disabling symptoms of mania, like irritability, recklessness, and inappropriate behavior.
The mind plays a cruel trick by reducing an individual’s self-awareness as mania ramps up. This can lead to intense interpersonal issues which the person then justifies through their feelings of creativity and uniqueness. Why does it matter if I made a disgusting joke in front of my new boss? He just doesn’t understand how original I am. I HAVE to spend this money for these rip-off courses if I want to become a great artist! My wife just doesn’t recognize the value of this training when she refuses to give me her credit card.
When the dust settles, many patients find that their entire life has been torn to pieces by the tornado of mania. People may lose relationships, jobs, homes, or even their freedom. It’s no wonder that bipolar individuals have high rates of homelessness, incarceration, addiction, and suicide.
It’s more than these societal factors, though: mania actually damages the brain. A 2015 study found that bipolar patients who suffered a manic episode had decreased grey matter in their prefrontal cortex, the area of the brain that regulates executive function. With decreased executive function, bipolar patients have difficulty regulating their thoughts and behaviors, accurately recalling information, and remaining on task when achieving a goal.
And these problems are not short-term, either. Longitudinal studies of bipolar patients found that at least a third of patients showed cognitive impairment up to seven years later. While it’s possible some of this may be attributed to heavy-duty medications like lithium, there’s some suggestion that psychiatric medications actually help to protect and repair the brain, meaning that impairment would be far worse without treatment.
Sadly, this damage can lead to quite grim outcomes. Virginia Woolf, who had struggled with bipolar psychosis, wrote to her husband that “I begin to hear voices and I can’t concentrate… You see I can’t even write this properly. I can’t read.” Her degrading sanity and despair soon claimed her life. She piled her pockets with stones and waded into the deep waters near her Lethe home.
It doesn’t have to end this way for any of us today. We can take inspiration from other facets of the bipolar experience: hope, optimism, and recovery.
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Bipolar recovery can also enable great art
Let’s be honest and admit that it’s far more enjoyable to watch cars crashing than paint drying. Many of us (yours truly included) are irresistibly drawn to the morbid and bizarre: it’s the reason we sign up for insane asylum tours or marvel at the fever dreams of Hieronymus Bosch. That’s why there has been so much written about the agony of Vincent Van Gogh, but so little about his hope and redemption.
Most biographers of Van Gogh focus on his mental illness, especially his shocking act of cutting off his own ear. But as Jonathan Jones points out in The Guardian, this myopia misses much of what makes Van Gogh so intriguing:
In the months after this mostly self-taught Dutch artist in his mid 30s arrived in Arles in February 1888 he invented a new kind of art that would come to be called expressionism.
In the process he drove himself mad.
That probably sounds like a dangerously Romantic way of putting it to curators of On the Verge of Insanity: Van Gogh and His Illness, an exhibition at the Van Gogh Museum in Amsterdam. This sensational show — how strange to see the rusty gun, found in a field at Auvers-sur-Oise, that the museum is “80% sure” Van Gogh shot himself with, in 1890, at the age of just 37 — is full of fascinating documents that tell a sad story of a man struggling with his declining mental health until finally, in despair of ever getting well or living independently, he chose suicide. It presents a lucid narrative of the final phase of Van Gogh’s life. Yet it is ultimately a pedantic and misleading exhibition whose pursuit of clinical accuracy misses the mystery of Van Gogh’s life and art.
By casting Van Gogh as “insane” and lasering in on his struggle with mental illness, the curators miss one of the most essential parts of his story: that he was influenced by depression, mania, and recovery.
Some of his most seminal works, including The Starry Night, were created during his year of voluntary hospitalization at Saint-Rémy de Provence. Just the act of admitting himself to an asylum represents a fierce desire to get well and a willingness to go through great hardship to get there.
He was helped in this pursuit by a rapturous appreciation for nature, spending hours examining the minutiae of flowers, insects, and trees. Another highly recognizable piece from this series is The Irises, which radiates a remarkable serenity. It’s clear from one of my favorite paintings, The Large Plane Trees, that, as Van Gogh wrote to his brother, working outside did him — and the work — great good. Vincent was into ecotherapy way before it was cool.
His work still inspires and cheers millions today, including me. I keep a copy of his Still Life: Vase with Twelve Sunflowers above my desk to remind me of the beauty of life. His writings are also full of joy and encouragement, such as this truly gorgeous summation of life: “the fishermen know that the sea is dangerous and the storm fearsome, but could never see that the dangers were a reason to continue strolling on the beach.”
Imagine how glorious life would be if we all took this idea to heart.
You might wonder why I consider Van Gogh an inspiration to those of us with mental illness, rather than a cautionary tale like Woolf and Plath. After all, didn’t he also end his own life? Well, perhaps not.
After over a hundred years, evidence has emerged that suggested his death may have been manslaughter, not suicide. In 2011, biographers Stephen Naifeh and Gregory White proposed the idea that Van Gogh was accidentally shot by two boys playing with a shotgun.
The authors’ decades-long investigation uncovered contemporaneous reports of the death, noting that “the accepted understanding of what happened in Auvers among the people who knew him was that he was killed accidentally by a couple of boys and he decided to protect them by accepting the blame.”
This revelation took the art world by storm, with historians coming forward to dismiss the idea as fantasy. The Van Gogh Museum, the official keeper of his memory, still contends that it was a self-inflicted gunshot wound.
Naifeh and White’s argument gained more firepower in 2014 when forensic scientist Dr. Vincent Di Mao examined the evidence and stated that “it is my opinion that, in all medical probability, the wound incurred by Van Gogh was not self-inflicted. In other words, he did not shoot himself.”
The theory that he protected the reputation of others is bolstered by a 2020 Architectural Digest article suggesting that Van Gogh had spent his final day working in the wheat fields on the colorful painting Tree Roots. The rich, Gauguinesque composition does not suggest someone who was intent on ending his life, but one who was living in the moment. Like so many of us who have gone through psychosis, he was reveling in the precarious peace that we cherish so deeply.
I refuse to believe that someone who has painted the depths of despair would create such a hopeful piece at a time of suffering. The idea that he was sheltering a young man from his mistakes corresponds much more closely with the man he was: a gentle soul whose pain had abraded away any attachment to the world, who accepted death with peace.
Van Gogh’s prodigious work during his stay at Saint-Rémy demonstrates that there is nothing more powerful for creativity than good mental health, even if cultural representations of mental illness refuse to accept this reality. But even if treatment dulls the mind, it lets that mind keep living to create another day — isn’t that is what most important?
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Mental health leads to more success
Women like Woolf and Plath had privilege and influence: their publications were enabled by familial support that protected them from more barbaric interventions.
Woolf took several “rest cures” throughout her life, something that wouldn’t have been possible for the majority of women struggling with mood disorders. Instead, these marginalized women were often placed in asylums, spending their time vomiting from “therapeutic” emetic drugs or being lobotomized and shocked.
While treatment could not fix things for Woolf, mostly because the treatments she needed were not yet invented, it did enable her to create the seminal works she is known for. Without that help, she likely would not have made anything.
I recognize that while I am not similarly talented as such luminaries, I am similarly privileged. I too have only been able to study writing because I have a loving, supportive family and good health insurance. So many others are far less fortunate through no fault of their own.
Still today, there are millions of neurodiverse individuals across the world who lack access to basic mental health services. Sometimes the infrastructure to support them is entirely lacking; sometimes it’s tantalizingly out of reach.
We are facing a mass extinction of creativity, powered purely by the capitalistic idea that mental health care is not a human right. So many people that are more talented than me will never publish anything by the cruel lottery of circumstance.
For all of us struggling with balancing creativity and health, I would urge you to tip the scales toward wholeness. Please, never go off your medication in hopes that you can find some inspiration: continue to follow the treatments prescribed by your physician.
If you lack access to healthcare, fight like hell to get it, both for yourself and for our entire society. And when the well run dries, have faith that you will eventually put your fingers to the keys again.
When I realized that my thoughts were a torrent rather than a trickle, I knew I needed my medication as soon as possible. I fought with my pharmacy for a refill and, in the meantime, asked my mom to watch me carefully. Within days, I was back to a slow stream of consciousness.
I know it’s essential to manage both the black dog of depression and the kaleidoscope tiger of mania. Either of these extremes could lead to innumerable tragedies, something I will fend off with all my strength.
After all, if I fill my pockets with stones, there’s no room for a pen.