Advantages Of The Bipolar Spectrum, The Link To Creativity Explained - Dr. Tiffany Greenwood

hi everyone I want to thank you all so much for joining us on today's webinar on the topic of advantages of the bipolar Spectrum the link to creativity explain and we are so honored to have Dr Tiffany Greenwood join us today to present on this Dr Greenwood is an associate professor in Department of Psychiatry at UC San Diego and her research focuses on defining the genetic architecture of bipore disorder and schizophrenia using dimensional phenotypes to provide a better reflection of the underlying biological process and with that I'd like to turn it over to Dr Greenwood hey thank you Jake it's really a pleasure to be with you today um and this is a topic that is of great interest to me and one I really enjoy speaking about um and so as you mentioned I am a geneticist by training but most of my work has focused on looking at alternative definitions of both bipolar disorder and schizophrenia and a lot of this work has centered on looking at aspects of temperament personality and cognition and I've become increasingly interested in this connection between creativity and bipolar disorder because temperament personality and cognition contribute to creativity as well and so I think if we understand um this aspect of the shared vulnerability between creativity and bipolar disorder it'll help us to understand the biological causes of bipolar disorder and that should facilitate treatment and so we'll we'll talk um about how that might be able to be very helpful um here today oh my slide advancer is not working oh that's fine if you could just I'll bear with us for one second a lot of Dr Greenwood gets that figured out that'd be great and I also would like to say that there will be a 15-minute question and answer session at the end of this presentation so you can drop your questions throughout and we'll take time to get to as many as we can after it's not working oh that's fine maybe you could just try to unshare and then start the sharing one more time okay actually um you know what let me foreign okay so I just wanted to um very quickly acknowledge my collaborators and the sources of funding that made this work possible um and so I feel like um with that um you know bipolar disorder is really um different than most common medical illnesses um and in that it's often perceived to be associated with these positive aspects and I think the magic button question um really highlights this fact and this question has been posed in a few different settings and basically asked if there were a button that you could press that would take away your bipolar disorder would you press it and in one study conducted online of it's not working again oh my gosh I don't know what to do I don't know what to do I can't go through my slides don't worry about it let's see here we go okay I just have to press it physically on the slide I guess okay of um an online study of more than 300 3 300 people only 54 actually said yes that they would push that button to take away their bipolar disorder completely and that's quite astounding when you think about that because what other medical illness would you ever feel would have that um kind of an effect I mean most people would just push that button and get rid of their pain and suffering but bipolar disorder is different and while it's um clearly associated with a lot of negative aspects that um cause a lot of disruption in one's life and are associated with um disability it also for many um many feel that being bipolar is an inherent part of their identity and that it imbues them with certainly positive characteristics creativity being one but there are several that people feel are associated with bipolar disorder and for these individuals and the positives actually outweigh some of the negatives and that's the reason they would not choose to push that button and completely eliminate the disorder of course they might be very willing to release some of the negative aspects and simply have the positives and um hopefully that can be a future point of research so that we can allow that to happen um and not take away all of it at once um but I think that um this is really an interesting topic and if we're going to treat um bipolar disorder better and more effectively in a personalized treatment manner um I think we really need to consider both the negatives and the positives because they both contribute to someone's willingness to seek treatment and to comply with the treatment and that's that's one disadvantage of some of these positives they come at that cost where people delay seeking treatment and may not wants to comply because they don't want to lose those positive aspects so um so this this connection between creativity and bipolar disorder days back to the time of Aristotle's observation that no great genius has ever existed without a stream of Madness and there have been a wealth of Investigations in this area that have supported this notion studies of eminently creative individuals reporting over-representation of mood disorder and psychosis on large population-based studies that look more at everyday creative leaves and not the eminently creative than those of the world that this everyday creativity they also report a significant over representation of bipoloid patients and their unaffected first degree relatives in his creative occupations some Studies have looked at creative performance um in bipolar patients and their unaffected Offspring and found that their performance is actually comparable to that of creative individuals so together this suggests that there's a strong familial connection between creativity and bipolar disorder however um it is the the creativity and professional success are actually more prominent in the unaffected first degree relatives rather than the people who have bipolar disorder themselves and creativity and Eminence are also more often associated with bipolar Spectrum traits rather than the full-blown illness so this is suggesting that there are aspects of the bipore spectrum that contribute to higher creativity but that the increasing symptom pathology actually can be a detriment to creative achievement foreign okay so um many have suggested this kind of model of a shared vulnerability between creativity and bipolar disorder and this is the classic inverted new representation of that model and so basically it suggests that creativity would increase along with genetic risk for bipolar disorder up into a threshold and at that point it would begin to diminish with the increasing impairment associated with the symptoms of bipolar disorder and they're um there are several traits that likely mediate this shared vulnerability and contribute to the creativity these are bipolar Spectrum traits and they represent the soft expression of the bipolar phenotype and there are several temperament and personality traits that have been shown to be related to bipolar disorder to creativity and bipolar disorder and creativity in unaffected individuals and these represent candidates for that shared vulnerability and some have even suggested that these trades are actually evolutionarily adaptive so in this next figure just like the previous they both are saying the same thing and it's they're both saying that these bipolar Spectrum traits are associated with underlying um condition of bipolar disorder and they're contributed through genetic risk for the illness and they they tend to increase and at the high end on the extreme is bipolar disorder but there's a threshold at which the genetic risk is more moderate and we have this increase in the expression of these phenotypes in unaffected individuals and at that point is where you would find um the genes for creativity and so it's really this mild moderate expression of bipolar phenotypes that provides an advantage for creativity and the genes provide for the server would then be expected to maintain in the population by unaffected individuals a portion of whom are actually benefiting from an increased Fitness that's being conferred by these positive bipolar substance rates and there have been a few genetic studies that have supported this idea of this shared genetic vulnerability so these bipolar Spectrum traits were shared vulnerability traits would lie in the space between bipolar disorder and creativity and be shared between the two um and they would be exhibited by those who are creative and also those who are a higher genetic risk without pulling Disorder so some of these traits refer to um the mood instability that's associated with regular disorder like the psychothymic temperament and so psychothermic temper temperament refers to that changeable mood a wide range of emotion and emotional intensity and of course at the extreme and bipolar disorder we would find moon cycle but this is a softer expression of that phenotype foreign personality is a softer expression of course of hypomania and anemia and it's associated with high mood and energy enhance flow of ideas self-confidence social ease and risk to be and it's thought to provide an advantage for Success which is also often been referred to as a hypomanic edge um other traits refer to kind of an experience and a type of a personality um so impulsivity is one of these and this is characterized by racing Bots which again are not the racing thoughts we associated with bipolar disorder anemia but kind of a subclinical expression of racing boss so someone who just has a lot of ideas um people with impulsivity tend to be on more easily distracted they have changing interests restless and spontaneously Behavior positive schizotippy refers to cognitive disorganization and unusual perceptual experiences and it's been repeatedly observed to be enhanced in individuals who are active in the creative arts and it's thought to represent that subclinical expression of the genes under Latin psychosis and finally open this to experience um now this personality trade is a little bit different all the others can be pushed to the extreme in the context of the illness whereas openness is just truly a positive trade it can't be extreme I mean even if you are very high on openness it's still a positive thing um so this characterizes people who are imaginative curious open-minded and empathetic um it's it's a central feature of creativity and has been repeatedly been associated with those who are creative um over inclusive thinking is a cognitive style that's also been associated with creativity it involves novel associations um among remotely connected ideas and so this facilitates originality so this is that creative thinking um the novel thing in the originality that we've seen um and creativity um and interestingly increased word production and um I'll say this kind of over-inclusive thinking um making loose associations is seen in Mania and it's actually been shown to be comparable to what is seen in Creative writers so there's that connection creative individuals are also thought to have a cognitive Advantage perhaps in terms apply IQ and cognitive flexibility IQ has actually been associated with creativity but it's necessary but not sufficient for high creativity so once an IQ level of about 120 has been reached it actually becomes personality factors that become more predictive of creative success and one of those factors is openness creative individuals also tend to have a more positive mood and that has been shown to provide a significant Advantage for creative thinking so um there have been several studies that have attempted to um identify and validate these shared vulnerability traits um the problem is that most have either used very small samples or a very limited number of phenotypes um so they're it's difficult to compare results across these studies some some Studies have not even used by poor individuals they've only relied on aspects of creativity and unaffected individuals and none has really looked at all of them in the same sample in all three groups the non-creative creative and bipolar and that's really what needs to be done so while this there's a huge set of data that supports these Notions and provides support for specific um aspects of the shared vulnerability what we really want to do is provide one definitive study that included everything and so that's what I'm going to describe here um so for this study we wanted to include all three groups that defined um that shared vulnerability so we're really modeling the study after that inverted new relationship we want people who are not creative we want people who are creative and those who have liberalism whether they're creative or not just have political illness and so um we conducted a structural structured clinical interviews on all participants of the study um and this was to not only confirm diagnoses of bipolar disorder but also to make sure that the unaffected individuals in this study had no personal or family history of mood disorder psychosis so anyone who isn't supposed to be an uninfected participant was ruled out if they had a history of obviously a bipolar disorder then they'd be in the other category um his history of psychosis or major recruitment depression which is genetically related to bipolar disorder so we wanted to make sure that we weren't picking up some noise in the data by improving anyone there also family history as well so they would be a genetic viability for these disorders so we wanted to make sure that we weren't um introducing additional numbers so we ran actually a quite extensive temperament and personality battery on the on our sample I'm only going to talk about a subset of the traits today because these were the primary hypotheses this is what we're really trying to study and these are the shared vulnerability traits of course many of these traits come as part of a larger battery and so we just administered the entire battery because we wanted to provide some contrast between traits that are not associated with creativity and are only associated with bipolar disorder and those that are shared between one so I'm only going to focus on the shared vulnerability traits today or those that we propose to be shared formulary Trace um if you're interested in seeing the full study the results were recently published last year and I don't know that they're publicly available yet but I would be happy to provide the properties everyone who's interested so the trace that we looked at are the ones that I mentioned or the terms of that shared vulnerability space in the previous slide these were the hypomanic personality the psychothermic temperament hyperthymic temperament is part of the battery that is associated that is used to test psychothermic temperaments and we evaluated that too and it provides a nice representation of the positive mood that is predicted to be enhanced in the creative individuals we looked at schizotipi which is that um subclinical expression of psychosis impulsivity and of course openness which is that Central feature of creativity in terms of creativity itself we evaluated um creative performance using a Divergent thinking task which is outside the box thinking and we also looked at aspects of achievement so I will say that our initial studies that I will show you did consider creativity defined by occupation because this is what all the other Studies have done so we wanted to provide a common platform to be able to compare our results to other studies however in later parts of the study which I'll show you we actually went back to the achievement because that's really a better way to identify creativity um just being involved in a creative profession doesn't really tell you imagine I'll show you why foreign so we also looked at aspects of cognition we looked at verbal and non-verbal reasoning which measured fluid intelligence and provide a measure of problem-solving ability and creative problem solving these also are a reflection of IQ which was predicted to be a little bit higher in the creative individuals we looked at humor appreciation which has been previously suggested to be part of the um the creative profile that hasn't really been tested in this way we also looked at spatial processing which is an interesting phenotype that might be advantageous for those who are particularly involved in a visual art and we looked at memory as kind of a baseline positive function so the final groups included 111 individuals with bipolar disorder and 205 individuals who were unaffected 102 of those reported being involved in a creative profession or having significant creative activities so we consider those to be our creative controls and the remaining individuals did not report any involvement in creative activities and they formed our non-green lift control group the distribution of gender age and education was similar and not significantly different between these three groups overall we had about 63 percent female participants um the average age of the participant was 40 it ranged um quite a bit that that was our average age and um our participants had on average 15 years of education so this is at least some college um most had completed at least High School and many had gone on to receive professional degrees but on average um 15 years of education was standard across the sample in the bipolar group we had a roughly equal distribution of bipolarism versus bipolar two but so they're a little bit more of individuals by 401 and across the entire group of bipolar participants we had about 38 percent who reported being involved in a creative profession we didn't actually recruit people who were creative and by fully they just came so um more than a third of the bipolar sample reported being creative so we analyze these shared vulnerability trace and what we were looking for were certain patterns of expression um the primary pattern we were looking for in terms of temperament and personality is this one that represents that kind of um intermediate phenotype uh pattern where bipolar disorder exists at the extreme because these are traces that presumably underlie the illness and the creative controls Express them but in a more moderate or mild fashion and would be significantly higher than the non-creative controls we also were expecting a pattern where the creative controls had an advantage and we didn't really find a difference between the non-creative and bipolar groups um for these traits we would expect to see this for hyperclimate temperament which is that positive node that was predicted to be um unique to the Creative Group and provide an advantage in terms of creative thinking um we also predicted that they would have that cognitive Advantage by an influence of Q and other aspects of cognition and then finally um there were some some tests like Pisces um so the literature does suggest that openness is um enhanced and bipolar disorder but it's so strongly correlated with creativity and so the actual um relationship of the phenotype and bipolar disorder to those who are creative is somewhat of an unknown so we wanted to explore that a little bit further we also um presumed that creative performance and achievement would be higher than the bipolar group but possibly not quite as high as in the creative control group so the literature on these particular um items is a little bit less consistent um there just aren't a lot of studies looking at creative performance in bipolar individuals or a few um so these were kind of our test variables okay so this is an initial graph of the results and so I'm just going to kind of Orient you because this will be how I will present all of the results for the study so what you see here is kind of a clustering uh the phenotypes in the non-creative group at zero and that's by Design because the scales for each of these phenotypes um differ quite dramatically and so if we just presented the raw scores um it'd be very difficult to compare um the results between the groups and we certainly couldn't look at them all on the same graph so in in converting these scores to standard scores were the mean of the inaugural control group is zero and we have a standard deviation of one and then applying that metric to the entire uh sample you're able to not only visualize all of the trace on a single graph but we also are able to um to visualize them as a sex scores so if effect sizes are um what they sound like the effects of the trait in one group compared to the other so all of these results are compared to the non-creative group an effect size of about 0.2 is considered small it would be a small effect it can be significant if the sample size was large enough but it's it's kind of a smaller effect anything less than point to you is not significantly um having real thoughts um an effect size of 0.5 would be a medium effect size or moderate effect size um and anything of 0.8 or larger um is a large effect size and so when we look at the Creative Group we can see that all of the proposed shareable notability traits are significantly elevated in the Creative Group compared to the non-creative group we also see an elevation in the hyperclimate temperament which again is that positive mood that we predicted would be elevated in creativity when we add the bipolar group we clearly have to change the scale quite a bit and that's because as hypothesized the bipolar Spectrum traits the cyclophthymic temperament the hypomania and the um or hypomanic personality and the positive schizophy these are expressions of the bipolar phenotype and so the bipolar group exists at the extreme and so that's we did actually find that pattern that we were expecting impulsivity as well because that's the reflection of the bipolar phenotype as well so we did not find hyperthymic temperament to be elevated in Buffalo group so it does seem that that would be something that was specific in characteristic of the Creator group alone openness is kind of interesting so this remember was one of our tests test hypotheses um we expected it would be elevated in bipolar disorder and it is it's significantly different from the non-creative group with an effect size of about 0.6 um and the Creative Group still maintains the advantage so the Creative Group is still significantly higher than the bipolar Group which is intermediate between creative and non-creative controls so I'd like to point out that all of these shared vulnerability traits as well as the hyperthymic temperament were actually associated with creative achievement among unaffected individuals so all of these traits whether they were part of the bipolar Spectrum or something that truly is a positive trade or predicted Higher Achievement when expressed in a higher form within moderation in the bipolar group however only openness to experience was actually associated with creative achievement because as one would expelt those that underlie The Bachelor Spectrum are pushed so far to the extreme that they really can't provide the damage for um for Creative achievement so to look at the cognitive traits we use a customized neuropsychological Valerie and as I mentioned we looked at non-verbal reasoning which used a matrix reasoning test that may be familiar to some of you it is often used to look at giftedness in children and is often used as an IQ test for adults and so in this class they are presented with an array and asked to choose the appropriate response that would fit in that array we also administered a verbal reasoning which used word analogies and asked them to pick um the word that best uh fit the analogy and each of these tasks um were Progressive meaning that if they got the answer right it would get progressively harder and harder until they started to miss questions you know with the um the difficulty of the decrease to really kind of pinpoint where their skills lie and their IQ is and so these were combined into a single measure of reasoning ability for the analysis we looked at spatial processing so this presents two lines at an angle to one another and ask the participants to rotate the blue line so that it becomes parallel to the red line and assesses how easily and efficiently and accurately they are able to do this so how many button presses do you need to actually get them to learn that can be parallel um and in terms of memory we included three different tasks um and provided 10 or sorry 20 um test subjects tests uh prompts I'm sorry um we used words um images as shapes in kind of a space a three-dimensional space and faces and they were presented with each of these items first and that's to memorize them and then presented again with these same items amongst 20 distractors and asked whether they thought they had seen this one before and so these three memory tasks were combined for a single measurement of memory so for humor appreciation we use verbal and non-verbal methods to examine this and the verbal presented headlines one of which continued a joke and the non-verbalismic cartoons one of which seemed a joke and maybe since they asked to um to select the one that they thought was more fun and or they could say that they were both equally funny and these also were combined for single measurements of humor appreciation so to look at divergent thinking or that creative thinking the outside of the box thinking this is creative performance um we use the process of creative thinking which is a standardized um measurement of this process and we use three different tasks to look at divergent thinking ability which also involves that element of over-inclusiveness that we've talked about being part of the shared vulnerability because in order to think creatively you have to make a lot of lease associations that's going to give you more novel responses um so the first tasks involve product Improvement they were presented with this little stuffed elephant and asked if to list how many different ways that they could think of to change this element elephant and make it more fun for a kid to play with and of course think of the most interesting and unusual it was not just you know anything that you can think of that we really different um we also presented them with an unusual uses task which asked them to list as many unusual uses as they can perform an item in this case we used to apply the big box and finally we can't adjust the post tasks which presented them with this image as a prompt and asked them to list as many consequences as they could think of of clouds having streamers that would kind of going to learn and each of these tasks was rated for fluency which is the number of total ideas that they could come up with flexibility which is the categories of ideas and this represents a shift in focus and originality leadership of course is how you make the ideas that they came up with are statistically um and these three domains of the Divergent thinking were analyzed separately so we had fluency flexibility and originality we also collapse them into a overall Divergent thinking score so here again is a graph showing the results in the non-created versus creative groups and again the monogata group is time centered at zero and the moons in the Creative Group for these phenotypes represents an effect size and so what we can see is that all of the trades cognitive and creative are significantly elevated in the creative control group the um creative performance the courses are quite a bit higher than the cognitive Trace but these are all statistically significant differences the bipolar group what we see is that we really see that Creative Advantage in terms of cognition um so that's what we're expecting to see where the where the bipolar and non-creative groups were about the same and that you can see some variants here but these are not statistically significant differences so it's true perform the same and the creative control were the only group that had a little bit of an advantage here I would also point out though that while the bipolar um control group or not creative control groups did not differ the bipolar group also did not show deficits on these particular measures of cognition that we propose to be related to creativity and that's not necessarily the case for other measures of practitioners quite a bit of literature looking at cognitive deficits and by four disorder and so there are deficits often observed for other under the functions but not these that we thought would be related to creativity so they aren't high like the preload patrols but they also aren't deficient either um when we look at the creative performance what we see is that the bipolar and creative groups performed about the same um so we they look a little bit different they're um there's some variants there but these are not statistically significant differences between the creative and bipolar groups they both are quite a bit higher than the non-creator group um and that's a very strongly significant result um you can see that there is the overall diversion of thinking score which is those three groups collapse together and then fluency and flexibility produce about the same results um so I just collapse them into a single measure um so that for ease of interpretation otherwise the lines would be really on top of each other and originality was really um where both of these groups could shine they came up with quite novel ideas so these studies really have confirmed um these aspects of the shared people Mobility between creativity and bipolar disorder the temperaments and personality traits that were postulated through under live the clinical expression of bipolar disorder where those with the disorder would lie at the extreme but they would still be moderately elevated in the Creative Group that was found to be the case we also found that um the two groups shared openness and was over inclusive thinking which was measured through this creative performance tests um and we also found that the Creative Group did appear to have a cognitive advantage and also on that positive mood which was um in theory providing an extra cognitive Advantage um in terms of creative thinking so we're really excited about these results because it proved all the hypotheses we had um the thing that gave me pause however was the fact that about 38 of our by four group reported being creative and so while I believe that the results for the bipolar Spectrum States would not be affected by this and nor would the cognitive traits I did worry that the results were openness and creative performance which were quite High were being affected by these individuals who were creative and bipolar and so I wanted to delve into that a little bit more into step out so for that we used our creative achievement questionnaire and this is a standardized questionnaire that evaluates achievement across 10 domains of creativity and so we administered this to everyone in this sample and I'm just showing you the visual arts and the music because those are the more common areas of creativity in our study although we did have individuals that had creativity across all of these um domains um so you can see when we look at the visual arts film for example we asked them to put an X next to any question that was true for them and then if it had an asterisk to Mark how many times that was true for them so you can see that it can range from zero when someone has no training or any kind of talent in that area way up to possibly several hundred if they have had their work proceed in a national publication multiple times and so there's really this broad range for any single domain and oftentimes people who are creative have some achievement across multiple different names um so we looked at these various domains of creativity came up with an overall achievement score and then standardized those achievements for us and so that's what you can see here so just like with the other traits we um set the control mean the non-creative control movement to zero with the standard deviation of one and so now you can see what kind of that would look like so there's still a lot of variation in the normal control group um but the mean is set to zero um when you look at the creative control group we can see that the scores are quite a bit shifted compared to the non-creatives and the bipolar has kind of arranged that overlaps both groups so what we wanted to do here was really Define what high creativity looked like using our achievement scores um so normally when I would do a study of quantitative traits I just temperamental personality or cognition in another context the line that I would draw the threshold I would use would be three standard deviations from the mean because this line represents the 99.7 percentile and if someone is crossing that threshold and they're the only ones over there they're outliers and so they should be removed from the study however this is a study of outliers we want people to be across that threshold so the social provided a nice cutting point because none of the non-creative controls frosted so we didn't have anyone that was an outlier in terms of the non-creative control group in the creative control group it actually turned out quite nicely so when we looked at the CAC those people who would pass that threshold really were hitting these higher levels of creativity their work is being recognized objectively as being creative in a public way so these aren't just people who are selling their work which they are but they are actually being publicly recognized as Heaven tell them so they're Crossing this kind of threshold of achievement whereas those um who falls on the other side they are involved in Creative professions that they just aren't um it's more everyday creativity they just aren't having that same high level of shooting them and so that provided a really nice Cut Point um and moving forward we eliminated those who did not leave this kind of high creativity threshold and we also applied it to the Bible board group and it kind of worked out nicely there too it actually identified all of the people on the sample who came in saying they were involved in the creative profession and none of the people who did not say that so it provided this nice um means of separating out people who had more everyday creativity um in the bipolar group and those who were working professionals as creatives so when we looked at these data we looked at all of the uh shared vulnerability traits again um and none were really different so the bipolar group whether they were creative or not creative they're still very high on those shared Builder ability traits um because they do represent the illness itself so they're still at the extreme no matter what they also didn't perform any differently on the cognitive tests where they did perform differently or on those measures thought I was a little bit worried about um the creative performance and we opened this so this is what the data look like so you can see um a couple of things that are worth mentioning one the creative bipolar group looks a whole lot like the creative controller they are very high on their creative performance there are scores for openness are identical and they both are highly original we also interestingly now see a hint of that hyperthymic temperament that originally was particular to the creative control group now we're starting to see that in the creative by horror group so that's suggesting that that trait that positive mood is really associated with creativity um however and the non-creative are poor group we still see aspects of openness and creative performance and originality in particular that are significantly elevated in this group compared to the inaugurated controls so this really does suggest that creativity and openness are part of the bipolar expression um they really are positive traits that are exhibited by many people who have bipolar disorder and in fact when you look at the standardized achievement score and even the non-creative individuals it still has an effect size of 0.6 so that's significantly higher than the non-creative controls so they do maintain some level of of creativity and achievements although not to the high level that the um the other group of Highly creative individuals do I mean their achievement scores were very very high around six just like the creative controls and so um I think this this satisfied my worry that we really were only seeing these results for Creative performance and openness in the bipolar group because of these highly creative bipolar individuals they are not being driven by that subset of the group they're actually um present and bipolar the server as well so um kind of to end I wanted to talk about treatment because thinking about the positive aspects of bipolar disorder is kind of fun but this is a serious disorder and so we don't want to lose sight of the fact that um you know we're talking about an illness that requires treatment and that being creative might provide some obstructions to Supernatural treatment so non-compliance with medications and treatment is just a general problem in bipolar disorder anyway but it's particularly an issue for those who are creative because they associate those new Swings with their creative ability and so they don't really want to limit them with things and that makes a lot of sense I mean if you feel that you're creative because your mood is so variable and you have those eyes and rows why would you want to live with that you want to be creative um so many people will begin a treatment plan and discontinue their medications because they feel that it's diminishing their creativity and this can absolutely happen at first but typically once someone finds the right medication for them and becomes stable the creativity comes back and it's more productive now because it's not being limited by those really high extreme expressions of the bipolar phenotype I mean we could see that in the data that it wasn't really an advantage to have these really extreme expressions of bipolar disorder so when we can limit that the creativity can become more productive and other individuals just find that the hypomania is enjoyable and they find that it's integral to their creative process it's not really supported by the data but that's the impression that that they need that type of movement to be creative and they just decide to not go on to go untreated for that and this will also delay treatment seeking quite a bit for that reason um however the symptoms of bipolar disorder typically worsen over time and when it's often treated the suicide rate is nine-fold higher and it's already fairly high with that pouring disorder anyway and so a nine volt increase in risk for suicide is is quite significant and so we really want to make sure that people um with this illness are seeking appropriate treatment for them and that can come in different forms of course um but creativity should not be an hindrance system treatment um so the hope is that by studying this connection of bipolar disorder to creativity we can make some strides towards facilitating personalized treatment um so for those who do have these positive aspects and want to maintain them the goal would be to limit the most things and not diminish that creatively um as a geneticist of course my hope is that this sitting this connection and the traits that lie between will shed light on no biological causes of bipolar disorder and then that should provide us with new targets um for medication that would be more specific um to the mood swings um without having an impact on the positive traits or other aspects and um there are a lot of unpleasant side effects in addition to loss of creativity that can be associated with bipolar meditations and so hopefully by targeting the biology a little bit more specifically you can avoid those on the present side of us um and finally I believe that if we acknowledge um that there are these positive aspects of bipolar disorder um and that it it there is this relationship with creativity and that the genes that are causing illness are actually performing a positive function in society as a whole they're facilitating creativity and invention it's been moving um human achievement forward um you know it will help us have more of an appreciation of neurodiversity and I think it can go a long way to reducing the stigma um and so I will just leave you with some comments of many people that I found I mean these are just a subset of people I found online that we're talking about their their illness and their struggles with medication um and the positive aspects of bipolar disorder because I think this is something that really resonates with a lot of people and many um want to be creative but they also want to feel stable and that's a struggle for them to find the right medication that helps them do both I'll take any questions that everyone has that was so amazing Tiffany I want to thank you so much for that presentation and if you have questions please drop them in the chat and we will answer them and one question that I have is between the creative bipolar disorder group and the creative control group was there any differences in whether someone both participated in music and painting for instance was there more dual creative outlets in anyone over the other they're um so there's a range so what we would tend to see as you could see there were um there's a range of creativity in the non-creative control group typically what we would see there was um people who wrote poetry maybe one award in high school got it published in the local newspaper but weren't poets um people who played in the high school bands uh maybe even the college band maybe they play a few different instruments proficiently but they don't play as part of a group um so the endorse was kind of lower levels of creativity and in some cases they did endorse um creativity across a couple of different domains but it was a much lower level and the Creative Group is kind of split there were some people who were extremely creative like off the charts created their scores were extremely high in one domain and then maybe just a smattering of other interests here and there um others were um very creative in more than one domain and typically they were related to one another we didn't necessarily see music and visual art both all the time a lot of times we would see something like for example theater and film and creative writing because those kind of grow together awesome right um so it there was a mix there I can't really say that there was a lot more um multiple domain endorsement of activity in the Creative Group it's just the level was so much higher because this is what they do yeah that's great that's super interesting and our next question is if you have ever done any studies on this with individuals that have both bipolar disorder and schizophrenia um not yet because so I actually when I initially approached this project what I wanted to look at was schizophrenia bipolar disorder and basically so I wanted to add a fourth group because there has been some suggestion of creativity and schizophrenia however there's many that believe that those um those uh relationships of creativity with schizophrenia might actually be stemming from a misdiagnosis of bipolar disorder and so there is a lot of misdiagnosis between bipolar disorder and schizophrenia you also have schizoaffective disorder which has some of that you know mood um variants as well it that part didn't get funded so we did what I wanted and honestly the the um connection is so much stronger with bipolar disorder um so and I don't know that I really believe we can have both bipolar disorder and schizophrenia um if you have both symptoms you would be schizoaffective and that's really a different phenotype than bipolar disorder um The psychosis is so prominent and what I can tell you about schizophrenia having worked on it for many many years cognitive deficits are very profound in schizophrenia in fact it's like one of the Hallmark symptoms of the disorder we could actually diagnose people with schizophrenia based on their cognitive profile um and that's a lot of the treatments for schizophrenia involves um you know improving cognitive function that's not really the case with bipolar disorder there is evidence for some cognitive deficits in some people there's also evidence for extreme IQ in some people and then there's evidence for people being just the same as your you know your average unaffected individual so there's really this range of um cognitive ability and bipolar disorder that we don't see with schizophrenia um they're really they're really quite different and the types of creativity that are associated with schizophrenia tends to be Math and Science in bipolar disorder it tends to be writing and Visual Arts and Music more of these um more really more creative expression so of course someone can be creative and inventive in in terms of math and science as well and that's you know a great characteristic to have but that's really associated with bipolar disorder is more of this kind of what we think of as Arts you know Visual and perform events oh that's great thank you for clarifying that and another question is there any relationship between originality in relationship to when the individual's last episode was hmm that's a good question um I can't answer them we didn't actually study that so for the purpose of the study we require that everyone be cymax um or in kind of a baseline episode at their personal Baseline because everyone's based on this slightly different um we wanted to make sure no one was actually in an episode however we do have data on um the most recent episode of the severity of that episode but that's that's an interesting question I might have to go back and investigate that that's great well if we have any more questions please get them in and one more we have is how would one approach a conversation with their doctor about experiencing severe depressive bouts after their diagnosis and feeling that they're lacking creativity um well so would the creativity be due to medication that they're on or is it due to the depressive episode itself because um creativity is sometimes thought to be a result of a depressive episode like while someone is is down there they're experiencing these Deep Emotions and thoughts and then when they come out um and they are feeling productive that's when the creative expression can happen most people aren't very creative when they're depressed and so I'm wondering you know if if that lack of creativity is is being perceived as part of the depression or is it being perceived um based on the medications that are being used to treat the depression and you know I think one thing about the current state of Psychiatry is that these um these positive traits aren't really well acknowledged or accepted and that's part of the reason I wanted to do this was to to Really highlight the fact that many people feel them and it's important to them and they don't want to take medication that's going to eliminate those positive aspects and it's not just creativity I mean there's a lot of positive aspects that some people with like the other sort of feel are associated with their illness now of course there's people who don't find any value with having the disorder and they are the ones that would push that button very quickly um and that's understandable as well but for those that have those positive aspects um you know it's it's it's a struggle and I don't think um all psychiatrists really um acknowledge that and they should because it really impacts treatment and compliance as I mentioned um yeah I mean when I was starting this study I I got a lot of kind of smirky comments from some of my colleagues about well everyone bipolars is very creative and I was like well yeah let's test that um so it's not everyone it's a lot of them considering so our final question is is does the state of creativity happen more in hypomania than depression so I would definitely say that hypermania would be more Associated however what the data really shows um is that it's not the state of papomania itself I mean of course when someone's hypomanic they feel um more energized and they feel more productive and they might feel very creative but the productivity level is a little bit fragmented I mean so they they must start a lot of different things and maybe not follow through with all of them but certainly they are have that energy and they are you know doing more things and thinking more things um so it can feel very creative however I would suggest that the the more mild version of hypomania the hypomanic personality um in in the absence of more you know significant symptoms that's really where the creativity um Can shine because the mood is stable it's not going to get too high you're not going to have that valve of depression that often would follow hypomania um and you can have this kind of Baseline level of creativity and productivity so I think that's really kind of something to highlight because a lot of people believe that that hypomania makes them creative and there really isn't evidence to suggest that it's the actual hypomania it's just things that come along with that that could still be present um once the hypolinate results we're good I'm glad we got that clarified and that about wraps up our webinar for today I want to thank everyone so much for joining and Dr Greenwood do you have any closing comments um not really just that um I do think this is a really important area of research and I hope that by continuing to have this discussion about the positives and the negatives both and consider both of them to be part of the bipolar experience um I hope that we really can provide better ways to treat people so that they get to maintain that creativity but not have to deal with the negative aspects of people survey I agree I agree completely and goodbye everyone this webinar will be uploaded to ibpf.org so please visit if you would like to view the webinar or send it to any friends or loved ones and have a great day thank you everyone thank you

Channel: International Bipolar Foundation

Views: 1,328

Keywords: bipolar

Id: ecC7Ei7pZ90

Length: 55min 49sec (3349 seconds)

Published: Thu Jun 08 2023