Part I
The
statistical prevalence of depressive disorder in the United States is staggering; add to
that the additional diagnosis of bipolar disorder for an unnerving picture of a
society with a substantial number of its members paralyzed by depression, or
riding a manic wave during any given year.
Here
are some numbers to consider: the lifetime prevalence of major depressive
disorder is 16.2%; the one-year prevalence is between 6.6% and 10%, depending
on the study. This means that somewhere
between thirteen and seventeen million Americans annually are diagnosed with
clinical depression. It almost appears
as if a canopy of low mood hovers over our world. Television ads hawk pharmaceutical solutions
in cartoon images of keys and locks to symbolize neurons and neurotransmitters;
a sad dog sits beside his abandoned tennis ball, awaiting his depressed master
for a game of fetch.
As
if these numbers aren’t pervasive enough, there are several important studies
by psychiatrists and psychologists that indicate writers may be at far higher
risk for depressive or manic-depressive illness than the population at large;
these studies examine the link between creativity and mood disorders and appear
to have found a connection, at least in so far as statistics and anecdotal
information. This is not simple
causation: I am a writer, therefore I am depressed. A majority of writers are not clinically
depressed or bipolar. And any hard
scientific evidence is unlikely for the time being and well into the future, a
mystery as yet to be solved. Rather, the
relationship is one of complex correlation – that creativity
and depressive/manic-depressive illness reside in the same
neighborhood.
The
conclusions of two studies in particular are often cited in discussions of the
seductive and dangerous relationship between creativity and mood disorders –
seductive and dangerous because the forces at work in the two distinct
diagnoses are associated with a high incidence of suicide.
Kay Jamison’s work in this area of psychiatry is well known and most
frequently referenced. She is the author
of “Touched With Fire: Manic-Depressive Illness and
the Artistic Temperament.” She has been
open about her own struggles with bipolar illness and her study concludes that
writers suffer from depressive or manic-depressive illness at a rate that is
between six to twenty times greater than the general population.
Nancy Andreason, former editor-in-chief of The
American Journal of Psychiatry and Chair of Mental Health Clinical Research
Center at the University
of Iowa, believes there
is definitely a relationship between the depression and creativity.
Dr. Andreason worked in fertile ground for her
research studies. Her landmark study of
creativity and mental illness used empirical evidence provided by thirty
prominent faculty members at the University
of Iowa Writers Workshop. Compared with her control group, 70% of the
authors in her study suffered from cumulative depression.
Dr. Andreason also
identified a higher incidence of depression, high intelligence and creativity
in first-degree relatives of the study group that speaks to the case for
possible genetic bias.
Drs. Andreason and Jamison identify traits in
creative writers that might also predispose to mood disorders. These include tolerance of high-risk
behavior, discontent and restlessness, acceptance of ambiguity, an
introspective nature, and a cognitive style in which the patterns of creative
energy and the creative process mirror the rhythms of depressive and
manic-depressive illness. To these I
would add self-doubt, self-absorption, fascination with death, a driven,
strongly competitive nature, the ability to listen to internal voices and translate
them into a beautiful cohesive pattern of words on a page, and the ability to
look at life through a finely ground lens.
Both psychiatrists believe that it’s impossible to write at length and
meaningfully when at the lowest point in a depressive illness – a vegetative
depression, or at the highest point in the bipolar cycle – a full blown manic
state which can include floridly psychotic and grandiose delusions, agitation
and severe restlessness. However, the nature
of mood disorders is generally episodic and cyclical; creativity seems to await those periods of relative calm that occur between
cycles. Relief from symptoms, as well as
the memory of the turmoil during those times of highs and lows,
may inform the writer’s vision, a grim resonance of Wordsworth’s emotional
overflow recollected in tranquility.
Most of us are familiar with the litany of authors who have survived or
died, victims of mood disorders, but who have written brilliantly and produced
great works of art, likely at considerable cost. William Styron,
Anne Sexton, Tennessee Williams, John Berryman, Virginia Woolf,
Ernest Hemingway, Lord Byron, William Blake, Edgar Allen Poe, Emily Dickinson,
Herman Melville, F. Scott Fitzgerald are among those most frequently
named. The collection of essays, “Unholy
Ghost: Writers on Depression,” published in 2001, adds more contemporary names
to the list. Would these writers have
been more or less productive had they not been depressed? Would their writing have been as insightful
and lasting – that final litmus test that time puts to words – without the
influence of dark moods? Did mood
disorder precede, co-occur, or follow like a misplaced comma, an afterthought
of the writing life?
What we know of many of these writers is that mental illness emerged
early, as did their creativity. There is
certainly evidence to point to longer more productive lives in the absence of
depressive illness. But definitive
answers still remain largely a matter for speculation and only the lives of the
writers themselves speak to us.
Several years ago Spalding Gray captured headlines when he disappeared
after years spent in a downward spiral toward what now appears to have been a
predictable outcome. His battle with
depression was revealed when his body was pulled from NYC’s East
River months after his disappearance in 2004 and the coroner ruled
his death a suicide.
William Styron died an octogenarian in
2006. In 1990, he published “Darkness
Visible,” an account that revealed the despair and anguish of his mental
illness.
Sylvia Plath’s is arguably the most resonant
of these stories of manic-depressive illness and suicide attempts. She took her own life at thirty-one, left
behind a husband, two young children, and a body of work that included the literary
classics “The Bell Jar” and “Ariel.”
I
use Plath as an example of our fascination with the
emotional lives of poets and writers.
Between 2001 and 2006 no less than four books (I myself reviewed one of
them) revisited Plath’s life and death: a young woman
blessed with creative brilliance, marriage to the poet Ted Hughes, two
children, and literary achievement, a brief but dramatic life, then suicide,
almost as if her abbreviated writing career were an also-ran.
She
is iconic; her larger-than-life story is mythos, her death as much part of a
body of literature as her literature.
From our vantage point, it seems perilously easy to link her creative
energy to manic-depressive illness and draw generalized conclusions from
this.
Plath
died in 1963. Poet Assia
Wevill, Ted Hughes’ lover during and following his
marriage to Plath, ended her life in 1969, taking her
daughter by Hughes with her. Anne Sexton
followed Plath into death eleven years later. All succumbed to gas inhalation, a passive
form of self-annihilation. While there
is no doubt as to their emotional highs and lows, or the tragic paths down
which each woman chose to walk, there is a strange and ominous connectivity to
the three deaths.
The patina of romance and tragedy, buttressed by what
we read of writers’
lives – melancholy swept away by exquisite highs, then the
plummet to the inner rings of hell – affords vicarious pleasure to many. The psychology of this is a topic for another
day and time. It is enough to state here
that we grasp onto every aspect of the lives of those we place on
pedestals. Why else suffer each new
biography, devour each new crumb and morsel of insight into Sylvia Plath’s life and death.
Perhaps we can reassure ourselves that some universal system of justice
is in play, that those given godlike creative gifts (or great beauty or
fortune) also intimately know the burden of a humanizing host of emotional
demons.
But trouble comes in many forms and there’s a danger when the writer
embraces the clichéd stereotype of despair and the lifestyle to go with
it. Or does not recognize the spiral up
or down, or resists help and attempts to ride it out.
The writing life is a harsh mistress, isolation, drudgery and rejection
interrupted by moments of insight, inspiration and the rush that comes with
publication. It’s a demanding way of
life. Given a world of other
possibilities, perhaps there are some who would put down their pens? Or not.
***
Part II of this essay will appear in the January 2007 issue of OLR. Writers and therapists agree or disagree, advise and debate.
‘Clinical depression’ and ‘manic-depressive illness’ refer to those
diagnoses for which certain criteria are established in the Diagnostic and
Statistical Manual of Mental Disorders.
Two personality types – dysthymic and cyclothymic – have greater chronicity
but are less severe than depressive and manic-depressive illness. These are not excluded from this discussion
but are distinguished from clinical depression or manic-depressive illness.
I am interested in hearing from writers about personal experience,
whether you agree or disagree that there is a connection between writing and
mood disorders, the nature of the connection, and how you cope. I am also interested in hearing from therapists
regarding the same topic.
Please let me know if I may quote or paraphrase you as well as if you
prefer that I use your name, initials or ‘anonymous.’
Email me at eve_nonfiction@yahoo.com.
Evelyn Sharenov
June 2007