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: http://www.mohammadalsuwaidan.com/





References:

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.





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It’s difficult to write anything meaningful following such a terrible event in Norway. So, a succinct blog this week, with no glib photographs.

ANOTHER BLACK DOG
Sane is celebrating its 25th anniversary this month and, to mark the occasion, it will be continuing the fight to beat the taboos surrounding mental illness by producing larger-than-life-size sculptures of dogs that its founder and chief executive, Marjorie Wallace, hopes will be sponsored by companies, schools and individuals and put in prominent positions up and down the country. Details at:
http://www.guardian.co.uk/society/2011/jul/24/mental-health-black-dog-sculpture-campaign
http://www.sane.org.uk/what_we_do/black_dog/

Regular readers of this blog will know that DADAA are supporting the Black Dog Day Drop, and more details can be found at:
http://blackdogdaydrop.blogspot.com

MEASURING WHAT MATTERS
National Statistician's Reflections on the National Debate on Measuring National Well-being

I had the pleasure of sitting on a panel that was part of the Office for National Statistics debate at Bolton University this year, and so was excited to get first sight of the reflections on this national debate. Whilst there is no explicit sign of creativity, culture and the arts in this narrative as yet, it is important we stay connected with this ongoing process in the development of what the coalition government will see as a methodologies for measuring well-being (and understanding it).

Available in Welsh and English at:
http://www.statistics.gov.uk/cci/article.asp?ID=2718

PUBLIC COLLECTIONS FOR PUBLIC HEALTH: MUSEUMS, HEALTH AND WELL-BEING
A workshop
Wednesday 21 September 2011, 2pm-5pm Manchester Art Gallery

Much museum practice in the field of health and wellbeing has been to run projects with clinical health partners. The workshop will discuss how this work can be extended. We believe that the health promoting resources of museums can be made available to a broader but still targeted population through working with colleagues from public health and other fields.

Free but you need to book a place with k.athey@manchester.org.uk 0161 235 8825  We will confirm whether you have a place.
For further information contact m.trustram@manchester.org.uk 0161 235 8849

Can My Child Have Bipolar Disorder? Pediatric Bipolar Disorder: Fact or Fiction

By Molly McVoy, M.D.   



Can children really have bipolar disorder?  Or, is it a parenting issue?  Is this mental illness overly-diagnosed?

Many of these questions have been raised in the media with increased frequency over the last several months.  What's most concerning is, that instead of focusing on diagnosis and treatment for children with serious mental illness, the debate has focused on who is to blame: is it parents, psychiatrists, drug companies, schools?  The bottom line is that children are suffering, and parents are struggling to keep their children safe, healthy, and happy.  More attention should be paid to actually helping these children, not to pointing fingers of blame.

Pediatric bipolar disorder is a rare but very real illness.  The most recent statistics indicate the mental illness affects approximately 1.5% of children.  Contrary to popular reports, the most recent studies also indicate the rates of pediatric bipolar disorder are not increasing over time, and the rates do not vary between US and non-US populations.¹

When pediatric bipolar disorder occurs, it can be very impairing.  Affected children have extreme mood swings – not for minutes at a time but for days.  Children can become suicidal, violent, and often feel quite out of control.  When properly diagnosed and treated, the lives of these children and their families can improve dramatically.  Treatment often involves a combination of mood stabilizing medication and intensive psychotherapy.  But when missed or misdiagnosed, these children may go on to suffer for a lifetime.



Stigma continues to be associated with a mental health diagnosis, and nowhere is that truer than in pediatric mental illness.  Perhaps, in the future, efforts will focus on how to help, not who to blame.

Links:

http://www.aacap.org/

http://www.bpkids.org/

References:

1. VanMeter, AR, Moreira, AL, Youngstrom, EA. Meta-analysis of epidemiologic studies of pediatric bipolar disorder. J Clin Psychiatry. 2011, May 31.

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Potter v Murdoch; the Numinous; Networking Event; Arts and Mental Health diary date; BBC Radio 4 and Open Public Services

ONE FROM THE GRAVE TO MR MURDOCH

Some of you may have heard me give a full version of my paper on the Big Society: Arts, Health and Well-being at the nalgao conference last year. In my presentation, I gave an account of the interview between the terminally-ill playwright Dennis Potter and Melvyn Bragg. I share this clip with you in light of the controversy over News Corp and the phone hacking ‘scandal’ (does it really surprise you?)and to remind us that Potter’s ideas are as relevant now as they were then.

On the NUMINOUS
Sveiki atvykę - mūsų skaitytojams Lietuvoje (Thanks to S)

A few months ago I heard the term numinous used in relation to nature and the arts; in particular as a way of describing that feeling we sometimes get when we’re moved by something that blows our minds, or in some way fills us full of awe. This sensation, which I’d suggest doesn’t happen often, when it does, is like really seeing something remarkable for the first time. It could be the beauty of a landscape that’s transformed by the right conditions (think: a giant silver ball of a moon; a cornfield gently swaying on the warmest of breezes; all the wonderful insect sounds of a mid-summers starry night, and the cool hand of someone you love in yours)1…or equally, that feeling of sheer exhilaration when you are immersed deeply in the climactic moment of a book, a film or a play when, oblivious to all others, a tear of pure tragedy or joy escapes your normally retentive eyes: symphonic bliss!

Sadly, this feeling escapes me all too often, and surrounded as I am by the trappings of consumerist superficiality, I frequently miss this temporal euphoria or sometimes, transient fear.2

In an engaging film of an un-moderated 2-hour discussion, Richard Dawkins and others debate, amongst other things, the possibility of differentiating the numinous from the supernatural and reclaiming it from its religious roots. This thing we feel, the sublime moment that exposes us to our sense of being, is typically seen as a gift from God. The twentieth century theologian Rudolf Otto divided the numinous into two parts: mysterium tremendum, which is the tendency to invoke fear and trembling; and mysterium fascinans, the tendency to attract, fascinate and compel.

Contemporary definitions define the numinous in relationship to a supernatural presence; the sublime; spiritual; sacred and transcendent. But if we are to understand the numinous in relation to the individual, isn’t it useful to separate the supernatural from the numinous? Is religion the only way of making sense of these rare and heightened moments?

Might it be that this experience is simply part of our neurology? –and if it is a heady mix of the social and the chemical, does removal of the supernatural diminish the meaning? I’m sure those of you who have dabbled in the illicit intoxicating world of Lysergic Acid Diethylamide may have an understanding of the chemically induced version of the numinous, as will those of you who have for other reasons, a fluctuation in your chemical balance. I think here, of our sometime giants of the arts world, who have been affected by precarious health and yet, have illuminated much of our thinking.

I’ve had the opportunity to share this notion of the numinous on my travels over the last few months, and responses to it have been varied, from dead-eyed incomprehension to complete recognition. For me, it’s useful for us to develop the ways in which we understand the reach of the arts and its occasional profound impact. Too often, the arts can be bland and prescriptive, offering mild distractions from our day-to-day reality, but once in a while, I’ll hear a story of an event, or moment that has had an overwhelming effect on an individual or group.

Last week, in what could have been a dull steering group meeting, a consultant in pediatric intensive care recounted the way in which the arts had rescued a young man from the darkest of suicidal thoughts, brought on by serious, life limiting disease. Through a moment of deep creative engagement, this young man had, had a lifeline thrown to him that had nothing to do with his illness; that transcended his frustration and fear, and illuminated the possibilities of life beyond the confines of sickness.

Did this young man have a numinous experience? – I have no doubt at all that he did. Do we have the evidence of this experience and its impact? – Of course not: that is the nature of our work. He wasn’t wired up to an EEG, ECG or a CT Scanner. Neither bloods, nor saliva were taken to scrutinize for raised levels of serotonin. And although a part of me would be thrilled to see those affirming areas of the brain sparkle and shine at moments of pure bliss, it would be an unnecessary health burden and entirely counter-intuitive.

Our semantics and the way we discuss the impact of the arts on health and wider society, means we should constantly explore what it is we believe and understand about our practice and its reach. By distinguishing the numinous from the supernatural, and articulating impact without making claims for miracles, we enrich our arts/health agenda.

1. Cheesy I know, but it is real and you do get the point?
2. Being driven by a friend across a desert the size of the UK in Central Australia, I woke from a slumber to whiteness as far as the eye could see. This vast, impossibly bright sand-scape was only punctuated by startling pillars of sand which rose high into the distant sky. I later learnt that these were part of a sand-storm heading in our direction. The experience was terrifying and exhilarating and the humbling product of the natural elements.

NETWORKING EVENT on THURSDAY 28th JULY

Due to circumstances beyond my control, the networking evening planned for next Thursday evening had been cancelled. Sorry for this, and normal service will be resumed as soon as possible!

ARTS, MENTAL HEALTH and WELL-BEING EVENT 

Thursday 20th October,

Manchester Metropolitan University, Oxford Road

http://www.dorothyrowe.com.au/

This event is being planned between the Greater Manchester Arts and Health Network and Arts for Health at MMU and isn’t a day of passive listening day, but one of moving this agenda on through learning and action.

Confirmed speaker/facilitators include:

Psychologist, Dorothy Rowe on Depression and Imagination

Mark O’Neill (Glasgow Life) on Cultural attendance and Public Mental  Health

We are currently discussing Artists input and Early Years input for the event, and will provide details shortly.

Please put this date in your diary, but remember putting this in your diary doesn’t guarantee you a place.

SIDE EFFECTS, BBC RADIO 4, SUNDAY 24th JULY

Written and Presented by CHRISTIE DICKASON

An Episode of Something Understood

At 6:05 am and 11:30 pm 

(And for a week thereafter on BBC R4 'Listen Again' at any time!)

An intriguing exploration of the unexpected interactions of art and illness

OPEN PUBLIC SERVICES 

White Paper published

The Government published its much anticipated Open Public Services White Paper this week which presses for radical changes to public services. New measures will see public services markets open up, users given more control, and the encouragement of innovation to drive better services for all, which will encourage a wider range of providers of many public services.

The paper has classified the delivery of public services into three categories: individual services, neighbourhood services and commissioned services, with power devolved to those levels, accordingly. Some of the main headlines so far include: proposals allowing communities to bid to run services, a legally enforceable “right to choose” services and proposals allowing for providers of some services to make profits for delivering results. The paper is extensive and covers a plethora of services across the country and, of course, forms part of the Government’s wider Big Society agenda.

In November the Government will set out how departments will put the principles into practice to open up public services over the parliament, including proposals for legislation. From April 2012 departments will publish regular progress reports on the steps taken to open public services.

There will be a listening period between July and September 2011. To add your voice click here. To read BBC coverage of the main proposals please click here

(Source: NCA News via Arts Development Ezine Issue 8)

‘To be shaken out of the ruts of ordinary perception, to be shown for a few timeless hours the outer and inner world, not as they appear to an animal obsessed with survival or to a human being obsessed with words and notions, but as they are apprehended, directly and unconditionally, by the Mind at Large – this is an experience of inestimable value to everyone…’

Aldous Huxley, The Doors of Perception, 1954

Networking, New Opportunities, the News of the World and Dance

Mi hoffwn ddweud diolch yn fawr iawn wrth bawb yn Rhuthun a Chaerdydd roeddent oll mor groesawus. Mae'r gwaith 'da chi'n ei wneud yn anhygoel ac rwyf yn gobeithio y gallwn weithio gyda'n gilydd yn y dyfodol. Os y gallaf eich cefnogi mewn unrhyw fodd, yn enwedig i alluogi rhwydweithio rhwng pobl o'r un feddwl, yna cysylltwch a mi...Clive

ENGAGE
Over the last couple of years, I’ve had the pleasure of working with a range of people involved in museums and galleries and who see the potential reach of their work on well-being. Renaissance North West and the Museum of Modern Art in New York are two such organisations that are leading the way and I’d urge any of you not aware of their work to have a look.

This week I’ve been working with colleagues in Engage Cymru at the Ruthin Craft Centre and National Museum and Gallery in Cardiff on their excellent engage programme. As well as being inspired by the people and projects, I’m increasingly aware of the pockets of excellence that take place in diverse communities, that if I hadn’t had the good fortune to learn about on these occasions, I’d never know about.

And it seems when I meet these inspiring people/projects, they all feel that they are somehow, small-fry; not part of the bigger picture…and the truly exciting thing for me (with some bloated egos tossed to one side for a moment), is that these pockets of excellence are not only happening in Wales and England*, but all over the world. I’ve seen tiny projects in Australia as well as the big ones and recently heard visionary stories of work in South Africa and truly ground breaking work in communities in the USA.

I recently heard Mike White describe this movement as 'a small scale global phenomenon’, to which I am deeply indebted. This sums us up, doesn’t it?

The conversations I’ve had inevitably come round to training, finances and more often than not networking.

I for one, am really keen that our networking opportunities aren’t hampered by bureaucracy: language: egos or imaginary boundaries. Technology increasingly means that we can communicate with each other regardless of distance, and with our idiosyncratic google translator (to some extent), regardless of language differences too. So, do you want to network and explore some of these issues further and like me, do you think we can do this without being hung up on obstacles. Get in touch, make suggestions and lets explore what is possible.

*I don’t really need to tell you how much groundbreaking work’s happening in Scotland and Ireland do I?…just look at the Bealtaine Festival for a starter, or perhaps if your child is poorly the Royal Aberdeen Children’s Hospital might be conducive to a speedy recovery…or the Maggies Centre’s…the list in these two countries is endless.

ARTS AT THE HEART
For the latest copy of Arts Development UK magazine (formerly nalgao) go to:
http://artsdevelopmentuk.org/resources/magazine

MEDICAL NOTES
The Royal Northern College of Music are looking for an experienced evaluator for our Youth Music funded Medical Notes project at Royal Manchester Children’s Hospital. Please find all details in the attached brief. Deadline for the submission of expression of interest is Monday 1 August 2011 at 10am. Interviews will be held in the week commencing 5 September.
http://www.rncm.ac.uk/component/content/article/73/100.html

CHESHIRE DANCE
CALL for 10 Facilitators with teaching and training experience for PAID contracts

There are 10 exciting facilitator roles in this project, apply if you have:

• Experience in facilitating specific community groups with different specialism’s
• Experience creating work for and engaging with community groups
• 3 – 5 years of professional practice

10 facilitator contracts are available ranging from £2,500 - £4,500 (20 – 40 days, dependent on skills, experience / funding) Shadowing opportunities will also be available with this work.

Please e-mail info@cheshiredance.org or call 01606 861770 for an application pack and return this to us by 5pm Thursday 18th August 2011

Interviews will be on 24th and 25th August 2011. http://www.cheshiredance.org/ 

Whilst we're all keen to have a go at the Murdoch empire, don't we need to examine our own appetite for the salacious and popularist, fed by consumerism and the 'free market'? This new article by Christopher Hitchens examines our hypocrisy.

It took another dog to eat Murdoch’s dog
“It is Sunday afternoon, preferably before the war. The wife is already asleep in the armchair, and the children have been sent out for a nice long walk. You put your feet up on the sofa, settle your spectacles on your nose, and open the News of the World. In these blissful circumstances, what is it that you want to read about? Naturally, about a murder.” – George Orwell, Decline of the English Murder

...thanks Sally!!!

These '...characters, are consciously “slumming” it by picking up a newspaper that was intended for the less-literate elements of the proletariat. But for decades, in fact since well back into the mid-Victorian epoch, Britain’s News of the World was the winning formula for the depiction of crime and squalor and vice. The brilliance of the formula lay in its venerable hypocrisy; actually in two distinct kinds of venerable hypocrisy...'

http://fullcomment.nationalpost.com/2011/07/13/christopher-hitchens-it-took-another-dog-to-eat-murdochs-dog  

ON THE TRAIL OF THE BLACK DOG...

...but just where is it?

Nothing but our thanks...

I have been overwhelmed by people’s responses to the Head to Head session last week at MMU. THANK YOU. In short, the event was superb, with 6 dynamic and exciting speakers sharing work of beauty, diversity and that challenged us. I want to say a big thanks to the speakers:

Mike White
Margret Meagher
David Doyle
Kate Wells
Ann O'Connor
Peter Wright

A great contribution from you all and I hope to share some of your presentations with participants from the event.

I have had a request from Peter Wright, who gave his card to someone at the event, only it had some notes on the back that he'd like! If you're the lucky owner of that card, could you get in touch with me directly?

As part of the Critical Mass events happening across the North of England, we also concluded the first stage of the m a n i f e s t o events and in between now and October, the meat is being put on the flesh. An especially big thanks to Ali Clough and Jay Haigh at the Looking Well in Bentham for launching this next phase so wonderfully last week.

Family Game Night Can Make You Smarter

By Scott Benson, M.D. 

My daughter brought two treats when she came home for college break.  A new game, Bananagrams, and a new book by Richard Restak, M.D. and puzzle master Scott Kim called The Playful Brain: the surprising science of how puzzles improve your mind. 

In this collaboration, Kim shares some of his favorite puzzle formats, and Dr. Restak explains the science behind the games.  Together they cover a wide variety of puzzles that have been shown to keep us alert, thinking, and youthful in mind and spirit.  fMRI data (which shows electrical activity in different parts of your brain) helps to tease out which areas of the brain are activated as people solve different types of puzzles.  

Scientists have not been able to prove a direct link between these forms of brain exercise and prevention of various forms of dementia.  But the puzzles, and games like Bananagrams, provide a focus for interpersonal interaction – playing with your family, talking with your neighbors – which does have a powerful effect on mood and our sense of well-being. 

Summer is the perfect time to bond with your kids in a board game challenge.  How do you get your family to put down their cell phones and turn off the TV to play a game?  Please share suggestions!

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