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    The Essential Psychopathology Of Creativity
    By Andrea Kuszewski | September 20th 2010 05:18 AM | 40 comments | Print | E-mail | Track Comments
    About Andrea

    Andrea is a Behavior Therapist and Consultant for children on the autism spectrum, residing in the state of FL; her background is in cognitive

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    If we could identify a gene for creativity, let's call it the "creativity gene", you would be hard pressed to find very many people who would consider it a "negative gene" or a hazard to possess or carry.  But what if, purely hypothetically, we could identify a gene for Schizophrenia?  Or Bipolar Disorder?  Or Depressive Disorder?  Or ADHD?  Would you select for those traits if you could genetically engineer your offspring at will?  If you wanted to give birth to a creative child, the answer should be yes.

    The very traits that make someone creative, passionate, and likely to achieve a high degree of success in their domain, are the same traits that define psychological disorders such as Bipolar Disorder, Schizophrenia, and ADHD.  So what is the difference between creativity and psychopathology?  Where do we draw the line between functional excess of extreme traits and the point at which they define a psychological disorder?  Is there a discriminating characteristic that separates these two groups?  Yes, there is, and it's called cognitive control, or high executive function.  We'll discuss this more in a bit.

    An article in the NY Times titled, "Just Manic Enough: Seeking Perfect Entrepreneurs", described individuals that were unnaturally creative, passionate, energetic, charismatic, and those most sought-after by venture capitalists as "hypomanic".  They go on to describe how these individuals, while successful and gifted at what they do, meet the criteria in the DSM as suffering from Hypomanic Episodes (one of the defining features of Bipolar Disorder).  From the DSM:
    DSM IV Criteria for Hypomanic Episode:


    A) Distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days that is clearly different from the usual nondepressed mood.

    B) During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
    1. Inflated self-esteem or grandiosity
    2. Decreased need for sleep (e.g. feels rested after only 3 hours of sleep)
    3. More talkative than usual or pressure to keep talking
    4. Flight of ideas or subjective experience that thoughts are racing
    5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
    6. Increase in goal-directed activity (at work, at school, or sexually) or psychomotor agitation
    7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g. engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
    C) The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.

    D) The disturbance in mood and the change in functioning are observable by others.

    E) The mood disturbance not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.

    F) The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication or other treatment) or a general medical condition (e.g., hyperthyroidism)
    Now, I don't know how many of you creative-types out there began to panic when you started reading this list of defining criteria, but I know I did.  In fact, of all the creative people I know in various fields of work and study (and I know a lot), I don't know too many who don't meet these criteria.  It's called being In The Zone, or Flow, as defined by Mihaly Csikszentmihalyi.  This is usually that happy-productive-place that we all love to be in, and don't seem to get enough of.  However, according to the DSM criteria, it appears if you are too intensely creative, you might very well be suffering from Hypomanic Episodes.

    Is there a difference between being hypomanic and being extremely creative?  Yes, there is.  While being an intensely creative person may imply you are meeting most of those criteria a lot of the time when you are in that state of flow, that doesn't mean you are dysfunctional.  This list also doesn't specify a degree or intensity of the symptoms.  There is a big difference between "people notice the change in your behavior" and "people are freaked out by the change in your behavior".  One seems a little bit more problematic than the other.

    Having untreated Bipolar Disorder or Hypomanic Episodes can be severely debilitating; let's see how debilitating it is to be in a creative flow.  Do you get hyper-focused on your task?  Yes.  Stay up all night working on it?  Sure, at times.  Do other people notice a change in your behavior?  Well, I'd hope my colleagues and friends can tell the difference between me sitting around mindlessly working and me in my creative flow.  Definite change in attitude- yes, we get happy when those creative moments hit.

    In fact, writing this very article, I have now stayed up all night, have been focused intensely on my work, yet easily distracted, AND I'm in a pretty noticeably good mood.  Oh, damn!  Someone call the psychiatrist!  Andi is having "an episode"!!!

    This list from the DSM also doesn't account for the balancing out of those traits by regulatory mechanisms that are present in successfully creative people.  You can have intense personality traits, while still maintaining control over them.  This is a mere checklist, which is one of the big problems I have with the DSM in its current form.

    To be honest, the Times article was pretty positive, and real "Yeah, you go, you crazy kids!" regarding this type of creative individual, but there was this disconcerting labeling of extremely creative people as having a "disorder".  This bothers me, because I don't think most people understand the bigger picture of genetics, balancing of traits, and the definition of a "disorder".  We see items adding up on the handy-dandy DSM checklist, and we are quick to classify people as having a disorder.  Stigma ensues.

    Yet another story, similar in message, has been circulating the last few days about Narcissists and their ability to convince people of their (not so) creative ideas.  I have many problems with that story for reasons I won't get into right now (like the criteria for labeling subjects as Narcissists, for one), but the main point was that individuals identified as having a personality disorder were actually the most successful at the task that was being measured - one that involved coming up with creative solutions, then convincing a group of people of the value of those ideas.  These are good traits to have - don't we define disorders partially by their degree of maladjustment and failure to function in society?  So why did the "pathological" individuals show more skill and have a higher rate of success?

    Bigger question I have for you: Why is everyone so surprised at this?


    The Essential Truth of Creativity

    The truth is, in order to be truly exceptional at something creative in nature, whatever domain it may be, you need to have those extreme traits that get you labeled by the DSM as meeting the criteria for some kind of a personality disorder.  However (and this is the catch), in order to have those extreme, intense traits and not suffer from a disorder, you also need to have some sort of regulatory mechanism that helps to control those traits.

    The psychologist interviewed for the Times article, John Gartner, and author of the book The Hypomanic Edge, essentially describes this type of excessively-creative-yet somehow-able-to-function-normally individual.  He says that the "attributes that make a good entrepreneur are common in certain manias, but are harnessed in ways that are hugely productive."  That harnessing, or cognitive control, is the one thing that really separates extreme, yet functional traits from dysfunction and psychopathology.

    Let's look at one more example involving the link between Schizophrenia and creativity.

    The traits that define schizotypy: divergent thinking, mental flexibility, and over-inclusive thinking style (lack of latent inhibition, or attending to irrelevant details and stimuli), are also traits that are necessary (yet necessarily regulated) in order to have the most success in creative achievement.

    Dr Liane Gabora, creativity researcher, described the phenomenon of having schizotypal traits while being functionally and successfully creative in her Beer Can Theory of Creativity.  A person with schizotypal traits with no cognitive control was like having all the cans of beer in the 6-pack, but no plastic thingy to hold them all together.  Divergence of thought without cognitive control doesn't give you that ability to discern if your wild ideas are delusional, real, appropriate, or even good ideas to pursue.  That plastic thingy makes all the difference between those same schizotypal traits manifesting as a schizophrenia spectrum disorder, or as successful creativity.  Thus, we can think of creativity here as "optimally functional schizotypy".


    Creativity Across Different Domains

    However, this distinction of functionality based on the presence or absence of cognitive control isn't limited to just Schizophrenia, or Bipolar Disorder.  It applies to other DSM disorder classifications as well - Depressive Disorder (features high emotional sensitivity), Narcissism (features high confidence and charisma), ADHD (features lots and lots of ideas coming in at all times) even Autism Spectrum Disorders (features very focused attention to detail).  Taking into account the traits involved in those disorders, and looking at different types of creativity, we could define it as "domain-specific-optimal-versions-of-pathological-traits", given the person has a high level of cognitive control.

    We Need Psychopathology If We Want Geniuses

    The point here is this: Were it not for those "disordered" genes, you wouldn't have extremely creative, successful people.  Being in the absolute middle of every trait spectrum, not too extreme in any one direction, makes you balanced, but rather boring.  The tails of the spectrum, or the fringe, is where all the exciting stuff happens.  Some of the exciting stuff goes uncontrolled and ends up being a psychological disorder, but some of those people with the traits that define Bipolar Disorder, Schizophrenia, ADHD, and other psychological conditions, have the fortunate gift of high cognitive control paired with those traits, and end up being the creative geniuses that we admire, aspire to be like, and desperately need in this world.

    So now, after this discussion, let's go back to that original question.  If we were to be able to identify the genes for Schizophrenia, or for Bipolar Disorder, or for ADHD... would we want to eliminate them?  If we were making a "designer baby", would you choose those genes to be added into your child's genome?

    I say yes.

    The more crucial variable that we should be trying to manipulate is the neural mechanisms for cognitive control, in order to take the most advantage of the gifts associated with those extreme and intense traits, or to allow someone with a debilitating disorder to gain control over it.  In this way, I don't look at psychopathology as "disorders", but rather an inability to maintain control over the set of traits you have.  Some people with more extreme traits need more control, others can do with less.  But if we want to continue to have exceptional, creative geniuses, those pathological traits are an absolute necessity.


    References:
    http://www.nytimes.com/2010/09/19/business/19entre.html?pagewanted=1&_r=2

    http://news.sciencemag.org/sciencenow/2010/09/is-narcissism-good-for-business.html

    Gabora, L. (2000). The beer can theory of creativity. In: (P. Bently&D. Corne, Eds.) Creative
    Evolutionary Systems. Morgan Kauffman


    Kuszewski, Andrea Marie, The Genetics of Creativity: A Serendipitous
    Assemblage of Madness (March 1, 2009). METODO Working Papers, No. 58.
    Available at SSRN: http://ssrn.com/abstract=1393603

    Comments

    Hank
    Isn't this evidence that DSM is just over-labeling in its latest incarnation?   We have an autism spectrum that now encompasses 60% of all people, all the while claiming that we want people to be individuals.    

    The NY Times makes article makes some good points, though business-y rather than science.  Irrational belief and pathological drive is essential to success.   It took two decades before TED had any credibility and one of the best compliments I ever got was a media executive at a large company years ago who said my having no experience was the key reason this was successful - because a media person would not have said it could be done the way I did it.  Am I pathological?   Not that I am aware of, but I suppose that's because no one in psychology has set out to find something in DSM to stick on me.  :)

    This is good stuff!
    Bonny Bonobo alias Brat
    The truth is, in order to be truly exceptional at something creative in nature, whatever domain it may be, you need to have those extreme traits that get you labeled by the DSM as meeting the criteria for some kind of a personality disorder. However (and this is the catch), in order to have those extreme, intense traits and not suffer from a disorder, you also need to have some sort of regulatory mechanism that helps to control those traits.
    One easy regulatory mechanism that I can think of is NEVER see a psychologist if you can help it.

    The more crucial variable that we should be trying to manipulate
    is the neural mechanisms for cognitive control, in order to take the
    most advantage of the gifts associated with those extreme and intense
    traits, or to allow someone with a debilitating disorder to gain control
    over it. In this way, I don't look at psychopathology as "disorders",
    but rather an inability to maintain control over the set of traits you
    have. Some people with more extreme traits need more control, others can
    do with less. But if we want to continue to have exceptional, creative
    geniuses, those pathological traits are an absolute necessity.

    I think that the neural mechanisms for cognitive control are called self-belief and self-esteem and that is exactly what gets destroyed by psychologists labeling people with their DSM. Good parenting and probably good child care and schooling, all help a child to develop good self-esteem and self-control and associated neural mechanisms, and of course the opposite is true.

    One trip to a psychologist can be disastrous, if a child or teenager is labeled as having say social conduct disorder or schizophrenia for example, as the influence of these bad narratives, on everyone concerned stretch far into the future. And no, in case you're wondering, I have never been diagnosed with a mental disorder. I have a psychology BSc Honors degree myself, but I have seen other quite brilliant people, lose confidence and then be unfairly stygmatised after being labeled with Bipolar Disorder and Schizophrenia. I don't expect DSM V to be any better, as long as it insists on labeling people in such a black and white way, unless it adopts a more scaled, shades of grey and multi-dimensionally interactive form of assessment. 




    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    If there is insurance reimbursement involved, and we know there is, then shades of gray are out. Insurance wants diagnosis codes. Plain and simple. Best bet is to seek help and pay out-of-pocket to a therapist who understands this. And finding those are like finding needles in haystacks. Also, it is hard for many people to afford this. Including myself.

    jlparkinson1
    So are we thinking there's essentially a kind of antagonistic pleiotropy going on here? That would definitely help account for the persistence of these otherwise deleterious alleles in the population. It would certainly make more sense to me than the common disease common variant hypothesis (at least where schizophrenia is concerned).
    What you don't mention is whether there also is a gene for the "plastic thingy" holding the beer cans together. Aren't you rolling the dice when you say, Yes I would pick the schizo&creative gene for my child?

    Andrea Kuszewski
    There is probably not a "gene" for the plastic thingy, but rather, it is the Prefrontal Cortex, functioning at the optimal level, given the other traits the person has. It relates to plasticity as well. It is a complex system. However, the main point is, the "erratic behavior" genes, or the positive symptoms that one usually associates with disorders like schizophrenia, are needed in order to have unique, extremely creative and innovative ideas. You can't have one without the other. So attempt to homogenize society to get rid of the extreme traits on any spectrum of behavior will greatly affect the level of "genius" in future generations.

    P.S. You saw the movie Gattaca, right? ;)
    I agree with the former statement- have you ever thought that saying you would choose those particular genes to your designer baby could possibly be offensive- especially to those who actually have those genes and have struggled with those disorders for their entire life? I cam across this article researching for a paper and was shocked by some of your statements. I was diagnosed with a bipolar disorder as a miserable six year old child and have struggled with it for twelve years- going through what seems like trillions of medication alterations, therapy sessions, and breakdowns. Yes, I do indeed excel in areas of creativity and I tend to score very high on certain tests, but I would not wish any kind of mental disorder on anyone - no matter what degree of creative ingeniousness it brings them. Next time you write something like this, (and I'm not saying I disagree with every point you make- you have some valid ideas), consider those who actually struggle with those disorders- then consider if you would wish that on yourself, or even more so, a child.

    SciencePimp
    So this basically supports what we've all known for some time and has been portrayed in pop-culture...
    "Mad" and "Genius" work well together though being one doesn't necessarily imply being the other.

    This also explains those voices I've been hearing. :-)
    Gerhard Adam
    Doesn't this also suggest that notions of augmenting human intelligence or reverse engineering the brain are actually quaint notions that fail to appreciate the complex interactions between traits that actually make up a creative, intelligent individual.

    It seems like this is precisely the sort of thing that would be missed by taking such a mechanistic view of brain function.
    Mundus vult decipi
    Andrea Kuszewski
    I love your comment, Gerhard. This type of understanding of intelligence and creativity definitely needs to be considered when speaking of creating AI.
    Bonny Bonobo alias Brat
    Yep, don't you think that's probably why the IBM AI brain just sits there doing nothing?
    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    Gerhard Adam
    If you're referring to IBM's "Deep Blue", I'm reluctant to call it AI, despite the cheerleaders for it.  In reality, the best that could be claimed is that it is a chess-playing machine.  Anything more stretches the boundaries of credulity.
    Mundus vult decipi
    All properties of the brain are properties of a phenotype, not a genotype. The genetic studies of neuropsychiatric disorders have found quite a few single gene causes. There are only a very few two gene causes of disorders (mostly deletions in somatic cells that cause cancer) and then there is a gigantic gulf to the most common neuropsychiatric disorders which must be "caused" by at least dozens and probably hundreds of genes.

    The neuropsychiatric disorders that people are looking for genetic causes for are not “genetic disorders”, they are “genetic features”, sort of the way that anaphylaxis is a “feature” even though it can kill you. It isn't that being killed by anaphylaxis is a survival feature, it isn't. But an immune system that can support an immune response so severe that it can kill you is better than an immune system that cannot.

    A brain that is delusional and hypomanic is not a survival feature under all circumstances, but it is a survival feature under some circumstances.

    The neuropsychiatric conditions that humans are susceptible to are (mostly) just variations of development. If you cloned people and made hundreds of copies, each of those clones would develop into a different individual. The course of neurodevelopment mostly depends on the in utero environment during the first trimester after the neural tube closes and the structures of the brain are formed. The details of those first structures affect everything that comes later via their geometry, by their epigenetic programming, and by things we don't even know about.

    Bonny Bonobo alias Brat
    Diet can also play an important role. There was a study done by someone called Smith I think, in Melbourne (I'll try to find it tomorrow) with a small population of adolescents (roughly about 50-100 I think) who were identified by their GPs as showing early symptoms of schizophrenia. Half were given large supplements of fish oil for several months and the other half were given a placebo and the number that went on to get schizophrenia was highly significantly lowered in the fish oil group. I've always thought that very creative people's brains are a bit like formula 6 racing cars, they need to be run on high octane fuel and low octane, cheap fuel can cause them to malfunction.
    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    Bonny Bonobo alias Brat
    There is another article here in Science 2.0 by News Staff in 2008 called 'Food and the Brain' at http://www.science20.com/news_releases/food_and_the_brain_hint_eat_more_... which explains how important diet, and specially fish oil is, for preventing the development of mental disorders like schizophrenia, bipolar etc in people who are for whatever reason more prone to develop these conditions. And another science 2.0 article titled Long-Chain Omega-3 Fatty Acids May Reduce Risk Of Psychotic Disorders by News Staff at http://www.scientificblogging.com/news_articles/longchain_omega3_fatty_a... for the full details supported by a paper by G. Paul Amminger et al., 'Long-Chain ω-3 Fatty Acids for Indicated Prevention of Psychotic Disorders: A Randomized, Placebo-Controlled Trial', Arch Gen Psychiatry, 2010, 67 (2), 146-154 I'm still looking for the Smith research.
    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    Bonny Bonobo alias Brat
    I don't have time to keep looking for the Smith study but here's a very similar one conducted in Austria with 81 people, ages 13 to 25, with warning signs of psychosis at http://www.msnbc.msn.com/id/35186424
    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    I found this article through Twitter, and was very excited to read it. See, in 1995 I did my Master's Thesis proposal on the link between creativity and emotional/behavioral disorders in children. I proposed that there was a link, and my personal thought was that if given tests of creativity that children with emotional/behavioral disorders would score higher. Unbelievable to read this and see that professionals are considering that link as well. Exciting!

    Andrea....
    Have you ever had a real Hypomanic episode?
    There is a huge difference between being in the zone, and being unable to snap out of the zone.
    The reason psychiatrists CANT let their patients stay in the hypomanic state, is because it could potentially lead to full blown mania. Although I totally agree, I was an absolute genius for four weeks. I could walk into Bill Gate's office and tell him how to run Microsoft.... or at least I thought I could.

    Andrea Kuszewski
    To answer your question: probably not. And that is part of my point in this article. To have bonafide Hypomanic Episodes is a serious thing, and should be given its rightful attention. But having a hyper-productive creative state, one that works to your advantage, being an asset to the individual... should not be labeled as having a disorder.

    However, the traits (genetically) for someone with true Hypomanic Episodes and someone with hyper-creative-yet-functional states are probably very similar, in regards to the positive aspects (positive in a clinical sense, meaning 'present' not 'good') of the behavior. The difference being that the Hypomanic patient can't snap out of it-  has no control over it, while the intensely creative functional person does. And I do realize I am incredibly simplifying this whole relationship, but I am trying to get the main point across.

    I feel that it is important to look at mental illness from this perspective as well, because it not only gives insight to etiology and penetrance of disorders, but also to treatment options. It also sends the message that 'different' or even 'eccentric' is not always a bad thing, and should be tolerated by society to a degree.

    Thanks for reading this, and for the comment!
    Bonny Bonobo alias Brat
    So Andrea, do you recognise that treatment options include diet and empowerment? And do you also recognise the negative and long term effects and disempowerment that is caused by labelling people using the DSM? Or are you just going to ignore the effects these can have in creating the difference between the Hypomanic patient who can't snap out of it and the intensely creative functional person who has self-esteem and self-confidence like you, who does manage to control it?
    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    Hank
    So Andrea, do you recognise that treatment options include diet and empowerment? And do you also recognise the negative and long term effects and disempowerment that is caused by labelling people using the DSM? Or are you just going to ignore the effects these can have in creating the difference
    I am not sure your approach is valid.   You make 2 presumptions that have some basis, but are not well known, and then declare she is 'ignoring' the effects if she doesn't agree with your presumptions.   I can't see how that sort of tone is warranted based on her article saying that labeling people is a bad idea.  I mean, that was her whole point.  
    Bonny Bonobo alias Brat
    Hank, I'm just asking Andrea if she agrees or disagrees, because she hasn't made any comment either way about diet or the long term effects and disempowerment of negative labelling from DSM. Maybe they're factors that she doesn't consider to be important? I hope my tone didn't seem anything other than curious maybe the word 'ignore' has somehow made my tone seem unwarranted? Sorry, if it came over that way. Maybe I should have said 'Or are you just not really interested in the effects these can have on creating the dfference?'
    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    Bonny Bonobo alias Brat
    Also, there's nowhere in Andrea's article that she says that labeling people is a bad idea, she says that labelling highly creative people like hersef, who do have the necessary neural control mechanisms, with a DSM disorder is a bad idea. I doubt if she thinks that labelling people with mental disorders is a bad idea, because that is one of the primary functions of a psychologist, to test and label people with mental disorders.
    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    Hank
    I understand now.   Though I would have though the function of a psychologist was to help people with disorders.  Certainly the never-ending committee meetings of the DSM folks are to test and label people and maybe do some social engineering on the other.
    Bonny Bonobo alias Brat
    There are a lot of misconceptions about what psychologists do to help people. They often tend to be experts in testing and evaluating and then helping people with Cognitive Behavior Therapy or CBT, however they are rarely highly qualified counsellors. Not one Psychology degree in Australia includes any counselling units and yet most of the Counselling degrees do include usually at least 4 to 6 psychology units, which I have recently had to redo, simply because in Australia there is no recognition of prior learning for any degree over 10 years old. It was interesting to discover that nothing much in those psychology units had changed in 25 years, except for FMri scans of course, which is a big breakthrough. It was easy for me to get high distinctions, so I wasn't complaining too much, apart from when I had to memorise the DSM IV for an Abnormal Psychology exam. Now I can't forget it. Personally, I think that its time that the field of psychology branched out to include counselling under its umbrella, then we would start to see some big improvements in the mental health care available to so many people, who occasionally need help with disabling psychological symptoms, at some stage in their life without them being left labelled and demoralised with the belief that they have a life long DSM mental disorder.
    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    In a medical context, the only purpose of a differential diagnosis is for differential treatment. If you don't have a differential treatment, a differential diagnosis is of zero value.

    In a social context the purpose of differential social labeling is for differential social treatment, that is to “other” people who are different and put them at the bottom of the social hierarchy so it is considered “ok” to treat them badly.

    Aitch
    Andrea
    Is it possible that people can have a milder form of the DSM symptoms, and not have 4 day hypomanic episode, but less prolonged?

    I used to suffer most of these symptoms, and took up Go-Kart and Car Racing and other dangerous sports. Shopping sprees don't do it for me...not even close
    I was also subjected to psychotherapeutic diagnosis for suspected hyperthyroidism, which really had a deleterious effect on my confidence, .....until the next mood jump when....whoohoo was the inner feeling. Confidence became taken almost for granted, but I think I had just put that down to youthful exuberance
    I have experienced many occasions when I have 'been in the zone' as it is now referred to, though I just used to say I was buzzing. [ex hippie]....highly elated and with very clear thought processes, often I had to put these spurts to use in some way, often if not physically in analysis of some problem or another, or suffer extreme irritability, often coupled with insomnia - not that dis-similar to certain drug induced effects
    I have never thought of it as being a genetic thing, but like Helen suggested, found dietary links with certain foodstuffs
    However, as I've grown older, I seem to have acquired less need of these symptoms, though I am still fairly much an insomniac and still get analytical rushes....could that be connected with greater self awareness and self-control.....or does it just wear off? [wink]

    Aitch
    Let's look for the stupidity gene. It would be a lot easier to find as it seems to becoming dominant in the USA.

    Bonny Bonobo alias Brat
    Andrea, is there any chance of you answering the questions directed to you in this article?
    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    Andrea Kuszewski
    Sure, Helen. I've answered some, and set others aside for when I am less busy. Lots of other things going on in the world right now that are demanding my attention, so I have to prioritize.

    To answer some:

    I have seen no relevant data that suggests schizophrenia is controlled and/or caused by diet. Emphasis on "relevant".

    Psychologists are very helpful to a lot of people, but not all psychologists are created equal. Some of them suck. I know a few, and it is a shame. I suggest you keep looking around till you find a good one. Not one that tells you what you want to hear and one who validates your already-formed opinions about yourself and the world, but one who is actually knowledgeable and proficient in the area of psychology that you need.

    Yes, training in perception and self-image does a lot of good for many people. But again, pseudoscience approaches and mystical beliefs only serve to damage the already fragile patient instead of helping them to have a rational and realistic view of themselves, the world, and how they fit into it.

    If there are other questions, I'll have to return to answer them. I hope this helps somewhat with your inquisition.

    -Andi
    Bonny Bonobo alias Brat
    Andrea, thanks for taking time out of your busy schedule to reply to me. I’m sure that your advice to anyone looking around for a psychologist ‘to find one who is knowledgeable and proficient in the area of psychology that they need’, is good advice. In Australia there is a website at http://www.psychology.org.au/findapsychologist/default.aspx which makes the task of at least locating a psychologist by locality and claimed proficiencies, quite easy. With regard to the connection between diet and mental illness, you may not be aware of both the quantity and quality of the evidence (epidemiological, physiological and through randomised controlled trials), that exist which show the link between mental illness and diet. A good starting point is at http://www.sustainweb.org/publications/?id=145 where there is a report called ‘Changing Diets, Changing Minds: how food affects mental health and behaviour’ researched and written by Courtney Van de Weyer. The report pulls together considerable published evidence linking what we eat to how we feel – from foetal brain and adolescent behaviour through to Alzheimer’s disease. ‘Due to both the quantity and quality of the evidence (epidemiological, physiological and through randomised controlled trials), the report proposes that the changes to the food system seen in the past century may be partly responsible for the rise in mental health and behavioural problems at the same time.’ ‘Issues addressed throughout the lifecycle include: preconceptual nutrition; maternal nutrition and foetal development; cognitive advantages of breastfeeding; diet and academic attainment and anti-social behaviour in childhood and adolescence; day-to-day food-related mood changes in adults; and cognitive decline in older people in relation to a life time of diet.’ ‘Specific mental diseases discussed include: ADHD, depression, schizophrenia and dementia (particularly Alzheimer’s disease). This research is then placed in the context of our changing diets – addressing diet and evolution, the agricultural and Industrial revolution and the upheaval of the 20th century (namely processed foods, food additives, industrialised farming, animal fat, declining fish stocks and the increasing use of pesticides).’ ‘ The roles of specific nutrients such as essential fatty acids (omega-3, or fish oils, and omega-6), hydrogenated (or trans) fats and various micronutrients (e.g., selenium, magnesium, iron and vitamin C) are also examined.’
    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    Bonny Bonobo alias Brat
    Also, Dr Andrew McCulloch from the Mental Health Foundation states that "we are only just beginning to understand how the brain as an organ is influenced by the nutrients it derives from the foods we eat and how diets have an impact on our mental health." A detailed report - Feeding Minds - from the Mental Health Foundation at http://www.mentalhealth.org.uk/campaigns/food-and-mental-health/feeding-... suggests that many Mental Health conditions such as Depression, schizophrenia, Alzheimer’s Disease and attention deficit hyperactivity disorder (ADHD) can be prevented / treated by consuming the right kinds of food and drinks. 'The number of cases of mental illness has been steadily growing and this affects us both socially and economically (Mental Ill-Health treatment is costing the UK nearly £100 billion per year). The Feeding Minds report suggests that the changes in our diets over the last 50 years are a contributing factor to this.'
    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    Hank
    You are confusing a 'link' and uncertainty about the brain with prevention, causation and cure.   Seriously, you should stop commenting about this because you seem to have gone from simply unknowledgeable to quackery and you are quote-mining to try and make it sound legitimate.
    Bonny Bonobo alias Brat
    Why are you telling me to stop commenting about this? Would you rather I wrote a blog? I am not unknowledgeable or a quack, I'm trying to have a sensible discussion about what influences the neural mechanisms that control behaviour in highly creative individuals. I am showing quotes with links and not claiming them as my own, otherwise I would be guilty of plagarism. If Andrea doesn't want people discuss her ideas about what influences the psychopathology of creativity then why is she writing an article here? Does she just want to say this is the way it is, end of discussion, or is it just you telling me that? Or do you only want PHDs to discuss these things with PHDs in a seperate forum with you and/or Bloggy as the Chairperson? Look at the 573 references at the end of this report. and tell me that they are all from unknowledgeable people and quacks. Also do you think the following organisations from page 97 are quacks? From the Report Changing Diets, Changing Minds: how food affects mental well being and behaviour http://www.sustainweb.org/news/01_2006_major_new_report_from_the_food_an... "The following are UK-based organisations that work specifically on the connection between diet and mental health and behaviour. It is not a definitive list and does not include many organisations that may provide information about the connection along with their other work". Food and Behaviour Research Box 6066 Nairn Scotland IV12 4YN www.fabresearch.org The Food and Mood Project Box 2737 Lewes, East Sussex BN7 2GN www.foodandmood.org The Hyperactive Children's' Support Group (HACSG) 71 Whyke Lane, Chichester, West Sussex PO19 7PD www.hacsg.org.uk Institute of Brain Chemistry and Human Nutrition North Campus London Metropolitan University 166-220 Holloway Rd. London N7 8DB www.north.londonmet.ac.uk/ibchn Institute of Optimum Nutrition - Brain Bio Centre 13 Blades Court Deodar Road Putney London SW15 2NU www.brainbiocentre.com Natural Justice University Laboratory of Physiology, Parks Road Oxford OX1 3PT www.physiol.ox.ac.uk/natural.justice The Schizophrenia Association of Great Britain "Bryn Hyfryd", The Crescent, Bangor. Gwynedd LL57 2AG www.sagb.co.uk
    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    Aitch
    Hank Have you never fasted?....and then found that your natural body needs become heightened, and you suddenly crave certain foodstuffs? I have, and together with the general improvement in my mental alertness, it's the best evidence anyone can have for a dietary link I support Helen's posts, as I happen to have personal experience of it Does that make me an unknowledgeable quack? Aitch
    Hank
    I have fasted, but when I was young so I think the harm it did was more than the benefit - I didn't crave anything and I had a lot of energy, as you would expect.   I don't recall any mental difference but that was some time ago.

    Anecdotal evidence as science proof is quackery, of course, else homeopathy is valid science, as is scientology and every placebo ever made, because they all worked for a few people who would claim that is the only data needed.
    Aitch
    Ah...there's the rub
    A few Scientists get together, it's called evidence....
    A few ordinary Jo's get together, it's just anecdote

    Thanks for clearing that up ;-)

    Aitch
    Bonny Bonobo alias Brat
    For more information on the relationship between diet and mental disorders see Shaheen E Lakhan, Karen F Vieira, 'Nutritional therapies for mental disorders', Nutrition Journal 2008, 7:2 doi:10.1186/1475-2891-7-2 referenced by News Staff’s article ‘Some Nutritional Supplements Work For Treatment Of Anxiety Disorders’ at http://www.science20.com/news_articles/some_nutritional_supplements_work...
    My latest forum article 'Australian Researchers Discover Potential Blue Green Algae Cause & Treatment of Motor Neuron Disease (MND)&(ALS)' Parkinsons's and Alzheimer's can be found at http://www.science20.com/forums/medicine
    The article shows there is a thin line between psychosis and creativity. It is important to take care of your mental health and de-stress. EXHALE it could be the difference in your breaking point.

    This article seems to infer that if you have hypomanic episodes alone you may be bipolar.

    The very traits that make someone creative, passionate, and likely to achieve a high degree of success in their domain, are the same traits that define psychological disorders such as Bipolar Disorder, Schizophrenia, and ADHD.

    That is quite simply not true, and shows a lack of research or even empathy for people who truly do suffer from these diseases. If you had taken the time to even read the first line from the Wikipedia entry:

    http://en.wikipedia.org/wiki/Bipolar_2

    "Bipolar II disorder is a bipolar spectrum disorder characterized by at least one hypomanic episode and at least one major depressive episode; with this disorder, depressive episodes can be more frequent and are more intense than hypomanic episodes."

    As someone who has struggled with Bipolar II all my life, I can tell you that while the hypomanic episodes have contributed greatly to my success, a good chunk of that is undermined by the major depressive episodes and the rapid cycling between states. I have been blessed with being raised in an environment that gave me a strong internal compass, the "executive function" that you refer to - without that I can see how my life could have taken a much different and ruinous path.

    In fact, writing this very article, I have now stayed up all night, have been focused intensely on my work, yet easily distracted, AND I'm in a pretty noticeably good mood. Oh, damn! Someone call the psychiatrist! Andi is having "an episode"!!!

    This just comes off as insulting to people that actually suffer from this disorder. Nobody is "attacking" your creativity.

    To answer your question: probably not. And that is part of my point in this article. To have bonafide Hypomanic Episodes is a serious thing, and should be given its rightful attention. But having a hyper-productive creative state, one that works to your advantage, being an asset to the individual... should not be labeled as having a disorder.

    Who is labelling you exactly? Hypomania by itself is indicative of nothing, it is simply a mood state.

    http://en.wikipedia.org/wiki/Hypomania

    However, the traits (genetically) for someone with true Hypomanic Episodes and someone with hyper-creative-yet-functional states are probably very similar, in regards to the positive aspects (positive in a clinical sense, meaning 'present' not 'good') of the behavior. The difference being that the Hypomanic patient can't snap out of it- has no control over it, while the intensely creative functional person does. And I do realize I am incredibly simplifying this whole relationship, but I am trying to get the main point across.

    First of all, no genetic marker for bipolar disorder has been found. Second, self-awareness of one's disorder (whether through reflection or psychiatry) can help greatly in "snapping out" of a hypomanic episodes. Manic and hypomanic episodes have the characteristic of "limited insight" in that you feel like nothing is wrong - in fact you've never felt better. For 20 years I thought I had chronic depression and never treated the hypomania, leading to a vicious circle of rapid mood swings.

    Anyway, this is quite long, and I understand the point of your article is that "don't label creative people as dysfunctional" but I suggest you do a little more research before throwing around terms like bipolar or schizophrenic without a better understanding of how serious they actually are.

    You may find this interesting as it discusses many of the same issues but also shines light on what it is really like to suffer from bipolar disorder. Suicide rates among those suffering from bipolar disorder are much higher than, for instance, depression.

    http://www.youtube.com/watch?v=P3EacQ4GfiU