Researchers from King's College London and the Karolina Institutet in Stockholm have published data linking high academic performance in school with the mental illness bipolar disorder.
Anecdotally, high academic intelligence has often been linked with the disorder, also known as manic depression. This research however is the first to offer any support to such a theory but is unlikely to give the whole story.
First things first; Bipolar disorder is a very real and serious subject. It is a disabling mental illness with around half a million sufferers in the UK. These people live through periods of usually crippling, crushing depression coupled with periods of soaring mania. The depression that occurs in bipolar disorder is among the most severe that you can imagine. As a medical student I was lucky enough to spend six weeks of my psychiatry training in a mental health unit in East London. The patients I met were mainly those who had been held for treatment under one section or another of the mental health act. Many of these people lived with bipolar disorder and were receiving treatment during spells of this deep deep depression. It is worth remembering that bipolar disorder is one of the mental illnesses most likely to lead to suicide.
The depression aspect of the illness is not neccessarily what people are most interested in. Depression isn't exactly fun, but mania, especially when it comes with a spark of talent and imagination certainly sounds like it might be. The romantic notion of genius and madness being closely related has caught the imagination since the time of the classical philosophers and has a lot to do with the perceived flashes of wit and inspiration that are sometimes seen when people are manic. Since Stephen Fry's excellent and moving 2006 documentary The Secret Life of The Manic Depressive bipolar disorder has had a somewhat higher position in the public imagination. One theme of this documentary was that people with the disease can, while living through a spell of mania (or its less severe cousin hypomania) have the most productive and creative times of their life. The documentary focussed on artistic types who found they were blessed with the ability to work extremely prolifically during manic spells. This presentation of the disorder is only one half of the story. When I've talked to people with bipolar disorder it has become clear that mania is not always (or even very often) about people who can't stop painting, or composing or writing poetry. I met people who had been walking the streets of the east end half-dressed in the middle of the night having unprotected sex with strangers and having to deal with the resulting pregnancies and infections. I met people who had given away or gambled all of their money. I met people, in short who were not having the greatest time of their life; people in desperate need of help because of their inability to keep safe. Mania is not a good thing.
The research from London and Sweden, published in this month's British Journal of Psychiatry was carried out by looking at Swedish school results. Between the ages of 15 and 16 young Swedes take compulsory exams similar to our GCSEs. The researchers took the results for almost a million young people taking these exams and, using the admirable Swedish national hospital records looked to see who ended up being admitted to hospital with a diagnosis of bipolar disorder between the ages of 17 and 31. The headline-grabbing result was that those with the highest grades had four times the risk of a hospital admission with bipolar disorder than those with average grades (a leap from 4 per 100,000 people to 16 per 100,000 people). This link was most apparent in humanities subjects, and less-so in the sciences. This seems to agree with ideas about creativity and bipolar disorder. However, another important result from the research is that having the lowest grades (in all subjects) gave people twice the risk of a hospital admission with bipolar disorder than their schoolmates with average grades. The research itself is meticulously conducted and it is likely that these numbers are pretty reliable and represent a real-life situation. I would suggest a couple of questions worth thinking about: This research identified that the average age of hospital admission with bipolar disorder was at around 21. Do your GCSE grades neccessarily reflect your intelligence or creativity at age 21? If bipolar disease does have a link with intelligence, then why isn't the relationship a linear one? Why are the lowest achievers at higher risk than those with average grades?
While there are doubtless famous artists, writers and for that matter scientists, doctors and lord-knows-who else who have managed to function well with bipolar disorder it's important to remember that most highly functioning people don't have it. Its very enticing to us however, this idea of the tortured genius. It appeals directly to our vanity on the one hand, the idea that those with a mental illness can be capable of greatness is a reminder that all of us, with our sub-clinical character flaws and foibles can at least have a stab at it. On the other hand, less attractively, maybe it has more to do with schadenfreude than aspiration; the flaws of the best and brightest validate our own.
Daniel James
Published in the London Student. March 2010
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