Positive Traits in the Bipolar Spectrum: The Space between Madness and Genius

Abstract

Bipolar disorder is a severe, lifelong mood disorder for which little is currently understood of the genetic mechanisms underlying risk. By examining related dimensional phenotypes, we may further our understanding of the disorder. Creativity has a historical connection with the bipolar spectrum and is particularly enhanced among unaffected first-degree relatives and those with bipolar spectrum traits. This suggests that some aspects of the bipolar spectrum may confer advantages, while more severe expressions of symptoms negatively influence creative accomplishment. Creativity is a complex, multidimensional construct with both cognitive and affective components, many of which appear to reflect a shared genetic vulnerability with bipolar disorder. It is suggested that a subset of bipolar risk variants confer advantages as positive traits according to an inverted-U-shaped curve with clinically unaffected allele carriers benefitting from the positive traits and serving to maintain the risk alleles in the population. The association of risk genes with creativity in healthy individuals (e.g., NRG1), as well as an overall sharing of common genetic variation between bipolar patients and creative individuals, provides support for this model. Current findings are summarized from a multidisciplinary perspective to demonstrate the feasibility of research in this area to reveal the mechanisms underlying illness.

Polygenic risk score for bipolar disorder associates with divergent thinking and brain structures in the prefrontal cortex

“…It has long been suggested and accepted that BD and mania are associated with increased forms of creativity (Greenwood, 2016).…”

“…It has long been suggested and accepted that BD and mania are associated with increased forms of creativity (Greenwood, 2016 ). Hypomania (a mild form of mania) is positively correlated with a fluency of divergent thinking (Furnham, Batey, Anand, & Manfield, 2008 ), which is the most typical measure of creativity in the laboratory setting.…”

Ludwig van Beethoven—a psychiatric perspective

“…Particular attention has been given to the question of how temperament and bipolar diathesis interact with creativity [37][38][39][40][41]. This interaction is interesting in both directions, as music can be used to express psychopathology [21,42] and as musicians can be affected by psychiatric disorders [42].…”

Common variants at 2q11.2, 8q21.3, and 11q13.2 are associated with major mood disorders

“…Earlier family and twin studies indicated a pivotal role of genetic factors in the etiology of mood disorders 3 – 6 ; however, the specific modes of inheritance have been found to be complex and polygenic 7 – 10 . In brief, while BPD and MDD differ from each other in age of onset, clinical presentation, and treatment response 11 , they still share several specific clinical features such as the presence of depressive episodes, mood instability and impaired cognition. Moreover, meta-analyses of family studies have found elevated rates of BPD in first-degree relatives of MDD patients and vice versa 12 .…”