Creativity and madness. That the two go hand in hand has become a cliché. Along with eccentricity, substance abuse, and a hapless attitude to personal finance, mental illness is one of the tropes we associate with the artistic mind.

What is the truth? Is there really a higher incidence of mental illness among creative people, or is this just an easy fallacy to explain the behaviour of those who see the world differently? And if there is a genuine correlation between creativity and madness could exploring the relationship between the two help us better understand them both?

One doesn’t have to delve very deep into the lives of some of our most revered writers, musicians and artists to uncover countless anecdotal accounts of the experience of mental illness and its effect on the creative process. Walter Isaacson in his brilliant recent biography of Da Vinci writes of the young Leonardo, ‘had he been a student at the outset of the twenty first century, he may have been put on a pharmaceutical regimen to alleviate his mood swings and attention deficit disorder.’ When pressed on the incidence of unusual behaviour among his peers Lord Byron explained, ‘We of the craft are all crazy. Some are affected by gaiety, others by melancholy, but all are more or less touched.’ And the novelist Virginia Wolf came to regard her own mental illness as her inspiration, ‘As an experience, madness is terrific I can assure you, and not to be sniffed at; and in its lava I still find most of the things I write about. It shoots out of one everything shaped, final, not in mere driblets, as sanity does.’

These personal stories of being ‘more or less touched’ are vivid, revealing and often helpful in giving context to why a particular artist made the work they did, yet they remain anecdotal. Dr Kay Redfield Jamison, a professor of psychiatry at John Hopkins University, has brought some scientific rigour to the question. In her book ‘Touched with Fire’, having reviewed all the available surveys, she concludes ‘across different methodologies and all kinds of populations the research is remarkably consistent – there is a very much increased rate of mood disorders, particularly bipolar disorder, but also depression, in highly imaginative artists and writers.’ She puts the incidence of mental illness at a formidable 10 to 30 times higher among creative individuals than the population at large.

So, if the science does indeed support the myth, why is it that the creative brain is more susceptible to mental illness, or indeed, vice versa?

In order to provide a meaningful answer I should first declare an interest in the question. My wife is both an artist and someone who has experienced recurrent periods of mental ill health. Before I sat down to write this article we talked about the influence of her own depressive illness on her work (www.kateshooter.com).

The first thing to say – and this might go some way to debunking at least one of the myths around the issue – is that when she’s at her lowest ebb making creative work is out of the question. Kate explains, ‘When I’m in what can be described as a clinical depressive state, I can’t make work at all. It just doesn’t happen. You can’t see the point of anything. You can’t see the point of you. I’m so busy trying to avoid the pain by crawling into bed, or fighting obsessive dark thoughts, that there’s no room for making or creating.’ The American composer Aaron Copeland has said something similar, ‘Too much depression will not result in a work of art, because a work of art is an affirmative gesture.’

It is when Kate is about to experience a bout of depression, in the period just before the black dog comes calling, that she finds her creativity surges.

‘There’s a point when I’m on the precipice of having a low where I’m agitated. I move quite fast. I’m sort of volatile but I’m motivated and that can be a really useful state for making work. I tend to go at things hammer and tongs. I can work for long periods of time and I’m filled with ideas’. She also describes a feeling of detachment  during these periods which provide her with the perspective she needs to paint: ‘You have to sort of unhinge yourself from the everyday and the manic periods really help that. It’s like you propel yourself into a different world and that different state helps you make work that you just couldn’t make otherwise.’

While the nihilism and self-loathing which accompany depression smother the creative impulse it seems that the mania or hypomania (mild mania) which often precede it have the opposite effect.

Take a look at the symptoms of mania in the psychiatrists’ bible, The Diagnostic and Statistical Manual of Mental Disorders, and, if you’re a creative person, even one who has never experienced mental illness before, you may find that they sound familiar …

1. Inflated self-esteem

2. Decreased need for sleep

3. More talkative than usual

4. A flight of ideas

5. An increase in goal directed activity

These diagnostic criteria to describe the characteristics of mania could just as well describe the sensation of flow - that state of creative nirvana to which all of us as writers, artists, designers, musicians aspire. Those all too rare episodes of profound creativity, when the words spill from your pen or the composition you’re working on suddenly seems to write itself.

During creative flow the self-doubt with which we are normally burdened disappears. There is a cognitive disinhibition that allows us to soar on flights of fancy, combining formerly discrete concepts to create original ideas. We lose an awareness of time, being absolutely absorbed in the task in hand. Sleep is out of the question. We are lost absolutely and gloriously in our own creativity. It is a kind of madness.

The deeper I delve into the subject the more convinced I become that mental illness and creativity can never truly be disentangled, because they both depend upon a state of mind in which we are suddenly liberated from the prosaic and predictable world of reason. Mania can be creative and creativity can be manic. And this is the reason we have come to conflate one with the other. The difference though is profound: too much creativity won’t kill you.

The danger of identifying the small bandwidth of insanity during which one can be exceptionally creative is that we fuel the romantic stereotype of the troubled genius. I quoted Virginia Woolf at the start of this article; she is just one of many creative people for whom the battle with depression overwhelmed the desire to live.

And yet … the more we bring the subject out into the open and the more we’re able to discuss mental illness in all its complexity, not simply in terms of what it destroys but also what it bestows, then the more likely we are to remove the stigma, to stop seeing madness and sanity as binary states, and to understand that all of us are on a continuum, it’s just a question of where you happen to sit.

This article originally appeared in Creative Review magazine.