The touch of madness, the stroke of genius

There is certainly a link between high intelligence and psychiatric disorders but at the other end of the spectrum lies depression

August 08, 2013 07:53 pm | Updated November 17, 2021 12:25 pm IST - NEW DELHI:

Do you think you are a genius? Take your time to reply because science is reaffirming the age old belief that those who are brilliant also have a stroke of madness about them. Quoting Aristotle, who said, “No great mind ever existed without a touch of madness,”Doctor James McCabe of the Institute of Psychiatry, King’s College London, speaks on Pod academy on a link between high intelligence and psychiatric disorders.

Dr. McCabe describes the illnesses, bipolar disorder and schizophrenia and says that while schizophrenia is more to do with genetics and delusions that the patient is under, bipolar disorder is about mood swings. “…the reason for the term bipolar is to refer to the two poles of the illness. So those are mania on the one hand, which is when your mood is very elated and you’re often very creative and excited….Then at the other end of the scale is depression…with profound sleep disturbance, with loss of appetite and they feel they have no energy. Occasionally, they might even get hallucinations and delusions associated with it. And the third state is being of a level mood, somewhere in the middle, and so the goal of treatment for bipolar disorder is to try and maximize the amount of time that people spend in that middle range when most people find that they’re functioning the best.”

The percentage of population affected is 1/2 to 1 per cent in Europe, though now definitions are undergoing change and the population being brought under the category of manic depression has increased.

Now coming to the crucial finding of McCabe’s study – both lower and higher achievers have an increased likelihood of developing manic depression.

He says, “We found that people who were in the top five per cent of the population are about four times more likely to develop bipolar disorder than the people with average grades and, at the same time, we found that people that were in the bottom per cent of the population in their school grades also had an increased risk of bipolar disorder, not quite as big, but about a doubling in risk. So, this suggests that there are potentially two different mechanisms operating here that are associated with high and low scores.”

If they took their exam in the time when they were manic that is very excited and creative, they probably did very well. And if they took their exams when they were depressed, they probably found themselves at the bottom of the pile. That is a rather simple explanation, but Dr. McCabe says the situation is difficult. Drugs to treat depression may hamper creativity. One of his patients, a professional violinist would not have her medicine (lithium) before a concert for it limited her. On the other hand people who go through these disorders also suffer from the anxiety, ‘why am I not creative in the manic stage?’

While that seems a nice stage to be in….creative and energetic, Dr. McCabe says, it is not all that pleasant for the after taste it leaves is bitter. By creative it does not only refer to the arts. McCabe gives the example of the famous mathematician John Nash. “…very very gifted, was a full professor by the age of 29 and around that time started to believe, for example, that he was being given secret messages in the newspapers by aliens. Ultimately he believed that he was the emperor of Antarctica. So he had some very odd beliefs and had a diagnosis of schizophrenia.”

McCabe says, “People who are given drugs which increase their dopamine level can sometimes become very creative.

And we know that, when people are in a manic state particularly, their dopamine systems are increased and some drugs stimulate dopamine receptors in the brain, so there is a biological possibility there for a link related to dopamine.”

Most significant, McCabe feels is that research in this direction will help us to understand, “…many different manifestations of the same underlying biological process, so that you can have similar biological underpinnings for a number of different psychiatric disorders, which are basically the symptoms that are manifest.”

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