BEAUTIFUL MINDS: Is there a link between genius and madness? by Kenneth Lyen INTRODUCTION In her book A Beautiful Mind, Sylvia Nasar writes about Nobel Prizewinner John Nash and describes how schizophrenia affected his thought processes. The biography reconfirms an age-old observation that “There is no great genius without a tincture of madness” (Seneca 3BC-AD65).   The idea of a link between genius and madness has long fascinated people. There are still a number of contentious issues. For example how does one define “genius” and “madness”? The boundaries between normal, abnormal, and supernormal, are arbitrary and blurred, and there may never be a satisfactory resolution. What may seem eccentric behavior to one observer may be regarded as madness by another. A crazy nut to some may be considered a genius by others. And if a genius is too far ahead of his time, his brilliant ideas might not be appreciated except posthumously. The social and cultural environment plays an important role in interpreting what is genius and what is madness. It may be prudent for one not to be sucked into the quicksands that surround the definition of madness. However one could loosely define a genius as one who is highly creative and has made a significant contribution to mankind, often through challenging established orthodoxy and establishing a new paradigm.   Some earthshaking ideas may have appeared insane when first proposed. For example, the concepts of Copernicus and Galileo’s solar-centric world, Darwin’s theory of evolution, Einstein’s space-time universe, or Picasso’s geometric paintings, all seemed quite preposterous initially. Furthermore, the revolutionaries themselves were considered by some of their contemporaries to be out of their minds as to so brazenly challenge established orthodoxy. However, one is not concerned with such matters in this article. The focus is whether or not geniuses have a propensity to psychiatric disorders, and if so, what is their impact.   IS THERE REALLY A LINK BETWEEN GENIUS AND MADNESS? Studies in the United States have shown that up to one-third of its population will suffer from some form of mental illness during one’s life. The chances of developing a mental disorder, regardless of whether one is a genius or a mere mortal, are extraordinarily high. Is the link between genius and madness spurious and just a matter of pure coincidence?   Proponents of a positive link will point to a number of research studies. Unfortunately nearly every one of them is flawed. Criticisms include ambiguous inclusionary criteria, the impossibility of validating historical data, the lack of control groups, small sample size, and the often unclear definitions of the highly creative (genius) and of mental illness. But despite all these shortcomings, there is growing support for the link between genius and mental illness. Research has generally followed two lines of approach:   a) Studying Creative Individuals Eminent historical individuals have been studied by researching their biographies to see what percentage of them have psychiatric illnesses. In 1949, Adele Juda investigated 113 German artists, architects, composers and writers. She found that one third of these subjects suffered from a mental illness, which included bipolar disease (manic-depression), major depression, and schizophrenia.  Colin Martindale in 1972 studied 42 English and French poets, and found significant psychiatric illness in 45% of them. Joseph Schildkraut and colleagues reported that about half of 15 American visual artists that they studied suffered from psychiatric illnesses. Arnold Ludwig (1992) in an impressive study of 1004 twentieth century artists and writers, found that 74% of them exhibited psychiatric symptoms at some stage of their lives, which compares with 32% for the national average. It must be admitted that labeling dead artists retrospectively with psychiatric diagnosis has raised many skeptical eyebrows, and hence this line of evidence has to be taken with a hefty pinch of salt.   Fortunately, there are a few studies of contemporary artists, writers and musicians. In 1974, Nancy Andreasen from the University of Iowa studied 30 faculty members attending a writers’ workshop and matched them with 30 controls. She found that 80% of participating writers suffered from depression or bipolar disorder, compared to 30% of her controls.   Kay Redfield Jamison in 1989 studied 47 distinguished British writers and visual artists, and found that 38% of them had been previously treated for a mood disorder, including bipolar disorder, which compares with less than 15% of the British general population.   Arnold Ludwig studied a sample of 59 female writers attending a Women Writers Conference and found that psychiatric problems were higher in writers compared with non-writers:              DIAGNOSIS WRITERS (%) NON-WRITERS (%) Depression 56 14 Mania 19 3 Panic Attacks 22 5 Eating Disorders 12 2 Drug Abuse 17 5 Childhood Sexual Abuse 39 12 The last category of evidence to support the link between mental illness and creativity comes from the US Bureau of the Census. The overall suicide rate among artists in the USA is three times the national average. These figures are broken down for each subcategory of artists (Figures given as number of suicides per 100,000 population):               ARTISTS RATE OF SUICIDE (per 100,000 population) Painters and Sculptors