The Bipolar Disorder Challenge: Cognitive Functioning Must We Sacrifice Our Super-powers in the Pursuit of Stability?
Must We Sacrifice Our Super-powers in the Pursuit of Stability?
This is the sixth post dealing with how our ability to think and process information relates to mood. The first four posts focussed on all the things that commonly go wrong that we need to know. Last week, in Making our Amazing but Problematic Brains Work for Us, we explored the very opposite, namely our high-performance software that often leaves the rest of the world for dead.
In response to last week’s post, Katya referred to our "dual-function" brains, from "lights out, no one’s home" to discoursing on the proximity of the next galaxy.
It’s as if we had next-generation iPhones for brains, I related, instead of the pocket calculators that govern the thinking of the pathetically normal. The catch is our futuristic brains are in beta phase, replete with bugs that compromise reliability. Often, we can’t even get the thing to power up.
To figure out what is going on, it is useful to take a look at the creativity connection. Kay Jamison in her 1993 book, "Touched with Fire," neatly framed the issue:
The fiery aspects of thought and feeling that initially compel the artistic voyage - fierce energy, high mood, and quick intelligence, a sense of the visionary and the grand, a restless and feverish temperament - commonly carry with them the capacity for vastly darker moods, grimmer energies, and, occasionally, bouts of “madness.”
But even depression - at least in its milder forms, she goes on to say - allows for greater tapping into the psychic depths.
According to Nancy Andreasen of the University of Iowa, creativity is largely an unconscious process. She quotes Mozart:
Whence and how [ideas] come, I know not; nor can I force them " Nor do I hear in my imagination the parts successively, but I hear them, as it were, all at once.
What seems to be going on at the neural level, according to Dr Andreasen, is that the unconscious processes play out in our association cortices. These cortices have no specific function. Rather, their role is to facilitate making connections between one part of the brain and another. When we are thinking creatively, these cortices are getting a workout.
Closely related to creativity is intuition, which is a hot topic of research. Intuition is generally described as “the ability to sense or know immediately without reasoning.”
Science views creativity and intuition as normal behavior writ large. Our brains, after all, are wired to function in novel situations. But, alas, extraordinary intuition and creativity tend to come pre-loaded with bipolar. "How intuitive are you?" I asked in a poll I conducted on my blog, "Knowledge is Necessity." Readers were allowed to fill in more than one reply, ranging from “borderline or full-on psychic, or at least it seems that way” to “sorry, I’m totally rational and logical.”
Nearly one in four responded affirmatively to the psychic possibility question while just one in ten confessed to being totally rational. Four in ten indicated that “my thoughts and ideas seem to come out of nowhere” while more than half reported that "I often read people and situations like a book."
What may be happening is a glitch in the brain’s ability to unconsciously filter out information, referred to as “latent inhibition” (LI). As I explain in an article on mcmanweb:
High LI is conducive to rational thought. Low LI is associated with psychosis and schizophrenia, but more recently researchers have also been linking it to intuition and creativity. But there is a catch, namely the need for strong executive function, which relates to the brain’s ability to cognitively control thoughts and behaviors and set goals. Those with schizophrenia tend to have notoriously weak executive function.
Similarly, we can add, the brain science is revealing that those of us with bipolar also have challenges with executive function, even when our moods are stable.
What seems to be happening is this:
Our brains are essentially open doors to the outside world. We are contending with far more informational and sensory and emotional input than the chronically normal. This is neither good nor bad unto itself. On one hand, it appears we have a lot more raw material to work and play with and on our good days our hyper-active association cortices are able to connect unlikely dots and come up with stunning revelations.
So long as our executive function is holding steady, we are at the controls of the most spectacular processing unit in the universe. In simplistic terms, we are thinking non-linearly while those around us are thinking linearly. In essence, we can link peanut butter to the big bang. Not only that, we have the capacity to fashion this revelation into a hit single or a new patent or a new variety of pizza.
The catch is that executive function does not seem to be built to handle the overload. Or maybe our executive function is a bit weak to begin with. At any rate, on our bad days we have too much stuff in our intrays to contend with. Our association cortices are spinning wildly, making all kinds of crazy connections. There is no one in charge in the control room. People around us look at us funny. They become alarmed at our behavior …
Literally, we walk a razor edge between hyper-performance and disaster. Understandably, a lot of us would opt for a more stable and predictable life, to be normal. But what about those of us who view our strange gift as a legitimate part of our personalities? Who see "normal" as neither praiseworthy nor desirable?
We are not talking about being addicted to our highs, as the psychiatric profession so erroneously mischaracterizes us. Basically, we are talking about using our super-powers without getting blindsided by kryptonite. Is such a goal attainable? Can we at least figure out a working compromise?
Much more to come …
John is an author and advocate for Mental Health. He wrote for HealthCentral as a patient expert for Depression and Bipolar Disorder.