Thursday, January 29, 2009

Are Bipolars Smarter than Everyone Else?

A study published in January's American Journal of Psychiatry found a strong correlation between people with lower childhood IQ scores and an adult diagnosis of mental illness.

The study was performed on the "Dunedin Cohort," a thousand-strong group of New Zealanders who have been tracked since their births in 1972-73. It was from this population that we got the first strong evidence involving the link between genetic vulnerability to stress and depression, which has led to a lot of re-thinking into cause and effect across the whole panoply of mental illness.

The current study involved a lot of the same researchers as the stress-depression study. The cohort was administered IQ tests at ages 7,9, and 11. Psychiatric evaluations were made at ages 18, 21, 26, and 32. The researchers found that "lower childhood IQ was associated with increased risk of developing schizophrenia spectrum disorder, adult depression, and adult anxiety."

Intriguingly, "higher childhood IQ predicted increased risk of adult mania." The authors of the study do caution, however, that this particular finding may represent a statistical anomaly.

Back in the 70's, Nancy Andreasen MD, PhD of the University of Iowa spotted a measurable bipolar-creativity link, and Kay Jamison's "Touched with Fire" of 1996 put the issue out in front of the public. But she also noted that:

"Thinking can range from florid psychosis, or madness, to patterns of unusually clear, fast, and creative associations, to retardation so profound that no meaningful activity can occur."

Indeed, the psychiatric literature is full of studies pointing to serious cognitive flaws in bipolar patients. In a study published in 2004, for instance, Deborah Yurgelun-Todd PhD of Harvard and her colleagues scanned the brains of 11 stable bipolar patients while performing a mental processing task, and found significant delays in their ability to respond with correct answers compared to 10 healthy controls.

The study also found decreased activation of the brain region responsible for processing the task compared to the controls.

That same year, at the APA annual meeting, I heard Dr Yurgelun-Todd propose that cognitive deficits should be regarded as a core feature of bipolar disorder.

In the current study, the authors point out that "lower childhood IQ may be a marker of neuroanatomical deficits that increase vulnerability to certain mental disorders." They also note the debilitating effects of stress and trauma.

What to make of all this? Some days our brains are running on rocket fuel; other days, molasses. Neither state is solely good or bad. Our best work often occurs at either pole. So do our worst moments.

Technically speaking, if our brains were manufactured goods, there would have been a product recall ages ago. But, here's the rub: Knowing that's the case, are you ready to turn yours in?

Further reading from mcmanweb: The Thought Spectrum

These days, my internal operating system is far and away the worst aspect of my illness I have to contend with. Moods, shmoods – I actually follow some of the advice in my book, "Living Well with Depression and Bipolar Disorder." But when my brain unexpectedly cuts out on me, what am I to do? These are no mere senior moments. The software simply isn’t loading right. When it happens, I know it and the people around me know it. This has been going on for as long as I can remember.

If you don’t think this is any big deal, then ask yourself: Knowing what you now know about me, how safe would you feel with me as an air traffic controller?


Anonymous said...

I feel that my brain is somewhat like a radio reciever. That is to say, that it alters frequency in clarity. Somedays I cannot tune into anything and other days I recieve the greatest music that uplifts and inspires people.
It is all about balance, personally speaking from experience. Sometimes my IQ is high and I can create and produce good things and other days I can barely speak.
I feel that the bittersweet condition of bipolarity is something that enables us to touch the 99% world that many people do not see. We all live in the 1%.
The hard part of this condition for me is maintaining a constant or regular performance. Then again, mundanity is not the greatest inspiration on the mind is it?
I need variety and to experience new things like anyone else and the ongoing alterations of perception can only lead to a better understand of deeper life that we all aspire to reach.

John McManamy said...

Hi, Anonymous. I definitely agree. There is an amazing world out there, and I'm convinced "normal" people miss out on 99 percent of it. Yes, there are times when I want to return my brain to the manufacturer, but never in exchange for a standard issue brain. To me, that would be the end of the world.

Sophia said...


As far as my intelligence is concerned, I really notice the effects my bipolarity has on it. I feel highly intelligent and creative when I'm up, and when I'm down, it's like you said - my brain turns into molasses - I feel quite stupid. I'm just glad I was able to make it through college before some of the symptoms began to show.

Similar to the study you mentioned in part of your post, as a child I was categorized as "gifted and talented" after being given an IQ test, and now I have bipolar disorder. Not that I'm comparing myself to the brilliance of some of history's greatest minds, but many highly intelligent people had mental illnesses. John Nash, Abraham Lincoln, Ernest Hemmingway, Sylvia Plath, William Styron, Vincent Van Gogh, Mozart, etc., etc., etc. (Maybe it makes me feel better to know that some famous people are not "normal".)

Anonymous said...

I think the researchers need to consider the correlation from another point of view; namely that the people with higher cognitive skills may also have better coping skills. They may be better able to take advantage of cognitive therapy and compensate for the loss of function associated with depressive and manic episodes.

John McManamy said...

Hi, Sophia. This is a line of enquiry I'd like to take a lot further. If you dig down to I think the second blog I posted here you will find a piece on creativity, featuring John Nash and more of Nancy Andreasen. Please keep commenting.

John McManamy said...

Hi, Lonestar. Wow! Great point. And I know you're right. I would also submit that through cognitive therapy and mindfulness, not only can we compensate for our states where our thinking is not working right but we can also take advantage of our cognitive superpowers without losing control. Imagine being able to stay in productive and creative hypomania for a long time without flipping out. Also imagine staying in an introspective and reflective mild depression without dropping through the floor.

AliceT said...

I agree so much with how our brain functions and cognitive superpowers move around with the mood changes and biochemical changes that are always fooling with our neurotransmitters. While my IQ both as a child and as an adult both tested apparently high, they probably just caught me on the right day for my functions!!!
And super yes to Lonestar, definitely and consciously have always used the beefed up IQ to improve stuff thru cognitive therapy and developing tremendous coping skills and resilience and life skills to deal with the Bipolar deficits even before my diagnosis.

John McManamy said...

Hey, Alice. Yes, yes, and yes. I have always maintained you have to be smart to successfully manage bipolar. Stupid kills, simple. And - you've really jogged my thinking here - imagine the harm many meds cause by slowing down our cognition. I'm all for meds - don't get me wrong - but dulled thinking from over-medication has to enormously handicap us in our recovery. Pdocs, I'm convinced, err on the side of over-medicating us instead of working with us to find our cognitive sweet spot.

Lisa Mora said...

So agree with anonymous! In fact I actually wrote about this in my book:
"Sometimes I describe it as if our brains were the amplifier on a stereo. In most people all the knobs and dials on this amplifier are set at around four to six, but for a person with bipolar disorder, all those knobs that pick up sights, senses, sounds, perceptions of all kinds, including the extra-sensory ones, are cranked right up to maximum. Input overloads the senses and it can become, at times, overwhelming. That is as close as I can come to describing how it feels to me." p.26
And this:
"It amazes me how similar in nature those diagnosed with bipolar are. We usually get on famously; we’re often the life of the party. We stand out. I began to meet them by chance, out night-clubbing, at parties, through friends. As I learned what the tell-tale traits were, I found I was able to pick up on that certain different-ness. We seem to be able to hone in and be drawn to each other like magnets. When you gather a bunch of mentally “ill” people together and they begin to talk about their experiences of life, something amazing happens. We speak of a depth of understanding, be it delusional or not, that sets us apart from those on “auto pilot”. There is a common sense of awareness of something much larger at play; there is a feeling of being more “tuned in”, a perception that often enters the realms of the extra-sensory — I have had some very vivid experiences within that world. You feel somehow smarter, as if you have a knowledge that sets you above so-called normal people. I believe that the energetic body that surrounds our physical bodies is somehow more vibrant; it extends further and has more impact. But then thinking and feeling all this is just another symptom of bipolar disorder, too, so who knows?" p.21

John McManamy said...

This is great, Lisa. Welcome to "Knowledge is Necessity." Please keep contributing.