I Began giving serious thought to the connections between artists and mental illness last year while preparing to interview Daniel Johnston, an underdog cult artist revered by everyone from Sonic Youth to Simpsons creator Matt Groening for his charmingly off-kilter, low-fi pop songs and creepy, childlike artwork. Unfortunately, he was also well known for his very public struggle with bipolar disorder (formerly referred to as manic depression), an illness that led him into and out of various institutions and greatly affected his ability to produce the work he's so dearly loved for. His collaborations with Lou Reed and Yo La Tengo were intriguing, but so was his quiet kinship with Kurt Cobain, an equally troubled fan who took to wearing a dirty T-shirt hand-illustrated by Johnston to dozens of public appearances throughout the '90s.
I began looking for clinical research examining known artists with medically definable symptoms of mental illness. In 1993, Dr. Kay Jamison of Johns Hopkins University published Touched with Fire: Manic-Depressive Illness and the Artistic Temperament, a densely researched work focusing exclusively on mental health afflictions in artists, including classical composers and jazz musicians. In 1995, Jamison published a compelling article in Scientific American suggesting that existing research pointed to a very real preponderance of bipolar disorders in creative minds; she went on to earn a MacArthur fellowship in 2001.
Although Jamison's work is fascinating, I was still wondering about rock musicians specifically--did anyone I admired (other than the sadly ubiquitous Kurt Cobain) have a history of such problems? More than a few, it turns out. There are the bipolar blackouts of Kristin Hersh, the acid-induced psychosis of Pink Floyd refugee Syd Barrett, Nick Drake's fatal overdose of antidepressants, the dark and delusional world once inhabited by Brian Wilson--even those poor saps in Badfinger lost half their members to suicide after years of wrestling with depression. Then my mind turned to talented musicians I personally knew, and the list was equally long and distressing.
The first person I thought of was 30-year-old Wayne Magnum,* my companion at Daniel Johnston's last Seattle show. Magnum was a modestly successful musician who I viewed as one of the most perceptive pop songwriters and naturally gifted vocalists in Seattle. He was also one of the freakiest guitar players I'd ever met: sloppy, self-taught, beautifully discordant, and consistently unique.
Five years before I met him, Magnum was found screaming and naked on his parents' porch, convinced that secret audio codes were being transmitted to him through electrical outlets. He believed that the subliminal messages he saw in newspaper headlines and heard in David Letterman's punch lines were signs that something really "cool and beautiful" was about to happen. Instead, he was legally committed to Harborview for several weeks, diagnosed with bipolar disorder, and released on lithium (a powerful psychotropic medication he still takes to this day) to an outpatient maintenance program.
Talking with Magnum about the long-term effects of a lithium diet and the experience of being committed against his will makes for sad, disturbing, hilarious, and just plain fascinating conversation. But it also raises many more complex questions about how fans, artists, the medical establishment, and mainstream society view the relationship between musicians and mental illness. Do we romanticize the idea of the tortured artist to such an extreme that we're convinced a person's best work is typically conceived during periods of emotional distress? Are artists disproportionately affected by genuine, clinically definable states of mental illness? How do the socioenvironmental factors of drug and alcohol use factor in? Can artists really harness these problems and apply them as creative tools?
Magnum has mixed feelings about the way mental illness and artistic ambitions often align in the public's eye. "I don't mind it, but I definitely think it's overly romanticized," he says. "I enjoy the fantasy of the mad artist or whatever, but it's also so exaggerated."
The broad endurance of that myth is a huge obstacle for therapists who treat musicians. Delia Gerhard, a Seattle-based counseling psychologist who specializes in treating musicians, says her clients often come to her believing that they will lose their creativity once they get healthy. "I have to focus on dispelling that myth and amplifying the fact that it takes a truly healthy person to be really creative," she explains. "That myth has been with us for a few centuries now and is almost a part of the schooling of artists. It falsely encourages the idea that self-destructiveness is a way of being expressive."
Of course, the classic mode of self-destruction in rock circles typically involves a bottle, straw, or needle. But what if some scenarios viewed as inevitable clichés--hedonistic indulgence followed by failed attempts at rehab--are really the sad cycles of a troubled musician vainly attempting self-medication?
"Absolutely," affirms Linda Phillips, a nurse and founder of Nuçi's Space, an Athens, Georgia-based clinic that focuses exclusively on the mental health needs of musicians. "A lot of what we see is depression or bipolarism, and we also see a lot of drug and alcohol problems which are a direct result of self-medication. If someone's an alcoholic or addict, they need treatment for chemical dependency--but they also need treatment for depression. It's been my experience that if we can get the depression taken care of, the other problems are much more quickly resolved."
After a period of depression, insomnia, and a great deal of introspective solitude, Magnum began exhibiting many of the classic symptoms of bipolar disorder--including auditory and visual hallucinations, and the hallmark manic episodes that make the illness so strangely suitable for artists. Challenging the myth of the tortured artist and successfully treating musicians afflicted with bipolar disorder is even harder when you realize that some of the disease's symptoms can in fact enhance creativity.
"Accumulating evidence suggests that the cognitive styles associated with hypomania (namely expansive thought and grandiose moods) can lead to increased fluency and frequency of thoughts," writes Kay Jamison in the Scientific American article. She also notes that patients in manic states tend to rhyme and use other sound associations, such as alliteration, far more often than healthy subjects do. One study even showed that patients used idiosyncratic words nearly three times as often as did control subjects.
The disturbing truth is that bipolar illness and creative accomplishment share certain features: the ability to function well on little sleep, the focus needed to work intensively, the presence of unconventional or irreverent attitudes, and a lack of self-censorship that allows for a great deal of elasticized thought. Passionate artists aware of this paradox may stubbornly refuse treatment or stop taking medication when they realize that drugs stabilize their creative mood swings. It's an essential quandary to consider when treating mentally ill artists, and one that could clearly use further study.
While under the care of his concerned parents, the television began sending Magnum the "personal messages" that eventually sent him over the edge. "I remember deciding to take off my shoes because Jesus had no shoes," he says. "And then running around [my parents' neighborhood] singing 'I Want to Be an Airborne Ranger.'" Things got ugly when he stripped naked and smashed a window, and his parents began to fear for their lives and his. "I felt I had lost all impulse control at that point," recalls Magnum. "I just wanted it to stop." He was placed at Harborview, an experience that was terrifying and inspiring and that ultimately changed his approach to creating music--for better and for worse.
"I felt that it gave me the right to be a crazy musician, as stupid as that sounds," he says. "It was almost like a fucked-up rite of passage--all of a sudden everyone thought it was okay that I was so weird, so I figured I should embrace that whole thing and try and use it. I have used words that I wrote down [while I was hospitalized], and I'm more comfortable with exploring stranger subject matter, which is good."
Phillips says patients will often think they're being extremely prolific during a manic phase. "But when they come down, they realize a lot of what they've done is unusable," she says. "Getting healthy is much more practical, creatively speaking."
Magnum agrees. Although his delusions gave him plenty of rich source material, he firmly believes it's important to be in control when it comes time to physically create. "The truth is," he explains, "you can't do anything organized when you're having a psychotic episode. I don't think van Gogh was actually painting paintings when he was losing his mind and cutting off his ear. You have to be sane to actually create."
So where do musicians go if they're having problems?
Magnum and many other artists I've talked with share a concern that the medical establishment can be too quick to prescribe psychotropic medications (including antidepressants). If a musician does need medication, it should be prescribed and monitored by a doctor who understands the unique needs and fears of the patient but doesn't allow the patient to romanticize his condition or sabotage his own treatment. It's also perfectly plausible that what a conservative psychiatrist views as a need for a prescription is really a need for intensive, specialized therapy incorporating an artistic perspective (and perhaps drug or alcohol treatment).
Jamison, Phillips, and Gerhard agree that musicians should always ask potential therapists or psychiatrists about their experience in treating artists, their skill level in handling chemical dependency issues, and their philosophical stance on the use of psychotropic medications. Artists shouldn't be afraid to ask questions and take responsibility for informing themselves about the quality and construct of their healthcare. It's recommended that you write your questions down before you speak or meet with a mental health professional and, if possible, bring a trusted friend to take notes during your meeting.
The websites of Nuçi's Space (www.nuci.org) and Seattle Mental Health (www.smh.org) are excellent starting places to learn more about options and seek appropriate referrals. Delia Gerhard, the Seattle psychologist who was interviewed for this article, can be reached at 789-3690.
Because many musicians are on limited incomes and may have little or no insurance coverage, low-cost options should be explored. Country Doctor Community Health Centers operate two clinics that can sometimes help out low-income patients with mental health needs; for more information, call the Capitol Hill clinic (299-1600) or the Carolyn Downs Family Medical Center (299-1900).
The following organizations have a broader focus on mental illness, but also sponsor support meetings around the country and can be helpful in recommending good matches for artists: the National Alliance for the Mentally Ill (703-524-7600), the National Depressive and Manic-Depressive Association (312-642-0049), and the Depression and Related Affective Disorders Association (410-955-4647).
For musicians seeking out nonjudgmental, specialized help with drug and alcohol problems, there's the Musicians' Assistance Program (www.map2000.org/home.html) and the MusiCares Foundation (www.grammy.com/musicares). A lot of local folks also recommend the services offered by Valley Medical Center, a nonprofit outpatient program (800-469-3979), and Lakeside-Milam Recovery Center, which offers inpatient and outpatient programs (425-823-3116).
* Subject's name and some details have been changed to protect his identity.