Why is mental illness so closely associated with creativity? Andreasen argues that depression is intertwined with a “cognitive style” that makes people more likely to produce successful works of art. In the creative process, Andreasen says, “one of the most important qualities is persistence.” Based on the Iowa sample, Andreasen found that “successful writers are like prizefighters who keep on getting hit but won’t go down. They’ll stick with it until it’s right.” While Andreasen acknowledges the burden of mental illness — she quotes Robert Lowell on depression not being a “gift of the Muse” and describes his reliance on lithium to escape the pain — she argues that many forms of creativity benefit from the relentless focus it makes possible. “Unfortunately, this type of thinking is often inseparable from the suffering,” she says. “If you’re at the cutting edge, then you’re going to bleed.”