Sometimes you can see it, in the eyes or hands suddenly restless. Mostly you hear it in a voice hollowed by the change.

My friend is an artist, a musician chiefly who tinkers with visual arts on the side. His work is wildly creative and unorthodox. When things are going well, his personality follows suit.

But there are times when an emotional curtain drops and behind it dwells a person for whom hope is a shrinking silhouette on a receding horizon.

It’s hardly unusual. For centuries, the stereotype of the mercurial artist has haunted our civilization, a figure as capable of fits as of masterpieces. But how true is it?

Sometimes it manifests subtly, as in musician Artie Shaw’s self-description that he was “cursed with serious-mindedness.”

Other times it’s far more severe. Virginia Wolff, Vincent Van Gogh, Ernest Hemingway, all committed suicide. Salvador Dali was considered schizophrenic. Pollock, Warhol, Cezanne, Plath, Beethoven, Goya, Michelangelo, Berlioz, de Kooning, Styron, Rothko, the list is long and storied.

Are artists mentally off-kilter in some way?

Dr. Arnold Ludwig, psychologist, professor and researcher at Kentucky Medical Center and author of “The Price of Greatness: Resolving the Creativity and Madness Controversy” spent a decade interviewing a thousand-plus people from a variety of fields, looking for correlations in mental state and vocation. He found between 59 to 77 percent of artists, writers and musicians suffered mental illness or “mood disorders” while among the other professions it was 18 to 29 percent.

The American Journal of Psychiatry found much the same, citing problems that fueled creativity while shattering personal lives.

A 2007 Stanford University study compared bipolar patients with a group of healthy people and found graduate students in creative fields showed more similarity with the bipolar group than with healthy students in less creative disciplines.

Joseph J. Schildkraut, an esteemed psychiatrist at Harvard Medical School proposed that art evolved as a way of accentuating the emotional significance of communal rituals and still expresses shared spiritual and sacred meanings, though few of those exist in modern "secular" societies. The artist’s examination of life’s meaning in this vacuum comes at a great cost, he maintained.

The lifestyle in particular can be trying. There’s a lack of socialization at times, a certain solitude plus a sporadic income that is paltry in most cases. Poverty is well known as a genesis of stress, indicated most often in the strain finances place on marriage. 

And then there’s the toll requested by the muse, a brutal honesty and introspection that can tax the psyche and soul.

But if this is indeed the case, then what is to be made of art’s role as a therapeutic tool? Can visual representations help construct a meaning to mental conflicts and favor their resolutions? 

Psychiatrists around the globe have believed so since the late 20th Century and that trust is still backed up by survey.

A 2008 University of Granada study also seemed to indicate it can help. Elizabeta Lopez Perez worked for a year with 20 acute mental patients who offered their own interpretations of classic works.

In the end, their projections of their inner world and repressed desires actually showed an ability to control otherwise unruly emotions and thoughts.

Closer to home, professionals used art therapy to help children work through stress from Hurricane Katrina and cited the progress made. Similar examples abound.

Personal experience seems to validate some of these hypotheses and contradictions. Absorption in writing, music or visual art allows a type of escape, a suspension of time and outside concern in the focus on the moment. Sometimes the release of emotion and travail into the art created can bring a type of swing into another state.

And it’s also true that sometimes the greatest emotional trials can produce the best of your art, when the passions nearer the surface break through in greatest abundance. Not always, but often.

And sometimes, sanity seems more possible as a result.

So then why doesn’t the immersion work for many of these artists? Shouldn’t the “therapy” of artistic pursuits have quelled Van Gogh’s outbursts, kept Wolff on the riverbank, Hemingway’s shotgun on the rack and Plath’s head out of the oven?

Maybe it did for a while. Maybe things would have been far worse without it.

And while mental illness is no predicator of creativity, artistic inclinations aren’t necessarily a dictate toward destruction or depression. Schildkraut found a wide range of personalities among the creative people he studied, regardless of tendencies.

Ultimately, what matters to me isn’t so much my friend’s art, but that its pursuit keeps his voice among us.

Because for all of us, the only thing that makes any of this bearable is each other.