This chapter describes creativity in bipolar disorder as a paradox, encompassing both negative and positive aspects. The negative facets relate to suffering, dysfunction, and production loss, while the positive aspects stem from the creative, artistic, and scientific achievements of individuals living with the disorder. This paradoxical relationship will be discussed from a process ontological perspective and the strange loop model by Douglas Hofstadter. The model emphasizes the intricate and dynamic nature of bipolar creativity that emanates from the interplay of brain-level processes, ecological influences, and social factors. Accounting for this complexity allows to envision bipolar creativity as a processual, ever-evolving, and innovating ecosystem. As a heuristic, the dynamic strange loop model has the potential to guide future research within the emerging transdisciplinary Convergence Mental Health paradigm. Two examples demonstrate the model’s applicability for clinical innovation driven by bipolar creativity.