I want to re-open this post to bring attention to a comment that James has sent (April 18, 2008), where he talks about his concept of having “caves” in our mind that constitute our “persona”. I found this metaphor intriguing, and I want to share this with you.

Article History: Originally Published November 22, 2007
In a previous article, I said that I’d write separately on what Suni submitted (”Some of the best writers and artists have undiagnosed or untreated mental issues… I am scared to death to be fully cured because it will take away what I like about myself”) and a question Quint asked via email (”Taking medication can alleviate the depression, but it also changes perception and personality. Are there trade-offs? Is the gain worth the loss?”)

There are two aspects of an important question raised by Suni, Quint, and many of you who have lived with both the “gifts and burdens” of the depression experience. These two aspects are:

1) Does medication interfere with my creativity, and ultimately, my personality, if I believe that medication alleviates a factor (depression) that enables my heightened sensitivity of my life experience?

and

2) Does depression play a role in making me more creative, given that I seem to have a heightened sensitivity of the life experience when I feel depressed?

The reason why I wanted to break this question down into two parts is because we must address the individual components of this complex question if we want to clearly see where we choose to stand on the answer to each individual component.

Before I begin, it is important to disclose that I’m writing from my personal experiences of having had severe depression, having taking antidepressants as well as receiving psychotherapy treatment, having had a relapse from depression, and currently being “in remission” from depression. Fortunately, I’ve formed a habit of regular journaling throughout my life, which means I have documentation and a historical written record of my own “creativity” at least through the written word. When I consider how critical writing is as my main creative outlet, retaining the ability to express myself creatively is extremely important to me.

First: Does medication interfere with my creativity, and ultimately, my personality, if I believe that medication alleviates a factor (depression) that enables my heightened sensitivity of my life experience?

Quint shared this article with me, called “I miss depression” by Tim Bugansky and particularly:

It’s been four years now since I began a course of treatment, swallowing daily a white pill that changes not only my brain chemistry, but also the very ways I perceive the world, the ways the world impacts me. Besides all the questions antidepressants raise about reality and perception, “mental illness” and normalcy, my personal reality is that I am different now. Antidepressants altered my existence.

Tim said that “Depression isolated me within myself, yet through its ever-present melancholy, it also made me feel completely connected to the world.”

When I was on an antidepressant, I experienced side effects that actually led me to explore a new dimension that I previously ignored: spirituality. At the time, I did not know that the strange dreams I was having while on medication was a side effect of the medication. I put a lot of weight into the “meaning” of some dreams, perhaps more than I should, although I could also argue that those dreams could very well be my psyche’s way of purging all the garbage that I could not allow myself to purge during my waking hours.

This shows that we are the writer of the meanings of what we experience. If I recognized the side effects as they really were, I would not have explored alternatives to make sense of what I was experiencing (vivid bizarre dreams and sleep disturbances). In a way, my ignorance of “what actually was” led me to explore a new possibility that became enriching. Even afterwards, when I realized “what actually was”, this did not take away from the growth that I had experienced as a result of my original ignorance.

I wrote creatively when I was on medication therapy, and my writing seemed to oscillate between several qualities: “spiritual exploration and healing” (for example, this poem I wrote) and “lots of anger needing to be expressed about what happened to me” (for example, memories of childhood emotional abuse experiences here, here, and here).

Medication can be tricky, because one person can get relief while retaining a sense of self and connection to the world while another person on the same dose can get relief while paying a price of loss of sense of self or disconnection from the world. This is why I’m thankful we have many more medication options to choose from today when compared with twenty years ago, because in many cases, we don’t have to “settle” or pay an exorbitant price to get relief from depressive symptoms. The trick though, is to recognize that “apathy” and feeling of disconnectedness from the world is not the same as “depression relief”.

Now: Does depression play a role in making me more creative, given that I seem to have a heightened sensitivity of the life experience when I feel depressed?

Back in 2001, a friend who started antidepressant therapy asked me the same question Suni and Quint had asked. At that time, I wrote an article in response, called, “No longer fighting the waters”. Notable excerpts from my article included my early observations of how much depression permeated my writings while I was depressed, and the true nature of what I thought was “a beautifully sad veil of the world”:

We may write prolifically and appear more creative when we were depressed. These expressions had remained our only outlets to communicate when we had shut ourselves off from the world. When I had revisited my writing during a depressed state, I was amazed at how dark and depressing my writing was. Poignant? Sensitive? Yes, but overshadowed by despair and dread permeating each sentence.

I concluded the article with the following:

Depression was being on a boat in stormy waters. You were in constant fear of capsizing. Normalcy is being on calm waters. You can sit still and rest, because the boat was no longer rocking. At first, the water may seem was too quiet, everything may seem too quiet. Then, you re-shift your focus from this new quietness, and look to the horizon for all the places you can go and explore.

Let the quietness come. Let the living come. Let the joy come. Let the changes come. Creativity was never a part of the “temporary”. Creativity is always a part of you. Depression was always a part of the “temporary” and is never a part of you. You can now sit back and enjoy the scenery instead of fighting the waters.

I came to this conclusion after experiencing a relapse earlier that year (2001) and with professional help, recovering from the relapse of a depressive episode. If you go to my personal account, “Misdiagnosis and Back: My Journey Through Depression” and scroll down to January 2001, you’ll find a piece of writing I had done during this relapse. That was how I saw myself. That was how I perceived the world. Were the words strong? Poignant? Dramatic? Yes. Was the piece cleverly sad and even darkly beautiful? I thought so, at least the part where I used this metaphor,

“I am a poisonous plant, I sicken a healthy being when they come in close contact with me.”

I had forgotten about this metaphor, but earlier this year, I wrote one of the most popular articles here called, “I’m Here to Remind You that You Are Not Your Illness” where I used a plant metaphor.

My personal experience tells me that the experience of depression heightened my sensation and perception of a particular shade of the color of the world. Particularly, I became highly sensitive to the suffering and pain in the human experience, because my own human experience was shaded by the feeling of suffering and pain.

The “burden” of depression while I experienced it was the veil it cast upon my eyes, such that I saw mainly sadness and despair in all aspects of my human experience.

Sometimes this sadness was so intense that I was propelled to exorcise my demons, at least temporarily, by writing it down and getting it off my chest (or more accurately, out of my head). Intensely-shaded perceptions make for intensely-shaded feelings, which make for intensely-shaded self-expression. Thus I have a slew of strong pieces of writing, all of which share the characteristic themes of pain and suffering of the human experience.

The “gift” of depression once I recovered from it was my ability to appreciate and be grateful for no longer being in depression’s stormy waters, and to remember enough of it to empathize with those who still fight against depression’s storm without falling prey to its poisonous grip.

There are two big differences between the writings that I’ve considered most important and that have been written “with” and “without” depression.

First, the tears that accompany a piece I’ve written “with” versus “without” depression are different.

The tears that came when I wrote, “Sick of Suffering” were tears of pain and despair. The kind that says, “please end this pain because I don’t want to end my life.”

On the other hand, the tears that came when I wrote one of my favorite pieces, “Divine Comedy” (link out to another one of my blogs) were tears of healing and inspiration. The kind that says, “I see suffering in the context that it is. I see Me as more than my suffering. I can even be grateful for this suffering because it steeled my will to live - and live well.” Another piece I wrote that falls into the same category of “inspired writing not depressed writing” is “That I Am” (link out to another one of my blogs), which I used to compete in a speech contest earlier this year.

Second, I’ve noticed that pieces I’ve written “with” depression has a “timeliness” to it, while pieces I’ve written “without” depression is “timeless” for me.

Today, when I read “Sick of Suffering”, tears that used to come no longer come to me. There is, of course, a possibility that “Sick of Suffering” touches someone who may be experiencing what I had experienced, and as a result, seeks help. In this case, sharing this writing becomes important to help those who suffer from depression know that they are not alone, and that someone else has experienced what they are experiencing, and that they CAN get through this.

On the other hand, I get choked up every time I read “Divine Comedy”. What I’ve written in moments of depression-free inspiration is enduring and even strengthens me against the stressors that lead to a downward depression spiral.

In conclusion, I’ve put depression and creativity in the following context for myself: My creativity comes through me and from me; NOT through depression or from depression.

A couple of months ago, Dr. Jonathan Leo contacted me about an article he had published that asks a very important question on the relationship that we (including myself) have come to take for granted: chemical balance and depression.

The journal article is called, “The Media and the Chemical Imbalance Theory of Depression.” It is a follow up to another article published in an open source scientific journal (PLoS Medicine) about the serotonin theory of depression.

The following is an excerpt of my response to Dr. Leo about his article.

Dear Jonathan,

I’ve read your paper and find your premise intriguing. Even though I’ve been trained as a scientist and also have experienced depression as a patient, I can honestly say that I’ve never questioned the semantics used around depression, as your paper questions. (Before I continue, I’ll also declare a potential conflict of interest since I used to work in the pharma industry and currently provide consulting services to biopharma companies in the area of medical affairs.)

I’m saying this without citing any sources or references, but rather based on personal experience of having received both pharmacological agents and psychological (cognitive) intervention. While I do think there is some sort of a “chemical imbalance” that occurs in a condition such as depression, I don’t believe that serotonin alone (or even in conjunction with an array of neurotransmitters) can provide a simple enough answer to “cause” depression. …Thus your demand to distinguish between “causative” vs. “correlative” is extremely important to address.

I also believe that depression is not a chemical problem alone, nor is it a sociological problem alone (i.e. “lack of willpower” or “oversensitive individual”), but a complex condition that may very well include genetic predisposition, chemical pathways, sociological context, and a person’s emotional make-up (which obviously can hardly be adequately objectively quantified to be scientifically examined). It is unlike certain cancers where a genetic defect leading to lack of a tumor suppressor protein then leads an individual to develop a cancer.

One of the “benefits” of the unproven chemical imbalance hypothesis has been an encouragement of those to seek treatment who otherwise may never have sought help for depression. However, this also goes to the other extreme, to the point where doctors are too quick to prescribe an antidepressant because they wanted to see the next patient and make their per diem “patient quotas” and break even financially as practicing doctors. Hence the overprescribed society we live in today.

Dr. Leo is now working on a paper about ghost writing and has edited a book called, Rethinking ADHD

I’m interested to what you think about Dr. Leo’s research, and questioning the “chemical imbalance (causative) theory” of depression.

Originally published on February 2, 2008

Recently this article has received many comments and seems to resonate with many who may not have asian parents, but can completely identify with the dysfunction described!

(… And I am sorry that you can.)

I am re-introducing this topic to generate additional dialog with readers via the comments section.

Originally published: May 26, 2006 @ 12:33

Ever since I reported on the high suicide rate of Asian American students, I’ve been thinking of writing something for them that addresses cultural conditioning.

Here is what I have observed from my own experience and coming from a first-generation asian immigrant family:

• Many asian parents are amazing at using manipulation, guilt, and self-pity to get their kids to do whatever they want, or at least make them most miserable if the kids disobey. They aren’t necessarily being malicious on purpose, they just learned it from their parents.
• I need to live the life I want to live, NOW, or I’ll die living the expectations of my parents, and do a crappy job at it anyway because I’d be miserable.
• Most families - asian or other - are pretty dysfunctional. I know I’m not the only daughter who has ever fallen victim to a mentally unstable mother. Knowing that I’m not the person this has ever happened to makes me feel less alone and more optimistic about overcoming these mental and emotional obstacles I’ve built over the years.
• I get depressed because I turn anger inwards, on myself, instead of expressing anger and setting boundaries.
• The harder I resist and try to change who my parents are, the harder I fail, because I can’t change my parents to get them to love me the way I want them to love me.
• I have learned to count my blessings and appreciate friends and my spouse for loving me the way that I want to be loved.

Up until a few years ago, I would get into fights with my mother whenever she starts to “talk trash.” What I mean by “talking trash” is making condescending statements or saying things to elicit guilt in other people or being very negative or wallowing in self-pity. She knows how to push my buttons, and I let her push my buttons.

One afternoon we were speaking on the telephone, and my mother started talking trash. She made comments like she shouldn’t have brought us to the US, and how we don’t behave like caring children because we never visited, and how her friends’ children treated their mothers so well compared with how we treated her, and if she died we probably wouldn’t care one iota.

Sound familiar?

Normally, my brain would pick up the signal to pick a fight and try to prove to her that she was wrong and that she should look at her own behaviors and that we were good kids.

For some reason I got sick of resisting that day, and something else came out of my mouth. I started agreeing with her.

I agreed that she shouldn’t have brought us to America. I agreed that we were crappy kids. I agreed that she was all alone and being ignored. I agreed that we might as well have come out from a rock. I agreed with whatever she was complaining about, and I offered no solution or reconciliation or amends whatsoever.

And she grew quiet and we ended the conversation rather well because we had no argument.

The toughest part about this technique is working with my ego to swallow the insults and offer no resistance and agreeing with something I didn’t agree with. But with practice, my ego got over it and my mother’s manipulation loosened its grip on my sanity.

The strange thing is that our relationship has actually improved since I stopped resisting, even when I have offered her no behavioral changes on my part.

I’m not going to lie and say that my emotionally and mental well-being has completely recovered from the different things I had endured with my mother when I was a little girl. To this day I still work on my mental conditioning and internal messages on a daily basis - so we’re talking about 30+ years and counting. But each day, I get a little better and I unlearn a little bit of the cruel messages I had learned to believe about who I am.

And it can get better for you too.