2.17.2009

melancholy

"One of the most potent brickbats in the depression wars is the notion that depression fuels creativity. In fact, [psychiatrist Peter D.] Kramer says that the impetus for writing Against Depression came in the years after the success of his Listening to Prozac, which examined how antidepressants effect people's sense of self. Whenever he gave a reading or a lecture, someone in the audience would invariably ask, 'What if Van Gogh had taken Prozac?' This question, of course, is shorthand for 'If we medicate depression, will we dampen the creativity that often exists alongside it?' "
from "The Depression Wars" by Field Maloney

if we're going to take a look at depression, we're going to have to choose which facet we look at. there is no standing outside of depression and seeing it whole; it's too big, too complicated to take in all at once. it's the same as describing all the people and events and objects on earth by going out into space and taking a satellite photo. while there's nothing inaccurate about the picture, it does not and cannot capture all the details and nuances that shape life; it doesn't show the subtle rhythms and interrelationships that define what it is to be alive today on planet earth.

same with depression. we can look at it as a public health problem, and certainly it is. according to the World Health Organization, depression is the leading cause of disability worldwide. its symptoms are detrimental to the normal functioning of human beings at best, and incredibly crippling or potentially fatal at worst. it affects all aspects of a person's life - work, school, relationships, family, and such basic functions as eating and sleeping.

so, as a society, how can we justify the fact that depression often remains socially taboo and frequently undiagnosed and untreated? after all, the function of any society is essentially defined by the health and well-being of its constituent members, and any society which is beset by a condition that adversely affects the ability millions of its citizens to work and live would do well to speak openly about it, rigorously search for an effective treatment, and go about eradicating it. this has generally been the case in the past, at least in america - there was a "Great Race" for a polio vaccine beginning in the 1930s, and similar efforts effectively eradicated malaria in this country. even such a hot-button and terrifying illness as HIV-AIDS has been candidly discussed by presidents and major news outlets, its research has been amply funded, and effective treatment demanded by the general populace.

why, then, is this not the case with depression?

i think that depression and mental illness in general is a different animal - it behaves differently, its life cycles and breeding habits are different. it is not as easy to pin down. a person is either HIV-positive or -negative, for example; there's no room for subjective interpretation. depression does not reside in a set location in the brain or body, there is no depression virus to pinpoint and study. most of all, unlike many diseases, it does not interact in the same way, or even in similar ways, with each sufferer.

humans are incredibly complex organisms, even discounting the fascinating phenomenon called "consciousness" or "the mind." we have large brains, and their functioning is not wholly understood. even if it were, i think we would still have a difficult time grappling with the constellation of physical ailments, emotional effects, and various states of mind associated with this thing we call "being depressed."

so, in order to fully understand depression, we have to look through a different lens, take a photograph from a different angle and try to understand it that way - namely, through the lens of the subjective human experience unique to each of us.

but if depression is different for everybody, can it really be concretely diagnosed? can we even say to two people, people with different experiences and circumstances and emotions, that they are suffering from the same illness? and what about such specialized forms such as post-partum depression, seasonal affective disorder (which wins the award, by the way, for worst acronym EVER), manic-depression or bipolar disorder, and atypical depression, which has its own set of maladies associated with it? are these the same illness, or something completely different?

these aren't questions i have answers to. i just believe they're questions that need to be asked in order for us to gain a foothold on the mountainous task that is understanding and combating depression.

so let's take off our health-inspector goggles for a minute and look at depression through the naked eyes of people who have been affected by it, either in their own lives or the lives of someone they care about.

there are a few schools of thought about the link between depression and creativity. they can basically be boiled down into three categories:

  1. those who believe a biological link between depression and creativity exists;
  2. those who do not, or who think the evidence is not conclusive; and
  3. those who believe a link exists, but it is not strictly biological or does not exist on a 1-to-1 ratio

i would put myself in this last category, although if further research were submitted that seemed to verify or strongly suggest a biological link, i wouldn't be in the least surprised. i am most skeptical of the second position. from what research i have done so far, it seems that creative people (artists, writers, musicians, film-makers and so forth) have higher incidences of reported depression or depression-like symptoms (often called melancholy or melancholia in the past), as well as higher rates of suicide. according to the excellent book The Noonday Demon, the profession with the highest reported rate of suicide is "writer," and within that the sub-category of "poet," often perceived within the literary community as being the most emotional and personal sort of writer.

my attitude is also indicative of my personal experiences with both depressive and creative types, who for some reason or another are my chosen peers. it seems to me, from the limited cross-segment of humanity that i am personally acquainted with, that a person suffering from one of these maladies is far more likely to suffer from the other as well.

why is this?

hypotheses abound, as with any controversial topic. since any idiot can form an opinion about any topic, there are as many opinions on this, it seems, as there are people on the planet. different philosophies posit different answers, as do disciplines as diverse as evolutionary biology and archetypal psychology. let me summarize one of the theories i find most fascinating.

it is one that is loosely based around concepts of meaning and meaninglessness, as put forward by existential philosophers, absurdist artists, and medical doctors alike (although each, to be sure, puts their own unique signature on the discussion). Eric Maisel, Ph.D., posits that creative people, or "creators" as he calls them, "experience depression simply because they are caught up in a struggle to make life seem meaningful to them. People for whom meaning is no problem are less likely to experience depression. But for creators, losses of meaning and doubt about life's meaningfulness are persistent problems - even the root causes of their depression."

Maisel (who, appropriately, is the author of a book called The Van Gogh Blues) sees the problem, then, as an experiential one, one with its root causes in the common topics of thought and activities of creative people - namely, sustained deep thought about the basic mysteries of the universe, not last among them problems of meaning, often phrased as "why are we here?" or "what are we here to do?" or "what ought we do with our lives?"

while the good doctor here seems a bit "self-helpy" (he is, after all, a clinical psychotherapist), he does raise an interesting point. one need look no further than the basic tenets of existentialism to see parallels which are, thankfully, much more well-developed and substantial. merely call to mind the idea of nausea or existential terror to see what i mean; it basically describes the mental state of a thinking, feeling individual when confronted with a seemingly absurd or meaningless world: one of disorientation, dread, and ennui. this is, of course, a fair summary of what many of us would term "depression."

(wikipedia tells me that existentialism has its roots in buddhist and early christian thought, as well as early secular philosophies. so it's easy to see that depression - and, more than that, depression's effects on living, feeling human subjects - has a long history within scholarly thought.)

i think that probably the most eloquent author on the subject of meaning is Soren Kierkegaard, although i may disagree with his ultimate conclusions on the source of meaning or truth. Kierkegaard basically states that humans have lost meaningfulness in their lives because of the rise of objective thought - the idea that truth can be proved by scientific measurement or logical rigor. but human thought and experience, he believes, cannot be formulated in terms of math or even history. meaning, for Kierkegaard, is something that rises from human choices and interactions. in The Sickness Unto Death, he writes:

"Is despair an excellence or a defect? Purely dialectically, it is both. The possibility of this sickness is man's superiority over the animal, for it indicates infinite sublimity that he is spirit. Consequently, to be able to despair is an infinite advantage, and yet to be in despair is not only the worst misfortune and misery - no, it is ruination."

according to Kierkegaard, despair is something that is intrinsically tied into consciousness - if you cannot ponder your own existence, you can never experience despair. there has to be what he calls "a spirit" and what i would call "a mind" for despair, or depression, to work upon. without a reflection upon one's mental state, despair is impossible.

(i tend not to agree with thinkers who say that humans have a premium on thought, self-awareness, and reflection. we certainly don't have a premium on emotion. i do think that in the human animal, the awareness of one's "self" or "ego" is more acute, and more acutely painful, maybe just because we have words and concepts that sharply delineate it. but i digress.)

of course, other authors have much to say on the subject, from Dostoevsky and Kafka through Nietzsche and on down the line to thinkers as diverse as Miguel de Unamuno y Jugo, Martin Heidegger, Albert Camus, Samuel Beckett, and of course Simone de Beauvior and Jean-Paul Sartre. while i'll touch on some of these authors and many others at length in later entries, let me move on for now.

out of existentialism came absurdism, which can be reduced without too many casualties to the statement that the efforts of humanity to find meaning in the universe are condemned to failure because no such meaning exists, and hence these efforts are absurd.

whereas existentialism, whether espoused in its atheistic or theistic form, states that it is essential that humans create meaning for themselves, absurdism posits that it is possible for humans to create meaning, though not essential. (nihilists, who take absurdism to its most extreme conclusions, say that this, too, is impossible.)

i can hear you protesting out there, asking what this all has to do with depression - which is, after all, something fairly well-understood, that can be statistically diagnosed and treated, that can indeed be labelled and categorized, a legitimate sickness for which one can receive federal disability benefits if one is so inclined.

and i'm going to ask you again to step out from behind the lens of the clinician, the pill doctor, the internal therapist or social worker that we've all internalized to at least some degree. really step out from there, even if it isn't easy, and just take a look as a person, someone who has to live and breathe and work and fuck, and ask yourself this:

doesn't it seem probable that on some level - not the chemical level or the evolutionary biology level or the social level - that the way that we see things has something to do with depression?

"see" isn't the best word. "perceive" would be better. how we perceive the events and circumstance of our lives has a huge bearing on the actions we take. it ties into our memories, our internal monologue ("self-talk" i think is the PC, psychologist's-office version), the way we interact with others.

and isn't our philosophy, or our system of belief and understanding comprising both rational thought and emotions, something that determines to a large extent how we perceive the world?

i think it definitely is. and if that's true (if it has any inherent meaning, ha ha ha), then depression isn't the same as AIDS or cancer or polio. it's actually a part of the human condition - but even that's not quite right. it would be better to say that it's a part of the subjective experience of individual humans, something that's different for everyone.

i'm not saying that depression and creativity have a link that you could point at or hold in your hands. all i'm saying is that people who spend a lot of time thinking about and reflecting upon the human condition - whether or not there is truth, for example - and who have even a seed of doubt about the answers to these questions are going to be more prone to doubt everything, even the input of their sensory organs.

to be constantly in doubt is a difficult thing. i'm a confirmed skeptic, so i can attest to that. would it be so odd if people who think like this - always questioning and doubting - were more prone to a condition which, while having an actual physical basis in brain chemistry and electrical interactions within the brain, is basically founded on an abstract yet profound doubt about whether or not anything could ever matter?

that's something that i always get into when i'm depressed. i think nothing matters, i don't matter, it couldn't possibly matter what i do. i feel insignificant and apathetic. and, of course, it has a real social element, too. if you can't really effect tangible, positive change in your situation, you learn to accept your situation, but it has a profound effect upon how you interact with the world in the future. you stop trying to change things because you have learned that it doesn't matter what you do. in laboratory studies of dogs, it's called "learned helplessness" and i think that has something to do with depression, too.

i realize this isn't a perfect argument. there's the obvious chicken-or-the-egg type question: is it my worldview that makes me depressed, or is it depression (or brain chemicals, or physical determinism) that defines my worldview?

i think it's easiest and most accurate to put it like this: depression and creativity are probably both phenomena which occur in a similar type of mind, one which happens to be possessed, not just by artists, but by thinkers of all stripes who admit even an iota of subjectivity into their worldviews. and i think this description could basically be applied, with more or less accuracy, to each and every human on the planet. that's what i think Kierkegaard was getting at: we all, by virtue of being human, have the capacity to doubt, to wonder, to create, and also to become depressed.

whew! thanks for staying with me through all that. it helps me to feel like there's an invisible readership out there, even if it's just a huge lie that i tell myself. i'd love any sort of feedback - first responses are fine, as are more reasoned-out arguments. tell me i'm completely wrong if you'd like, tell me off, just please try to be honest in your criticisms. i promise i won't cut myself over it or anything like that, har har.

i don't know what the next entry will be about. probably more on authors and artists. i think there's a wealth of literature out there about depression and mental illness that i'm really eager to dig into further. or maybe i'll get into a little bit more physical, meat-and-potatoes type research stuff. also, i want to include some resources for people dealing with depression who don't necessarily have the means or the inclination to resort of pharmaceutical treatments - that way, even if this whole blog / book project doesn't amount to anything, it won't be a complete waste of space.

as for the book i want to write, i'm still feeling my way around the idea. roald dahl said writing a book is like taking a walk and looking at a scenic vista - first you see it from this path, then from this valley, and finally you reach a peak where you can see the whole thing clearly, but first you have to take the walk and explore all the different angles and viewpoints. and i think he's right. just like depression: there isn't just one way to look at it. there is as much potential creativity, and potential melancholy, as there is human experience.

and how do you even begin to THINK about quantifying that?

okay. until next time, loyal readers, enjoy-a this Goya. it's called "Saturn Devouring His Son" and i think it is one of the craziest paintings of all time.



4 comments:

Phillip said...

Ok, HERE WE GO!

1. "depression does not reside in a set location in the brain or body, there is no depression virus to pinpoint and study." This is kind of interesting, because it is very likely that in the eventual there will be something that allows us to target set locations, and there very well might be tests done. What would Mr SOREN KERIERIERIRKGAAAAAAAAaaaA11!onegard say, if depression were God? Mental illness and I go way back. In spite of my long history with psychiatrists and psychologists, I've never persued the details of my diagnosis, because I worry that it will change my perspective and mess with a good thing. Is that fear, or a fidelity to faith?


2. from what research i have done so far, it seems that creative people (artists, writers, musicians, film-makers and so forth) have higher incidences of reported depression or depression-like symptoms (often called melancholy or melancholia in the past), as well as higher rates of suicide. according to the excellent book The Noonday Demon, the profession with the highest reported rate of suicide is "writer," and within that the sub-category of "poet," often perceived within the literary community as being the most emotional and personal sort of writer.

It is interesting to talk about this, because poets/writers are aware of this image already. This is what poets and writers 'are like'. This is an inherited image, and will have an impact regardless of biology. Of course, now we're talking about seperating biology from 'not biology' as though there's robot parts and living parts in your brain :P Also, the activities specified are highly reflective activities. Perhaps the reflective process is directly involved? Also, there is a higher incidence of atheism/agnosticism in those professions, which could come into play considering the threat of ETERNAL DAMNATION.

3.hahaha, I'm commenting on this as I read it. hilarious that both of my previous comments are addressed. Especially funny that you have Kieeieierkaagaaaaa1rd referenced specifically. There's nothing 'PC' about the term self-talk, by the way. In fact it's a little insulting. How you treat the process of therapy and medication indicates that you have had very little direct experience with either.


4. Remember, cancer and polio were not always cancer and polio. In the past they were demons and curses.

Sorry it's taken me so long to get to this. I hope to see you soon.

ihatejournalism said...

I didn't read all of what you wrote-- I'm too tired-- but I will say this: Once my first therapist realized that my problems were not only caused by trauma, but were also caused by over-examination of the self and the world-- that's when things started to become effective. Or at least he earned some of my trust. Quote: "You are the first teen (17 at the time) I've talked to whose main problem is an essential fear of meaninglessness. You can only laugh because you fear nothingness."

And that was about as useful as poor, naive Aaron was to me. (I became a case study he presented at a conference-- "Rumination and Its Effects on Maintaining a Depressive Mood" or something like that. Just an interesting note)

elly_or_esther said...

With this post a few thoughts came to mind, kind of parallel to what you were writing about.

First thing is a memory of what my therapist said to me once. One of the more important things a person who is depressed should do is be able to separate feeling down versus feeling depressed. I know in my past that when I felt off or a little down, that I would immediately say to myself that I'm getting depressed again. That thought would stick in my mind and would start this cyclical thought process that a) I'm depressed b) I'll always be depressed c) things will never get better d) I'll feel even worse. The hardest thing to do is trying to learn how to separate these two emotions.

The second though was about self perception/purpose. After thinking about it a while, I think that my depression came about in middle school. I had a sense of purpose in life, I knew what I wanted to be and where I stood in the world. Only after years of feeling depressed and trying to reach out to other people did my sense of purpose begin to diminish. I grew tired and apathetic. I read about existentialism, questioned what I could actually hope to achieve in my life. Things that used to drive me became less meaningful.

I do know that I have become more self critical, self analytical as time passes. This might because I'm growing more tired of how i feel and am searching for some justification. I understand less and less where I'm heading but I'm starting to realize some of the reasons of where I've been (if that makes sense.)

As for the writers/artists, I slightly twitch a little when people attribute their gift to their depression (not that you did.) I guess it's because of the quote from I <3 huckabees "When am I not myself." Depression does seem to change yr mindset, or at least your focus. It just seems impossible, dangerous to question what someone could accomplish if they were actually feeling "normal." Impossible because assuming that you would accomplish things differently if you felt better but there isn't really evidence for that (see quote.) Dangerous because you're left with this feeling of inadequacy and helplessness for not 'achieving your potential.' Or even more, dangerous because you feel that without this depression that you could not be creative, achieve what you have now.

Anyways, your post has given me a lot to think about.

His Majesty King Mob said...

there is no possible way i can reply to these incredibly thoughtful and much appreciated comments in comment form, so i'll have to devote an entry to it some day. i just wanted to say thank you guys for slogging through this post - i really value your insights and viewpoints, considering that my insights and viewpoints are limited to, um. well, just my own head, i guess.

love,
carmen