I Am Not A Myth - One Person's Story of Depression, Creativity and the SSRI Trade-off

I've done something to my shoulder and I'm not supposed to be typing but there's something rattling around my head and I need to get it out.

A minor twitter spat. A friend I know fairly well, with whom I've talked about MH issues both online and in person, was talking about her experience with SSRIs, and said that contrary to her expectations, they had not deleteriously affected her creativity. Normally, I would have been content to say "I'm glad that's working out for you" but she RT'd something from another of her followers which basically said "it's a myth that SSRIs affect people's creativity." Wow. Red Flag to a bull. Needless to say, the resulting argument with the third party didn't go well, and I excused myself from the conversation with my friend, and used the block button on the third party when they would not stop.

For a start, not all brains are the same. Not all "Depression"s are the same. I strongly believe - though I am not a medical doctor and I have no proof, I've just lost a lot of my life to it, and have spoken to a lot of people who also suffer - that "Depression" is not, in itself, the disease. I speak of "Depression" like I speak of "Fever" - yes, it's a real and debilitating thing, but it is the symptom of a multitude of underlying causes, with a myriad of treatments which may or may not be effective for fevers with differing causes. If the fever is the result of an infection, antibiotics may be necessary and life-saving; if it's the result of sunstroke, they will be useless. Similarly, anti-depressants may be hugely effective in treatment of depressions with origins in biochemistry, but useless in depressions with environmental causes. Everything does not work for everyone.

This person kept insisting that it's "A Myth" that SSRIs affect creativity. A "dangerous myth" that may prevent people from seeking life-saving medication. Where. Do. I. Start. I mean, I start 1) talking about What Depression Is and 2) talking about What Creativity Is. You can't go making blanket statements like that until you've defined what you mean by those terms. For my money, denying or suppressing information about real side effects that some people experience is also an incredibly dangerous and irresponsible thing to be doing. It is not "A Myth" - it is my direct personal experience. SSRIs deleteriously affected my creativity.

You know what else deleteriously affected my creativity? DEPRESSION. I'm not talking about Melancholy, I'm not talking about Hiraeth or beautiful sadness or grieving or those other states and moods that can help or even spur creativity. I'm talking about the black hole can't-get-out-of-bed cold grey fog that kills all emotion, including creativity, stone dead. Effective, appropriate medication administered under the control of a psychiatric professional, or depression? No contest. You cannot create if you are not even alive.

However, I also have to say that it was my personal experience, with long-term (several years') use of SSRIs that they did affect my creativity. This was a side effect, for me. I usually go through about 2 sketchbooks a year; this is my normal rate of creativity. I have one sketchbook for the entire 4 year period I was on SSRIs. I tend to write at least one novel or fan fiction epic a year. I started a few but did not finish one during the meds years; I completed my first NaNoWriMo the year I came off them. I'm not going to hide that or handwave it away because it might potentially "scare someone off getting treatment." But what I am going to do is explain *how* it affected me and why, because like all depressions are not the same, not all Creativities are the same.

1) SSRIs affect your sexual response. This is so well established that I remember it being in the literature in my meds packages. My libido dribbled away to nothing. I stopped dating because without sexual attraction there was no point. At that point, I lived in a shared house with no lock on my bedroom door. The other day I was trying to remember how I ever masturbated - let alone how I had sex - in that house. The shocking answer was, for nearly 2 years, I just didn't. It was like living with a barbie-crotch. Dead downstairs. I got to the point where I started hanging out on Asexual communities, asking "is this my future now?"

This is one of the ways in which my creativity works: my libido is like an engine that fires the whole thing. Sometimes literally (hmm, I'm not even going to pretend like I haven't spent the past few weeks drawing 17 sketches of a certain person currently fuelling my erotic imagination) sometimes more as a kind of petrol which fuels other interests - architecture, music, botany - from which I get an almost erotic creative charge. No libido, no erotic charge, and the drive in that creative engine of mine just withers away.

2) SSRIs can be effective at controlling OCD thought patterns and behaviour. No shit, Sherlock! That's how they're advertised on the tin. When I say "I'm a little bit OCD" I do not mean that I like all my pencils to face the same way. I mean "Right now, I'm not actually as bad as that year I spent washing my hands so often - sometimes multiple times every hour - that all my skin crinkled up like the cracked floor of of a dried out lake and bled if I touched it." I started drawing in high school - strange, ornate, writhing patterns - as a way of diminishing anxiety and making the bad thoughtworms go away. Ditto writing - a way of transforming the anxious thoughtworms of Bad Things That Might Happen into little stories with endings worked out and little bows of logic tied on all the loose ends of the plots.

Creating, for me, is a kind of compulsion. It started out as a way of allaying fears and anxieties, and ended up as a kind of itch I had to scratch. OCD means that I got good at things I did over and over and over. Play the same riff on the guitar for 4 hours straight, you will eventually master it. Compulsively draw the same pop star 17 times in a row, you'll get good at portraits. All of my drawings, all of my stories, all of my songs, came from those strange little mental loops that would not leave me alone. Sometimes it's stupid! (17 paintings of Carlos Dengler! Why!) Sometimes it's profound. (Why would I have to chase down every last remnant of a wood that disappeared 200 years ago? I don't know, but an online nature magazine published the results of that weird compulsion.) I know it sounds nuts! But that's how it works for me. (And I was delighted to read an interview with a long-time hero, Bill Drummond, describing his own art in exactly the same way. Compulsions.)

This is the double-edged sword. Any medication that is effective enough to stop the thoughtworms and control the OCD also kills that strange urge to do a thing over and over which results in doing art enough times to make it good. No more OCD looping, no more drawing something over and over until it's perfect; no more playing a riff until I've got it; no more having to finish writing the story because I need to know how it ends. Take away the petrol of libido and the engine doesn't run. Take away the looping brain, and the engine turns over, but ignition does not catch.

This is, of course, only one side of the story. During the SSRI years, I finally got and held down a stable, full-time, permanent job. Having stable employment meant I  could buy a home of my own, and got out of the endless flatmate roulette. These environmental factors vastly diminished stress - the diminishing of stress ameliorated my mental health. But it was a trade-off. The benefits outweighed the side effects at that point. But it does not erase the fact that I experienced those side effects.

This is my story! This does not have to be your story. Everybody's brain is different. Different people's depressions are caused by and cured by different things. Different people's creativity works in different ways, and manifests itself in different ways. (Sorry I didn't do this in the form of a cute comic! That's not how my depression manifested itself either.) If your creativity is fuelled by a different source than this weird combination of OCD and lust, SSRIs may do nothing at all to it! If you are in a point where you are so depressed you cannot even create (where I had got to when I went on SSRIs) you have nothing to lose by taking medication which may turn out to be life-saving! But do not PRESUME to tell me that my experiences are "A Myth" because they do not conform to your experiences. That is the most dangerous bullshit of all.