Creativity - looking for opinions

[Ulyssesm90]

Okay, so:

I've had terrible anxiety for about 7-8 months or so now, sometimes centering around my health (i.e. hypochondria), but not specifically all the time. I have panic attacks every few days, and sometimes these last for a long time (like a day, two days) until I intervene in some way. I went to my doctors for help, and we tried a lot of different things. With my first doctor (I didn't "doctor shop" as they say, I left him because after unsuccessful medications he literally called me a "basket case") we tried Celexa, which I could only bear to take for 5-6 days because it was making me abnormally restless (and I'll note I tried really hard with all of these to go as far as I can), and then we tried BuSpar + Wellbutrin, the Wellbutrin was fine but the BuSpar but me straight to sleep every single dose (I even missed work one I wanted it to work so badly). With my next doctor he gave me Xanax as needed and we tried Clonazepam twice a day for a while. That was the first thing that really helped, but we had to stop after two months or so because my doctor didn't want to have to increase my dose and after the two months I was starting to get some side effects (memory loss, scared the daylights out of me but thankfully went away after I quit).

Anyway, there's some background. Now, as I'm typing this I'm realizing just how much medication I've tried in the past and it seems to make my question a little silly, but nonetheless I'm still terrified by it. I'm a musician, and I am very fortunate to make a good living doing what I do. For me music is what I am going to dedicate my life to, without a doubt, and in it I am not ashamed to say I bear my soul. Sometimes it's the only real form of communication I have, my saving grace if you will (though I can't say I'm partial to the word "grace"), and so far people enjoy what I have to offer them. It is undoubtedly a creative process, one which for me transcends everything else; I'm very fortunate to have this and would gladly give everything to hold on to it. My anxiety is interfering with my life, and now after 8 months with my music, which is my life. I am becoming more and more disabled, and something has got to give.

I have an incredibly intense fear of going on a long tern medication again; my doctor is recommending Effexor XR as it's one of the drug classes I haven't tried yet. On the one hand I am aware of the possible success that these drugs can offer, though I've had little success with them myself as of yet, but on the other hand I can not get it out of my mind that I am, at least while taking this medication, fundamentally altering my mind, that which is most sacred to me. For all my own anxieties and self-doubts and depression, I like who I am and I DON'T want that to change. I don't want to lose that spark that drives us, that flame that burns fires and moves people to act. My fear is that by going on a medication for a long period, which on the one hand I'm more motivated to do than ever and on the other hand I avoid like the plague, I will "level out". I'll lose myself, I'll no longer be who I am "supposed" to be, however you want it it frightens me. I'm sure others out there must have wondered the same thing, perhaps in a more general way or perhaps in a way more specific to their own lives. Do you think this is a rational fear? If you have experience taking a drug like this long term can you tell me how it affects you? I realize that might be a kind of personal thing to ask, but I would be ever so deeply appreciative if you might do so. I feel like my life is on the line, and I'm only 22 years old!

Thank you,
Ulyssesm90

Oh also P.S.: I forgot to mention, I did CBT for a while too. I was with a psychologist but only for a few months, as he left my state at that time. I did find that helpful, we mostly did exposure therapy, along with some mindfulness exercises. I still carry the lessons he taught me to this day, and practice them regularly. I recognize that more important than anything, well at least in my opinion, is correctly faulty and negative thought processes. But at the same time, here I am. For the longest time I will admit that I was denying having anything wrong with me, hell I think that's where the hypochondria came from frankly, because I refused to accept panic disorder as my diagnosis and "knew" that "something" else just had to be wrong. I thought that even if this is just anxiety that whatever it is I can just get over it and move on, but I am now accepting that perhaps I, like my doctors have told me, do have an actual 'disorder'. I, for some reason, dislike this idea, and some part of me still insists that if I do have a disease of the mind I shouldn't need medication; it's kind of a "if [insert xyz artist with a sever mental disorder] didn't need Effexor, why should I?!?" thing, but I also realize the irrationality of that thinking, and, more saliently, my quality of life right now is just abysmal, especially if I am alone (which, in my line of work, is nearly constantly), and I just can't keep going on like this.

[insights]

I saw a doco some years ago which examined this very question - do antidepressants help or hinder creativity. From memory they assembled 6 well known artists, authors and musicians and the result split fairly evenly between helped, hindered and no effect.

Creativity is an ephemeral thing that can be affected by many things, and it is indeed possible that easing your anxiety and depression will rob you of it to some degree. How many achy-breaky heart songs would have gone unwritten if the depressed composer was on antidepressants? Of course the reverse is also true, anxiety/depression might be impeding your creativity. Unfortunately, the only way to find out how they will affect you is by trying one for an extended period.

If Wellbutrin worked well why didn't you continue it without the Buspar, which probably didn't do anything beyond the sedation anyway?  BTW-I'm surprised you were able to tolerate Wellbutrin. It is often a great drug for depression, but most with anxiety find it way too stimulating.

Ian

[Ulyssesm90]

insights - I stopped the Wellbutrin because when I went back to my doctor to tell him that I couldn't take the BuSpar anymore that was the visit in which he insulted me and showed me that he wasn't taking me very seriously by calling me a basketcase; I hasten to add that fortunately with my current doctor (with whom I've been longstanding) this is far from the case as he is genuinely respectful and a good listener too (so hard to find these days!)

It's funny, because today is a day where I don't feel like I need anything. Not a perfect day, but pretty damn good, and if every day could be like this then I wouldn't even be on this forum, but I know that in only a short time - but hopefully not too short - things will get dire again, they always do. I'm sure this must be a conflict for many people starting pharmacotherapy, this feeling that they don't want to take a drug for a long period of time for a problem they only have intermittently. That said, if you had heart disease you wouldn't stop taking your heart meds because you "feel better" because there is an underlying problem; I wonder if this is the same way, it's too bad the science is really out so far on what causes anxiety and depression. I'm aware of course of the theories of chemical imbalance in the neurotransmitters and such, but right now they're just hypotheses and not really testable. Anyways, when it comes to your mind everything gets confusing and muddled, I guess that's one reason why I'm so afraid to affect it in such a way.

[insights]

it's too bad the science is really out so far on what causes anxiety and depression. I'm aware of course of the theories of chemical imbalance in the neurotransmitters and such, but right now they're just hypotheses and not really testable.

The chemical imbalance hypothesis was disproved almost as soon as it was postulated, at least in research labs. See: Serotonin: The 'chemical imbalance' myth Unfortunately, the concept still lingers in the popular mythology and even in much of the medical profession.

The best theory we have is that chronic stress hormones exposure kills of neurons in the hippocampal areas of the brain and inhibit the budding and growth of new ones. Antidepressants (ADs) reverse the damage by encouraging neurogenesis. Much of the detail still needs to be worked out, but so far the pieces seem to fit and are consistent with what patients experience when they begin taking ADs. Sadly, because of the backlash against ADs in recent years some of the leading pharmaceutical companies in the field have either abandoned development of new drugs, or put them on the back-burner which is also having an effect on basic research and we might not understand all of the processes for some time.

Ian

[stevo1111]

I interact with mostly PhDs in my line of work and a good number of them are absolute shining examples of the human manifestation of anxiety disorders. Oddly enough, most will outright deny to you that there is anything unusual about themselves... as they scamper off to hide in their offices to work on the same detail for 20hrs per day for 4 months straight.

None the less, an old timer that I've been able to interact with has been on imipramine since the 1970s, and he has done quite well in terms of creativity and accomplishment. David Foster Wallice was openly on Nardil for quite some time and was a modern literary genius. Alternatively, I struggled to get a thing done while on Lexapro and am beginning to find a bit of emotional blunting from long term use of Buspar - decreased motivation but I believe it actually makes me better at remembering things. A close friend was an absolute mental slug on Paxil and nearly failed out of grad school because he kept mislabeling test tubes...

There is a bit of research into Nootropics, or things that make your brain function better. Check out the wiki page, it may of some interest. Although I have no personal experience with Effexor, it seems to have a rather stimulating personality. You may actually find it quite helpful with motivation and mood. In my opinion, if your hunger and passion for doing what you do return and you can get out of your head for periods of time you will be as creative as ever!

It is indeed an absolute shame that pharmaceutical companies aren't doing much research into medication anxiety and depressive disorders as of late. While the current medications are alright, I suppose, some basic scientific research that illuminated even the beginning of understanding would be a major breakthrough. The dollars just don't seem to stack up for them though... Compared to how much we know about doping silicon wafers to make computer chips the brain might as well be a black hole. With modern microscopy you could likely see cells modify in-situ.

[Ulyssesm90]

Wow, fascinating answers, thanks so much! insights - I didn't know that, everything mainstream you find about the monoamine hypothesis pretty much just accepts it as canon, but I hadn't even heard about the neurogenesis idea, which just at arm's length seems to make a lot more sense. I remember them making a big deal about a study done with BuSpar combined with Melatonin supplements as a means of neurogenesis.

Yes, it really is too bad that more good work isn't being done on the subject. When I first started doing some research I came across disorders of the thyroid gland, and what really amazed me was how doctors could quantify a part of the body which so crucially regulates mood; this among other things of course - the thyroid glad influences everything in the body really, autonomic function and your nervous systems etc. But that someone could go to a doctor and present with certain symptoms and the doctor could give them a calculable number as to why they weren't feeling right. Now, obviously when talking about serotonin levels and noepinephrine levels this is a different matter, but imagine if we could equally quantify these, or at least truly realize their role, or if they even play a role at all. Anyway, I find it fascinating that we might one day really be able to understand the mood centers of the brain and help them the same way we help every other part of the body.

stevo1111 - thank you for your comment, it was good to hear about such influential figures like David Foster Wallace taking these kinds of medications. Sometimes I catch myself saying things like "well if Van Gogh didn't need Effexor than why should I?" but then I remember that he ended up cutting his ear off in a fit of mania. And also I have to remember to tell myself that if the drug doesn't make me feel good then I can always come off it and try something else. I didn't know that Effexor had a stimulating effect, but that seems like it's exactly what I need right now. Everyone's comments have been really helpful so far, thank you all very much, it's given me a lot of good things to think about in this exciting but scary time!

[Betsy]

Hey!
I'm 21, in my third year of art school. I'm majoring in glassblowing, and my creativity is obviously extremely important to me as well.

When I was 17 or 18, I was put on celexa (citalopram). I still kept producing inspired work, but I found that my thoughts were a little "cloudy"-I would have a hard time pin-pointing a particular idea I was searching for, or defining exactly what I was thinking about. I also slept. A LOT. Like, 10 or 11 hours a night, which didn't leave nearly as much time as I would have liked for my creative exploits.

I just got off celexa in January, and I feel a lot better. I feel like my head is crisper-the air is clearer. The fog has cleared. Getting off, though, was absolute torture. I had to go on prozac for a while while I weaned off of the celexa because it is so habit-forming, but I had a bad reaction to the prozac and became horribly depressed and even suicidal for a couple of weeks. Needless to say, the doctor took me off that immediately, so I dealt with the withdrawal effects of that pretty fast too. Neither were fun, and that is one reason to be wary of any kind of mind-altering medication, in my opinion.

I still don't feel 100% there, even after going off the citalopram. I'm not sure if it's because of the other medication I'm on (topirimate, for migraines), or if there was some lasting effects of the citalopram. In any case, it's scary. If you can possibly find a more natural way to deal with your anxiety, I'd recommend that. Of course, everyone is different and you might just find the perfect medication for you that doesn't affect your creativity, but if you can help yourself without altering your brain, why risk it? Try more Cognitive Behavioral Therapy-find a doctor that you really trust and like and work with them for a while. Exercise. Talk. And if you need to go on medication, do so, but take the adverse affects and withdrawal pains into consideration. When I first when on anxiety meds, I was desperate and didn't care how they were going to affect me in the long term because I needed relief so badly...now, I wish I had thought about it a little more, though they were good in the sense that they helped me gain some stability.

I hope that helps!