A Borrowed Life

I was told that I am light in a body;
But “Why am I in such pain?”, I ask.
They say: “Because you are living a life that is not your own.”

“Over the last two weeks, how often have you felt down, depressed, or hopeless?” During my stay in an emergency psychiatric unit due to my suicidal ideation, I was asked to fill out a PHQ-9 for the first time in my life. In the tiny room with off-white furnishings and the antiseptic scent of sanitizer, I could peer through a clear plastic window on top of the wall. There, I watched a middle-aged woman with dirty blonde hair typing at her computer while laughing and chatting with her coworker behind her. “Bet they are laughing at my case,” I thought. I then continued to reflect on this surreal situation: did I actually try to buy charcoal to kill myself? What was I thinking?

After a week, I was released with a diagnosis of Anxiety Disorder, a bottle of purple pills, and mandatory therapy for three months. From here, I embarked on an on-and-off three-year quest to figure out what was going on with me. “I am fine; My life is fine.” I told almost every therapist I have worked with, “but I just have this chest pain and my mood can become very off from time to time.” 

Years into therapy, I had acquired the vocabulary to describe what had happened to me. I understand big psychology words like “parentification”, “attachment style”, “neuroplasticity”, and “parasympathetic nervous system”. I had acquired a cabinet of pills to treat different symptoms: purple pills for my anxiety, yellow and pink pills for different kinds of chest pain, and blue pills for my sleep. My pharmacy cabinet looked like a vibrant rainbow, yet my heart remained as stoic as a stone. Occasionally I was able to cry during a therapy session; the cathartic kind of crying. Then the pain and tension in my body would ease up and give me a brief break. I learned that any negative emotion that is repressed and not allowed to be expressed outwards in a healthy manner would turn inward, compress, and start damaging you from the inside until it is finally allowed to come out and be released. I also realized that a person can store these unresolved feelings for years, or decades… and when they finally come out, it is as if they were never altered. They have never diminished with the passage of time.

I looked inside of myself and saw the bottled-up emotions like an endless dark tunnel, which I had no idea how far back I had to traverse through. 

• • •

The Scarlet Sage Herb is a local apothecary in San Francisco conveniently located along Valencia Street on my commute from work to home. It was my aromatic sanctuary. Herbal aromas, from the sharpness of eucalyptus to the calming embrace of chamomile, and the comforting warmth of cinnamon to the earthy richness of patchouli, weaved together like a fragrant tapestry. It became a little ritual of mine to stop in there for a couple of minutes to enjoy the smell of herbs before I headed back home, a weekday ritual that transcended the mundane and gave me a brief moment of peace in the bustling city. The store also had a loft area where divination readers read people’s fortune, which I intentionally avoided because it was too “woo-woo”.

On a Wednesday after work, or it could be Thursday. I couldn’t remember, but it was one of the later weekdays. I was bathing myself in the aroma of herbs and suddenly heard a cascade of shimmering soprano-like notes dropping from the loft. My hands were shaking involuntarily and my breath shortened. What is this? Like a sailor drawn to a siren’s song, I drifted up to the loft. To my surprise, no dreadlocks, frankincense, or any kind of hippie stereotype I was expecting appeared before me. A lady wearing an Irish tweed cap greeted me. “Are you looking for healing?”, she said while smiling softly. I guess yes? Smoothed by the large monstera roots that covered the loft and charmed by her calming presence, I started to ramble about my pain in the chest and my incessant anxiety. She calmed me down, asked me to sit down, and then re-started her siren-like singing. 

I had no idea what to expect, but my hands kept shaking. Then I started to burp, big and loud, one after another — “How unladylike I am” I thought — but I really, couldn’t control it. “Let’s get your father’s energy out of you, shall we?” She paused and spoke the first English sentence since starting the session, and then slowly shifted back to the arias that pierced through my body.

I passed out almost immediately after I got home. I didn’t meet any fairy, angel, or deity in my dream, nor did I acquire any instant enlightenment. Yet, the next morning, I encountered the first miracle in my life, a miracle I used to pray for in tears: the heavy stone in my chest was gone. The whole day was followed by flowing ecstasy, and everything became so warm and lovely. The sounds of honking taxis, animated chatter, the rhythmic footsteps of hurried commuters, dogs chasing each other at Dolores Park, and kids giggling by the train station. I could hear the deep and soothing tenor of Louis Armstrong singing in my heartstrings, smooth as a well-aged bourbon.

I see skies of blue. And clouds of white, the bright blessed day, the dark sacred night. And I think to myself, What a wonderful world.

Indeed, what a wonderful world. How come I never noticed it?

• • •

The next therapy session was around the corner, and I had no idea what to tell my therapist other than that I probably was cured by some woo-woo magic. “How are you doing?” “I am doing amazing, you know? I feel I am alive!” I imagined how the conversation between my therapist and I would play out. But before talking to her, I still have the questionnaires to fill in. 

“Over the last two weeks, how often have you felt down, depressed, or hopeless?”

Ah. Yes. 
It suddenly clicked.
I’ve seen this question week after week and had always rated this question a 0 or 1. But that day something clicked in me. Ah…. yes, that word is “depressed”. I had been “depressed”! I had been “depressed” as long as I could remember.

In Plato’s famous cave allegory, prisoners are chained inside a dark cave, facing the wall. They have been there since birth and can only see the shadows cast on the wall by objects behind them, which are illuminated by a fire. The prisoners take these shadows to be the only reality because it’s the only thing they’ve ever known. They don’t know what the sun looks like. Just as I didn’t know how un-depressed felt until the stone in my chest was lifted.

I almost cried my lungs out in that therapy session. I asked that poor therapist again and again “How come you never noticed I am depressed?” “How come I never felt alive?” “What happened to me?”

Depression is seen as a “Mood Disorder” in Western medicine. In the Psychiatry’s “Bible”, the DSM (The Diagnostic and Statistical Manual of Mental Disorders), Depression is described as “usually experienced as a mood lower than normal; patients may describe it as feeling “unhappy,” “downhearted,” “bummed,” “blue,” or any other terms expressing sadness”. For me, looking retrospectively, depression is the loss of the ability to feel emotions of all kinds. It’s something more like numbness. It’s the feeling of indifference depicted by Albert Camus in The Stranger: “Maman died today. Or yesterday maybe, I don’t know. That doesn’t mean anything. Maybe it was yesterday.” Life became a series of events that I just have to go through, or sometimes push through. And I couldn’t figure out why I was doing the “life” thing at all. 

Years later when I was back to graduate school studying psychology, I found literature on early cross-cultural psychopathology studies emphasizing the apparent rarity of depression in Eastern cultures. Cross-national comparative community studies found that the prevalence of lifetime depression in Taiwan and Korea was 1.5% and 2.9%, respectively, as opposed to 5.2% in the United States.[1] For my culture, survey of psychopathology cases was undertaken in 12 regions of China in 1982 and replicated in seven of these regions in 1993. Of the almost 20,000 people surveyed, only 16 reported having had a mood disorder at some point in their lives.[2] Such findings may suggest that the rate of depression in Asia is much lower than in the United States. However, I don’t believe depression, or at least depressive symptoms, is that rare among Asians. I believe the Western assessment system for depression probably doesn’t work that well for the Eastern population.

The Western conceptualization of mental health relies on the notion of dualism, considering the mind and the body as separate entities — the psyche and the soma. Not until the past decades, did pioneers like Dr. Peter Levin and Dr. Bessel van der Kolk start to popularize the idea of “The Body Keeps the Score” and the mind-body alignment. In non-Western cultures lacking differentiation between the two realms, it was no surprise that researchers tend to highlight the more widespread occurrence of somatic symptoms.[3–6] 

My therapist at that time couldn’t give me a thorough answer, but she assured me that anxiety and depression can happen hand in hand and that I was getting the right treatment.

“I don’t want this life,” I looked down at my tea and looked up at my therapist “I don’t like any aspect of it.”

“How so?” She nudged me.

“Because…” that day, those big psychology words floating in my brain finally registered, on how sensitive children become inscribed into “adult” roles, taking care of or comforting bewildered and under-functioning parents while ignoring their own needs; on how the “model minority” unconsciously achieve and overachieve to become what the society deemed worthy; on how I was burdened by my family’s legacy of survival and conditioned by the environment to self-repress. ⁣⁣I slowly muttered, “Because I have been living a life that is not mine.”

The Latin root of the word “depression” is deprimere. It means “being pressed down”. For me, what was being pressed down was not my mood, but my interests, my values, my sensitivity, my life, my humanity, my soul, and my body, which had been screaming in pain.

Now I finally found a name to tame.

————

[1] Weissman MM, Bland RC, Canino GJ, et al. Cross-national epidemiology of major depression and bipolar disorder. Journal of the American Medical Association. 1996;276(4):293–299.
[2] Zhang, W. X., Shen, Y. C., & Li, S. R. (1998). Epidemiological investigation of mental disorders in 7 areas of China. Chinese Journal of Psychiatry, 31, 69–71.
[3] Kleinman A. Neurasthenia and depression: a study of somatization and culture in China. Culture, Medicine, and Psychiatry, 1982;6:117–190
[4] Pfeiffer W. The symptomatology of depression viewed transculturally. Transcultural Psychiatric Research Review 1968;5:121–124
[5] Mezzich JE, Raab ES. Depressive symptomatology across the Americas. Arch Gen Psychiatry 1980;37:818–823
[6] Bhatt A, Tomenson B, Benjamin S. Transcultural patterns of somatization in primary care: a preliminary report. Journal of Psychosomatic Research 1989;33:671–680