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Zen & the Art of Manic Depression

Kagan Goh

When people ask, “Who are you?”

I answer, “My name is Kagan Goh.”

Invariably, the next question is “What do you do?”

“I am an MD.”

“A medical doctor?”

“A manic depressive. Certified.”

When my MD—that is, my real medical doctor—told me I had an incurable illness that would last my whole life, I decided then and there that I would embrace it as my full-time job, a professional manic depressive, educating people about issues affecting those of us with mental illness. So, here I am.

People are both fascinated and scared of manic depression because it is a mental illness that affects one’s moods and emotions. Perhaps they are afraid that they too have the potential to become crazy. A traumatic event—such as losing one’s job, the death of a loved one, being evicted from one’s home, or a divorce—can trigger a mental health breakdown. Many of us are one paycheck away from living on the streets. Take two steps backward and fall into the abyss. The reality is that we are all standing on the edge of the precipice.

I was diagnosed as manic depressive in 1993, on Valentine’s Day of all days. I prefer the term manic depression to the clinical and politically correct term bipolar, because it more accurately describes my personal lived experience of both the highs of mania and the lows of depression that characterize this condition.

I consider myself an emotional empathic, a chameleon who is able to experience the whole rainbow spectrum of human feelings, from the highs of mania to the lows of depression and every emotional color in between. I find it ironic that I was diagnosed on Valentine’s Day, as most manic depressives I know are obsessed with love. The state of love and insanity are fundamentally intertwined. Perhaps the potent emotions of infatuation and mania come from the same source of love-inspired imagination.

For me, manic depression is an addiction to the love of being alive. I wonder if people prone to addiction are actually addicted to the state of bliss. We become so euphoric from loving life that we fly high like Icarus, only to have our wings melt under the sun’s heat—which sends us crashing down to the despairing depths of depression. The medical profession defines manic depression as a bipolar chemical disorder, but when we’re in love, our body also produces extra chemicals. When we’re afraid, in fight-or-flight mode, or angry our body also produces extra chemicals. ^

Being manic depressive, my body is like a pharmacy dispensing the drugs that people pay good money for—except I get high for free. And my brain’s chemistry is more potent than any black-market LSD, DMT, ecstasy, psychedelic mushrooms, or peyote. Nothing can compare; it’s a drop of water to the ocean. It’s ironic too: most people pay for drugs to get high, while I take pharmaceutical drugs such as lithium or Epival to keep my feet on the ground. The brain carries its own consciousness-altering drugs, including hallucinogens such as dimethyltryptamine (DMT). Maybe the chemicals produced during a bipolar episode induce a heightened state of consciousness: the chemical equation for a spiritual experience.

Imagine your mind is an Open House. Rummaging in the basement, you find a fuse box. Opening it, you flick on the switches and your whole mind, body, and spirit illuminate. I discover I have bright lights I never knew I possessed. I call this brilliance the “genius” mode, in which I have been in such an enlightened state of consciousness that I have discovered psychic abilities and written several screenplays, novels, poetry, and short stories all in the space of one week. Being more charismatic than usual, I attract friends and lovers. My Open House is a jam-packed party. This is what you call mania. Then I blow a fuse, and everyone leaves. I am left in the dark alone, feeling empty and depleted. This is depression. I enter what I call the “idiot” mode. I feel a thousand years old, prematurely senile. My memory is a blank page. I can’t even do the simplest tasks, like count out the right bus fare. I feel stupid. I sleep my life away. I can hear the cruel winds tear through my heart as I wander lost in the wilderness, waiting for my soul to come home to me. I am in the Dark Night of the Soul. My Open House is closed. So, the trick is moderation. To have a satisfied mind and use only as many lights and as much electricity as you need. No more. No less. What Buddhists call the “Middle Path.”

My friend Jen Lam shared an analogy on Facebook entitled Drowning and Trauma. She starts: “So imagine a line of people starting on the sand on a beach and all the way into the water. The folks at the end of the line are almost nearly fully submerged, tiptoeing on the sand, occasionally treading water, trying to keep their heads above water. Along the line, there are some folks with life jackets.” As the tides and storms come and go, those high up on the beach do fine, a few in the middle, falter and stumble, and those further out (people dealing with mental health challenges) even some with life jackets (those with support systems) get swept out to sea. Those at sea appear to be acting irrationally when they shoot out of the water trying to get air, while those on the beach wonder why the drowning don’t just come out of the water.

In some early cultures, people who might be considered mentally ill were valued in their society as mad fools, court jesters, tricksters, and shamans. They played an important role as spiritual healers and were valued by their tribe. Shamans are ambassadors who are able to move back and forth between ordinary states of consciousness and extraordinary states of consciousness. In their shamanic state, they are able to transcend the membrane between sanity and insanity.

In North American society, I am a freak, an outcast. If I was born in a different culture, however, I might have a valued place in society, perhaps as a (dare I say the word) shaman, for I have studied shamanism and mythology and find I have been through the same rites of passage, the same initiations: going to heaven (mania), only to descend into the underworld, the Dark Night of the Soul (depression), to emerge in the Middle Path of Nirvana, where one can achieve harmony and balance by avoiding the extremes. One can find peace of mind. I might sound arrogant, but I feel like a self-taught shaman, able to travel back and forth undetected across the border of reality and fantasy as an illegal migrant worker of the soul. Welcome to a displaced country called the Imagination.

“The mystic, endowed with native talents … and following … the instruction of a master, enters the waters and finds he can swim; whereas the schizophrenic, unprepared, unguided, and ungifted, has fallen or has intentionally plunged, and is drowning.”—Joseph Campbell, Myths to Live By

As the wise mythologist Joseph Campbell notes above, the difference between a mystic and a schizophrenic is that the mystic knows how to swim in the waters of the subconscious while the schizophrenic does not, thus drowning in the self-same waters. As a child, I remember watching a cartoon in which a mouse accidentally fell into a bowl of milk. The mouse paddled frantically, essentially learning to swim. Its persistent motion churned the milk into solid butter, and the mouse was able to climb out of the bowl. I am that mouse. At first, I was drowning in the waters of my subconscious, but as I splashed about, I learned how to swim out of sheer survival. I learned how to swim because my choice was either to survive or to drown. I believe the schizophrenic can become a mystic if only he or she learns to swim.

        People with mental illness have the potential to heal themselves and in the process become healers, mystics, and shamans—either by learning to swim in the waters of the subconscious as initiated by a mentor or, like me, by self-learning through sheer survival instincts.

What might be construed as a mental illness may be interpreted as a spiritual emergence, which has the potential to be a vehicle for personal growth, healing, and spiritual transformation. According to psychiatrist Stanislav Grof, one of the founders of transpersonal psychology, a new perspective is developing that views “mental health breakdowns” or crises as transformative spiritual breakthroughs that can hold tremendous healing potential.

“One of the most important implications of the research of holotropic states is the realization that many of the conditions, which are currently diagnosed as psychotic and indiscriminately treated by suppressive medication, are actually difficult stages of a radical personality transformation and of spiritual opening. If they are correctly understood and supported, these psychospiritual crises can result in emotional and psychosomatic healing, remarkable psychological transformation, and consciousness evolution.” (Stanislav Grof and Christina Grof 1989, 1990).

I had a spiritual emergence in which my third eye was opened. In my mind’s eye, I was made to understand that we are living in crucial times when all souls urgently need to reach satori (the Buddhist term for “awakening”). All of us children of God must transcend ignorance and prejudice to become enlightened, for we are born to manifest the best and nothing less. As the darkness encroaches, the forces of good must rise and shine brightly so we can become beacons for the souls lost in the darkness, guiding them back home to the light. And as each of us awakens and shines, we start a chain reaction, sparking others to ignite. It is not blasphemy but the holiest truth to say that we must all awaken to our true inheritance as children of God to become the Gods that we actually are. We must all awaken to become Messiahs. No one will be left behind, for the universe is the safety net preventing us from tearing through the web of existence. Our civilization is undergoing an invisible renaissance. Prejudice, bigotry, racism, sexism, homophobia will be eradicated with one great leap when we all realize we are not alone but All One.

When I shared the vision of my spiritual awakening with my psychiatrist, he said I was suffering from megalomania and called my revelations “hallucinations,” as if only medical doctors had a monopoly on reality and the truth. He ridiculed my own spiritual faith as “God ideation” or “spiritual delusion.” The majority of the psychiatric establishment fails to acknowledge that there is both an ordinary state and an extraordinary state of consciousness. To one living in the ordinary state of consciousness those living in an extraordinary state of consciousness seem to be living in a fantasy, while those in an extraordinary state of consciousness perceive those living in an ordinary state of consciousness as living blinkered lives trapped in an illusory unreality. This schism is an illusion, for the two realities are just flip sides of the same yin–yang duality. A shaman is an ambassador of the soul who understands and speaks both languages and is able to move between both states at will.

First, we need to ask ourselves, What is madness? Psychosis is commonly characterized as a loss of touch with reality. People with mental illness might be losing touch with ordinary states of consciousness, but they are getting in touch with extraordinary states of consciousness. Perhaps madness is the byproduct of an overactive imagination that is unable to distinguish between reality and fantasy. During psychosis, the insane are unaware they are insane. Psychiatrists call this “loss of insight,” but perhaps the insight the insane are gaining is consciousness into the subconscious contents of their imagination.

Maybe madness has more in common with lucid dreaming (a dream state during which the dreamer is aware he or she is dreaming), in that the insane understand and can interpret the meaning of their visions or hallucinations, the signs and symbols of the contents of the subconscious mind. These hallucinations or visions make sense to the person experiencing them—as if they have the key to unlock the secrets to the meaning of their own dream imagery—but to someone witnessing from the outside, their behavior may seem irrational and bizarre. Just as dream logic only makes sense to the dreamer, insane logic only makes sense to the insane.

Since my diagnosis in 1993, I have had several manic, psychotic, and depressive episodes. I find the term episode humorous, for I liken manic, psychotic, or depressive episodes to television episodes. Just as every television episode has a moral to its story, my episodes all have themes with morals and lessons that I am meant to learn through the experience of crazy wisdom.

As I mentioned earlier, mental illness can be triggered by a traumatic event in our lives. The psychiatric establishment often dehumanizes and pathologizes the person who has experienced trauma as a sick person who needs medication instead of a person with a problem who needs therapy and counseling. Most patients with mental illness are unable to afford psychotherapy. I am not in denial that many people with mental illnesses may need treatment with medications. However, often what these individuals really need is therapy to address and heal their underlying problems and traumas. Without an environment that supports the inner work of healing trauma, there is a tendency for the healing process of the psyche to get stuck, going round and round the same contents without resolution.


Instead of asking someone who has a mental illness “What’s wrong with you?”, it would be refreshing to hear people ask, “What happened to you?”

The first question pathologizes the person, assuming something is inherently wrong with them that needs to be “fixed” or “cured,” most likely by medication.

The first question addresses a sick person.

The second question addresses a person with a sickness.

There is a huge difference between the two because the first one sees the person as “damaged goods” or “broken,” while the second one sees the person as “whole,” as being a person first who happens to have a sickness.  We are not our sickness. 

Now, don’t get me wrong. I am not denying that I have a sickness. I just want to be treated with respect and dignity as a human being. I am not in denial that sometimes medication is necessary in order to lead a more functional stable and balanced life. Just as there are no problem people, just people with problematic behaviors. Never lose sight of our inherent humanity. It is our birthright. To paraphrase one of Eleanor Roosevelt’s quotes: “No one can take away our dignity without our permission.” Never give it up. It’s what makes us human.

I often get this response when I highlight the gifts of madness: “What do you mean mental illness is a blessing or gift? It has been nothing but a curse, a source of suffering and misery. I have symptoms of manic depression and it is just not nice.” Like the yinyang duality of life, there is a positive and a negative side to every equation. That is why my symbol of the yinyang has both a smiley face and a sad face to represent the two sides of this duality: the happy manic side and the sad depressive side of the bipolar condition. I don’t want to be a Pollyanna, painting only an imbalanced and inaccurate positive, optimistic picture, because it’s not a question of either/or. Mental illness is both a blessing and a curse; a gift as well as an illness. I don’t want to give the wrong impression. I work as a mental health worker and have witnessed and experienced firsthand that mental illness is sometimes just that: a terrible, debilitating illness. Oftentimes a person with mental illness is paranoid, delusional, and has lost insight and touch with reality.

Another dangerous—and tragic—downside of the equation is that mental illness has claimed many lives. I myself have contemplated suicide when I was at the edge of the precipice, staring into the abyss of despair. Thankfully, I weathered the maelstrom of my madness and survived samsara. I count myself fortunate to still be alive and kicking today. I also know how traumatic it is to lose someone to suicide.

I don’t want to oversimplify this complex condition as always being a spiritual experience, nor say that people with mental illness cannot experience spiritual emergencies. It is not all black and white. The spectrum of mental illness is a grey zone with a lot of overlap between so-called ordinary and non-ordinary states of consciousness. The argument isn't about whether people with mental illness can or cannot experience spiritual emergencies. It’s about whether the person has insight into their illness? Can the person distinguish the difference between a genuine spiritual breakthrough and a mental health breakdown?

It is one thing to experience visions and hallucinations, but if the person’s delusional or paranoid states are impairing their everyday functioning, one must ask whether this is a so-called spiritual breakthrough/awakening or simply a mental health breakdown? One must be cautious not to glamorize or romanticize mental illness as always being a spiritual awakening. The danger of perceiving mental illness always as a spiritual crisis may prevent the person from seeking help when in fact they are struggling with a mental health crisis.  

According to Stanislav Grof and Christina Grof: “Episodes of non-ordinary states of consciousness cover a very wide spectrum, from purely spiritual states without any pathological features to conditions that are clearly biological in nature and require medical treatment. It is extremely important to take a balanced approach and to be able to differentiate spiritual emergencies from genuine psychoses. While traditional approaches tend to pathologize mystical states, there is the opposite danger of spiritualizing psychotic states and glorifying pathology or, even worse, overlooking an organic problem. Transpersonal counseling is not appropriate for conditions of a clearly psychotic nature, characterized by lack of insight, paranoid delusions and hallucinations, and extravagant behavior. People who require large doses of tranquilizers are clearly not candidates for the new approaches.” 

However, let’s not throw the baby out with the bathwater. People with mental illness could benefit greatly from being supported by Spiritual Emergency Network “helpers” such as professional counselors, mentors, volunteers, and laypeople who could assist them when they are experiencing non-ordinary states of consciousness. Just as shamans often awaken to their gifts as healer though the initiation of surviving an illness, people with mental illnesses could benefit greatly by being supported by a sensitive, compassionate, and understanding spiritual community. This spiritual community would ideally encompass a more tolerant community of health care practitioners. Perhaps shamans and mystics can teach swimming lessons to the schizophrenic. Maybe then the schizophrenic can learn to swim by being initiated through shamanistic and spiritual practices to become a mystic. 

As it stands, people with mental illness are ostracized, stigmatized, and discriminated against by society. When it comes to our rights, we are still living in the Dark Ages. I’d like to envision the day when the Mad Pride movement (which champions the rights of people who identify within the mental health spectrum) will be accepted in the same way the Gay Pride Movement has garnered greater solidarity and acceptance for people living within the gender spectrum in the LGBTQ community. I’d like to envision a time when people with mental illness are not considered aberrations to be hated and feared but are accepted as invaluable, contributing, productive, and unique citizens in their own right.

The illness aspect of mental illness is only the tip of the iceberg. Much hidden potential rests beneath the surface. I refuse to call manic depression or bipolar a “disorder” or an “illness.” I prefer to call it a “condition,” for it has the potential to be a tremendously positive force in one’s life. In my life, I try to harness this untapped source of creativity and spirituality not just to survive but also to thrive by turning this curse into a blessing, transforming my mental health into mental wealth by embracing this all-too-human bittersweet condition called life.

Perhaps people with mental illness are not freaks of nature but instead the next evolutionary stage in humankind. Maybe we are mutants. We are X-Men, who have evolved to the next level of human development. I wonder if people with mental illness are using more of the brain’s untapped potential—unlocking secret hidden powers, psychic abilities, and extrasensory perception. Powers that make us see, feel, and experience things ordinary people are unable to. Perhaps mental illness is a spectrum—one in which everyone has the latent dormant ability to tap into these hidden, unused powers. Perhaps what ordinary people really fear is, if you dig deep enough, we all have the potential to be crazy.

In closing, I quote from author Jodi Lundgren’s Adbusters magazine article Naked Marilyn: “As psychiatry clings more and more desperately to biochemical explanations with an ever-less convincing disregard for the social conditions that foster emotional disturbance, ‘psychosis’ responds with creative resistance. In fact, the therapeutic potential of creativity has long been recognized, even by the psychiatric establishment. But where treatments such as art therapy seek to return the individual to the existing social order, mad imaginings trace lines of flight away from it. As a group, the mad not only envision but live alternatives to the dominant norms. Paradoxically, the health of a society relies on the emergence of such diversity. We may very possibly need this sickness to make us well.”


Kagan Goh

Kagan Goh

Kagan Goh is a Vancouver-based Chinese-Canadian multidisciplinary artist: award-winning filmmaker, published author, spoken-word poet, playwright, actor, and mental health advocate and activist. He was diagnosed with manic depression at the age of twenty-three, in 1993. Kagan has been invited to perform at readings, festivals and on radio, and has published in numerous anthologies, periodicals, and magazines. In 2012, Select Books in Singapore published his poetic memoir, focused upon his relationship with his esteemed father, Who Let in the Sky? In Kagan Goh’s follow-up memoir, Surviving Samsara, he recounts his struggles with manic depression, breaking the silence around mental illness.

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