“There is this myth that you have to be anxious to be creative, that you have to be depressed to be a genius,” he said during PAMA panel.

A month after taking to Twitter to criticize the media’s description of his work as “sad boy music,” Mercury Prize-winning singer-songwriter James Blake spoke at the annual symposium of the Performing Arts Medicine Association (PAMA) on Sunday at Chapman University in Orange County, Calif., to discuss his own experience with depression and anxiety and to encourage artists struggling with similar issues not to suffer in silence.

Speaking as part of a panel called “You Got This: Managing the Suicide Crisis in the Arts Population,” Blake, 29, spoke openly about his depression leading to “suicidal thoughts” while on tour early in his career. “I was taken away from normal life essentially at an age where I was half-formed,” said the London-born musician, who achieved international renown with sparsely soulful tracks like “Limit to Your Love” and “The Wilhelm Scream” when he was just 21. On the road, he explained, "your connection to other people becomes surface level. So if you were only in town for one day and someone asked you how you are, you go into the good stuff…which generally doesn’t involve how anxious you feel [or] how depressed you feel.”

Blake added that unhealthy eating habits, a common peril for touring musicians, exacerbated his mental struggles. “I would say that chemical imbalance due to diet and the deterioration of my health was a huge, huge factor in my depression and eventual suicidal thoughts,” he said. “I developed [dietary] intolerances that would lead to existential depression on a daily basis. I would eat a certain thing and then all day I would feel like there was just no point.”

PAMA began in the 1980s as part of the Aspen Music Festival and was originally focused on health issues among classical musicians. It has expanded its mission in recent years to include outreach to musicians and performing artists from all genres and disciplines. So when Blake offered to participate in this year’s symposium, PAMA board member and program chair Jennie Morton jumped at the chance to include his perspective.

“He’s very passionate about getting information out there to musicians,” Morton said. “And he’s very passionate that the artist’s viewpoint is shared in any discussion about this and that it’s not just coming from medical, healthcare [and] psychological practitioners.”

The “You Got This” panel addressed what many studies have suggested is an underreported epidemic of mental health issues among working musicians. A 2016 U.K. study reported that more than 70 percent of musicians surveyed had experienced panic attacks or high levels of anxiety, and one of the panelists, clinical and performance psychologist Patrick Gannon, addressed what he called an “emerging epidemic of suicide” (45,000 in 2016 in the U.S. alone) that disproportionately affects musicians, among whom the suicide rate is three times higher than the national average.

According to the experts at PAMA, there are many reasons why musicians and other creatives are more predisposed to mental health issues and suicide than their peers: the physical and mental demands of the craft, lack of access to healthcare, and a culture that romanticizes substance abuse as a symbol of artistic free-spiritedness. There is even a growing body of evidence suggesting that there may be a neurological link between creativity and certain kinds of mental illness. “People with the capacity for divergent thought -- which is kind of the definition of creativity -- they have vulnerabilities in their psychological makeup that can predispose them to issues of increased anxiety [and] depression,” Morton said.

Speaking from his own experience, Blake cautioned against conflating creativity with psychological suffering. “There is this myth that you have to be anxious to be creative, that you have to be depressed to be a genius,” he said during the panel. “I can truly say that anxiety has never helped me create. And I’ve watched it destroy my friends’ creative process too.”

For Blake, help came in the form of EMDR therapy -- an experimental treatment that uses physical triggers like rapid eye movement to "reprocess" traumatic memories, which "really broke the back of all the traumas and repressions that had led me to depression in the first place,” he said. He also credited the positive influence of his girlfriend, with whom he lives in Los Angeles. With her help, Blake said, he was able to sever ties with people who were enabling his unhealthy behavior and manage his career in a more sustainable way. “Honestly, a lot of catharsis just came in telling lots of people to fuck off,” he said. “And saying no. Saying no to constant touring. No [amount of] money will ever be enough.”

He is among the artists speaking out now because, “we’ve reached a critical point,” he added. “We are the generation that’s watched several other generations of musicians turn to drugs and turn to excess and coping mechanisms that have destroyed them. And there are so many high-profile people recently who’ve taken their own lives. So we, I think, have a responsibility to talk about it and to remove the stigma.”