A crack in the wall. Most people wouldn't even notice it. But for Danielle Hark, it was a spark of inspiration.
Six months after giving birth to her first daughter in 2010, Hark, a writer and photographer from Millburn, N.J., fell into a severe depression. Getting out of bed became impossible. Anxiety struck whenever she considered leaving the house. Thoughts of suicide loomed.
One day in the shower, she suddenly felt she couldn't breathe. "I thought I was dying," she recalled. "I didn't need to kill myself because I was about to be dead."
Hark reached for her phone to call for help, but accidentally snapped a photo instead. Then she noticed the crack and thought, "That would make a good picture."
"Just that one thought and just that one breath helped me to become more present," she said.
Photography didn't cure her depression, but it started her on a journey of recovery — one that she continues today. Taking photographs gets her out of the house, engaging with the world around her, and transforming things that some see as ugly — crumbling paint, cracks in a sidewalk — into art.
Hark has founded a website for photographers affected by mental illness, hoping to raise awareness and encourage others to document their recovery. On Nov. 10, she'll be sharing her story at the debut of a chamber music ensemble focused on mental health.
It's one of a growing number of creative endeavors that are bringing mental health center stage. Most of these initiatives — from theater performances to local art shows — aim to create awareness. But for those with mental illness, such as Hark, who stand at the center of these works as performers and creators, the process becomes a path to healing. It's not a cure, but it provides a sense of control over their lives that can sometimes feel lost.
Performing in a play or taking photos is not the same as taking part in creative-arts therapy, said Rachel Brandoff, coordinator of the art-therapy specialization in counseling at Thomas Jefferson University, but "it's a parallel process in many ways." Creative-arts therapy involves a trained professional who guides and interprets the work. But engaging in a creative work on one's own can still help people find purpose, better understand their emotions, and connect with others.
"People can have a really powerful and transformative experience even if it's not therapy," Brandoff said.
Over the years, Hark has used theater, poetry, and mixed-media art — along with medication and therapy — to deal with depression, anxiety, bipolar disorder, and post-traumatic stress disorder. Every night after her children go to sleep, she spends hours in her basement studio, a routine that gives her structure and purpose.
Philadelphia flutist Susanna Loewy feels the same way about music. Practicing scales for an hour each morning helps her energize and refocus when she's depressed.
Loewy co-founded Ellipses Ensemble, the mental health-focused concert series at which Hark's story will be shared. She hopes music might provide a pathway to recovery for some, the way it does for her.
Short answer: Researchers don't know yet.
Though they've shown creative-arts therapies improve mood and can even lower stress hormones such as adrenaline and cortisol, researchers are still trying to figure out how that happens.
Some studies indicate that creating art allows people to communicate emotions that are difficult to say out loud. Others point to art's ability to distract the mind from negative thoughts. Emerging research is focusing on how engaging in creative work improves connections in the brain — a process called neuroplasticity — and can even help generate new connections — called neurogenesis.
Human brains are constantly thinking about the future, said Girija Kaimal, an assistant professor in the creative-arts therapies department at Drexel University. For those with depression or suicidal thoughts, the future can look bleak. They might feel they are a burden to others or have nothing to contribute. The creative process helps change people's perspectives.
"It gives individuals with mental illness a way to imagine a positive and fulfilling future," she said.
Art also helps people better understand their emotions — like a mirror, reflecting back what they have created.
When Nick Emeigh sat down to write his story of living with schizoaffective disorder, he thought about how to explain the mental illness to someone who'd never heard of it. He searched for the perfect metaphor to describe the overwhelming loneliness and constant fear that no one would understand what he's going through or they might lock him away.
"You're able to connect with what you're actually feeling on a deeper level," he said, "because you're looking for the right words to describe to someone who might not understand."
Emeigh performed the essay in October at an Elkins Park show of This Is My Brave, a national nonprofit that coordinates performances around the country in which people with mental illness share their stories through poetry, essays, and music.
He told a story of devils and angels, traveling into hell through "Untreated Mental Illness Road," and fighting to escape with his sister's help. "I woke up in heaven, and some people call that a hospital," he wrote.
Creating a work of art can also give physical shape to an invisible illness, Brandoff said. People can step outside themselves and turn their diagnosis into a painting or photograph. "It allows them to understand it as a piece of themselves and not themselves entirely," she said.
It took a while for Jasmine Tot to reach that point. She'd often felt depressed in high school, but the illness became consuming when her best friend was killed two days after graduation.
"People didn't want to be around me because I was always upset or sad," she said. "That's when I realized I have to figure this out."
Control came from picking up a paintbrush. Tot would blend colors, paint large strokes, add detail, and by the end, "I know my emotions are on the canvas and I can move forward," she said.
She recently displayed her work at a Philadelphia showcase called The Funeral, aimed at creating a space to discuss mental health.
For Ed Quinn, a retired officer from the Philadelphia Adult Probation and Parole Department who struggles with depression and alcoholism, performing his story at This Is My Brave allowed him to stop hiding his mental illness from others.
Sharing it aloud was "like taking off a couple layers of coats you don't need in the first place," Quinn said. "I'm just left with the actual problem, which is then easier to cope with."
One big advantage to creative arts, Brandoff said, is that they can reach more people — those who can't seek therapy, who think they don't need it, and even those without an actual diagnosis.
That power was clear to Gabriel Nathan when he put on a play with his colleagues at a psychiatric hospital in Montgomery County in 2014. Although Nathan deals with anxiety and depression, not all his coworkers had diagnoses. Yet when they performed Our Town by Thornton Wilder, they all benefited.
"We learned to be vulnerable with one another and with an audience," said Nathan, who now works as editor of a website about mental-illness recovery.
"It let people's guard down a bit," he said. "'Oh, I'm just rehearsing for a play.' No, you're not. You're actually doing more."