For about four months now I have been slogging through a prolonged period of depression. It's actually not the worst I've ever had, in the sense that I have not been actively trying to destroy myself and I've been capable of doing routine work, but it's been bad. The phone rings, and I don't answer. In the mornings I count the hours until I get to go to bed again. I am detached and flat with my kids. My libido is--pffft! Worst of all, I cannot think of a reason why I should continue to be here, what possible interest there could be for me on this planet for another five years, let alone another 25. I have started and put down a dozen books; my concentration doesn't last past chapter two. And if reading is impossible, writing is even more so, which is why there haven't been many blog entries lately. My career as a writer seems over; every day, I feel a little bit deader.
A lot of things have led to this, none of them anybody's fault; it's just the way life is sometimes. My mother died just over a year ago, and I miss her acutely. I published a book I had poured the last three or four years of my life into, and--unlike my first book--the interest from the mainstream media was nonexistent. (Which is not to say that I regard it as a failure or not worth doing; whoever is reading this has probably run across my book; the fact that the mainstream media didn't pick up on it has nothing to do with the importance of the topic; and I know it's helped some people.) But still: the book was written against long odds, and I guess I had hopes that it would spark more of a public conversation than it did about the topic of depression and motherhood, so there's disappointment, to say the least. This year has also been a year of health issues, probably not coincidentally: surgery on my knee, an unusual number of colds and stomach bugs and fevers, arthritis in my neck and lower back. This was the year we established a health club membership and I was going to finally lose those 20 pounds (again). Didn't happen.
But mainly, it's just the fact that it's winter--February, to be exact--and this has always been my worst month. It comes every year without fail. This year it came early. And every day for the past three or four months, I have felt a little bit deader, a little bit less like ever coming back to life. I upped my meds, and that didn't help. I started in on the benzodiazepines again, even though they are addictive, for the same reason that you reach for morphine when you're having surgery: it blocks the pain of constant anxiety...even though there will be hell to pay later on.
Depression takes a toll, and not just on you. Repeated episodes of depression have been associated with decreased volume in the hippocampus, the area of the brain where emotion and memory are integrated. For people who think antidepressants are a crutch, here's some news: a lifetime of untreated depression can literally leave you brain damaged. And that's saying nothing of the damage to your family: the husband who gets a hologram for a wife, the children who beg, " Mommy, can you spend some time with me?" only to hear, "No, I can't, I'm sick." They get fooled, because the person they know as mommy is still making dinner and picking them up at school--she's not on life support in a hospital anywhere--but she's not really mommy. She's the person who is inhabiting mommy's body, and, increasingly, that person is a ghost. (Which is why I chose the title I did for my book,The Ghost in the House.)
All of which comes as background for my reason to take a step which may sound extreme: electroconvulsive therapy, or ECT. Yeah, I've seen One Flies Over the Cuckoo's Nest, and I know that what people think when they think of ECT is of a drooling Jack Nicholson at the hands of a punitive medical establishment, a shell of his former self. ECT began a bit that way, but even in the 1960s it was nowhere near as barbaric as Ken Kesey described. Today it's often done on an outpatient basis, and among its more famous consumers is Kitty Dukakis, wife of former Democratic Presidential candidate Michael Dukakis, who has written her own book (with co-author Larry Tye) entitled Shock: The Healing Power of Electroconvulsive Therapy. Mrs. Dukakis' experience is extremely atypical, in some ways: she gets "maintenance" ECT about once a year, since her experience with depression follows an extremely predictable pattern (which, come to think of it, mine does too). I also have two friends who have gone through ECT, one of them twice and one of those times back in the bad old days before they sedated patients or gave them muscle relaxants to mitigate the physical effects of the artificially induced seizure, and before techniques were developed the minimize the (usually temporary) memory loss associated with ECT. Even so, both of these people said it helped them.
How does it work? Doctors don't know. But then, they don't know much about how antidepressants work, either, just that they usually do. The brain is still very much a mystery to science, even though we know more about it than we ever used to, and it may well be, as a scientist at Eli Lilly once told me, "If the brain were simple enough for us to understand, we would be too simple to understand it." About all we know is that a low-voltage electrical current, when passed through a portion of the temporal lobe, will induce a temporary seizure, and that this in turn changes the levels of neurotransmitters in the brain (which is what antidepressants do, by a different mechanism). Still, it remains extremely controversial. My own psychiatrist was not thrilled with my idea; he calls the ECT doctors "shock jocks." But one of the things you learn when you have a chronic illness is that, in the end, it's not your doctor who will be living with the results of what you do or what you don't do. It's you....and your family. In the end, my psychiatrist wrote the referral, and said he could understand my decision even if he didn't agree with it.
I had my first treatment yesterday. It was like getting hit by a truck (and I can say that with some authority, having survived being hit by a car as a teenager while getting off a school bus). Today, I have some muscle aches. It also gave me the mother of all migraines, and for an hour or so I was extremely disoriented. But then things slipped back into place, and now I can even remember the anesthesiologist saying, "You're going to sleep now" as he pressed the syringe into my IV. I also know that last night I looked at the sunset with real appreciation, and that after I went to bed I cried for a long, long time. They were healing tears. I felt much better after I was through.
Am I doing the right thing? God only knows; I don't. All I know is I have two little girls that I love, and a husband I love, and things I want to do. And when I die, whenever that day comes, I don't want anybody to be able to say it was for lack of wanting to live.