Here is an article from last Sunday's paper about UNC and ECT. ECT is the treatment that has most effectively handled my clinical depression. Depression is as debilitating as many other illnesses. Amazingly, depression still carries a stigma that is nothing compared to the stigma of this treatment.
For me, ECT has been a life raft when I was sure it could get no worse. The first series I got was in Florida in 2006 after a period of almost 6 months of a "medically recalcitrant major depressive episode". For 6 months I was not myself. I was simply going through the motions of life. My eyes were vacant. I got no joy out of my usual interests...volunteering at school, doing stuff with my children, reading (OMG...can you imagine?), doing the Sunday Times crossword, etc.
The first 3 or 4 treatments were done bilaterally which means the electrical stimulus was applied to the right and left temple. I experienced tremendous short term memory loss and confusion. Following each treatment, I experienced crushing headaches and muscle aches. After the treatment, I couldn't remember the clothes I was wearing, the woman who had been taking care of me for the last month or where my children were (we had sent them to stay with friends in NC). As questions arose in my mind, I felt panicky that I couldn't remember things. After the first treatment, my sister suggested that I write a letter to myself to be read after the treatment which helped to stimulate those memories and reassure me that everything was OK.
There was discussion at that point of doing maintenance ECT, but after the initial series of 6 treatments, I was stabilized on medication, so the maintenance was forgotten.
Several months ago, I began to slip into the abyss again. I don't know what triggered it. I was shaken by my aunt's sudden death, realizing that I had never lost anyone suddenly in my adult life. We had moved AGAIN (for the 4th time in 3 years)...and although this was a welcome move BACK to where we wanted to be, moving is still incredibly stressful. And yes, I was overdoing, as is my habit.
For me, the onset of a depressive episode begins with fatigue. For a while I try to rationalize it...oh, maybe my iron is low, I should have my thyroid checked, I'm doing too much. But eventually the fatigue becomes so burdensome that I wake in the morning and my first thought is, "When can I take a nap?" As days pass and I am in bed most of the time, the depression spawns episodes of guilt and relentless crying as I ponder the horror of my abandonment of my family while I lay abed. On December 20, the situation became particulary dire.
My friends Sharis, Karen and Kim formed an ad hoc team to get me help. Kim ensured that my children were taken care of. Sharis and Karen drove me to UNC. They called my husband and told him where we were headed. He was in Florida and was immediately headed toward the airport to be back by my side. Karen and Sharis stayed with me from 6 p.m. until almost 1 a.m. when I was finally admitted to the hospital and my husband had arrived.
While in the hospital, I had no responsibilities, no decisions to make and nothing to think about except helping myself, availing myself of the programs the hospital offered and being honest about the state I was in. Amongst the "inmates", as my 12 year old son described us, everyone was open and forthright about why they were there...which gave rise to my realization that "We are all different; We are all the same." I began my ECT as an in-patient, having my first two treatments while I was hospitalized.
At UNC, they seem to be much more up-to-date with their methods. They used "modified bilateral" placement...one stimulus on the temple and one on the forehead. They said this placement resulted in much less memory loss and confusion. I came out of the first treatment remembering the other patients on the floor, the nurses, etc. I had a headache and muscle aches. But each time I go back, they ask me about the aftermath of the previous treatment and make adjustments to the meds they administer in the IV.
I feel well cared for. I know my doctors and nurses...and all are wonderful (hello, Mary Jane and Ginny if you are reading this!). I feel like I have input into and control over my treatments because they listen to me. And then there are the small, special touches...like Laura, one of the nurses in the procedure room, who touched my foot as I was about to go under anesthesia and said, "We'll take good care of you."
So, why do I go on and on about this? Well, for one thing, when I am NOT in a depressive episode, I am the poster child for the high-energy, effervescent, outgoing and I-can-do-anything woman. When I tell people that I have Depression, they are shocked because I seem like the antithesis of depression. I know that there are many, many people who experience depression and aren't diagnosed because they are ashamed of their behavior, they wallow in the guilt and believe their own negative thoughts and they don't "believe in" mental illness and don't understand that it can be a physiological state genetically encoded in their brain. So if that's you, or someone you know, I want to encourage you to get help. Go to your regular doctor first and rule out the iron and thyroid issues. And proceed from there.
Do not feel guilty or weak about taking anti-depressants. Depression is not a character flaw!!! It is not something that you can resolve by pulling yourself up by your bootstraps, by muscling through it or by prayer. You need a professional diagnosis, a treatment plan and probably therapy to help you build the skills and coping mechanisms that can help you deal with depression. If you were a diabetic, would you feel that needing insulin was a character flaw? Would dialysis for a kidney problem be a sign of weakness? Would you eschew chemotherapy and try to tough it out if you had cancer?
OK, I'm getting down off my high horse now. If you would like to read other accounts of my experiences with depression and books that I recommend, please go to:
Book review of The Ghost in the House by Tracy Thompson (her blog is Maternally Challenged)
Book review of Shock by Kitty Dukakis
Kitty e-mails Di!
You can comment or e-mail me privately if you want. Also, if you are interested in ordering any of the books referred to above, please click on my BookSense icon and support your local independent bookstore!
Di
"When I tell people that I have Depression, they are shocked," Boy, can I relate to that! (I commented further on your facebook)
Posted by: Diana | August 05, 2009 at 07:56 PM
I was "shocked" but so incredibly pleased that you were so brave to write this article. I pray that it will help others who still feel there is a stigma (unfortunately there often is) and refuse to get help until it is too late. Thank you.
Posted by: Mary | August 05, 2009 at 11:20 PM