head at dizzying speed—a phantasmagoric slide show of incomprehensible pictures that made me clench my jaw so hard my dentist had to give me a mouth guard to keep me from grinding my teeth into powder.
Unbeknownst to my children, I stopped writing because I couldn't think, couldn't spell, couldn't remember, couldn't type, couldn't imagine or arrange ideas. Nor did my children notice when I stopped doing the crossword puzzle every evening after dinner, but that change and others were not lost on my husband. As my faculties failed, he could see that it was impossible for me to think of a ten-letter word for unhappiness when a three-letter word as simple as joy had slipped beyond my grasp.
For me, depression comes on incrementally. I've been hospitalized for mental illness four times now. Each time, the first thing I lost was the ability to read books, with their long and complex plots. Then went magazine articles, then newspaper articles. Eventually, all I could handle were the headlines on the front page of the daily paper. Television storylines were too busy—and, in any event, they required me to sit still, something beyond my control. Radio was all noise, and I craved silence. Social interaction was too stressful; almost any topic could make me cry. These inexplicable episodes were so embarrassing, for me as well as for the person I was trying to talk to, that it became easier just to stay home.
It's not that I wasn't trying—am not still trying—to live a normal life. For many years I have kayaked, downhill skied, swum, biked, worked out at the gym, lunched weekly with a friend, volunteered at my children's schools, served on boards, and maintained a minimal social calendar, because I've read that these activities are good for me. But gradually these things, like my intellectual life, would slip away. In short, my public self walked away from me like a shadow that had acquired a life and a step of its own.
The first time that happened, 12 years ago, the path that I found myself on led to Dartmouth- Hitchcock Medical Center.
For me, depression comes on incrementally. I've been hospitalized for mental illness four times now. Each time, the first thing I lost was the ability to read books, with their long and complex plots. Then went magazine articles. . . . Eventually, all I could handle were the headlines on the front page of the paper.
Just to understand the need to be hospitalized for my own safety—in other words, to hear what my husband and doctor were saying—took nearly all the cognitive ability I had left. While I was in the hospital that first time, the doctors reassessed my medication regimen, and a sensitive young chaplain counseled me. During my second hospitalization, 18 months later, electroconvulsive therapy (ECT) eventually put me on my feet again. Although I was terrified of ECT, it returned my life to me, minus a year's worth of memories.
For roughly the next 10 years, I rocketed along on my virtual carnival ride. Then, two years ago, things began to deteriorate again. My son was a senior in college and my daughter a senior in high school. Both of them were absorbed by the kinds of events and demands that typically accompany those stages in life. Although I knew I was getting sicker and sicker, because I could feel my life falling apart in all sorts of little ways that are cumulatively devastating, I did not want to spoil my children's respective senior years or heap pressure on them when they were already feeling the squeeze of their own life changes. So I hid my condition as best I could. But mental illness does not hide easily. At one point, my son sent me flowers because the tone of my voice on the phone worried him. My daughter's soccer coach once came up to me on the sideline at the end of a practice and asked gently if I was okay. This kind gesture brought tears to my eyes, but I lied and said, "Of course."
I finally went into the hospital again in the fall of 2003, after spending a long evening on the phone with a 911 operator. I was as embarrassed and humiliated as I had been the first time I was admitted. Once more I had to hand over everything—from my razor to my hair dryer to my migraine
medicine—to enter a self-contained universe where patients devote themselves to trying to understand better why we have been put together in the first place and what we need to do to be released. I attended all the group sessions on medicine, relationships within families, relapse, and how to recognize signs of oncoming illness.
Again, however, weeks passed while talk therapy and medicines failed to help me turn the corner. Reluctantly, I agreed to have more ECT. I had never recovered any details of the year I'd lost to ECT a decade earlier, so I was probably more afraid of this second round than I had been of the first. Nonetheless, I saw it as my only hope. If I was to get well enough to go home, this was clearly the path I would have to take. My mood picked up surprisingly quickly once I'd had the treatments, and I went home shortly thereafter.
The first time, just to understand the need to be hospitalized for my own safety—in other words, to hear what my husband and doctor were saying—took nearly all the cognitive ability I had left.
Electroconvulsive therapy is a gift wrapped in thorns. True, the new ECT practice of unilateral, rather than bilateral, treatment usually cuts the patient's memory loss considerably but, unfortunately, does not eliminate it. After the second round of ECT treatments I still had significant problems with remembering, even though the period of lost time was shorter. As before, I would joke about it and try to minimize it in public, but people rarely understood that my blankness was nothing like their forgetfulness. The things I had forgotten—people I'd met, meetings I'd attended, places I'd been, conversations I'd had—did not lie at the periphery of my memory, toying with my consciousness like a word on the tip of one's tongue. Nothing anyone said could push that name or event into my awareness. What I had forgotten was gone. Period.
Plus there were other side effects, principally an overwhelming fatigue and an inability to think sophisticated thought. So although ECT could work magic in terms of banishing