The Scar: A Personal History of Depression and Recovery

194 Pages·2016·2.14 MB·English

by  Mary Cregan

The Scar
A PERSONAL HISTORY OF DEPRESSION AND RECOVERY
Mary Cregan
THE SCAR is a work of nonfiction. Names (including those of all patients, as well as all physicians and
others involved in the author’s care) have been changed, along with certain potentially identifying
details.
FOR JAMIE AND LUKE
“Yet why not say what happened?”
—ROBERT LOWELL, “Epilogue”
Contents
Preface
1. What Happened
2. What Happened Next
3. How to Save a Life
4. The Paradise of Bedlams
5. Where Do the Dead Go?
6. Early Blues
7. The Promise of Prozac
8. No Feeling Is Final
Acknowledgments
Notes
Preface
Going through a box of old photographs recently, I came upon one taken long
ago at a baby shower in a friend’s New York apartment. I’m seated at the center
of the photograph, wearing a gray winter dress, my eight-month pregnancy
mostly hidden behind the gift-box on my lap. I’m twenty-seven. A small stuffed
bear sits at my feet beside its crumpled wrapping paper. My husband is to my
left, looking relaxed, holding a beer, and several of our college friends are in the
photo as well, drinking, eating, watching me open their presents. I’m holding up
another gift I’ve just unwrapped: a newborn’s onesie in white, sprinkled with
tiny bears outlined in pink and blue. Looking at this young woman many years
later, I feel a rush of fear and pity for her, unprepared as she is for what will
unfold a few weeks later when her baby dies.
Another photograph sits on the desk where I write. It was taken thirteen
years later, after a divorce and remarriage, on a visit to Arizona in the
springtime. In the background, out of focus, is a blur of mountain, aspen trees,
and blue sky. In the foreground, in close-up, I’m hugging my rosy-cheeked nine-
month-old son, his broad forehead and dark hair much like my own, his eyes lit
up in a smile as his father snaps the picture. On a hike that day, I had let the baby
down from his carrier to test his legs and watched him grasp the big round
boulders along the side of the trail. The photograph was taken a moment later,
just as I’ve lifted him up, and our faces reflect the pleasure of being outdoors in
the sunshine. I keep this photograph on my desk because it radiates happiness
and comfort: it reminds me of what I’ve been given, and how love for my
husband and son continues to anchor and sustain me.
This book is about the difficult path I traveled between the moments
captured in these two photographs. After the death of my infant daughter, I fell
into a depression so severe and unrelenting that I was admitted to a psychiatric
hospital where I nearly succeeded in taking my own life. Since then, I have
never taken the fact of my existence for granted. Instead of living as I do now—
teaching, writing, spending time with friends and family, taking pleasure in
watching my son grow up—I might be nothing more than a fading memory in
the minds of those who knew me as a woman who died young, in sad and
desperate circumstances. I’m aware, as I remember that long-ago day of gift-
giving, that my own life has been another kind of gift: a second chance. Even so,
the depression that emerged so clearly at that time has never entirely left me. It is
the trace of bad luck that lingers, amid so much good fortune that has come to
me since.
Depression is far more widely acknowledged today than it was back then.
The word “depression” is ubiquitous, and the disorder is too—though depression
takes a variety of forms and diagnostic labels. In 2016, nearly 11 percent of
Americans from eighteen to twenty-five experienced a major depressive episode
(as did 9 percent of adolescents from twelve to seventeen and 6.7 percent of the
general adult population). The correlation between depression and suicide is
striking: the risk is significantly higher for people with mood disorders, and
highest among those who have been hospitalized.
When I was diagnosed with a major depressive episode in the wake of my
first child’s death, I had no idea what the long-term implications of that
diagnosis would be. I didn’t even grasp that I was facing a long-term situation.
Nobody could tell me whether my depression was the result of an inherited
vulnerability, or whether it was rooted in my temperament, or my life
experience, or to what extent it was a combination of all of these. Nor could
even the most dedicated and sympathetic doctors provide clear answers to what
seemed the simplest and most urgent questions: What exactly was depression?
Why did some medications work, while others didn’t? Would I ever be able to
put it behind me?
Five years ago, I began trying to answer these questions, initially in an effort
to understand competing claims in an ongoing debate about whether the
antidepressants I’d been taking for many years were merely expensive placebos.
I had already read a number of memoirs and other popular books on depression,
but I began to investigate the subject more widely and intensively. I had earned a
doctorate in English literature and was comfortable doing research outside of the
discipline in which I had been trained. And as someone who had lived with
depression—and experienced the worst of it—I approached medical, social, and
cultural questions about the disorder and its treatment from an insider’s
perspective that few of the historians and scientists who have written on the
subject can provide.
Once I decided to include my own history in this investigation, I worried
about the exposure that would come with publishing what I was writing. In my
large Irish Catholic family, the tacit understanding was that it was best not to
draw attention to oneself. A couple of decades leading discussions and lecturing
in college literature classrooms had brought me a greater ease with the self-
exposure necessary for teaching. Yet in all professional settings and most social
ones, this particular story—my past, my diagnosis, the vulnerability to
recurrence, the ongoing, quiet necessity of dealing with being depressed for
months at a time—has remained deeply private.
A couple of years into the project, a close friend asked me why on earth I
would want to revisit the worst days of my life. The simplest answer is that after
decades of trying to keep it hidden and behind me, I wanted to turn to the past
and face it squarely. Those who have lived through a traumatic experience will
know what I mean. I wanted to understand what had happened. Having survived
to tell this story, I’ve long known that I have something to say about what
happened back then.
The first two chapters were the hardest to write (and because of the sadness
they contain, may be the hardest to read). But once I had written them and better
understood the gravity of my subject, I realized that telling this story—and
sharing it through publication—was a way of refusing the shame and stigma that
still cling to the subjects of mental illness and suicide. I often think about what
might have been different for that young woman at the baby shower, who didn’t
know that help existed for the inchoate feelings she had long had about herself,
and who didn’t realize that while feeling devastated was a normal response to
the loss of an infant, feeling suicidal was not. This book is written for her, and
for the young women in my family who have inherited the same vulnerability. It
is also for the countless people who find themselves struggling to cope with
internal forces that feel overwhelming but—as I try to show in these pages—are
survivable.
This book is more than a memoir. It seeks to build a bridge from my
individual narrative to the broader landscapes of literature, cultural history, and
science, where the questions I’ve been asking have been addressed by many who
came before me—writers, poets, psychiatrists, historians, chemists, and
neuroscientists. I’ve found a deep satisfaction and a sense of fellowship in
reading writers of the past, who did not have the benefit of even the partial
scientific explanations we now have. Centuries-old accounts provided accurate
descriptions of the harrowing state of mind that leads to suicide and a
confirmation that the illness that beset me has been described with great
consistency across time. When we lose sight of the long history of the illness
formerly called melancholia, we lose this sense of continuity. While the
experience of depression is intensely solitary, reading has been a way of binding
myself to the larger effort at understanding and to the community of sufferers.
Recognizing my own experience in that of others—those who endured the
peculiar madness of melancholia, those who laid themselves down the first time
for shock treatment, those who fell again and again into the void and had to
make their hesitating way back—has been a means of finding a history into
which I could insert myself, one in which my experience makes some sense.
In the chapters that follow, my accounts of loss and mourning, melancholia,
shock treatment, the asylum, and the development of antidepressant drugs situate
my personal experience within the long, hopeful, and as yet incomplete
movement toward effective treatment and cure. I’ve been able to return to the
person I was in my twenties and thirties aided by hospital records, notebook
entries, and the memories of people who were close to me at the time, even as
I’m also present in these pages as a much older self, reflecting on the
repercussions of these events and the continuing presence of depressive episodes
over the past three decades. Sometimes memoir and context are interwoven;
sometimes they are juxtaposed. In both cases, it is my hope that those who are
not experts—those afflicted with depression as well as their loved ones—will
have a better understanding of the past and of the road ahead, and at the same
time, I hope to allow those whose lives are committed to treating depression to
see one patient’s experience from the inside.