A shadow on the brain

Shadow on the Brain; One woman's search for the roots of chronic depression
[FINAL Edition 1]
The Washington Post (pre-1997 Fulltext) - Washington, D.C.
It is deep in the night; morning is a mirage. And the thing I have dreaded has happened: The beast is outside my window. It is a mechanical beast, and it screams -- steel against steel, a heavy thundering of weight. There is the oppressive sense of something huge and black. It is confined for now, but it threatens to bolt loose, breaking all natural laws; if I move, it might notice me. I lie motionless, trying not to breathe. The beast slows, grumbling, then shudders, slides and finally comes to a raucous, banging stop outside my window. Somehow the silence is worse than the cacophony that preceded it. It is a silence of something about to happen, broken at intervals by another metallic groan as the beast moves, muttering in its sleep. The fear is a bubble that rises from the pit of my stomach to my lips. Then there is a shadow in the doorway: my mother. "It's a freight train, Tace," she says tiredly. "Go back to sleep." In a minute, I hear her voice across the hallway, in my parents' bedroom. "I swear, I think she can hear those trains the minute they leave the station in Chattanooga." IT IS SUMMER, and I am in the back yard, a shelter under a close, cool canopy of oak trees. My mother's chaise lounge rests on bare dirt, next to the duck pen. She is sitting with the mother of one of my playmates, and they are sipping iced tea from tall frosted metal glasses, and I should be comfortable. But I'm not. I feel a familiar, gnawing fear. What's wrong? Something's wrong. I keep waiting for it to happen. "It's so nice to sit back here when it's raining, the trees are so close you don't get wet at all," my mother is saying. Somehow that casual remark is branded in my brain as if she had said, "The Russians are bombing us" or "I am dying." Those were the things I expected to hear. IT IS YEARS LATER. I am in fourth grade. One day I leave my seat in the classroom and go down the hall to the girls' room. I walk close to the wall, trying not to take up space I feel I have no right to. Inside the restroom, I crouch behind a toilet, my arms wrapped around my knees. I do not cry; I am just wordlessly sad. I have been wordlessly sad for quite a while. People seem to take this for granted. "My hill and dale girl," my mother calls me, and I have no way of knowing that the way I feel is at all unusual. I only know it feels unbearable. And so for relief I sit behind the toilet, where at least it's cool and quiet, away from the boisterous classroom and the noise that seems to hurt my skin. Unable to figure out why I am sad, equipped with only a child's logic, I eventually decide that it is because President Kennedy is still dead. Even then, this rationale did not seem satisfactory. AND SO OVER TIME, the typical anxieties of childhood became something else -- merged into a different and altogether darker pattern, the way drops form rivulets that wear paths in stone. Something a bit like that was going on in my brain. But it would be years before I knew the word for what was happening, and decades before I truly understood what that word meant. The word was depression -- a milquetoast word, really, one that does no justice to the ancient shadow on the brain it supposedly describes. How can it? It covers too much, from the transient grief of a motorist whose car has been dented to the howling desolation of the man who lifts a loaded gun to his temple. I call it the Beast instead -- a label that casually came to mind one day and that I discarded at first because it seemed melodramatic. But on reflection, it suits this thing that is now part of my brain, something I refer to at times as "him" -- though I imagine "him" less as a creature than as a force, something that has slipped outside the bounds of natural existence, a psychic freight train of roaring despair. For most of my life, the Beast has been my implacable and unpredictable enemy, disappearing for months or years, then returning in strength. Our skirmishes have been too many to number, but when it comes to major battles, I count four: 1975, 1981, 1985 and 1989 -- dates that mark the onset of severe depressive episodes that lasted anywhere from six months to two years. It was during the most recent of those major battles, on a bleak February afternoon in 1990, that the Beast came closest to a final victory. I remember the moment vividly: I sat alone in The Washington Post pressroom at the federal courthouse, fingers poised above the keyboard of my computer. I was fearful of discovery, ready to erase my file at the sound of a footstep. But stronger than fear was the compulsion to leave some record behind, to describe the intention that had led me the previous night to pack up my journalism awards, to arrange for someone to take care of my cats, and to write a will. "Right now I am feeling that I want to die," I typed. "I am ashamed of this. I feel it is a weakness." The next day, under the momentary sway of a sane impulse that saved my life, I did something I had spent two decades trying to avoid: With the help of a friend, I checked myself into a psychiatric hospital. It took more than a year, many hours of therapy and half a dozen experiments with different combinations of antidepressants before I felt safe enough to say, "I am well." But eventually, I could say it. Life did not return to normal; it got better than that. In the aftermath of that terrible time, I returned to my job as a journalist and found new passion and depth in my work. More important, I stopped looking for a man who would rescue me and found a man who would love me as an equal. Today, he is my husband. Life is good. Which is not to say that life is perfect. Because of my long history with this illness, I know it will recur; it has already, in mild form, two or three times. But now I know my enemy. I've even named him -- and naming is the gift God gave to Adam; naming is power. Nowadays, what interests me is understanding the Beast, in all his manifestations. Depression is an illness that imprints itself uniquely on each personality; in a way, its mysteries point us to the answer to that ancient philosophical conundrum, the mind-body problem. Exactly how that works -- how biochemical changes in the brain conspire with genetic predisposition or external events, or both, to create a disorder that can tempt the mind to its own destruction -- we do not yet know. But it begins with who we are, which begins with the place and the people we come from. MOST OF MY EARLY MEMORIES are like sunlight through a tree, dappled with dread. At night, after everybody was asleep, I would kneel at the cedar chest in my bedroom, making a shrine by spreading the white sheer curtains around me. There I would bargain with God for relief from this awful sense of guilt and impending disaster. If I could be good enough, my father would not lose his job, my mother would not die of cancer, our house would not burn down. I would go to bed holding a cross made of plastic that absorbed light and glowed for a while in the dark, hoping to drift to sleep while the emblem of my Savior watched over me, a magical purplish glow. But the glow often faded before sleep came. On some nights, I drifted in and out of an anxious doze, snapped into consciousness by the crowing of my grandmother's rooster across the cornfield from my bedroom. It might be dawn; it might be 3 a.m. The sound seemed an accusation aimed at me for sins I could not name. Verily, I say unto thee, That this night, before the cock crow, thou shalt deny me thrice. My mother was afraid. "I had a terrible dream last night," she said one day. The four of us -- my parents, my sister, Nonny, and I -- were in the car, at the top of a hill deep in the countryside south of Atlanta. We had been "visiting," dropping by relatives' houses on a Sunday afternoon, an old Southern custom. Now it was late. Ahead of us, the sun had burned to a dull orange and was sinking behind a knotted bramble of bare tree branches, throwing shadows across monochrome fields marked with the stubble of last summer's corn. My mother was always having terrible dreams, prophecies of disaster or interminable slow-motion nightmares in which she could not escape the thing that was pursuing her. It was the legacy of her past: a childhood of poverty, the early loss of both parents, years of deprivation and abuse from relatives. From all of that she had salvaged her Southern fundamentalist faith. Jesus was her refuge, the one Being who had never deserted her or made her feel unworthy; she loved her Savior with the fervor of an abandoned child. But even kindly Jesus warned us of doomsday, and that was what she was talking about now. My sister and I leaned over the front seat; she sat beside my father as he drove, and looked into the sunset. "The sun was blood red, like it was the end of the world," she said. Her words gave me a chill. "What happened in the dream, Mama?" I asked. "Were we in it?" "Yes," she said, shortly. Then she shuddered. "I don't want to talk about it." No matter how I pressed her, she would not say more. I leaned back into the car seat. How horrible it must have been, that she couldn't tell us. The dream was an omen; I believed in omens. We expected the end of the world, the Second Coming of Christ. It could happen at any moment. For no man knows the day or the hour . . . I will come on thee as a thief, and thou shalt not know what hour I will come upon thee . . . The sun shall be darkened, and the moon shall not give her light, and the stars of heaven shall fall, and the powers that are in heaven shall be shaken. But I knew what her dream was about: It was about me, being I could not remember a time when I did not know that. The faith that steeled my mother for life, which my father accepted and which seemed to come so naturally for my older sister, did not come naturally to me. From the beginning, my confusion centered on this thing called the Second Coming. It was supposed to be the moment of ultimate rapture for all Christians, when believers were to be caught up in the air and taken directly to Heaven. We heard the Bible verses in church. I tell you, in that night there shall be two men in one bed; the one shall be taken and the other shall be left . . . Two men shall be in the field; the one shall be taken, and the other left. It was a moment all Christians supposedly longed for. But every description sounded terrible, disorienting and strange to me. I just didn't get it. And the fact that this alternate view made no sense, that I awaited the Second Coming with horror and dread, was proof of my difference from others. And different, to a child, was a curse. Different meant defective. "The angels beckon me from Heaven's open door, and I can't feel at home in this world anymore," we sang in church. But the world was my home. I was in love with the tangible; in my mind, even the letters of the alphabet possessed shape, color, texture, weight. This was Georgia, 20 miles south of Atlanta. The time was the early '60s. One night when I was 7, President Kennedy was on television. I said, "What is it?" The adults stared at the television and did not answer. Afterward, we had a family conference around the round oak kitchen table about what to do if a nuclear bomb fell on Atlanta. Do not get on the bus, my mother ordered; I will come get you, no matter what. At church, pale men in dark horn-rimmed glasses bent over me and asked me to suppose that godless Russians had threatened to shoot me if I did not renounce Jesus Christ. What would I do? I would renounce Jesus and go home, I thought; maybe then they would leave me alone. But I didn't say that. Telling the pale men that I was ready to knuckle under to the godless Russians was not what they wanted to hear. The imminence of nuclear war, centered around someplace called Cuba, got tangled up in my mind with the Second Coming. I couldn't decide which scared me more: the godless Russians or Jesus in the sky, coming for the Final Judgment. Somehow I always thought both events would take place directly over the marquee of the Roosevelt Drive-in Theater, visible from our back doorstep. My mother remembers one Fourth of July in either 1962 or 1963. She and my father had stepped out into the driveway around midnight to watch the annual fireworks show put on by the drive-in. My sister and I were asleep, they thought, in the back bedroom. At some point, between whistles and pops, my mother became aware of screaming from the back of the house. It was the two of us, awakened by the noise. We thought it was the end of the world. I have no memory of this event. I knew only that annihilation loomed. It could happen while I was asleep, while I was pulling up my socks, while I was fighting with my sister; I could wake up from a nap and discover myself doomed to eternal Hell while the rest of my family had gone to Heaven in the Great Rapture or the giant mushroom cloud, whichever came first. THERE WERE CLEAR SIGNS on at least one side of my family -- my father's -- that a vulnerability to mood disorders was woven into the family genes. At some point in the 1930s, one story went, my father's mother simply went to bed and stayed there for a decade. No one knew exactly why, though there was some vague mention of "female troubles." In retrospect, it seems she simply gave up on life. My father was sent to live with his aunt in Gadsden, Ala., while his older brother stayed at home to help care for their mother. Years later, as an adult, I learned of another child -- a girl born before my father, whose existence my grandmother rarely spoke of. Her name was Helen Faye. She had died at age 3 in a household accident. While my grandmother's back was turned, Helen Faye managed to climb up on a stool near the stove, where she upset a pot of boiling water. She died several days later. My father's father was a roguishly handsome man who was one of Birmingham's first motorcycle policemen. No one in the family ever heard my grandmother call him anything but "Boy" -- not in the demeaning sense also known then in the South, as addressed to black men, but as a simple word of endearment, an unusual gesture in a woman so reticent. At some point after Helen Faye's death, he left. In some versions of the story, he simply departed -- went out for a pack of cigarettes, as the saying goes, and never came back; in other versions, they had fought over his decision to go look for work in Mobile. His brother found him, years later, working on the docks in San Francisco. When I was an infant, my mother says, there came news that he had remarried. My grandmother was living with my parents then -- she spent most of her life, after her bedridden period, shuttling from one son's house to the other -- and my mother was awakened in the night by the sound of racking sobs. By then, my grandfather had been gone for several decades. My grandmother still wore her wedding ring. So death and abandonment took up residence in our house, trapped under a blanket of suffocating silence, and for comfort there was a kindly Jesus who might come at any moment to judge the quick and the dead. By the time I formed my first memories of my father's mother, she was a bent woman, more frail and elderly than her years, who sat on the sofa and seemed to absorb all the light and levity in the room. Her need for human contact -- any kind -- was insatiable, but her usual way of asking for it was to request personal favors. "Would you trim my toenails?" she would ask. "Would you wash my hair?" Of my mother's parents I know even less. She has a picture, taken about 1929, of two little girls standing against the side of a house. It appears to be morning. Both have bobbed hair and are carrying Easter baskets. The older one, about 7, is looking directly into the camera. The younger one, who is about 3, is looking off to one side -- distracted for the moment by a butterfly, perhaps, or the appearance of the family cat. Looming across the foreground are two large shadows, a man and a woman, evidently the adults who are taking the picture. The 3-year-old is my mother. The shadows are her only visible reminder of her parents. She never knew her father. He left not long after that, for reasons never explained, the way men left families in the Depression to seek work elsewhere or simply to rid themselves of the burdens of a wife and children. My mother was told that he had died. She has only vague memories of her mother -- a serious, deeply religious woman with auburn hair, who worked in the Nabisco factory in downtown Atlanta, making biscuit boxes. She died of influenza when my mother was 4, the winter after that Easter snapshot was made. My aunt -- the 7-year-old in that picture -- was told that as their mother was dying, she made her own sister promise to take care of her two little girls. The promise was casually made and just as casually broken; poverty had made my mother's family bitter and mean-spirited. Two children, to them, simply meant a bigger grocery bill. Neither my mother nor her sister have ever spoken of their relatives with anything approaching affection. The only uncle who was financially stable, an accountant with Coca-Cola, did petition to adopt them. But the courts refused to give him custody, citing his alcoholism. For a time, my mother and her sister shuttled among the homes of various relatives, treated like the unwanted children they were. My mother remembers a family argument that ended with the two of them being pushed out of a car and left by the side of a deserted road in the country. How long they were there she does not remember; it seemed like a week, though it was probably not more than an hour. She remembers standing there with her sister in the tall grass, watching the car drive away. She was 6 years old; her sister was 10. The two of them wound up as full-time residents of the Southern Christian Children's Home in downtown Atlanta. During one particularly lean period, money was so scarce that the children got a piece of bread with some pasty peanut butter for dinner at night. My mother learned to eat the bread and save the peanut butter, rolling it into a ball to eat in bed at night before she went to sleep. My aunt left the children's home at 16 to make an unwise marriage. My mother was luckier: She was adopted at the age of 8. Not surprisingly, she lavished her unqualified adoration on the man who came to her rescue. He was a rawboned Georgia farmer named John Derrick, whose wife, Cora, could not have children. I called him Pa-Pa. By the time I was 4 or 5, he was retired from Southern Railway, the job he had taken to pay the bills. But at heart he was still a farmer, and up to the year before he died, he was still reflexively putting seeds in the soil. One of my earliest memories is of sitting on his lap while he fished a knife out of a front pocket of his worn overalls to peel an apple for me. My memories of those years are primitive and sensory: -- Of a dirt road that is red clay, gluey and slick when wet. I dig it out from under my nails, find it between my toes. I walk behind Pa-Pa as he plows the upper cornfield with his white mule, Becky. It is early spring, and the crumbling clots of dirt are cold, as if the plow is opening up the winter earth to the steady spring sun. The dirt smells dark, a musky scent of -- Or of another spring, a few years later, as I lie on the earth outside the barn, across the dirt lane from where Pa-Pa plowed. He died on a spring day like this, a day like an old lady's idea of Heaven: a little too hot, a little too perfumed, a little too floral. I smell honeysuckle. Running under that scent, like the harsh one-note plaint of a didjeridu, is a faint animal stench from the barn. The sun is hot on my back. I lie face down in the grass, my cheek pressed to the earth, and while I sleep it seems I can feel the earth move, almost imperceptibly, toward late afternoon. So much sadness -- and yet, by the time my parents had met and married, life seemed bright, the worst hardships behind them. Pictures of my mother from that period show a beautiful woman with awkward, rounded-shouldered posture, a pose she adopted because she thought her height was unfeminine. She was slim, with red hair, green eyes and a gardenia-pale complexion. My father was skinny in those years, with black curly hair and an intense gaze that my sister would later inherit. He came home from World War II, they met while working at Delta Airlines, and they married a year later, following their version of a script that millions of returning veterans and their brides were also following. Pa-Pa carved out eight acres of his woods and cornfields next door to his own house, and my father ordered some house blueprints out of a magazine. He and Pa-Pa built most of the house from scratch, contracting out the skilled labor but mixing cement and hoisting two-by-fours themselves. My mother plastered the walls. The result was a split-level ranch house with a pine-paneled den and a two-sided living room fireplace I still recall with affection. My sister was conceived in that house in the winter of 1953. I was born two years later. In those years, my father was getting his law degree at night while working by day in the cargo department at Delta. I was lulled to sleep at night by the sound of my mother's Royal manual typewriter in the kitchen, as she typed his school papers. The two of them were well matched. After his motherless childhood, my father soaked up my mother's unqualified love the way thirsty ground accepts water; with my father, my mother felt truly wanted at last. They honeymooned in California, stopping in Los Angeles to visit her sister, by then on her second husband. In a picture from that trip, my mother lounges against a low-slung late-1940s car, wearing slacks and looking radiant and sexy. Yet there is something -- a tension in her pose, an unease in her expression -- that suggests the camera had captured something from her without her permission. She was shy. But my father had a politician's gift for being with people; with him, she knew the giddy, vicarious pleasure of popularity. He played on the office softball team and won trophies, pitching left-handed; he played on the office golf team and won trophies, playing right-handed. He played in the church bowling league and brought home so many trophies that my mother stacked them in closets. He joked constantly, even in church; it was years before I realized how much he hid behind that mask of jollity. What made it effective was the fact that he was truly funny. "Did you hear what Tommy said?" people would say to each other at parties, repeating some one-liner. I was his shill, a risible child who instantly rose to his bait; nothing pleased him more than making me laugh. "After the service tonight, there will be a short elders' meeting," the minister intoned from the pulpit, and my father stage-whispered, "What about the tall elders?" -- knowing that I was defenseless, that there was no way I could repress the rising hilarity. He was impulsive. Once he came home from work, tearing into the driveway, brakes grinding, horn beeping, yelling at us to get in the car. We screamed up the road to the freeway overpass that was being built near our house, where my father pointed west toward a peculiarly brilliant red sunset. He had wanted us to see it. After he got his law degree, he moved into management at Delta, and we qualified for free airline passes. But he never planned trips; we just took them. Once he came home from work and announced, "We're going to Australia," and that weekend we did. It was the first of several similar adventures, which over the years took us to such places as Ireland, New Zealand, Hawaii -- anywhere my parents had always hankered to explore and wanted us to see. My mother found this no less thrilling than my sister and I did. "Who would have thought," she would say frequently, "that an orphan from the Southern Christian Children's Home would wind up in -- " In their best moments, those trips were hilarious, ad hoc enterprises. Once, trying to escape a large and oddly uninhabited airport in Auckland, we found ourselves in a rental car, stopped at the end of a road that had put us directly onto a runway. "Now what?" my mother asked, and always the eager wiseacre, I stuck my head between her and my father in the front seat. "What you do now," I said, "is locate the windsock and take off into the wind." Sometimes rage would consume him, for inconsequential reasons -- a lawn mower that wouldn't start, the mayonnaise jar left open on the kitchen counter. At those times, he frightened me; his fury could clear the room. There was something exaggerated in the way he threw a tool down or slammed a door, a fierceness that seemed to come from nowhere. In him I sensed a deep, unfathomable anger -- perhaps because, even then, I sensed that I had it, too. Then it would be over. He wandered through the house, singing nonsense lyrics to popular tunes. "Toreador/ Don't spit upon the floor/ Use the cuspidor/ That is what it's for," he bellowed; or " LEP -rosy/ Night and day you TOR TURE me/ Sometimes I wonder/ Why I fall asunder . . ." For my mother, his ebullience was a tonic. She was happy. I watched her from the kitchen doorway as she stood at the sink, wearing a green striped seersucker dress, her red hair pulled off her face. Her hands moved in and out of the soapsuds; her face was calm and serious. I thought no one in the world was more beautiful. "Love lifted me," she sang in her clear, true soprano, or, "He hideth my soul in the cleft of a rock/ That shadows a dry, thirsty land./ He hideth my soul in the depths of his love/ And covers me there with his hand." IT WAS DECEMBER 18, 1968, the last day of school before the Christmas holidays, a clear and chilly afternoon. My bus stopped at its usual spot, across the railroad tracks, within sight of my house. "Be sweet," my friend Necie said to me as I filed off behind my sister. The last thing I remember is a glint of sunlight on metal out of the corner of my eye. The car had come over a slight rise, traveling so fast that I never saw it. It missed my sister by inches. I took the blow in my lower right back and went up over the hood like a rag doll. It was a week before I came to, on Christmas Eve. On the television set beside my bed, the Apollo 8 astronauts were about to make man's first journey around the dark side of the moon. I caught glimpses of it, in intervals between morphine-induced sleep, through my right eye, the only part of me that wasn't encased in gauze. The impact had shattered the bones of my lower back and pelvis, and I had deep lacerations on the outside of my left thigh, where I apparently skidded along the road. Lesser lacerations marked me from head to toe; there was even a speck of gravel embedded in my wrist. The internal damage was also significant: intestinal hemorrhages and a bruised spleen. But the worst injury, to me, was to my face: Something metal on the car had left a ragged tear of skin that opened just below the hairline above my left eye and exposed the whole left side of my skull, miraculously missing the eye. It took six hours of surgery to put me back into human form, most of that spent by the plastic surgeon working on my face. The accident coincided with a major growth spurt of puberty. After three weeks, I left the hospital in a wheelchair; in three months, I was walking without a limp. But there was a slashing red scar that covered a quarter of my face, starting just above my left eye, turning the outer edge of my eye up into a distorted upward squint. Overnight, I was no longer a child. I was that ungainly thing, an adolescent. Worse: an adolescent with a scarred face. I never knew exactly how the accident happened. It was a time of racial tension. Martin Luther King Jr. had been assassinated the previous April, and there were dark mutterings among some people at church that the driver, a 19-year-old black man, had run me down on purpose, because I was white. Late in the spring, there was a criminal trial. In court, the driver said his brakes had failed. In the courthouse corridor, our families regarded each other with hostility. My family waited for some token of remorse; his family waited to see what form of injustice the court system would inflict. After lunch, I was called to the witness stand. The questions from the prosecutor were perfunctory. Then he asked me to step down from the witness box and walk in front of the jury. He guided me down the row of jurors slowly. Some of them leaned forward to get a good look at the red scars on my face; I remember an older man who looked at me and flinched. The scars, I realized much later, had nothing to do with proving the defendant had committed a crime. But they were an eloquent, unspoken message from the prosecutor to the 12 white people in the jury box: Here was a young white girl who had been robbed of one of a woman's most valuable assets, and a black man had done it. The defense attorney had no questions. The jury took half an hour to convict. I heard later that the judge gave him three years. The whole thing was unbearable, so in my mind I sealed it away. Don't worry, people told me; the scars are bad right now, but plastic surgery will fix that. And so I waited. The summer after the accident, I had the first of a series of plastic surgeries -- a day or two in the hospital, followed by several weeks spent with a bandaged face, hiding inside the house, looking as if I had been in a bar fight. Each time, I waited for the bandages to be removed, to see the face I had had before; each time, I was disappointed. In fact, the only thing that could heal the scars was the passage of time. To a 14-year-old, this was an alien concept. "You're a pretty girl," my mother kept trying to reassure me, but all I had to do was look in the mirror to see that this was untrue. And so I adopted the only tactic left to me: I tried to ignore it. It worked, some of the time. Once, as I was waiting at a bus stop, a stranger inquired rudely, "What happened to your face?" I looked straight ahead, unable to think of a reply. "Don't worry, darlin'," said my doctor, a rakish man I had a crush on. "You're gonna be an interestin' lookin' woman." I wasn't stupid; I knew "interesting" was just one step up from "ugly," and ranked far behind "beautiful" or even "pretty." Anyway, he was a living disavowal of his own words: His current wife, he told everybody proudly, was a former Playboy bunny. My plastic surgeon was a man of medical renown who radiated an emotional chill; he observed my face impassively, the way an artist considers his options. In his silence, I heard an eloquent commentary on the impossibility of my dreams. Finally, despite her moral qualms about allowing me to wear makeup so young, my mother took me to a Merle Norman studio. There a lady slathered my face with heavy masque foundation, dusted that with powder, dusted the powder with rouge, then took a makeup pencil and drew a new eyebrow over my left eye. Then she sold us a bag full of Merle Norman products. "You look beautiful," she said, when she was done, which was untrue; I looked embalmed. But from that moment, I never left the house without my makeup. It maddened me, that I had to wear makeup, that I was scarred and pasty-faced. My sister, then 15, had grown another inch over the past year, and her face had lost its childish roundness; with her dark hair and large brown eyes, she was developing a dusky prettiness that was enhanced by the startled-doe look she turned on people when they spoke her name. It did not occur to me then that she was suffering, too, that she reacted to the attention our parents lavished on me by withdrawing further into her books and her fantasy life. As far as I can remember, there was very little discussion of the fact that she had nearly gotten killed, too. I only knew that I was jealous. Nonny got her hair cut today, so now I am definitely the plainer sister in the family. I always knew I was . . . She's got all it takes to be really pretty, and she's learning how to take advantage of it. As for me, I look as good as I'm ever going to look. I had waited for adolescence like any other young girl, as if it would be a Disney dream and something magical would happen. Now, although I longed to hear my father say I was pretty, I knew it would never happen. I didn't even ask. When I came home from the hospital, he had picked me up in his arms and carried me into the house, but I felt no comfort in his touch, only embarrassment. I never knew what he thought about the accident; he never told me. We talked about it only once, years later, in a conversation that was stilted and unnatural. My mother talked about it frequently. To her, my survival was a miracle; she offered her fervent thanks that God had spared her daughter. Listening to her prayers, it seemed ungrateful of me to complain about the means by which God had accomplished this. Once again, pale men in dark glasses bent over me at church, this time to murmur their thanks that the good Lord had allowed me to survive, and like a good daughter I echoed their piety. Inside, my rage retreated, sullen and silent. It would be years before I realized I was angry. BY MY SENIOR YEAR in high school, I had fallen in with a crowd the rest of the school referred to sardonically as "creamers," as in "cream of the crop," the top of our class in an ordinary Georgia public high school. Being a "creamer" was the same thing as being called a geek or a nerd, but that was okay with me; at last, I had found a group to belong to. In geek tradition, we stuck together. We even went to the prom en masse, since none of us could work up the nerve to ask anyone else for a date. By graduation, I had garnered a number of academic honors, I played tennis, I had even acquired a boyfriend. I read constantly. My reading list was heavily male, British and 19th century, though an occasional American got thrown in: Dickens -- Great Expectations was my favorite book -- Thackeray, Hemingway, the Bronte sisters, F. Scott Fitzgerald, Thurber. My life was full of the normal teenage things -- sleepover parties, clubs, working on the school yearbook staff. But signs of chronic depression were emerging. Even before the accident, I had begun to make frequent trips to the doctor, always complaining of a variety of ailments. Some were real; others had no clear physical cause. Before and after the accident, I seemed to suffer constantly from stomachaches, headaches, a mysterious cough, strange lumps in my lymph glands -- a list of ailments baffling to my doctors and worrisome to my mother, whose experiences had taught her that there is no such thing as bad news, only catastrophe. Each ailment convinced her I was suffering from a fatal disease. The family doctor referred me to an internist, who referred me to a neurologist, who gave me an EEG. It was normal. My urine was tested for diabetes; my blood was tested for leukemia. Those tests were normal, too. Finally, in bafflement, the internist gave up and wrote a prescription for Valium. I was thrilled. Not only was I getting some attention, which I craved, but the Valium meant that I was also -- finally -- going to get a good night's sleep. May 1973: "It's going on 1 a.m., but I'm writing until I get sleepy. Last night I had a recurrence of all my old symptoms -- insomnia, dozing off only to find myself awakened with a start ten minutes later by my own beating heart, unable to catch my breath . . . Tonight I took a dose of cough medicine with codeine, plus ten milligrams of Valium, and I hope I can sleep . . . This started about a year and a half ago, when we were going to move, and I have had problems with it off and on since then." The anxiety was like poison ivy. It took nothing to set off that mental itch -- a chance remark, remembering an event from the day before -- but once it started I found it impossible to stop the cycle. My thoughts twisted and circled, my pulse hammered, I couldn't concentrate. The only thing I wanted was to make sense of this feeling -- and the explanation, or apparent explanation, was obvious: I was worried about boys. But I was a Christian, and Christian girls were supposed to have their minds on higher things. We were supposed to be happy. "Doubt," one Sunday school teacher told us solemnly, "is of the devil." I was filled with doubt, I was wormy with it. When the principal of our public high school brought a beauty queen to a football pep rally to offer her own personal Christian testimony, I sat in the bleachers with my friend Jim as, one by one, all the people around us went down to rededicate their lives to Christ. I wasn't making a statement; I just hated the emotional coercion. I also hated my face. There were times when I silently mouthed obscenities at myself in the bathroom mirror, sick at the sight of the red keloid scar that marred my forehead. But I admitted that to no one; for years, whenever anyone brought up the subject of the accident, I would leave the room, too furious to speak. With nowhere else to direct that anger, I focused it on the most readily available target -- myself. The urge to do this, to catalogue my inferiorities, was one of the earliest impulses behind the creation of my journal; enclosed in that first volume, I found scraps of paper predating the beginning of my journal in December 1969. On one such paper, dated October 23, 1969, I had written: Basically I am a very cold and withdrawn person . . . Most {people} think I am honest, dependable and trustworthy, a fine young Christian girl. I have to state that this is, I'm afraid, mostly hypocritical . . . I have tried to be a good Christian, but because of the above-stated tendency for being hypocritical, and also an alarming tendency towards deceit and conceit, I have found it extremely hard . . . I am much worse than the drunks on the streets or the prostitutes in the barrooms, as they do not pretend to be better than they are. I cannot say the same for myself. P.S. When I read this I will probably start feeling sorry for myself. At other times, those journal entries show that at some level I understood that my physical ailments and my mental state were linked. I feel fine in the middle of the day; at night I start feeling depressed, and in the morning I trace the hours on the clock til bedtime. I am really not worth all this self-pity, because I have anything that anybody could ever ask for. Well, I must not lie to myself: I have been thinking sometimes about attempting suicide because that would put me in the hospital . . . I know why I am having fainting fits, dizzy spells and general less-than-normal health; it's because of all these dark thoughts I keep thinking. But these were episodes. For long periods, life was normal, with its normal ups and downs. Sometimes I found it hard to believe I was the same person. If you turn to the beginning of this epic saga, you'll read some pretty morbid thoughts on dying and suicide. "Just an adolescent phase," all you learned psychiatrists will say. Maybe so . . . But for a while I literally went through the valley of the shadow of death. I remember one summer afternoon when I was walking home from feeding the horses. I suddenly thought incredulously, "You mean, you really wanted to die? You must have been out of your mind!" It was like flying low in an airplane, in and out of thunderheads. The normal work of adolescence -- acquiring knowledge, achieving emotional maturity, discovering sex, preparing for college and independence -- took a back seat to navigating the daily storm front. I was angry, so angry. My father's black rages now seemed trivial, compared with the fury I felt but could not express. It seemed uncontrollable, and for that reason I frightened myself, sought to push it to the back of my mind. And for a long while, I succeeded. At times, when the emotional storms had abated, I felt energized, optimistic, full of myself -- the adolescent version of the laughing, risible child I had been. There was a song from my senior year in high school that became linked in my mind to those times: "I think I can make it now, the pain has gone./ All of the bad feelings have disappeared . . ." Sometimes, in black moments, my turmoil spilled out in nervous, melodramatic pronouncements; I was dying for someone to discover what I tried so hard to hide. When the Valium prescription ran out, I replaced it with over-the-counter sleeping pills, which I took by the fistful. Once, riding with a carload of friends to a football game, I announced: "Last night, I had to take 10 Sominex to get to sleep." My friend Jim spoke up from the back seat. "I don't think you should take so many pills, Tracy," he said -- and I treasured that remark for years, as if it had been a profession of love: He had noticed. At home, the rule of silence prevailed. Once my mother found a drawer full of empty Sominex bottles in my bureau and threw them out; I did not discover until years later that she had sobbed for a day, afraid that I was becoming a drug addict. I did not tell anyone that despite the Sominex I still awoke at 4 a.m. with my heart pounding so loudly I could hear it in my ears. I did not tell anyone that when, in the winter of my senior year, I found out that Jim had gone out on a date with one of my best friends, I had gone home and taken half a bottle of aspirin. I wanted to die, or get noticed, but neither of those things happened. Over the next two decades, that formulation gradually changed. It became: Get noticed or die. It was only logical: An intense, narcissistic craving for praise and attention gave me the means for keeping the Beast at bay. I had few internal props, no reliable way of feeling good about who I was; I found no pleasure in being me. Happiness, then, could only come from outside -- and it was possible, it was tantalizingly close to my reach, if I could just get the right job, win the right prize, snag the attention of the right man and figure out how to keep it. Real happiness, of course, had nothing to do with any of this. IT IS BARELY daylight. As my mind floats up from the still pool of sleep, its first conscious act is to note the blue-gray light creeping under the bedroom curtains. Then, like a 1950s television screen coming on, objects in the bedroom gently come into view: bookshelf, television, dresser. The neighbors' dog is yipping outside, and I hear the wood flute call of a mourning dove. Drowsily, I roll over and look at my husband. He is deeply asleep, his hand thrown outside the covers, and as I move, he stirs slightly. Soon the clock radio will come on, and the day will begin. Last night, I dreamed of anxiety, something about being trapped in a car in a traffic jam, in an agony of needing to be somewhere else. The car was full of people who knew about my pain but who could do nothing about it. Their helpless sympathy made me unreasonably angry. The dream was vivid; I can feel the aftermath of the anxiety now, in the muscle tension in my stomach and back. The anxiety in the dream was the diffuse, free-floating type I associate with depression. It seems odd, to dream about depression -- though no different, I suppose, from having any other kind of dream-memory. Maybe a person lost in schizophrenia dreams of normal life, of taking out the garbage; I don't know. But the dreams always alarm me, because the feelings in them seem so real. I am superstitious, afraid that merely dreaming about them will release them, like an evil genie escaping from a bottle. Anyway, as far as my brain is concerned, which is more real -- these dream feelings or the present, waking, moment? Which is now, as David rolls over, half awake, and stretches out his arm to draw me close. The present comes into focus; my mind starts to fill with what I have to do today -- ordinary things like my writing schedule, some gardening I plan to do afterward. These things seem lovely to me, my pleasure in them effortless. David's arm is around me; there is something nourishing in the touch of his skin on mine, the warmth of his chest against my back. We have been together for almost two years now, married for one. He is a physicist, I am a writer, our work has almost nothing in common. Not the man I'm looking for, I thought the night he first made an awkward pass at me. I told him so, and he listened, sitting there on my sofa wearing his wire-rimmed glasses -- the kind, he had told me, laughing, that all science geeks wore. He heard me out. "That's okay," he had said, when I was through. "You're worth waiting for. Besides, I'm a good guy. If you stick around long enough, you'll figure that out." That story is a joke on me now, part of our shared folklore, along with the tale of our first date, when I came to the door in a fashionable silk outfit and David assumed I was in pajamas. He thought if it was silk, you wore it to bed. For smart people, we aren't too bright, I think, and grin to myself. We lie there, limbs tangled in drowsy disarray, until the radio clicks on. In between this moment, and that bleak day in February 1990 when I sat in the federal courthouse pressroom and tried to compose a suicide note, lies a distance of only four years -- though in psychic terms, it is a journey at least as long as everything that has gone before. When I checked into a hospital that February, I had only the vaguest grasp of what depression is -- a set of notions probably similar to those most people walk around with: Depression is something that makes you feel sad; it's not a real illness, except when it afflicts artistic types; ordinary people like me can't possibly admit to having a mental illness. I was wrong or only partially correct on all counts, as I learned over the next two years. It was a period of my life when most of my energy, intellectual and physical, became devoted to finding ways to understand and conquer -- or at least come to a truce with -- the Beast. There were several turning points, the first one being that moment of surrender -- or what felt like surrender -- when I consented to become a psychiatric patient. The two weeks I spent behind locked doors in the Georgetown University Hospital psychiatric ward gave me a much-needed respite from the killing struggle to maintain appearances, a time when I could not possibly hurt myself and my body was allowed to rest. A second turning point came in August 1990, when, after months of experimenting with traditional antidepressants and their debilitating side effects, months in which my depression seemed only barely held at bay and just getting to the office every day constituted a major life achievement, my psychiatrist finally agreed to switch me to Prozac, an antidepressant drug then new on the market. Within weeks, the mental hurricane, which had lasted for more than a year by that point, had stopped dead in its tracks. I offer no proof; all I know is what happened to me, which is that first X happened, and then Y. But it is hard not to attribute that miracle to the little green-and-white pills, difficult not to give them credit for the fact that since then I've lived something like a normal life. It's been a gift. And, without at first realizing it, I have been living on the cutting edge of a social and medical revolution. Prozac has been spawning books, television shows and innumerable news articles ever since, not to mention a growing number of "copycat" drugs. Until Prozac, antidepressants were the chemical offspring of drugs originally developed to treat other illnesses -- tuberculosis, say, or hay fever; their effects on depression were discovered by accident. Prozac is the first "designer" antidepressant, developed to affect one specific neurotransmitter, serotonin, whose malfunction is at least one of the causes of depression. And now even Prozac is becoming passe; by refining the methods of discovery that led to it, researchers are developing more powerful drugs with even more specific influences on brain biology, including previously intractable illnesses such as severe schizophrenia. These are the wonder drugs of the 1990s, which scientists are calling the Decade of the Brain, and they inspire awe and fear. To me, awe seems fitting. Perhaps only someone who has experienced a mental illness like the black free fall of depression -- which is not even the worst mental illness there is -- can really appreciate the magnitude of this achievement. An estimated 4 million people in the United States alone take Prozac for a variety of ailments, ranging from simple depression to obsessive-compulsive disorders. Yet government estimates put the number of people who suffer from a serious depressive episode in any given year at roughly 10 million. Of that number, fewer than half seek any medical treatment at all, preferring to suffer in silence rather than risk the stigma of being labeled mentally ill. A respectable argument could be made that the problem isn't too many people taking drugs for this illness, but too few. Yet the debate over psychotropic drugs is based on a very different assumption: that doctors are prescribing drugs like Prozac, Paxil and Zoloft with careless abandon to people who don't need them. We even have a name for this: "cosmetic psychopharmacology" -- a term coined by psychiatrist Peter Kramer to describe basically healthy people who "are not so much cured of illness as transformed" by taking Prozac. In fact, both sides may be right. Some people -- adventurers, those who push the limits in search of whatever the next enlightenment may bring -- are probably getting psychotropic drugs when they don't need them. But millions more who could benefit from those drugs are too frightened or ashamed to seek them out. If you are really sick, if you are frightened that you are losing your mind, few things are more terrifying than taking a pill that will further alter the way your brain is working. Most people have to be desperate to do it. "I don't know about this Prozac," a man says to me at a party. "Seems like everybody's taking it. Pretty soon I'll have to take it, too, just to keep up." He is only half joking. I smile politely and sip my drink. Here is a person who has never visited the featureless white room of mental illness, I think, who has never formed an intimate acquaintance with the Beast. He has no concept of what it means to go through an ordinary day hauling an invisible 150-pound lead weight -- one you'd just as soon not discuss, because its very presence constitutes a social embarrassment. Try being that person, I want to tell him, if you want to understand what it means to live at a disadvantage. Try that for a while, and you'll have something to fear. I'm closing in on 40 -- a milestone age, the point at which youth stops being a state of being I can take for granted, and becomes a relative term. It's too early for grand summary statements -- but even so, I find myself weighing conclusions about how much this illness has come to define me, and how much I have imprinted my personality on it. I'm casting about for some rule, some unifying principle, by which this puzzle of my life can be seen as a whole. And it seems to me that my illness has been the product of three forces: genetics, culture and chance. I was born with a predisposition to suffer from depression. I was also fated to grow up in a culture filled with anxiety -- some the product of the times I lived in, some the product of the religious sensibilities imposed on me by my parents, who were themselves transmitting the culture they were born into. Part of it was the residual fearfulness I sensed from my mother, who could not escape her own past. And then there was a childhood accident that marred my face just as I was entering adolescence -- a chance event, a unique stressor, that forever altered my trajectory. Over time, all these things worked together -- and, in doing so, they permanently altered the "wiring" in my brain, which was not perfectly "wired" to begin with. This way of thinking about depression, which scientists are exploring, is known informally as "kindling." It makes sense to me. It describes the way my brain works in other spheres: mastering an algebra problem in eighth grade, learning to serve a tennis ball -- a bombardment of stimuli, a repeated reaction, the spark of comprehension, the eventual effortlessness of what had once seemed foreign and impossible. Emotions, I believe, are also partly learned; over time, what begins as simple childhood anxiety can, in susceptible persons, become a series of stimuli that teaches the brain something new -- that "teaches" it, in short, how to feel the blank apathy, the looming sense of futility and worthlessness that is the most familiar face of depression. But emotions can be relearned -- with help. Part of my recovery is the growing ability to escape the suffocating self-absorption engendered by this illness -- and that, in turn, has led to the realization that the patient is only the first of depression's many victims. When I was emotionally shut down as a result of depression, the people who loved me suffered from my absence. Even the compensating behaviors I adopted to deal with the effects of chronic depression exacted a toll on other people. The exaggerated hunger for attention and praise it spawned in me often came at the expense of my older sister, who has always been as shy as I am outgoing. In my desperate desire to charm and excel, I often managed to deflect attention from her achievements, so different from mine. Depression did not create the basic differences in our personalities, but it exacerbated every point of friction -- and the damage, to some extent, has been permanent. She is just one in a long list of collateral casualties; everyone else close to me has suffered, too. IN THE FALL of 1975, I awoke in my dorm room at Emory University in the grip of a dream. In it, I was in the basement of my old house, which had been converted into a restaurant. The light was glaring, the walls white and stark. I was eating something mushy and brown, a food designed not to give pleasure but only to sustain life. And then out of nowhere, I began to have a marvelous feeling that I had a stupendous secret: It was spring outside. I excused myself and slipped out the door. Outside was my grandfather's old cornfield, the same field he had plowed so long ago with Becky the mule. It was covered with the stubble of last year's cornstalks; this year's planting had not yet begun. It was chilly, like the day I followed behind him in the furrows of his plow, but there was warmth in the sun. The earth was brown, the sky drab, but I could hear music from somewhere. It was faint, but growing stronger. I took off my sweater and hat and shoes, feeling the earth slowly warming beneath my feet, letting my hair go loose. And then wolves appeared. They were my secret gods, my helpers; nobody but me knew about them, but I had actually dared to name them. They were dangerous, but I was not frightened. I felt supremely happy. I began to run across the cornfield, the wolves loping along beside me as if we were all part of the same pack, and wild, strange music filled the sky. It is tempting to romanticize, to look back and say that dream presaged my eventual triumph over the Beast. But there is no triumph here, only wiser ways of fighting. I suspect that after all these years, the Beast and I are life partners. But it's okay. I have an ordinary life -- and though some might think this is dull, I tell you it is sweet. Ordinary life is a miraculous thing. Tracy Thompson covers welfare reform on The Post's Metro staff. This article is adapted from her forthcoming book The Beast, to be published next month by G.P. Putnam's Sons. Copyright 1995 by Tracy Thompson. [Illustration]
PHOTO-COLOR,,Courtesy Ruth Thompson; PHOTO,,Ann Elliott Cutting CAPTION: The author in 1958 with her older
sister, Nonny, and their mother, Ruth. CAPTION: Tracy at age 2 with Ruth, above. The faith that steeled the mother for
life did not come naturally to the daughter. CAPTION: Thompson in 1979. She had a name for her depression: the
Beast. But it was years before she truly understood the disease.
Reproduced with permission of the copyright owner. Further reproduction or distribution is prohibited without permission.

Source: http://www.tracythompson.com/pdfs/shadow-on-the-brain.pdf

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