Nora Super is a healthcare practitioner who has decided to share her longtime battle with depression. I applaud her for being open about this mental health problem affecting millions of people worldwide. This is how it began:
“I had my first episode of major depressive disorder in 2005 at the age of forty-one. I had been under a tremendous amount of stress, having just gone through a divorce. I was also going to grad school while simultaneously working full-time and raising two young daughters. I wasn’t sleeping well and had been feeling increasingly anxious and sad. Then Hurricane Katrina hit. Although I had lived in the Washington, D.C., area for more than twenty years, New Orleans is my hometown—I still have relatives who live there and great affection for the city and its unique culture.”
“I was devastated to see people suffering in squalid conditions in the Louisiana Superdome. I could not fathom why we could not get water and food to people in an American city when we could airdrop necessities in war-torn countries across the globe. I felt as if my city had been abandoned. I couldn’t think straight. My thoughts went round and round in a spiral. I had less and less energy and was unable to concentrate on my work. Eventually, I couldn’t get out of bed in the morning, and it took a tremendous amount of energy just to take a shower. My distorted mind convinced me that my family would be better off if I were dead, and I came up with detailed plans for how I would end my life. Over the course of six months, I was hospitalized five times”.
“I tried a variety of antidepressants, gradually increasing the potency of the drugs. I saw a therapist and psychiatrist regularly. I participated in cognitive behavioral group therapy. Still, I sank further into depression. Finally, a physician friend recommended electroconvulsive therapy or ECT. This therapy had gotten a bad rap over the years, especially in One Flew Over the Cuckoo’s Nest, which portrayed it as a punitive, painful treatment. Mental health professionals told me stories about how, in the past, ECT often had been given to patients in psychiatric wards without their consent, without anesthesia, and with severe adverse effects. But others told me that it was now safe and extremely effective.”
“I was reluctant. However, as I had been unable to work for more than six months and knew that my family was deeply worried about me, I decided to give it a try. It ended up saving my life.”
“My ECT was performed as an outpatient procedure, as is generally the case. The actual procedure took about five minutes. I received general anesthesia and muscle relaxers, and electrodes were placed on my scalp. Low-intensity electrical impulses were then emitted to create a brief, controlled seizure that affected the neurons and chemicals in my brain. Treatments are generally given three times a week until the symptoms are in remission, and they may be spaced out over months as maintenance therapy.”
“It was as if my brain was jump-started. It made me feel better almost immediately, and I felt nearly recovered by the fourth treatment.”
“ECT is one of the most effective treatments for severe depression. Yet this is the first time I’ve publicly admitted that I’ve received the treatment because of the stigma associated with it. Mental illness is stigmatized in general, and ECT is so stigmatized that many people are afraid to even mention the treatment that helped them get better. Why are those of us who’ve received it so reluctant to talk about it? No one is ashamed of receiving chemotherapy or immunotherapy. Yet in addition to the negative media impressions about ECT, mental health professionals still portray it as a “last resort” for those with “treatment-resistant” depression. I am left feeling as if it’s my fault that I need it—and ashamed for being suicidal—when I should be shouting to the world about the benefits, for me, of this treatment.”
Dra. Martha Andrea Castro Noriega, MD 