In 1959, my mother suffered what people commonly referred to as a nervous breakdown after my youngest sister’s birth. Mom spent six months in a local, Catholic psychiatric hospital while Dad and Grandma assumed command of the household. I was seven years old, the second-oldest of five children. Eventually, Mom visited us a few times on Sundays, and then returned home in November, presumably ready to assume her duties as a wife and mother. Sadly, Mom remained gripped by depression for the rest of her life.
Because my memories of that time are wrapped in thick layers of gauze, I’ve had to rely on others to fill in the gaps. My father, grandmother, and Mom’s close friends believed that Mom experienced postpartum depression, starting after my birth, and worsening with each successive child. My older brother shared this memory about a year ago when I asked what he remembered about Mom’s 1959 illness: “I came home from college and found her in the basement, banging her head against the wall, moaning, ‘I can’t take it anymore.’”
My heart ached when I heard that story, but I still puzzled over why Mom never recovered. Until I found Dad’s collection of records in a dusty box stashed in my sister’s attic. Old insurance and medication records, newspaper and magazine articles, and letters to doctors were neatly organized in an unassuming manila folder. As I leafed through the contents, intuition whispered that I’d finally have the missing puzzle pieces I’d searched for all my life.
Some of the most valuable clues were in a letter, typed on onion skin paper, that sat on top of the file. It was dated 1-17-83 and addressed to Dr. L., one of Mom’s many doctors. Dad wrote the following notes:
5th child born Feb.59. Normal birth and she carried baby in good spirits. About mid-April started having problems and had first visit with psychiatrist of May 8, 1959. Between then and June 22nd, ’59, he treated her with Amytal, Ritalin, Nardil, Trilafen, NaBu-4, Dexamyl tabs and spansules, and Tofranil. By the end of May ‘59 she was so bad, that even to my nonprofessional eye, I didn’t see how she could avoid hospitalization… She remained there to late Nov. 59. During this time, she received medicine and numerous EST [electroshock therapy] treatments.
The only drug I recognized in that long list was Ritalin, an amphetamine that had been widely prescribed for depression in the 1950s and ’60s. I quickly set to work looking up the rest, all the while screaming inside, How could anyone give a nursing mother with three small children and a newborn so many drugs in such a short period of time? A quick search on the website drugs.com helped me to understand the other drugs my mother took when she first got depressed. Amytal is a long-acting barbiturate; Nardil is an MAO-inhibitor (a type of antidepressant); Trilafon is an antipsychotic; Nembutal is a barbiturate used as a sedative; Tofranil is a tricyclic antidepressant; and Dexamyl is a combination of an amphetamine and a barbiturate.
It was easy enough for me to find the commonly listed effects of all of those drugs, and I wondered how Mom’s doctor could have prescribed all of them in such a short time. Dad’s records don’t indicate if she took all of them together, but even if she took a few, discontinued them, and started a few others, the chemical load must have overwhelmed her system. What struck me in looking at the effects of all the medications was that many of them could cause anxiety, sleeplessness, and agitation—three things I clearly remember my mother struggling with.
Now my brother’s story made more sense—I think Mom was banging her head on the wall because she couldn’t tolerate what the drugs did to her. Her doctor told a different story in the diagnosis that my father noted: “This psychiatrist [Dr. S.] diagnosed it [Mom’s illness] as severe depression with agitation and not due to childbirth.” The doctor’s assessment rang true in one sense—it seemed pretty clear to me that Mom’s severe depression with agitation was due to the massive amounts of drugs she was taking and was, indeed, not related to childbirth. But somehow, I don’t think that’s what the doctor meant. While I have no doubt that my mother struggled against overwhelming feelings of sadness and fatigue, which led to the initial appointment with Dr. S., I believe Mom’s breakdown was probably chemically-induced due to overprescription of drugs.
Dad had also kept some of the original prescription bills related to Mom’s 1959 hospitalization, and between August and October, she took Thorazine, Nembutal, and Tofranil on a regular basis, in addition to receiving an undisclosed number of electroshock therapy treatments. When she came home, the doctor had her on a regimen of Phenobarbital, Miltown (an antianxiety drug), and the tricyclic Tofranil. Dad supplemented that regimen with carefully measured decanters of white wine that I once caught him cutting with water. When he saw me watching, he cautioned, “Don’t ever tell your mother what you saw.” Nowhere in the thirty years of records is there any indication of Mom’s drinking, which all of us tacitly accepted as a significant part of her daily routine.
I also found homemade spreadsheets where Dad listed the dates and medication amounts for Mom’s drugs, often annotated with notes about her responses. The information in those charts prompted me to investigate possible medication effects that may have influenced Mom’s internal state which led her to attempt suicide in 1967. At the time, she was taking a combination of Aventyl (a tricyclic which can cause restlessness, agitation, and anxiety), Dexamyl (amphetamine and barbiturate combination), and Phenobarbital (a barbiturate which is linked to nightmares, nervousness, depression, and anxiety). The effects of all of these medications, combined with Mom’s continued daily drinking, probably led to the intense feelings of despair that drove her to slit her wrists in December. Dad found her in the bathroom that night. I accompanied my parents to the hospital, while my two siblings, ages twelve and thirteen, stayed home and cleaned up the bathroom. None of us ever spoke of that night again.
What about therapy, I wondered, and how did Mom’s psychiatrist treat her after that tragic night? One would think the doctor should have increased Mom’s routine visits to keep a closer watch on her. But according to Dad’s records, that’s not what happened. In fact, Mom’s doctor saw her twice a month, beginning in January of 1960, only about two months after she was released from the hospital, and continuing through June of 1968. However, in the weeks immediately following her suicide attempt in 1967, he did not see her more frequently, a fact which seems to indicate a lack of support and concern. By August of 1968, Dad’s notes indicate that Dr. S. wanted to hospitalize my mother. Dad’s notes and the conversations I can remember ring with the angry charge that “Dr. S. just threw up his hands and gave up on her.”
Because Dad was adamant about keeping Mom out of the hospital, he sought out Dr. M., a well-known psychiatrist who performed electroconvulsive therapy (ECT) treatments in his office. Between August of 1968 and June of 1970, Dr. M. administered thirty-nine ECT treatments to my mother, sometimes giving her as many as five treatments in a month. The one time I remember accompanying my father to help him bring Mom home, I was shocked by her dazed look and unsteady walk. I remember her sleeping through the next day and experiencing memory loss from that time forward. Dad told me that Dr. M. did the procedure without anesthesia, but from some of the reading I’ve done on earlier ECT administration, it seems likely that Dr. M. probably used a short-acting barbiturate to sedate Mom. Otherwise, how could she submit to so many treatments? And how could Dad willingly put her through that pain? I think both of them must have been more desperate for relief than any of us kids could have guessed.
I wish I could say that Mom got better after all of that ECT, but she never attained such a reward for all of her efforts and suffering. In 1973, after suffering from mysterious dental pain for several months and finding no relief, a neurologist helped Mom and Dad to see that she was suffering from depression. Mom was hospitalized for at least a month and endured detox for both barbiturates and alcohol, but she was unable to maintain her sobriety once she came home. I was sickened to learn that Mom’s doctors routinely prescribed Thorazine for her from 1969 to 1983, a practice which would explain why she suffered from tardive dyskinesia and later from severe full-body trembling, possibly akathisia. Mom was hospitalized again for several weeks in 1993, and for the first time, her psychiatrist confronted the family about her alcohol dependence and informed all of us that her MRIs showed evidence of small strokes and blood in the brain. He asked all of us to pledge to refrain from serving alcohol at family gatherings, but we were split on the issue of whether Mom had a problem or not, so she continued to drink along with all of her medications until her death in 2002.
I remember my mother suffering from horrible, visceral anxiety where she would take deep, fast breaths and then wring her hands as if she were Lady Macbeth. Now that I understand more about her medications, I realize how impossible it is to determine if my mother was actually very depressed and anxious or if she was one of the early victims of polypharmacy, trapped in physical and emotional pain due to overmedication and a lack of supportive therapy. It seems clear from the records that Mom’s doctors saw her condition as biochemical and treated her accordingly, tweaking the pills as they went along, and in a sense, resigning themselves to maintaining her “treatment resistant” condition with the only tools they believed in.
Despite all of her sedating and numbing medications, Mom lived a rich and meaningful life. She cared for us, made sure we had regular, nutritious meals and provided a supportive presence when we needed help. Mom hosted her bridge group, participated in a book club, and made weekly trips to talks at the local art museum with one of my aunts. She was also a gifted artist with a degree in costume design from Maryland Institute College of Art, but her talent never matured once all of us were born. Sadly, she never picked up a paint brush in all the years I knew her.
As a child, I made two vows: to help my mother get well and to never be like her. I had internalized a powerful lesson: Physical illness was understood, accepted, and treated kindly, while any signs of emotional weakness were shunned and sometimes mocked, as when my father told me I was too sensitive if I got upset over his teasing. Over the years, I suffered from mysterious pain, similar to my mother’s dental pain. Luckily, each time my body cried out for help, whether it was with pelvic pain, back pain, or intestinal distress, I was able to resolve the issues, sometimes with medication, and eventually with massage and acupuncture. I began to understand the ways my psyche used physical pain to communicate emotional distress. And I remained terrified of being trapped in depression.
I had my first diagnosed depression—postpartum depression—after my daughter’s birth in 1982, but quickly resolved it by briefly using the tricyclic antidepressant Elavil before discontinuing it due to pressure from my husband. Elavil also worked when I had another episode a few years later, and again, I stopped taking it once I felt better. My husband berated me for using antidepressants, and in retrospect, I think he was terrified that I’d be like my mother: our shorthand for “you’ll never get well.”
In 1993, my worst fears were realized with a double-threat: an intractable migraine and an unrelenting depression. My husband and I had a very difficult relationship almost from the outset, but by the mid 90s we seemed to be living on parallel paths, coming together for the children and social occasions, but sharing fewer interests and growing in different directions. When I consulted with my family doctor, I told him, “I know this headache has a psychological cause, and I’m working on things. I’m just not sure what the problem is.” He prescribed two antidepressants—Elavil to help with the headache and Paxil to relieve the depression.
By 1996, three years later, I’d consulted a parade of psychiatrists who’d prescribed grab-bags full of medication. Nothing had worked, for either the headache or the depression. My newest psychiatrist insisted I see a headache specialist, and when I told the nurse practitioner about my theory of physical depression, she immediately prescribed MS-Contin, Migranol nasal spray, DHE-injections, and eventually Oxy-Contin and Methadone.
The headache continued pounding away inside my skull, and I felt so dead inside that suicide seemed like my only option. I begged my doctor for ECT treatments and tried several more combinations of antidepressants and mood regulators before the depression lifted in 1997. But still the migraine raged on.
In the fall of 1999, I had my first car accident, swerving across Route 70 five times before planting my bumper in a guardrail. Miraculously, I didn’t hurt anyone. I told myself it was a one-off and kept driving. In January of 2000, I fell asleep on a busy thoroughfare and slammed my Toyota into the back of a large van. I heard a man pounding on my window as I woke up and found my car filling with smoke and an airbag pinning me tight to my seat. That man turned out to be the van’s owner who disappeared as soon as my father arrived to help. To this day, I think he was an angel sent to save me.
Western medicine had failed me. The deep shame that I felt for taking Methadone combined with the shock of two accidents forced me to confront my life with fresh eyes. I lined up my pill bottles on the counter for a reality check. My psychiatrist insisted I take maintenance meds to prevent recurrence of depression—Wellbutrin, Topamax (a mood regulator), Elavil, and Valium. My headache doctor had me on Methadone, DHE injections, Migranol nasal spray, and a stash of injectable Demerol for the bad days. But I wasn’t high. I was numb.
It was time for radical action, so I called Kayla, an energy healer who’d been recommended by a friend. I told her my story and finished by saying, “I want my life back. Can you help me?”
Her answer: “I can almost guarantee I’ll get rid of the pain, but I cannot guarantee what else might happen. Are you ready?”
Kayla worked with me doing distance energy healing, clearing my chakras and giving me images of what she saw energetically. Because I was already tuned in to the mind-body connection, I surrendered myself to her care. She provided flower essence mixtures that I put in my water, and I was gradually able to cut down on the pain meds. After four months of working with Kayla, my headache had vanished, along with the awful pills that had kept me in such a fog. Only then was I able to leave my abusive marriage—the real source of my pain.
Since May of 2000, I’ve remained free of all pain medications. My infrequent headaches serve as a warning to attend to my life, and I’m able to manage the pain with Tylenol, flower essences and lavender essential oils. I’ve been depression-free since 1997 and psychiatric drug-free since the early 2000s. I smile every time I remember the warning my psychiatrist issued when I told him I’d discontinued my medication: “You have a damaged brain from repeated episodes of depression. If you don’t take meds, you’ll be sicker than you’ve ever been before.” I’m glad I didn’t listen to him.
When I look back over the course of my mother’s and my own treatment for depression, one inescapable fact becomes blindingly clear. No matter how many medications my mother took, she never got well. And I can’t pinpoint any particular drug or treatment that allowed me to finally escape from depression. By today’s standards, both of us would be labeled as treatment resistant, situating the problem within us, as if somehow, we were willfully resisting. What’s been most puzzling to me is why many doctors continue to prescribe medications, often in combination, when it’s clear that they aren’t working. After a while, why doesn’t it occur to them that maybe the treatment itself is the problem? From much of the reading I’ve done regarding the causes of mental distress and the effects of commonly prescribed drug treatments, I see a tremendous gap between what many medical professionals and average people think about depression and anxiety and what vast amounts of research have demonstrated over the last fifty years.
I wish that I could have helped my mother to get well, but I recognize that she and my father were victims of the times they lived in. On the other hand, once I found the tools that helped me to heal at a deep level, my life has been rich and full. I am blessed with a satisfying career, good relationships with my children, and the support of wonderful friends. I’m grateful for the help I’ve found and for the healer who helped me to trust the deep wisdom housed in my body. I imagine Mom’s story and mine joining a great chorus of voices whose song of hope will lift many hearts burdened with doubt. Let’s all keep singing.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.