In my recent book, Crash: A Memoir of Overmedication and Recovery, I offer a detailed exploration of my journey through the maze of ineffective and often harmful psychiatric “care” that both my mother and I received when we experienced depression, anxiety, and chronic pain. Early on, I picked up the notion that depression was due to something difficult you experienced—for my mother, it was the births of her children in close succession. She took copious amounts of pills and saw her psychiatrist fairly regularly, but she never got well for any extended length of time.
And when I had experiences of depression, I took a psych drug for a month or so and then discontinued it, so it didn’t seem like I needed a drug forever to be OK. Until the mid-90s when depression and chronic pain hit me at the same time and nothing at all helped. For many people, my story and my mother’s will be familiar—they try drug after drug and then maybe several ECT shocks and still don’t get well. Maybe your doctor treats you with numerous headache drugs and you still have a migraine. Maybe you’re given opioids as part of a pain management cocktail. What happens then?
I explore those questions and many more in my memoir. And in case you think that something that happened over 30 or 60 years ago—in the case of my mother—can’t be relevant today, here are a few news articles that relate to the experiences I recount in my book and an endorsement from a pharmacology professor at Georgetown.
“I read your book cover to cover tonight; I hadn’t meant to read the whole thing, but it is so well-written,,clear ,and compelling. I would love to have a hard copy to share with students.”
~ Adriane Fugh-Berman, pharmacology professor at Georgetown Medical School
“Converging lines of evidence now suggest that depression—a common comorbidity in the setting of chronic pain—may in some patients represent an unrecognized yet potentially reversible harm of opioid therapy.”
Last week when I opened up the Sunday edition of The Baltimore Sun, I read an op-ed piece written by three psychiatrists entitled “Haunted asylums are a Halloween staple: Does the fictional gore undermine psychiatry’s good?” The authors emphasized the point that rendering psychiatric treatments as horrific and damaging and “demonizing” patients who need treatment could deter those who need it most. But I had to take issue with their point about electroconvulsive therapy (ECT), a procedure where a doctor administers a current of electricity strong enough to induce a grand mail seizure, is “brief, still, and quiet.”
Because both my mother and I experienced ineffective treatment and overmedication for depression and chronic pain, I have spent the past twenty years trying to figure out what happened to us. Putting those pieces together involved reading research about psychiatric treatments, including the use of antidepressants, anti-anxiety drugs, and ECT. And contrary to what many psychiatrists will tell you, the treatments are largely ineffective at best and can be very harmful at worst.
In response to the three psychiatrists’ letter regarding the demonizing of psychiatry by using old asylums as places to terrorize visitors looking for a Halloween scare, I offer a more skeptical take on the current treatments one is offered by modern psychiatry. As someone who has experienced depression and anxiety in the past and watched friends and family members suffer, I am well aware of the serious nature of emotional distress issues, and I am in favor of evidence-based treatment. But for many people, the treatments run counter to the latest research, are ineffective at best, and sometimes even harmful.
One of the main problems plaguing modern psychiatry is its overreliance on the biological model of mental illness, often simply referred to as the chemical imbalance theory. Yet prominent leaders in the field have disavowed this theory, though many in the general public have not gotten the word. For example, Dr. Ronald Pies, psychiatrist, of SUNY Upstate Medical and Tufts Universities, denies the chemical imbalance theory that modern treatment is based on: “In short, the ‘chemical imbalance theory’ was never a real theory, nor was it widely propounded by responsible practitioners in the field of psychiatry.” And lest you think Dr. Pies is exaggerating, you could consult the latest research By Dr. Joanna Moncrieff et al in which shows that there is no serotonin imbalance in the brain.
Despite its leaders disavowing the theory of a chemical imbalance causing emotional distress, psychiatrists routinely prescribe “treatment” consisting of drugs that purport to correct a chemical imbalance—which we now know does not exist. And recent research states that antidepressants only work for 15% of the people who take them. Few, if any, doctors mention the horrors of sexual dysfunction, sometimes permanent, that afflict many people who take psychiatric drugs. Most people who watch TV have heard the litany of the more common side effects of psych drugswhich include insomnia, sedation, constipation, headaches, weight gain, blurred vision, tremors, and seizures.
And if you try two or three drugs and your doctor deems you to be treatment resistant .…meaning the drugs don’t work for you…then your doctor can administer an electrical current strong enough to induce a grand mal seizure. Electroconvulsive therapy [ECT] is a serious and harsh procedure by any measure, despite Drs. Phelps, Mutalik, and Appell’s assurance that ECT is “brief, still, and quiet.” Even so, recent literature reveals that for 50-70% of people who receive ECT relapse within two to four months and some as soon as four weeks. The doctors mentioned above fail to inform readers that harms from ECT can include permanent memory loss, brain trauma, and even brain damage.
We may be removed from the horrors of the “Field of Screams”, but research shows us that many of psychiatry’s current treatments, far from being precise and effective, are often deemed futile at best and potentially very harmful at worst. Given that many recent studies show that exercise is as effective as antidepressants in treating most cases of depression, shouldn’t patients be offered the least harmful method of treatment first? And after reviewing many of the harms that are possible with the use of antidepressants and ECT, let’s consider the results of National Institute of Mental Health study concluded about the course of untreated depression: “If as many as 85% of depressed individuals who go without somatic treatment [drugs, ECT, and other treatments] spontaneously recover within one year, it would be extremely difficult for any intervention to demonstrate a superior result to this.”
I’m pleased to announce that my memoir, Crash,is available for purchase on the following platforms: Bookshop, Amazon, and Barnes & Noble, & Ebook Versions, as well as here on my website. Putting this book together was like assembling a giant jigsaw puzzle—fitting experiences together with research helped me to develop a deeper understanding of what happened to me when I sought help for a severe depression and chronic migraine. Contrary to many of the upbeat and happy images you see in the commercials for antidepressants, my journey was one of trying one drug after another, yet never finding relief. The research I did for the book revealed that I was far from alone in that experience–only about 15% of the people who take antidepressants experience improvement greater than what’s accounted for beyond the placebo effect.
Part of the reason I’m so interested in the topic is because I grew up in a home with a mother who suffered from chronic, unremitting depression for nearly 40 years. Mom did everything the doctors told her, yet she could never escape the heavy pall of darkness. I kept wondering: Why could I recover and Mom couldn’t? I found the answers buried in an old folder in my sister’s attic. Crash braids my story with my mother’s to explore her journey using Dad’s detailed records from 30 years of her care, interwoven with research and vignettes from my past.
All through my illnesses, “I’ll never be like my mother,” was my fervent mantra. I vowed to escape her fate despite year after year of unsuccessful treatments with numerous drugs and many rounds of electroconvulsive therapy. Crash is the story of what I learned about treating depression and chronic pain and the steps I took to finally recover. My memoir serves as a missive to women struggling to heal, carve their own path, and demand better care.
Here’s what some noted people in the field of psychiatric reform had to say about Crash:
“Ann Bracken’s evocative memoir powerfully tells of how psychiatry’s diagnoses and treatments can lead to loss, illness, and despair, and how escaping from that paradigm of care can be a starting point for a full and robust recovery.”
~Robert Whitaker, Author of Anatomy of an Epidemic
“Ann Bracken artfully braids her path out of chronic pain and major depression, while questioning the system designed to help her, and reaching back into her mother’s history to find a way to help her as well. Bracken gives us permission to ask questions about our current mental health treatment; read and educate ourselves on the risks, benefits, and alternatives to psychiatry’s status quo; and above all, not to quit until we find our own path to a healed life.”
~Angela Peacock, MSW, mental health advocate and featured in award-winning documentary, Medicating Normal
“A fascinating memoir of two generations of medical and psychiatric mismanagement and suffering, and how one brave woman figured out what was happening and successfully took control of her health and well being… and prevented a third generation from following the same path.”
~Stuart Shipko, MD, author of Surviving Panic Disorder and Xanax Withdrawal
I wrote this essay after seeing the film Luna, about a brother and sister who were both medicated for ADHD and now struggle with self image, motivation, and the negative effects of stimulant drugs.
When I graduated from college in 1974, I felt well-prepared to work as a speech and language pathologist in the public schools. I knew how to use an articulation test to screen for speech delays and pronunciation problems. Using a variety of standardized and informal assessments, as well as teacher input, I could determine areas where a child was struggling with language comprehension and expression. I easily performed routine hearing screenings to determine whether a child needed a full audiological workup. But what I wasn’t prepared for was making recommendations to parents for children who were labeled as “hyperactive.”
During my second year of working in the schools, one of my duties was working on a screening committee. The screening committee in my school consisted of the assistant principal, the school psychologist, the reading specialist, the classroom teacher making the referral, and the speech pathologist (me). Children were referred to the committee for a variety of concerns—struggles with reading or math; speech, language, or hearing problems; and “hyperactivity,” which was later renamed as Attention Deficit Hyperactivity Disorder (ADHD).
Three aspects of the screening committee’s discussions regarding the children, almost always boys, that either teachers or parents considered to be hyperactive stand out for me. When we surveyed the child’s records, we almost always discovered he had what we euphemistically called a “late birthday” because he was born near the end of the year. That meant that he was usually one of the youngest children in the class. Additionally, when we checked into the child’s home life, we often discovered that his parents had recently divorced or there’d been a death in the family. And lastly, there was always someone on the committee, often the assistant principal or the school psychologist, who recommended that the parent seek a medication consultation for the child.
“Assigned reading” was as much a dreaded phrase when I was young as it was to my high school students’ ears when I taught several years ago. Everyone pretty much agrees that there’s a much better chance you’ll enjoy reading if you choose the books yourself, rather than read from a prescribed list. But in 2021, I assigned myself several books that belong to the great cannon of literature, books that I’d somehow never read.
Determined to make up for missed opportunities, I began the year ambitiously with a pretty formidable list: Pride and Prejudice by Jane Austen, Shakespeare’s King Lear, Emily Wilson’s translation of The Odyssey, The House of Mirth by Edith Wharton, and A Tree Grows in Brooklyn by Betty Smith. I read many other books as well–fiction and nonfiction, but I’m proud to say I read the books–for the most part–and I have a new set of reading ideas for 2022.
Should I hang my head and confess that I didn’t enjoy Pride and Prejudice? I’ve seen the film versions and the play and loved both of them. The characters were interesting and sometimes even funny, and I did admire Miss Bennet, but Austin’s prose left me flat. I suppose it was her style that I didn’t like–so full of descriptions and long sentences. I read up to page 200 and then put it aside, feeling like I’d had my fill of Austen for a time.
I read A Tree Grows in Brooklyn as an adolescent because my mother recommended it, but I re-read it in 2021 just so I could appreciate it as an adult. I loved the story of Francie and her family. Smith writes realistically about tenement life in New York city at the turn of the 20th century, capturing the grit and desperation that people like the Nolans must have felt as they worked just to survive. Many situations ring true today–women staying with charming men despite serious drinking problems, families scrambling to feed children, and a young girl nurturing a dream of something much grander for her own adult life. I was actually surprised by how much I enjoyed the book and found myself wishing I could remember what I thought about the story when I was a girl more like Francie Nolan.
I read several acts of King Lear before finally giving up and watching a movie of the play. I appreciate more than ever, the kids who hate reading Shakespeare, but love the stories when they come alive on a stage or on the screen. I remember seeing the play at the Ashland Shakespeare Festival a number of years ago, and the scene that stands out for me is the king with his fool in the rain. But I must have been so caught up in the spectacle of the play in Oregon that I forgot that nearly everyone dies.
Edith Wharton’s prose in The House of Mirth was exceptional, and I was pulled into the story from the start. I loved Lily Bart and rooted for her to find someone shegenuinelyloved who could help her financially as well. And The Odyssey--I think I would have enjoyed it much more if I’d been able to take a course with a Greek scholar, like Emily Wilson. I enjoyed the parts that I was very familiar with–the adventures with Polyphemus, Circe, and Calypso and the homecoming. But I found the repetition and long rambles about banquets and strategy to be boring. Still, I’m glad I stuck with it and read the entire epic poem, and Emily Wilso has my undying admiration for her translation and depth of knowledge.
I’m still forming my list for 2022, and may explore more Wharton. I’ve decided to listen to Mary Shelley’s Frankenstein because I often find I enjoy listening to some older forms of prose more than I enjoy reading them.
There are always so many more books that I want to read than I actually complete–I often wish I could just swim in a pool of stories!
In honor of April, which is National Poetry Month, I’m exploring a variety of ways that people can use poetry to enrich their lives. This week I’m looking at poetry and it’s close cousin, music, as ways to add depth and texture to teaching history and exploring social justice.
This line from poet William Carols Williams about where to find news has always intrigued me:
“It is difficult to get the news from poems test men die miserably every day for lack of what is found there.”
I think the same could be said for getting our history from poems and songs, or at least using those arts to give us an alternate lens of past events that are often rendered in a sterile listing of facts. I’m not saying that you could actually teach history by using only poetry and songs, but you can add depth to events that are often given just a few paragraphs of explanation, if they are mentioned at all
Poems offer us personal glimpses into the people who lived through events, such as wars, labor movements, and fights for justice. By reading and reciting an author’s poems, we may begin to realize the felt-sense of that person’s experiences and begin to see more clearly how our lives and struggles are related to the author’s.
I think the other benefit of using poetry is that the abstract is made concrete by telling the story of a personal experience. When history teachers want to talk about segregation and the impact that the Jim Crow system had on ordinary Black Americans, perhaps they could turn to Langston Hughes’s poem “Merry-Go-Round” for a compelling entry point that will engage students in a visceral experience.
Colored child at carnival
Where is the Jim Crow section
On this merry-go-round,
Mister, cause I want to ride?
Down South where I come from
White and colored
Can’t sit side by side.
Down South on the train
There’s a Jim Crow car.
On the bus, we’re put in the back–
But there ain’t no back
To a merry-go-round!
Where’s the horse
For a kid that’s black?
For more recent history of the senseless violence and continuing racism that Black Americans face, teachers could look to the Poets.org and select a few poems from the Black Lives Matter page, which has some profoundly moving poetry. And to look at some history from the recent past, read Lucille Clifton’s poem, “jasper texas 1998,” about James Byrd in Texas in 1998. You can find this poem in Blessing the Boats.
And what about the role of songs in getting students engaged with history? One song that taught me something I had never heard of is “Christmas in the Trenches” by John McCutcheon. McCutcheon recounts the story of the 1914 Christmas Truce that happened during Christmas Eve in 1914 as German and British troops huddled in frozen trenches to celebrate Christmas in the midst of carnage.
The song raises a series of questions about why we fight wars and about the power of getting to know the “enemy” as a person. So often, once people on opposite sides of a battle begin to share their personal stories, they find they have much in common. And when they begin to think that both sides have families and friends who love them, they begin to lose the will to fight.
Here’s the song and a link to Joyeux Noel, the movie that was made a few years ago that explores the Christmas Truce of 1914 in greater detail. Imagine the questions that students might raise if they heard this song and watched the film.
In honor of National Poetry Month, I’m posting a couple of columns that can help you see often-neglected uses for poetry. Besides its great beauty and ability to capture emotions, poetry can be a useful tool in many aspects of life–like dealing with depression.
How can poetry help depression? Aren’t medication and therapy the best ways to treat the illness? My story may surprise you.
When I suffered from depression in the early 1990s, Prozac was the new “miracle drug.” Along with this so-called “miracle drug came a physical explanation of causation: that depression is caused by a chemical imbalance in the brain. This thesis is still widely promulgated, though much research is coming to light that disputes and even negates this biomedical explanation for the darkness that is so prevalent in our modern world. More information on the research side can be found at the website Mad in America, curated by science reporter Robert Whitaker. As part of Whitaker’s work to educate the public, he invites doctors, psychologists, counselors, and patients from all over the world to share research, essays, and personal experiences on the issues of depression and its treatment.
Even in the 1990s when I struggled to climb out of depression and tried numerous medications for several years with no results, the idea that the chemicals in my brain were out of whack did not provide a solid answer. Instead, I pursued a more metaphysical explanation for the questions that haunted me: “Why am I depressed?” and “What longings are unfulfilled?”
And that’s what led me to poetry.
One of the most valuable resources I found to aid in making sense of the gifts of depression is poet David Whyte’s 1992 CD entitled The Poetry of Self Compassion. Whyte’s recitation of Mary Oliver’s “The Journey” confirmed my feelings of being on a perilous but necessary journey through darkness and confusion. And I was deeply confused by the all-encompassing darkness that I was experiencing. But once I heard Whyte recite “The Journey,” I knew that someone understood a piece of what I was experiencing. And that the way I was feeling had nothing to do with messed up brain chemistry. My depression had everything to do with self-discovery and taking charge of my life.
One day you finally knew
what you had to do, and began,
though the voices around you
their bad advice–though the whole house
began to tremble
and you felt the old tug
at your ankles.
“Mend my life!”each voice cried.
But you didn’t stop.You knew what you had to do,
though the wind pried
with its stiff fingersat the very foundations,
though their melancholy
was terrible.It was already lateenough, and a wild night,
and the road full of fallen
branches and stones.
But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,
and there was a new voice
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,
determined to do
the only thing you could do–
determined to save
the only life you could save.
~Mary OliverI remember listening to the poem over and over–as if rolling around a mysterious new food in my mouth, trying to figure out what it tasted like that was familiar. What was it I was determined to do? What else besides raise my children, serve my community, and be a good wife? I just knew there was more. And Mary Oliver’s words gave me the courage to make the journey that would save my life.
The answer was slow in coming, but I gradually began to realize that my struggles with depression and a migraine headache exacerbated my ex-husband’s verbal abuse to the point where I could finally see it. Depression and chronic pain became my crucible for change and my pathway to a new life. Poetry became my way to unlock the profound secrets that illness led me to discover. Poetry helped me to have compassion for my journey and for all the mistakes I had made along the way.
Whyte ends on a note of great compassion in the poem “The Faces at Braga” as he compares surrendering to the fire of depression and embracing your flaws in this way: “If only we could give ourselves to the blows of the carver’s hands, the lines in our faces would be the trace lines of rivers feeding the sea” and we would “gather all our flaws in celebration, to merge with them perfectly…” What a compelling call–to celebrate one’s flaws. What a gift of healing.
This essay originally appeared in the Currere Exchange, Vol. 4, No. 1, 2020.
While I’m no longer able to volunteer inside of a prison, I’m continuing my advocacy work by mentoring a writer who is incarcerated in a Maryland prison. If you’re interested, check out the Justice Arts Coalition’s pARTner Project for more details.
In 2015, my editor at Little Patuxent Review gave me an assignment I wanted to refuse; she asked me to interview a professor who ran a writing group—in a prison—and then to visit the prison and interview the men. The woman who ran the group—Professor M., a sociology professor at a major research institution who’d volunteered in the prison for seven years—spoke very positively about the men who participated in her group. Near the end of our interview, she shared a program with me for a literary day of the arts where the men had performed their original poems, stories, and songs. Their faces looked young and happy, which was a complete surprise to me. Professor M. assured me that I’d like the men, and her parting words were especially compelling: “There’s no one else that I’d rather spend a few hours with in a discussion.” I was intrigued, but frightened to go into a prison. My mind buzzed with all of the common middle-class stereotypes about “those people” behind bars and how they might act. “Those people”: school drop outs, drug dealers, hustlers, maybe even murderers. At that time, I had driven by the prison only once and never had the slightest desire to volunteer there. Several of my writer colleagues worked in prisons, and while I admired them, I had kept my distance, partly out of fear and partly because my protective shell had begun to crack as I learned about the prison industrial complex and the school-to-prison pipeline.
Many of my former high school students had brushes with the juvenile justice system, but none of them were especially “bad” kids. Instead, they were kids who had tough home lives or who had made really poor, impulsive decisions or who’d been unfairly targeted by a biased system that landed them in the lap of the law. Deep down, my spirit realized that, if I were to go into a prison and meet the men, I’d probably form a bond with them. Up to that moment, I’d walled myself off from that possibility, but my interview with Professor M. had piqued my curiosity.
Once my security clearance came through, I accompanied Professor M. to meet her writing group. Along with a lone pad of paper and a single pen, I’d brought a copy of my first poetry book, The Altar of Innocence, for the men to read and share. I thought they could relate to my story about drug and alcohol abuse, depression, and divorce. Ninety minutes were allotted to interview five men, so I’d prepared questions about something that I wanted to know and understand better: Who were you when you came here? and Who are you now? I wasn’t allowed to have a recording device and couldn’t take any pictures, so I wrote notes on everything I experienced in order to capture the look and feel of the prison. My hastily scribbled sentences contained every detail that I could observe—the yellow X on the elevator floor designating the spot where no one could stand for fear of stalling the elevator, the insulation peeling off of the pipes in the hallway, the black metal peeking through chipped paint on the bars, the smell of bleach in the hallway outside the school, the song-like Baltimore and foreign dialects of the guards—and most of all, the men in the writing group.
Each one of them greeted me with a smile and shook my hand to welcome me to the group. Professor M. had told them why I was coming and then gave them a bit of my background—college lecturer, writer, and former high school teacher.
After about 15 minutes of introductions and chatting, we got started with the business of the interviews. The men sat around a large, rectangular table, each with a black and white composition book that held his writing. I didn’t think we’d have time for sharing, but it was good to see that they’d come prepared. I made notes about the physical condition of the room and copied down the quote written in neat cursive on wide yellow bulletin board paper that served as the backdrop on the stage. “Education is a passport to the future, for tomorrow belongs to those who prepare for it.”
I was impressed by the men’s good manners and calm demeanors. They laughed and joked with one another and shared stories with Professor M. and me. I felt much more relaxed than I’d imagined, and I was totally enthralled with all that the men had to share about their lives.
Here is a sample of what they told me. All of the men’s names throughout the manuscript have been changed to preserve their anonymity.
“I was misguided. I had no sense of self-worth. I grew up without any guidance. I’d say I was a lost individual. I was only reading at about the 7th grade level. I did some dumb things. I’ve been here since I was 15, and now I’m 28. Who I am now is a happy individual. I’m striving to be a better person—educated, moral, all that. I’m working on my character. I meditate, pray, work on my attitude. I want to contribute in a positive way. Part of what helps me is reading. When I read words, and I didn’t know what they meant, I went and got a dictionary. The idea that I could learn on my own was a spark.”~ Ryan, from East Baltimore
Author’s note: This essay forms the foundation for my memoir-in-search-of-a-publisher, Putting the Pieces Together: A Story of Overmedication and Recovery.
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 actuallyvery 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.
Want to read the rest of the story? Please hop on over to the Mad in America blog where this essay was originally publishedin May of 2019.
It’s customary at the start of a new year to make resolutions–and then for them to fall by the wayside within a few weeks. I know–I’ve done it in the past. But I have a new strategy inspired by the book One Small Step Can Change Your Life: The Kaizen Way by Robert Maurer, Ph.D.
I read the book several years ago and frequently return to Maurer’s advice when I encounter a goal I’m flummoxed by. The main takeaway in the book, at least for me, is two-fold: We often become overwhelmed by changes that we perceive as being too big to handle, and if you think you’re taking a small step towards your goal, go even smaller.
He gives the example of helping a client address her idea that she didn’t have time to exercise by securing her commitment to walking for one minute as she watched her favorite TV show. She gradually progressed to walking during one commercial break, then two, and pretty soon, she was walking for 30 minutes while she watched TV, meeting a suggested fitness goal.
Maurer explains that the brain fears change, and when we decide to make a change from no exercise to 30 minutes a day, the amygdala goes into freak-out mode, paralyzing us. But if our movements toward a goal are incremental to the point of insignificance, we’ll make changes more smoothly and eventually reach our goals.
One change I want to make is to read some of the great literature that I’ve missed over the years. For the most part, I’ve missed it because of my chosen major in college–speech pathology–and the need to do some much required reading for all the courses I’ve taught over the years.
But now that I’m retired, I’m looking forward to reading books that call to me to explore them in full. To start with, I’ve purchased Emily Wilson’s translation of The Odyssey, which critics say is brilliant. I’ll also finally “get my Austen on” and read Pride and Prejudice, then King Lear,some essays by James Baldwin, and Adrienne Rich’s Diving Into the Wreck. Those few titles may take me through 2021, and I plan to work out time for short segments of reading where I can savor the language and enjoy the experience.
I’ve often approached things that I’ve missed–like significant books–by reading enough to have a passing knowledge of the plot and characters. I’ve seen myself as an ice skater, skimming the surface of the ice, just ahead of the fall. But now I’m shifting my perspective to that of a wader–slowly entering the stream and savoring the beauty of the tide pools.