A Jolt to the System

This small electrical device may be the last hope for the chronically depressed

"I still go through mood changes," he says. "I have my blue days and good days, but there are a lot more good days now."

His main side effect has been the hoarseness, which comes every five minutes for a few seconds. At those times, it sounds as if he's being strangled, but he says that he doesn't feel pain, just slight pressure on his larynx. If he wants to shut off the device, he can, with the use of a magnet strapped to his wrist. And though doctors have yet to attribute use of the device to constipation, Davis says that's also been a factor.

Whether or not the FDA approves the device, Davis says he's not worried: "It works for me." Still, he occasionally questions what the long-term effects of continually stimulating the vagus nerve might be. "I do worry about that," he says, then quickly adds, "not worry, think about it."

His wife, after all those years of seeing him go from one treatment to another, was reluctant to believe something was finally triggering improvement. "When depression becomes a part of your life, it never leaves," she says. Yes, she sees a change in him, a "return of confidence," but she still can't conceive of depression ever vanishing from their lives.


"I have this thing of not looking directly in the eyes," she says, "because I think people can see inside me, and that makes me ashamed."

Seated near a large window, this woman of 48, who asks that she not be identified, clutches the sides of her chair. Dressed in a gray, baggy sweater and full skirt that cover most of her, she all the while averts the gaze of a stranger.

The shame. Only at the age of 39 in the confines of a therapist's office was she finally able to speak of her past, of her childhood in the Midwest, of how she and two other sisters were molested by both her father and two older brothers. Of the abuse, she says that by "today's standards," it would be considered rape.

"I'm an incest survivor," she says. "I've been in psychotherapy for 10 years and probably will be the rest of my life." And she's on medication, which, she says, does little to improve her moods. "After a length of time, the body becomes immune to it," she says. When not at work or at home, she's usually in therapy, group and individual.

She finally told her mother about the abuse when she was an adult, and the answer was swift: "We don't talk about our secrets. Not to strangers."

Her husband simply told her that the past should remain the past. They're now divorced.

This woman, who holds a steady, professional job, hides her depression well. From her clean-cut appearance, her firm handshake, no one at work would know what she does: that she's tried nearly every anti-depressant there is, that there's not a day that goes by, not even today, when she doesn't wish for death, that on weekends, she finds refuge in 18 hours of sleep at a time. And there was that time, several years ago now, when she downed a batch of anti-depressants and showed up at her therapist's office on the verge of an overdose, only to be taken away by ambulance.

Whether her depression is triggered by life events, she can't say. All she knows is: "After a while, depression becomes its own illness."

"I look at death as peace from torment," she says. But now she knows that she won't do it, can't, she says, because she doesn't want her grown children and grandchildren to bear the pain. They're her only "saving grace."

Almost two years ago now, she turned on the evening news and heard of the pilot study at UT Southwestern. A participant, a grandmother like herself, spoke of not finding pleasure in life. "That struck a chord," she says. "There are fleeting moments of happiness, but they're always short-lived.

"When I look at flowers," she says softly, tears just beneath the surface on this gray, rainy day, "I think, 'How long will they live?'"

The next day, after that show, she called UT Southwestern and soon sent them her medical records. For nearly a year, she didn't hear back. The wait, she says, was pure hell. And then, one day, she got the letter. She was in.

"I look at it as a chance, a piece of hope," she says. She's silent a moment. "But I do remind myself every day that it may not work."

But what of those childhood memories?

"I don't expect the device to take away the memories," she says defensively, looking out the window and pointing to a nearby skeleton of a tree.

"I want to see that tree out there," she says, her eyes narrowing, "and not see it bare and dead in the wintertime but that in two months it will have leaves on it.

"I don't have any hopes that it [the device] will make me forget," she adds. "That's impossible, but it might give me enough of a chemical boost to give me a different perspective."

Days later, she calls, mentions that her surgery is scheduled for early March. She sighs. "I'm still trying to hold on for that."

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