Emotional Abyss; Physical Cause? — (The New York Times)

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The New York Times


Published: October 30, 2007

My father killed himself at 46. So not surprisingly, at 46 I felt nervous and a bit depressed. As a scientist, I looked at the facts, the data. Life was fundamentally fine ­ married to a supportive man, with three healthy sons and a good career. But the anxiety prompted me to seek a psychiatrist.

His diagnosis was burnout­ dysthymia, to use the clinical term. There was no need for medication, but I could benefit from psychotherapy, to deal with my repressed feelings as the child of a suicide.

Skeptical at first ­this analytical stuff is not science! ­ I gradually began to appreciate the parallels between his discipline and mine.

In science and in psychotherapy, one approaches a problem from different angles, observes, hypothesizes, discards theories and begins to draw conclusions. When the evidence from various directions converges on a point, that point becomes a discovery, a new “truth.”

After four years of therapy, all seemed well. But three years later, I suddenly began to feel profoundly depressed and returned to therapy.

Let’s try an antidepressant, and I bet you’ll come out of it,” my psychiatrist said. Medication loomed large. I had never taken more than aspirin, not even for childbirth. But as the depression deepened, I capitulated, using antidepressants in various combinations and at increasing doses.

While I was in this psychic hell, unable to eat or sleep, an odd e-mail message arrived from a colleague and friend, a Nobel Prize-winning scientist. He questioned my contributions to a collaborative discovery that had won me recognition. In my irrational fog, I assumed that all my scientific work was fraudulent and that my friend had found me out.

This psychosis was the scariest aspect of my depression. I did not realize that my colleague had nominated me to an esteemed scientific academy and was checking his facts. My paranoia deepened, my depression worsened, and as a last resort I was admitted to a psychiatric hospital.

There, I was stripped of all independence, a right valued even in my stupor. The staff took belongings like tweezers (no “sharps” allowed, not even blunt ones) and vitamins (no drugs, not even food supplements). I was bereft and frightened. But then the staff embraced and cared for me. I felt cradled, held like a baby.

Yet the depression persisted, and I became a candidate for the dreaded shock therapy. I was repeatedly strapped to a table and zapped, but almost immediately began to recover from the incapacitating despair that had shut down my life.

I suffered three relapses; none was as severe as the first, but only cutting-edge psychopharmacology and talk therapy kept me from rehospitalization. Nevertheless, each relapse pushed me into a dark void, in which setting the dinner table, let alone preparing the meal, seemed overwhelming.

The episodes put me back in touch with my father’s death, and although suicide seemed like an alternative to my hopelessness, it was not an option. I had too much to live for.

Then came a turning point. My psychiatrist had been struck by the sudden onset of a first major depression in midlife. He insisted on a blood workup. The results showed an endocrine condition called hyperparathyroidism, which causes elevated levels of blood calcium and parathyroid hormone. He pointed out a potential link to depression, prompting me to check the data.

When I did, sure enough, I grasped that there might indeed be a significant connection. Four years after my hospitalization for depression, I had surgery to control the parathyroid problem, followed by a second operation two years later. Plotting the data, I realized that when my calcium and hormone levels returned to normal, so did the moods. That was three years ago.

I wonder whether my father also suffered from hyperparathyroidism. I also wonder whether doctors might routinely explore a physical basis for the sudden, unexplained onset of emotional pain.

Of course, I may not be permanently cured of depression. My time in the abyss opened a place whose door will always remain ajar. But one thing’s for sure: I’ll keep monitoring my moods ­ and collecting the data.

Marlene Belfort is director of genetics at the Wadsworth Center laboratory of the New York State Health Department