Saved: the life I lost to despair

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Saved: the life I lost to despair
http://www.timesonline.co.uk/article/0,,2090-2001406,00.html

Cathy Wield's story of her battle with depression has been difficult to tell. It reveals unpleasant truths about the NHS but is, ultimately, a moving account of redemption.

It was like a mist coming down - a dark mist that clung to every part of my body and mind. I lived it and breathed it. It shrouded me in a deep anguish that gnawed within. I felt lonely, forlorn, lost, helpless. I was being sucked under this dark, thick, disgusting quagmire. Every thought condemned me.

I felt my depression was a moral defect: I was a weak person, I shouldn't have let this happen, I was ruining my own life and ruining life for everybody around me. I felt my husband Phil deserved a better wife, and that if I was out of the way he could remarry. I had to die.

I thought I knew about mental illness. After all, I am a doctor - a specialist registrar in emergency medicine. But all my training and knowledge could not prepare me for the seven years I lost to worthlessness and the all-consuming urge to harm myself.

There doesn't have to be a reason why people get depressed or suicidal. It can come from nowhere and plunge perfectly normal people into a pit where it seems the only escape is death. That is what happened to me.

My story is necessarily harrowing, with disturbing glimpses of how the NHS deals with an often hidden and stigmatised disease. But ultimately it is also about redemption. Thanks to pioneering treatment in a Scottish hospital I am living proof that mental illness can be cured, just like any other disease. This is a story with a happy ending.

It was December 1994 when I felt the depression descend. I was a busy mother of four, a doctor in an accident and emergency department in Southampton. My children - Rebecca, 12, Simon, 10, Stephanie, 8 and Jonathan, 6 - were
healthy and happy, the girls showing potential to be top-class ballet dancers.

Hours as a junior doctor were long and the work was sometimes difficult, but I had made the decision to go part-time and Phil and I were pleased with how the future looked.

Yet I was continuously exhausted, and sleep, when it came, would never refresh me. Every task, however small, was an effort. Eating was a chore. I diagnosed myself - I knew I was depressed. And I knew that people who were depressed got treatment and got better very quickly. So I thought, anyway. I started on medication and took some time off work. Surely that would do the trick? The depression deepened. I would spend days in the bedroom, refusing to come out or to speak. One day I phoned one of my friends who happened to be a psychiatrist and told her: "I'm going to kill myself." It was a gradual
realisation I'd come to, amid an overwhelming sense of despair and anguish.

My doctor said if I had electroconvulsive therapy (ECT), I would feel better. I remember the bewilderment I felt when Phil left me at the hospital. I was thinking: "What on earth have I done?" I was entering the world of the mentally ill where there are no flowers, no chocolates and no sympathy.

In the coming years I would have ECT more than 100 times, usually with helpful - but temporary - effects. ECT is not at all like it is portrayed on television. You are given an anaesthetic, then you are given an electric shock which causes your body to have a fit. They give you paralysing agent so your body doesn't jerk around like you see in films.

But things can go wrong. Once, the anaesthetist made the mistake of giving me the paralysing drug before putting me to sleep. I was left paralysed, unable to move or communicate, knowing what was about to happen. In my mind I was shouting at them: "I'm awake, I'm awake, don't do it! Please don't do it!" The first jolt knocked me out.

After my first six weeks in hospital I was allowed home, but soon all I could think about was ways I could end my life. It became a pattern where I would be admitted and given ECT and that would just lift my mood enough for me to go home. But the desire to harm myself was becoming worse.

Nearby there was a railway track, so I used to think about throwing myself in front of a train. I started to slowly poison myself with overdoses of lithium - I thought nobody would notice that way. Then I decided to starve to death and stopped eating.

I could think of nothing else - carbon monoxide poisoning, jumping off a wardrobe, hanging myself, suffocating in a plastic bag tied over my head. The self-harm started by pouring boiling water over myself. Then I started cutting with razor blades that I smuggled into the hospital.

The pain of doing these things to myself was a distraction from the awful pain in my head. It was also punitive, because I kept thinking that I was a bad person. I would just have thoughts saying: "Cut. Cut. You have to cut." When I did it, it would relieve the thought. In the medical world there is still a tendency to think of the mentally ill as the "bad, sad or mad". Care was the forgotten word. I didn't feel cared for. I think the staff honestly believed that if you were given any sympathy it would increase the chances of your self-harming again. They didn't seem to realise the link between self-harm and low self-esteem. Many, I expect, had simply burnt out years ago.

The state of most of the five mental hospitals I ended up in was far worse than would be tolerated in any other part of the NHS. They were shabby, smelly, dreary, stained and often dirty. Many times I felt physically threatened. I remember a violent woman throwing a chair that narrowly missed my head.

As the years went on I became increasingly unwilling to co-operate, and ended up being sectioned. The treatment I eventually received was very much a last resort. Six years into my illness, the doctor who was looking after me, Professor Chris Thompson, said: "Maybe you should have neurosurgery."

I was quite shocked. The only time I had come across such a thing was the lobotomy in One Flew Over the Cuckoo's Nest. He explained this was nothing like that: it was a very discreet operation where two holes would be drilled in my head and probes put into a specific area to destroy a tiny amount of tissue.

I realised this was my only chance. If it was unsuccessful, then people could not blame me for killing myself.

The operation took place in September 2001 at Ninewells hospital in Dundee. Only six such operations take place in Scotland every year. Patients are told they are not likely to feel any benefits for three to four months, but that was not how it turned out at all.

On day eight after the operation I was sitting in the ward with my nurse beside me. And suddenly a light switched on in my head. And I realised I was better, just like that, in an instant. I thought to myself, what about the self-harm? And I realised that no, I didn't want that any more. Of course, then I had to convince my doctors I wasn't just bluffing. But they could
tell from my whole demeanour: I was cured.

They let me out with Phil and we travelled around the east of Scotland - visiting Edinburgh and St Andrews and Glamis Castle. I was just exuberant. The September 11 attacks in the US had happened, but had just passed me by. I wanted to know about everything. I wanted to know what e-mail was. What were the children doing? They had grown up; they were 18, 16, 14 and 12.

I was so distressed that I had missed so much of their childhoods. I hadn't begun to realise just how badly it had affected them. Phil was absolutely exhausted, and found it hard to adjust.

I went back to work within nine months of my recovery, back into A&E in Southampton, the same department where I had been a patient on numerous occasions for self-harm. I had to come back and say: "I'm sorry, I'm really sorry. I was ill but I'm better now."

We have now moved to Aberdeenshire and new jobs in the same hospital - Scotland just has so many positive associations for us. Some readjustments have been hard, especially with my youngest son, Jonathan. I'd just walked in and said I was Mum again, and that he had to go to bed, tidy his room and eat his dinner and whatever. And he quite resented that.

One day he just rang the doorbell and didn't come in. I asked him what was up and he said: "Are you ever going back to that hospital again?" And I said no, never. And he just breathed a sigh of relief, and walked in. Everything was going to be fine

Life After Darkness: A Doctor's Journey Through Severe Depression, by Cathy Wield, is published by Radcliffe Publishing, £16.95.