Clarification appended, Jan. 22, 2010
Therese Borchard writes about depression every day on her award-winning blog at Beliefnet.com. But it took a special leap of faith to share the stories of her breakdowns, hospitalizations and ongoing struggle with depression in her new book Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes. "This will do wonders for my chances of future employment," she cracks. TIME writer Amy Sullivan talked with Borchard about the challenges of writing about mental illness (especially one's own) at the writer's home in Annapolis, Md.
The story you tell is very raw and can't have been easy to share. What made you decide to write this book?
I didn't write it for about 18 years because I thought that writing about your own life was self-indulgent. But then I thought about what kept me going through the darkest days, reading memoirs by other people who have struggled with depression — Kay Redfield Jamison, Anne Lamott — and who emerged even stronger and more capable.
When you're in the midst of depression, that's the scariest thing — it seems that you're going to feel like that forever. The pain created by depression kills almost 1 million people a year. It almost killed me, and it did kill my aunt. If I can give just one person hope that there's an end to depression, that it is treatable, then that made it worth it for me to write the book.
Have you reached the point where you feel that your depression is treatable?
I have. At first I was overmedicated by a psychiatrist — going through so many combinations of medications — and that made me very afraid of trusting psychiatrists and drugs. So I went from that extreme to doing everything holistically and hoping yoga, acupuncture and meditation would cure me. What I've found now is a happy medium between the two.
I wanted to ask you about your experience with psychiatrists because you really ran the gauntlet through multiple doctors before you found the right fit.
Because I have a form of bipolar depression in which the manias are hard to detect, I went through a series of doctors who misdiagnosed me. I was exhibiting symptoms of bipolar disorder in college — and seeing a few psychiatrists — but it wasn't until 10 years and seven doctors later that I was diagnosed.
Ten years is a long time to go before finding the right treatment. Have you learned anything that could help others speed up the process?
I'd advise people to go to a teaching hospital because the doctors there are less likely to be bought by big Pharma, and they're more connected to the research. It's easy to take the samples and to be lazy. At a teaching hospital, you're more apt to find a psychiatrist who will listen to your story and prescribe medications they know work. My doctor is open to drugs like lithium that have been around for a long time and have a great track record but aren't going to make her rich.
What was the most painful part of writing the book?
By far the hardest part was writing about my kids and the heartache of trying to get well in the midst of parenting. My illness got much worse after my second child was born, and it's been so hard sometimes not being able to explain to him what clinical depression is, [or] why I'm crying. I want them to understand what depression is, but I don't want them to have that baggage of growing up with a whack-job mom.
I understand why people think that mothers who commit suicide are selfish. But I also understand the thought process, believing that getting out of their life is the best thing you can do for them, that it would be an act of love because your existence is poison to them.
If you had better understood the scope of your illness earlier, do you think that would have affected your decisions about having children?
I would have proceeded much more carefully. I can't imagine a life without the kids, but I would have been more proactive about getting a network of support, especially in those first days. And I would have placed more value on my own health, getting out of the house and working some, and getting enough sleep and rest. The brutal combination of isolation and sleep deprivation is a recipe for mental illness for new moms. There have been studies showing that in the first few weeks after giving birth, new mothers are seven times more likely to be hospitalized for mental illness as moms with older children.
You argue that depression is still stigmatized in a way that physical illnesses aren't. Have you experienced that?
Yes. People judged me when I was in such pain. They would lecture about how if I just ate organically or meditated this way or went to yoga more often, I'd be fine. When I tried medication, people on the holistic side told me I was copping out, taking happy pills. And when I focused on yoga, people on the other side warned me against doing anything in Eastern medicine.
What advice do you have for people in the midst of depression right now?
Get enough sleep. Go to bed at the same time every night and wake up at the same time every morning. Exercise: it has an antidepressant effect. I'm not going to be like Tom Cruise and say you won't need antidepressants if you exercise, but it is enough for some people. And watch what you eat. For sugar sensitive people — which many depressives are — sugar can be like a drug.
But the No. 1 thing is to have hope. It's hard to believe it when you're struggling, but depression does go away. William Styron says, "It is conquerable." If it wasn't, everybody who is depressed would commit suicide. I had to keep reminding myself of that when I was on my 23rd medication combination.
The original version of this article misstated the average length of time it takes for a patient suffering from depression to achieve positive treatment results.