Book Review    

Life After Darkness (A doctor's journey through severe depression)

Cathy Wield (Forewords by Keith Matthews and Chris Thompson) Radcliffe Publishing Oxford and Seattle (2006, pp. 219)   

This autobiographical book details the experiences as a patient of a doctor who was also a mother with 4 children.

Dr Wield suffered 7 years of depression and committed self-harm as well as attempting suicide. Eventually she received brain surgery, following which she returned to her career and ultimately rediscovered the joys of life and her family.

It is a book written full of hope despite the suffering that had been endured in the past. The depression resulted in the author Cathy Wield feeling suicidal, as is so often the case with the depressed, and with little or no hope of the future.

Professor Keith Matthews, Professor of Psychiatry, University of Dundee, who wrote the foreword to the book describes the author, both before when she was severely depressed and afterwards. Dr Wield describes her years of darkness while she was depressed.

The objective of the book was important, just as it was also important to combat the stigma associated with depression and mental illness generally. Both Professor Matthews and the author state clearly some of the practices used by psychiatric staff and comment on the lack of trained staff, and centres for dealing with such problems as depression.

A second foreword by Professor Chris Thompson, Director of Health Care, Priory Group, Surrey, again brings to the fore some of the fallacies and opinions provided by those who know little about what is happening. Professor Thompson also emphasises the importance of psychological treatment or as he puts it “the importance of a listening ear”.

Both the author and Professor Thompson agree on the importance of inculcating hope in such patients. They feel it is also important not to denigrate what the general public does not understand as far as therapeutic methods available are concerned, those including electroconvulsive therapy and surgery.

Throughout the book the author describes her experiences in the Department of Psychiatry of Southampton . She describes the way her fellow patients are viewed by outsiders as ‘sad', ‘mad', or ‘bad' and even more so as ‘nutters', ‘loonies', and ‘crazy'. She also states how much support she had from her consultants. She describes her 7 years of illness as being very much like a prison - a prisoner of her mental illness rather than being incarcerated by bars.

She also describes a happy earlier life, having 4 children and a good husband before her illness struck. She views her depression as “falling into the pit”. She received very little support or improvement from medication and ECT.

ECT however lifted her mood and she was able to go home, but unfortunately she had to be readmitted for another course of ECT. Again the success with this was short-lived. The author describes the aftermath of having received 17 ECT treatments at the Priory Hospital, Roehamton.

Despite such treatment the depression continued and she also suffered from self-harming behaviour and intrusive thoughts. Her account of suffering from depression is well documented through her diary. She reports many efforts to help her through a variety of treatment approaches, all of which were either unsuccessful or only had short-term success.

The book has a fairy tale ending, despite the drastic step which needed to be taken in that the only successful way of dealing with the depression appeared to be a neurosurgical operation, bilateral anterior cingulotomy.

Following this the depression appeared to have lifted almost like a miracle. The author describes this as “ …all of a sudden a light switched on in my head! It was as if a power cable had been connected and the generator had gone on: this tremendous sensation of light blazing through my innermost being happened in an instant. I was amazed, startled, almost bewildered. I started to cry, realising that the darkness had gone, the depression was over!”

The author was able to return to work with all her mind functioning effectively.

This is a book that should be of great interest to psychiatrists and psychologists working with depressed individuals, as well as to persons suffering from depression.

Dr L F Lowenstein

Available for c. £15 from Amazon ; this link includes two "customer reviews" from fellow sufferers who applaud the message of hope in extremity it offers. [Editor]