ect.org

by Linda Andre
Director, CTIP

The Cognitive Effects of Electroconvulsive Therapy in Community Settings

NIMH-funded research study published in the January 2007 issue of Neuropsychopharmacology

Author and primary investigator: Harold Sackeim

Funding: NIMH grants

#35636, Affective and Cognitive Consequences of ECT, funded since 1981 for a total of approximately ten million dollars so far (grant has been renewed through 2009)

#59069, ECT Practices in Community Settings—Evaluating Outcomes, funded since 1999 for a total of approximately 3.5 million dollars so far

Summary: After 25 years and millions of dollars of federal funding to research the adverse cognitive effects of ECT—25 years in which not one single longterm followup study was ever published—self-proclaimed “world expert” on ECT Harold Sackeim has now reversed his position, admitting that ECT routinely causes permanent memory loss and deficits in cognitive abilities. His new study—the first to be published in which he followed patients as long as six months, and one of his only studies to use controls—validates a generation of patient reports of permanent iatrogenic disability, and disproves Sackeim’s previously published claims that these reports were simply symptoms of mental illness. Other findings: there is no evidence that ECT increases intelligence, as Sackeim has previously claimed; and women are much more likely than men to experience severe permanent amnesia.

Significance: Harold Sackeim has been called the Pope of ECT, and for good reason. He’s published more on ECT than anyone in the world, has received more money to research it than anyone in the world, and is the author of the American Psychiatric Association’s patient information statement and consent forms, which are used by most hospitals in America. Through his writing, teaching, testimony—and positions on peer review, editorial, and funding boards, including NIMH grant review panels—he has more influence on what the profession and the public believe about ECT than anyone in the world. What Harold says goes.

Conclusion: This study could have been done at any point in the past 25 years. If it had, a generation of patients could have been warned of the likelihood of permanent significant memory and cognitive deficits before, instead of finding out after, ECT. In fact, there is evidence—from Harold’s own statements—that over the years he has in fact conducted studies following up ECT patients for a long as five years…but never published the results. Why not? Why did it take 25 years and over ten million dollars to validate what patients have been saying all along? In other words: What did Harold know, when did he know it, and why wasn’t it revealed?

Quotable quote from the study: This study provides the first evidence in a large, prospective sample that the adverse cognitive effects can persist for an extended period, and that they characterize routine treatment with ECT in community settings.

For a detailed critique, see below.

For the past 25 years, patients who received electroconvulsive therapy (ECT) have been told by the nation’s top ECT doctor that the controversial treatment doesn’t cause permanent amnesia or cognitive deficits and, in fact, improves memory and increases intelligence. Psychologist Harold Sackeim of Columbia University also taught a generation of ECT practitioners around the world that permanent amnesia is so rare it could never be studied. Sackeim was the popularizer if not originator of the position that former patients who said the treatment erased memory were simply mentally ill and thus not credible.

His newest and perhaps last ECT research study disproves his tenaciously held claims about the treatment’s harmlessness. It is, in effect a stunning self-repudiation of a 25-year research career…one in which he accepted federal research money with one hand and consulting fees from shock machine companies with the other.

See, for instance, the key finding:

This study provides the first evidence in a large, prospective sample that the adverse cognitive effects can persist for an extended period, and that they characterize routine treatment with ECT in community settings.

Similarly, from the abstract:

Despite ongoing controversy, there has never been a large scale, prospective study of the cognitive effects of electroconvulsive therapy

Sounds like the research team is congratulating itself for being “the first,” as if they’d made a discovery before anyone else, doesn’t it? You might think that…if you didn’t know that Sackeim has held the only available NIMH research grant to study ECT’s adverse effects, titled “Affective and Cognitive Consequences of ECT,” continuously since 1981…and if you didn’t know what Sackeim promised the federal government in his original application for grant funding:

“The major objective of the proposed research is to examine the effects of bilateral and right unilateral electroconvulsive therapy on affective and cognitive functioning. The consequences of the two treatment modes will be studied in regard to neuropsychological functions that have previously not been studied…Drug-free inpatients presenting major unipolar depressive disorder will be tested before, during and after treatment and a matched normal control group will be tested at comparably spaced times.”

Instead of doing this, however, he used his grant money largely to compare different types of ECT to each other, not to examine the effects of ECT; and only less than a handful of his 200+ published studies used normal controls, an absolute necessity to isolate the effects of ECT.

Why did it take 25 years to conduct one large, long-term controlled follow-up study? And in the absence on this research, why did Harold so confidently assure professionals, patients, legislators, and the public that ECT was safe?

A closer look at the study shows us that, in fact, Harold and his team are still not being honest with us, still not revealing all they know. They tried their damnedest not to find out what ECT really does…but failed. Here they reveal only the minimum information they had to concede after using every trick in the book to bias their research in favor of not finding negative effects of ECT.

What tricks did they use here?

1) The assumption that ECT does not cause permanent amnesia and cognitive deficits was built into the design of the study. How so? The study allowed subjects who’d had ECT before, as recently as two months prior, to be counted as the “before ECT” patients–meaning before this course of ECT. It assumed that any effects of ECT resolve within two months. 43% of the subjects had had prior ECT, so that at least half of the data involved comparing the effects of ECT to the effects of more ECT–not isolating the effects of ECT.

2) The outcome measures used to measure amnesia and cognitive function are irrelevant and inadequate to measure the known effects of ECT. Yet even deliberately using measures that would result in underestimating deficits, these deficits were still found to be profound and persistent!

For a critique of the tests used by Sackeim, see Robertson and Pryor’s article, Memory and cognitive effects of ECT: informing and assessing patients, in Advances in Psychiatric Treatment (2006), vol. 12, p. 228-238. For example, the Mini Mental Status exam used by Sackeim is a test that screens for dementia, the grossest and most glaring form of cognitive disability, and is useless for detecting the kinds of deficits caused by ECT.

Sackeim uses a memory test he invented himself, the Autobiographical Memory Inventory. This test is unpublished, not publicly available, not validated, and is not used except by ECT advocates. Robertson and Pryor note that the majority of questions are not relevant to the types of information forgotten by ECT survivors, nor can the test detect amnesia beyond a one-year period. A string of references in Sackeim’s new article attempt to provide support for the claim that the AMI “has shown strong reliability and validity as a measure of retrograde amnesia.” Not only do they not show this, but all the referenced articles were written by Sackeim himself!

3) Patient IQs were estimated pre-ECT using a method that underestimates intellectual ability especially with much higher than average IQs; no attempt was made to ascertain actual IQ. No one looked at these patients’ IQs post-shock to see what happened to them; why not?

Sackeim et al. conclude, based on inaccurate assumptions and no data from these or any other patients, that “Individuals with greater premorbid abilities can better compensate for the impact of ECT on cognitive functions” (references claiming to support this point have nothing to do with ECT but are articles about an unproven theory of “cognitive reserve”).

Even if the researchers didn’t choose to seek out survivors of ECT who once had very high IQs, or to respond to the many survivors of formerly superior IQs who have contacted them, there is a substantial record of accounts by persons who had extremely high or genius IQs who have spoken and written publicly of the devastating effects of having those IQs lowered by ECT (Jonathan Cott, Linda Andre, Anne Donahue, and Marilyn Rice are four such individuals.) None of these accounts suggests that people with “greater premorbid abilities” have an easier time after ECT; in fact, they strongly suggest the opposite.

In addition to these tricks, the researchers used one of the most reliable methods of biasing results: concealing data.

1) “A substantial number of secondary cognitive measures” are said to have been administered along with the named tests, yet the researchers nowhere reveal what they were and what the results were.

2) The names of the seven facilities in the New York City metropolitan area are not revealed. While this isn’t necessary for evaluating the results of the study, it means the facilities with the worst outcomes can’t be held publicly accountable, nor can the millions of city residents protect themselves from the worst offenders.

3) The results of the cognitive tests on the 24 control subjects are not revealed, nor is how they compared to the people who had ECT.

It’s a very big deal for the Sackeim team to use matched normal controls; in 25 years and hundreds of studies they have not done so. Normal controls are essential to ethical and valid research. This article states that “The comparison sample completed the same neuropsychological battery at time points corresponding to the assessment period in patients.” But you search in vain to find out how the controls did on the five named tests of memory and cognitive functioning and the unnamed “secondary measures”, and how they compared to the ECT patients immediately and six months after ECT. It’s not in the text, and it’s not in the tables. So why have the controls take the tests at all, if you’re not going to reveal the results?

Only one thing is revealed: The normal controls did much better than the bilateral ECT patients on the (flawed) measure of amnesia:

“The average decrement in AMI-SF scores in patients treated exclusively with BL ECT was 3.4 and 2.8 times the amount of forgetting seen in the healthy comparison groups at the post-ECT and 6-month time periods, respectively, suggesting that the deficits were substantial.”

4) Sackeim does not reveal—has never revealed in hundreds of published articles—his financial ties to the shock machine companies Mecta and Somatics. Yet in sworn testimony, Sackeim admits he has worked for Mecta for at least twenty years. He designs their shock machines for them. Not only is disclosure required by journals such as Neuropsychopharmacology (ironically, the subject of a recent scandal in which authors and even the journal’s editor did not reveal their ties to another company which has hired Sackeim, Cyberonics), it is also required by state law (because Sackeim is an employee of New York State) and federal law (because Sackeim accepts NIMH money).
Sackeim flaunts these laws by not disclosing the money he makes from the shock machine manufacturers.

This article is a damning critique of work done over 25 years (and at the expense of millions of taxpayer dollars) by this very team of researchers.

If you know that Sackeim’s been funded for decades to do this research and chose not to do it, the following statements read very differently than the researchers intended. Instead of self-congratulation, they read as condemnation.

“Empirical information about ECT’s long-term effects derives mainly from small sample studies conducted in research settings, with follow-up intervals limited to two months or less…These studies could not adequately assess the severity and persistence of long-term deficits.”

The use of small samples and short-term follow-up characterizes all of Sackeim’s work until now, and was their choice, deliberately made so as not to know (officially) about “the severity and persistence of long-term deficits.” These researchers single-handedly had the wherewithal to address these belatedly-acknowledged flaws in their own research at any time since 1981.

“We conducted the first large-scale, prospective study of cognitive outcomes following ECT.”

Why the first study only after 25 years? What of the generation of patients—two and a half million people according to their own estimate—who have received shock in those years without knowing the long-term consequences?

“Severity of depressive symptoms showed little relationship with the cognitive measures. At the post-ECT time point, none of the 11 measures were related to concurrent HRSD scores. Findings were also negative for 8 of the 11 measures at the six-month follow-up.”

Translation: patients aren’t just imagining or lying about their cognitive and memory deficits because they’re crazy. Yet in many published articles written on the NIMH dime, and over and over in public testimony and in court, that is exactly what Sackeim and Prudic have claimed. And they have influenced countless others to believe it.

DAMNING FINDING #1: amnesia is substantial and permanent

“The average decrement in AMI-SF scores in patients treated exclusively with BL ECT was 3.4 and 2.8 times the amount of forgetting seen in the healthy comparison groups at the post-ECT and 6-month time periods, respectively, suggesting that the deficits were substantial.”

“At the six-month time point, there continued to be a significant relationship between the number of BL ECT treatments and the extent of retrograde amnesia.”

“Greater amnesia for autobiographical events was significantly correlated with the number of ECT treatments received 6 months earlier.”

DAMNING FINDING #2: cognitive deficits are substantial and permanent

“Compared to baseline performance, at the postECT time point the total patient sample showed deficits in the mMMS, sensitivity of the CPT, delayed recall of the BSRT, delayed reproduction on the CFT…” (All are measures of memory and cognitive ability).

“This study provides the first evidence in a large, prospective sample that the adverse cognitive effects can persist for an extended period, and that they characterize routine treatment with ECT in community settings.”

DAMNING FINDING #3: ECT permanently affects reaction time

“Although psychomotor function is of practical importance with respect to driving and other motor activities, the impact of ECT on this domain has rarely been examined…”

(Once again: Whose fault is that?)

“The fact that relative reaction time deficits were observed at the 6-month follow-up indicates a persistent change in the speed of information processing, motor initiation, or response levels…The findings here raise the concern that this form of stimulation has deleterious long-term effects of elemental aspects of motor performance or information processing.”

DAMNING FINDING #4: Bilateral ECT is no good

“For decades, BL ECT represented the gold standard with respect to ECT efficacy…A majority (of US ECT practitioners) administer mainly or exclusively BL ECT…
There appears to be little justification for the continued first-line use of BL ECT in the treatment of major depression.”

(More than 90% of the ECT given in the U.S., and at least as high a proportion in other countries, is bilateral.)

DAMNING FINDING #5 They lied when they wrote in the APA consent form that ECT improves your memory

What this team has said in numerous published articles—and what Sackeim wrote into the American Psychiatric Association guidelines on ECT, the “bible” used by all rank and file shock doctors—that ECT improves memory and intelligence, is not true.

“It is noteworthy that most cognitive parameters were substantially improved at 6-month follow-up relative to pre-ECT baseline, presumably because of the negative impact of the depressed state on baseline performance…It cannot be concluded, however, that the extent of improvement in any group returned to premorbid levels.”

DAMNING FINDING #6: A much greater percentage of women than men are damaged by ECT than men: 81% vs. 18%.

“There was a gender difference, with a greater preponderance of women (81.6%) compared to men (18.4%) in the persistent deficit group.”

No doubt Sackeim and his handlers will try to “spin” this study as a scientific breakthrough, and hold him up as a reformer and patient advocate. Nothing could be farther from the truth.

Where is the apology to the generation of people who were lied to, who will never regain their memories and their cognitive abilities?

Full study

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A beginning to forget
Mom writes a happy ending to battle with postpartum depression

BY BILL LOHMANN
TIMES-DISPATCH
Nov 26 2006

The birth of her only child is not even a blur to Carolyn Brink.

She doesn’t remember it at all.

In fact, she doesn’t remember the first few months of Zachary’s life. She was trapped in the depths of postpartum depression, a perilous condition made even more dangerous by an adverse reaction to the drugs prescribed to help her. She recalls almost nothing from that period except this:

” I came close to not being around,” she said. “I about killed myself.”

Brink’s story has a happy ending. She survived, her baby is fine and her family is strong. More than two years later, she feels back to her old self. A family friend recently published a book about her ordeal (”Mommies Cry Too: A Painful & Triumphant Story of Postpartum Depression,” by Carol S. Harcarik); reading it, Brink said, is “like reading a story that happened to someone else.”

Brink said she is willing to put herself in the public spotlight so she can help other women who experience postpartum depression.

“I had a great family, a great life and a successful career, and I was thrown into this ridiculous tailspin,” said Brink. “People can look at me and say, ‘If it could happen to her, it could happen to me.’ But they can also say, ‘She got better, I can get better.’

“I figure if I talk about it, maybe other people can have hope.”

Brink, 31, and her husband, De- mian, 34, moved to Richmond in 2002 from Minnesota. Both wound up working for The Martin Agency. Like most first-time parents, they eagerly anticipated the birth of their son, Zachary, in May 2004. The euphoria lasted until Zachary was placed in his mother’s arms for the first time shortly after his birth.

“I had in my mind what it was going to be like when she first saw him,” said Demian. “Tears, hugs, smiling.”

However, her reaction was oddly detached and distant. “Not that overflowing emotion I’ve come to expect and love about her,” he said.

When she returned home, Carolyn was anxious and panicky and wanted little to do with Zachary. She was almost catatonic at times. She said she’d made a terrible mistake by having a baby and that maybe she and Demian should put him up for adoption. Later, she spoke of suicide.

This from a person who by her admission is an overachieving “Type A” personality who had always tried to find the positive side of life and never harbored thoughts of killing herself.

“It was a long, hard struggle,” said Mary-Jane Kitchen, Carolyn’s mother, who lived in Wisconsin but stayed with her daughter, son-in-law and grandson through much of the nightmare. “Fortunately, throughout this whole thing, she was very open and honest about her feelings, even though it was really hard to listen to what she was saying. But because she was open and honest, it was easier for me to gauge where she was and how serious it was. If she hadn’t been so honest, I don’t know . . . “

Only a few days after Zachary’s birth, Carolyn’s mother and husband sought medical help for her. At first, the prescription was relaxation techniques and more sleep. Then came medication. Then different antidepressants. Nothing worked for long, and she was getting worse. Finally, she underwent electroconvulsive treatments, which provided slight relief but no significant improvement.

Not knowing where to turn next, her father called a physician friend at the Mayo Clinic in Rochester, Minn. She checked in in September 2004, and her life turned for the better.

Using a test that was new at the time, doctors determined her body was slow to metabolize drugs, meaning the drugs she was taking weren’t being processed quickly enough and were, in effect, poisoning her. She was prescribed different medication and began to improve. She also underwent talk therapy and was home by mid-October.

She remembers little before Mayo — her Mayo doctors believe her loss of memory is related to the electroconvulsive treatments and may be temporary but she had her life back and soon came to a most fulfilling revelation: She is a good mother.

“It took a long time” to come to that realization, Carolyn said. Now, she’s looking forward to being a mother again. She and Demian have talked about having more children, and her doctors say with proper planning and a support system in place,she should make a better postpartum adjustment.

“It would be nice,” Carolyn said of providing a sibling for Zachary, “to be there from the beginning and have memories of it.”

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Those who know me know that I’m a big believer in a better quality of life through the power of pet love, for the elderly and persons with disabilities. I’d like to ask you to consider giving to a wonderful program this holiday season, “A Season of Suppers,” which will provide pet food along with hot meals via the Meals on Wheels program.

A program like this has been on my Wish List for a long time. Wishes do sometimes come true.

More from Associated Press:

By ANGELA K. BROWN
Nov 23 2006

FORT WORTH, Texas - When 87-year-old Lucille Mann knits, her 2 1/2-pound dog Pepper curls up beside her or nuzzles in her lap.

“I just don’t know what I’d do without her because she’s my life,” she said.

Realizing the two are inseparable, Meals On Wheels of Tarrant County not only delivers daily meals to Mann, but also drops off some pet food for her treasured Chihuahua.

About a fourth of the Fort Worth chapter’s 400 clients receive free pet food in addition to daily meals. The chapter started providing cat and dog food five years ago after volunteers noticed a growing number of clients feeding pets from their own plates.

This holiday season, the Meals On Wheels Association of America and Banfield, The Pet Hospital are teaming up to help needy seniors nationwide feed their pets.

They hope to collect 1 million pounds of critter vittles at 575 Banfield veterinary hospitals across the country during a two-month pet food drive called “A Season of Suppers.” Since the cause started earlier this month, donation boxes have been filling up quickly, so volunteers are already making deliveries.

“The holiday time is when there is a more acute awareness of people in need, especially seniors who may not have other relatives and are really more isolated than the general population,” said Sandy Campbell, president of Banfield Charitable Trust, the veterinary practice’s nonprofit organization.

Portland, Ore.-based Banfield and Meals On Wheels also are accepting monetary donations in hopes of raising $100,000 for the meal-delivery agency’s “We All Love Our Pets” program. The pet food program already helps seniors in Fort Worth, Fort Lauderdale, Fla., and Sacramento, Calif. and the agency would like to expand into other communities.

“It’s truly awesome they’re doing this,” said Janine Brown, program manager of senior nutrition services at the Sacramento County Department of Human Assistance. “Not only do seniors not have to share their food, which isn’t healthy for pets, but they can keep the limited amount of income for their medicine and electric bills.”

Elizabeth Escontrias and her brother, Manuel Valle, who live in Fort Worth, said their lives are enriched by their several cats and five small dogs, including a feisty 11-year-old Chihuahua named Bad Girl whose tongue always hangs out.

But feeding them is difficult on a fixed income, they said.

“I’d have to give them away if they (Meals On Wheels) didn’t help me,” said Escontrias, 68. “Our animals are just like family. They’re our little children.”

Meals On Wheels provides food for homebound people age 60 and older. Many are low-income, although there is no minimum income requirement.

Though the priority is providing meals to seniors — four in 10 Meals on Wheels chapters nationwide have waiting lists — the agency says the pet food program improves the quality of life for its clients.

“For most of our clients, their pet is probably the most important thing in their lives. It’s their family and the only friendly face they see,” said Enid A. Borden, CEO of Meals On Wheels Association of America. “That’s why this program is so important.”

___

On the Net:

Meals On Wheels Association of America: http://www.mowaa.org

Banfield, The Pet Hospital: http://www.banfield.net

4 Responses »

The Associated Press
Nov 24 2006

WASHINGTON — Whistle-blowers tipped off the government to $1.3 billion worth of fraud cases over the last year, largely at hospitals or other healthcare providers, the Justice Department said this week.

Whistle-blowers were paid $190 million over the year for alerting the government to the fraud. In all, the department recovered a record $3.1 billion in settlements from individuals and companies during the 2006 fiscal year that ended Sept. 30.

The largest settlement, worth $920 million, came against Dallas-based Tenet Healthcare Corp. Following claims from six whistle-blowers, prosecutors accused Tenet of overbilling the government for $806 million in Medicare payments and paying $49 million in kickbacks to doctors who referred patients to the chain.

One Response »

MindFreedom UPDATE — 21 November 2006
Nonviolent Revolution in Mental Health Care
http://www.MindFreedom.org - please forward

*Tomorrow* Wednesday, 22 November 2006 - MindFreedom News Hour Free Internet Radio

Guest is Al Siebert, psychiatric-survivor psychologist-author

To listen live click on http://www.theprn.org at 4 pm EST, 1 pm PST tomorrow Wednesday, 22 Nov. 2006, or listen to the archive later. Yes, the archives now work!

You may phone in to the show live toll free with your questions or comments, or e-mail them to radio@mindfreedom.org.

Host of the show — which begins and ends with news and resources about changing the mental health system — is David Oaks, psychiatric survivor, human rights activist for 30 years, and director of MindFreedom International.

~~~~~~~~~~~~

Al Siebert short bio:

Al Siebert received his M.A. and PhD. in clinical psychology from the University of Michigan. Al is a psychiatric survivor and calls his story the “Marvelous Menninger Adventure.” He has been a strong advocate for the human rights of people who considered to be “mental patients” for many years.

Dr. Siebert:

** is author of professional journal articles about the ways that psychiatry misrepresents what is known about “schizophrenia.”

** is project director of the “Weller Than Well” research project searching for people made stronger by their so-called “psychotic” experiences.

** serves on Advisory Council for International Center for the Study of Psychiatry and Psychology, founded by Peter Breggin.

** hosts the popular Successful Schizophrenia website.

** is author of A SCHIZOPHRENIA BREAKTHROUGH: Progress Toward Freeing Our Minds from Our Minds. A textbook for graduate students with “Issues for Critical Thinking and Research.” Foreword by William Glasser, M.D.

In addition to the above, Dr. Siebert is internationally recognized for his research into the inner nature of highly resilient survivors. His most recent book, The Resiliency Advantage, is winner of the “2006 Best Self-Help Book” award.

More info on Al’s projects and books see http://www.resiliencycenter.com/ http://www.thrivenet.com/ http://www.successfulschizophrenia.org/

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More info on MindFreedom see http://www.MindFreedom.org

~~~~~~~~~~~~

Next week, Wed. 29 November 2006 — Leah Harris, psychiatric survivor activist and on the board of National Association for Rights Protection and Advocacy. Leah calls for greater involvement of youth, and dedication to youth issues.

~~~~~~~~~~~~

Announcing: MindFreedom totally redesigned web site is now up at http://www.MindFreedom.org. We are finishing a few last minute touches but feel free to drop by for a preview and spread the word.

~~~~~~~~~~~~

Join MindFreedom International, donate, or renew your membership.

Do you want to…

* Win human rights campaigns in mental health?

* End abuse by the psychiatric drug industry?

* Support the self-determination of psychiatric survivors?

* Promote safe, humane and effective options in mental health?

You are not alone! MindFreedom is a nonprofit human rights group that unites 100 sponsor and affiliate groups with individual members, and is accredited by the United Nations as a Non-Governmental Organization (NGO) with Consultative Roster Status. Join or donate today!

MindFreedom is one of the very few totally independent groups in the mental health field with no funding from governments, drug companies, religions, corporations, or the mental health system. While most of MindFreedom’s members are psychiatric survivors, *all* who support human rights are invited to join and become active leaders.

JOIN, RENEW, DONATE, or give GIFT MEMBERSHIPS to MindFreedom International today:

http://www.mindfreedom.org/join-donate

For a MAD MARKET of books and other products to support human rights campaigns in mental health:

http://www.mindfreedom.org/mad-market

MindFreedom International Office: 454 Willamette, Suite 216 - POB 11284; Eugene, OR 97440-3484 USA

web site: http://www.mindfreedom.org
e-mail: office@mindfreedom.org
office phone: (541) 345-9106
toll free: 1-877-MAD-PRIDe or 1-877-623-7743
fax: (541) 345-3737

Please forward.

“Human salvation lies in the hands of the creatively maladjusted.” - Martin Luther King, Jr.

_______________________________________________

If you are not on the MindFreedom-News alert list already, sign up for this free non-profit public service here: http://www.intenex.net/lists/listinfo/mindfreedom-news

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By Clare Masters

November 18, 2006
The Daily Telegraph

CONTROVERSIAL electric shock treatment is making a comeback in NSW hospitals, with new figures showing the use has doubled in the past 10 years, including on schoolchildren.

Federal Government statistics show the use of Electro Convulsive Therapy (ECT) – electric shock delivered to the brain – has risen in the state from 2093 in 1994-1995 to 5291 in 2005-2006.

The Medicare statistics recorded 16 cases in the five to 14 age bracket.

The figures come as the Western Australian Government bans ECT for children under the age of 12, but the NSW Government has ruled out prohibiting the treatment for children.

“NSW Health is not aware of any child under 12 years having received ECT in the public hospital system in recent years,” a spokeswoman said.

The Royal Australian and New Zealand College of Psychiatrists Dr Phil Brock said the college did not recommend the use of ECT on children due to their developing brains.

Sydney University’s Professor of Child and Adolescent Psychiatry Garry Walter said he was unaware of any cases in NSW relating to very young children but said it was possible in 15 year olds.

“It is rare but when it is used it can be lifesaving – its use is most common in young people with severe mood disorders,” he said.

Notorious for its barbaric use in Sydney’s Chelmsford Private Psychiatric Hospital, shut down nearly 30 years ago, ECT is increasingly used across the country – up from 9034 in 1994-1995 to 18,083 in 2005-2006.

Although doctors are still mystified as to how the therapy works, it is used to treat mental disorders such as depression and psychosis.

Adverse reports of ECT include memory loss, spontaneous seizures and headaches and modern treatment involves administering, under anaesthetic, a series of electric shocks to the brain at intervals over a few weeks.

Reports on Australian mental health support website depression.com.au record one person claiming the treatment was “humane” and “changed my life”.

Another 54-year-old male said he suffered short-term memory loss and headaches and a 43-year-old male reported forgetting his phone number.

“I will never voluntarily have ECT again,” he wrote.

2 Responses »

25th April 2006
http://www.oxford.anglican.org
Diocese of Oxford

Jo Harries says that life has taught her that God is a God of  surprises. ‘I often wonder what he has for me next’, she says. And no wonder - she had early dreams to be a medical missionary in Islamic countries, but instead became the wife of the Bishop of Oxford. Her career as a paediatrician has been halted by her own repeated
hospitalisations. But as Rebecca Paveley discovered, her sense of God’s presence and his purpose in her life is unfaltering.

I meet Jo Harries on a sunny, spring day in the house that is soon to be packed away and its keys handed back. The home shows no sign of the turmoil of packing that must be going on after the couple’s 19 year long stay there.

They have until June to leave and are moving back to their own house in Barnes, south London. I ask Jo what she will miss and she says, straight away, the garden. It is beautifully laid out, well-tended and large.

But though she is sad at leaving, she is already embracing the future. Born in Essex, she was brought up with God, prayer and church at the centre of family life.  ‘I have always been somebody who has had a sense of the presence of God. When I was a child my parents used to pray in the evenings with us and we went to church. I remember I didn’t like the smell of booze after the communion!’ she recalls.

As a child, she was allowed to choose one ‘ordinary’ book and one ‘Jesus’ book. ‘I loved the stories in the Jesus book,’ she says. But at 10, she was sent away to boarding school, where she was terribly unhappy at first, before going on to Benenden.

‘There too religion was very important to me. I  prepared for confirmation though I wasn’t absolutely sure I was ready for it but I did go ahead and get confirmed at 15 or 16 and I got a lot out of the early morning church services.’

After school and before taking up her place at Girton, Cambridge, she went to Florence for a few months and was, she says with a smile, ‘quite wild’ there. But by the time she was settled at Cambridge she was determined to be a medical missionary, joining a group of fellow Christians who met fortnightly to pray for and write to missionaries out in the field.

This was to remain her ambition for years to come. But an invite to a sailing club dinner set her life going in a very different direction. She didn’t take up the invitation straight away, and by the time she did the young man who had asked her had asked several others.

‘He was bewailing the fact at breakfast at his college, Selwyn, while he was sitting next to Richard [Harries]. Richard offered to help and take me. It was the day before the university lacrosse match and I didn’t play very well in it! We saw a lot of each other that summer term and fell in love really after the exams.

‘I had already booked to travel to Greece and Turkey and Persia to see some of the people we’d been praying for. When I told my father I wanted to marry Richard he said, what has that got to do with going to Persia? So I went, and sent long letters back.’

She felt confused about what her direction should be - marriage, or a career as a medical missionary. ‘I felt very much that I wanted to work with Muslim women but I felt I was also called to marry Richard and he didn’t feel called to work in Islamic countries. I was confused about what was right but decided it would all work out in the end so I went on with my medical training in London and lived with Richard’s parents while he went to Cuddesdon [theological college, near Oxford].

Jo’s visits up to Cuddesdon are remembered by other students for her flamboyant blue MGA motorcar, given to her by her family. While women weren’t allowed to stay at Cuddesdon, the fact Richard had a room in a farmhouse rather than in the college itself meant that Jo was able to visit regularly.

They married on St Peter’s Day 1963, while Richard was serving his title in London and she was working as a house officer in a hospital. But her life was to take a quite different turn, while she was still struggling with her earlier plans to become a medical missionary.

Their son Mark was born and Jo was struck with puerperal psychosis (the most severe form of postnatal depression). It took a while to be diagnosed and then she was in hospital for a long time and was given ECT, electroconvulsive therapy. The illness was devastating for her and for Richard.

Her baby son was in hospital with her, but she wasn’t allowed to see him. Since the first episode she has been sectioned several times, usually, she says, corresponding with a crisis.

Work was difficult and the ECT meant she had to ‘relearn everything’.

Daughter Clare was born a few years later, and fortunately the illness didn’t return. Jo stayed very much involved in Richard’s parish, despite her health problems, and has stayed active in parish and charitable activities throughout her time in Oxford.

She has also explored Tai Chi, which she says brings her into a ‘wonderful position of stillness’. She was told not to meditate after trying it once while on a clergy wives retreat and having a ‘white flash – a Hiroshima moment’.

Since moving to Oxford she has been involved in circle dancing, a form of sacred dancing, and has danced in Winchester Cathedral. Charitable work has dominated her time in the diocese and she has been involved with FLAME, the Mothers Union, the Family Nurturing Network and the Red Ribbon group amongst others, as well as environmental groups and those working for social justice, like Christian Concern for One World.

She has also travelled widely with Bishop Richard, including visits to Taize and recently to Kimberley and Kuruman, our twin diocese, with a group of parishioners from the Diocese.

She hasn’t worked for several years as she has had several stays in the Warneford Hospital.

‘I don’t know what God is going to give me next,’ she tells me. I’m sure everyone in the Oxford Diocese will hope it is health, and happiness, as she and Bishop Richard enter the next stage of their lives together.

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William Styron, 1925-2006
Unlikely bard of depression.
By Nell Casey
Slate
Nov. 7, 2006

When I first met William Styron, in the summer of 2001, he was frail, barely back on his feet after a brutal bout with depression. I met him and his wife, Rose, at a bookstore where we read from Unholy Ghost, a collection of essays on depression I’d edited, and to which both Styrons had contributed. I was taken aback by Styron’s vulnerability. It was his ravaging sorrow that had brought us there, but still somehow his reputation as Famous Writer (and the few brusque phone conversations that preceded our meeting) had trumped his reputation as Depressed Person in my mind. As we talked, his hands gently trembled, and he spoke with a far-off quietness, as if his words were traveling from a great distance.

When Styron died last week of pneumonia at the age of 81, obituary writers scrambled to assess his literary achievements. But, while he was undoubtedly a brilliant and adventurous novelist, Darkness Visible, his concise, 84-page memoir of his own emotional descent, transformed him into a contemporary translator of the illness and, subsequently, an ardent mental-health advocate.

Styron disliked the term depression, calling it “a true wimp of a word for such a major illness.” Nonetheless, it was this word—and illness—that came to define the last third of his life. Darkness Visible began as a talk Styron gave in 1989 at a symposium on affective disorders sponsored by the Johns Hopkins School of Medicine. Later the same year, at the urging of Tina Brown, then the editor-in-chief of Vanity Fair, he published a longer version of the story in her magazine. In 1990, Random House published an expanded version of the essay as a book, and it became a national best seller.

Thus began Styron’s second act as a depressed person, for which he became, in his words, “reluctantly famous.” He eventually became a crusader as well, someone who faced up to the responsibility, once the course had been set, to continue the good work his book had begun. “Almost every day, Bill is in contact with fellow depression sufferers by mail or by phone,” Rose Styron wrote in 2001; she cited several instances when her husband, a person who cherished his privacy and solitude, skillfully counseled people who contacted him in the midst of their emotional crises.

Styron spoke at readings and on panels about his struggles—an experience that can feel like torture, describing your personal life with such frequency that it starts to taste like cardboard in your mouth. And yet he was consistently genuine and patient, devoting a good deal of his time to the many who approached him for help. It is little wonder Styron never published another novel after Darkness Visible came out.

Styron was certainly not the first celebrated writer to produce a personal account of his own emotional plunge. In 1936, for example, F. Scott Fitzgerald published three piercing essays about his spiritual depletion in Esquire, later collected in a book called The Crack-Up. But Styron described his illness with a distinct lyrical clarity. He offered up the secrets of his despair but also maintained a degree of formality—occasionally trading the word I for one, as in “one does not abandon, even briefly, one’s bed of nails but is attached wherever one goes.” This choice gave his words a sense of restraint but not withholding—an elegant high-wire act. In addition, he nimbly placed depression in historical and cultural context throughout, drawing from the work and lives of Albert Camus, Abbie Hoffman, and Ingmar Bergman, among others.

Styron also wrote with unusual gratitude about being hospitalized, sidestepping the stigma so often associated with spending time in an institution. “The hospital offers the mild, oddly gratifying trauma of sudden stabilization—” he wrote, “a transfer out of the too familiar surroundings of home, where all is anxiety and discord, into an orderly and benign detention where one’s only duty is to try to get well.”

And Styron’s timing was right. He shared his experience at a moment when a sizable audience was ready to receive it. In 1990, the public awareness of and tolerance for the illness was higher; Prozac had just begun to enter our minds—literally and figuratively—two years earlier. Darkness Visible ushered in an abundant era of depression writing. It’s funny to think that Styron paved the way for Marie Osmond (to choose one of the many who have recently offered their own accounts of depression), but perhaps his point in attending those many mental-health conferences was not just to demythologize the illness but also himself: The formidable writer was simply another sufferer in that setting.

Still, no good deed goes unpunished, and even Styron’s work had its critics. In 1997, the literary journal American Scholar published an essay called Depression: Darker Than Darkness by Joel P. Smith, a former vice president of Stanford University. He described his stay at a psychiatric hospital and the friendship he struck up with a fellow resident—who later committed suicide—named Clare. In it, Smith asks Clare to read Darkness Visible.

“She called it a ‘crock,’ ” wrote Smith. “She pointed out that Styron was depressed for a few months, not many years like us. What she actually said is that he had a ‘candy-ass’ depression. … [H]e did not have to rely on anti-depressant medication, much less rely on a radical remedy such as electroconvulsive therapy; his hospital stay was at a place which is as comfortable as they come; and, crucially, he was never alone. It rankles us, no matter what the virtues of Styron’s book may be, to feel he speaks for us.” (It is worth noting: Smith and I had a brief correspondence about the possibility of reprinting his essay—which I admire for its candor and style, if not its message here—in Unholy Ghost.)

This was a short piece in a small-circulation magazine; it was hardly a public lashing for Styron. Still, the sentiment was there—you haven’t suffered enough—and it is, to a larger degree, a problem with which many depressives must grapple. The illness is not always measurable by traditional medical standards; only the sufferer truly knows the severity of his own sadness, and therefore it can be hard to validate. Ironically, it is sometimes harder to prove the legitimacy of the illness to fellow depressives, some of whom resort to measuring their own pain in numbers of hospitalizations and electric shock treatments. It is disheartening, this jockeying for position as the most downtrodden. As one reader of Smith’s essay pointed out in a letter to the editor, “We don’t have to start pushing each other out of the nest.”

In the fall of 2002, I saw Styron once more at a mental-health conference. I was taken aback again, this time by his strength. He was a different man. Or maybe he was just the man he used to be. Either way, he was there: He had returned physically and emotionally.

In the closing of Darkness Visible, Styron worries that the more optimistic message of Dante’s Inferno has been lost with so much focus on the melancholy lines, “In the middle of the journey of our life/ I found myself in a dark wood,/ For I had lost the right path.” He then resurrects the forgotten part of that passage, “And so we came forth, and once again beheld the stars.” Perhaps now we should do the same for Styron—and also remember him for his courage in the face of terrifying affliction.

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Lincoln Today
Nov. 1, 2006

Your computer or laptop might not be the first place you’d turn to if you’re feeling depressed but thanks to charity, the Mental Health Foundation, help is literally at hand.

The Foundation has teamed up with interactive healthcare specialists Ultrasis to offer free access to an online self-help programme for anybody experiencing mild or moderate depression.

The programme launches today and uses proven Cognitive Behavioural Therapy practices that will allow users to go at their own pace learning self-help techniques to help them manage their depression.

The online programme should mean more people receive treatment, quicker.

Andrew McCulloch, Chief Executive of the Mental Health Foundation, said, “Cognitive Behavioural Therapy is widely accepted as one of the most effective and practical methods for treating depression, but not everybody is able to or wants to visit a therapist.

“Depression Relief is an online self-help programme that can be accessed anytime, enabling a person to use it at their own speed and in a place that suits them.”

The programme will be free to use for those aged 18 and over from today until January 3 2007.

Click here to access online program.

Free computerised CBT for depression online
Nov 6 2006
EHealth Insider

Free computerised cognitive behavioural therapy (CCBT) for depression has been made available online after a deal between software developers Ultrasis and the Mental Health Foundation.

The online self-help program, Depression Relief, is available for a free four-week trial from a link on the Mental Health Foundation website. The system is a cut-down version of Ultrasis’ Beating the Blues and will run between now and 3 January, 2007.

Moira Frasier, head of policy at the Mental Health Foundation, told E-Health Insider: “The Depression Relief website will be like a self-help group online, based on CBT principles and detailing alternative forms of therapy for help. It will allow users to check for help themselves, rather than spend a long time waiting for availability to see your hospital CBT therapy specialist.”

Ultrasis already work with the NHS using CBT with its Beating the Blues computer based treatment for depression. The software is initially being rolled out in Newham and Doncaster as part of a pilot scheme, with a view to full implementation across the NHS by March 2007.

The free Depression Relief software is a specially-created, patient-accessible version of the Beating the Blues software. It will allow users to go at their own pace through each step, learning self-help techniques to manage their own condition.

Frasier told EHI: “Often, you find that searching for therapy online doesn’t always give patients the best choices and recommends non-prescription drugs as remedies. Depression Relief will offer patients proper therapy and they can see other patients’ feedback as a motivation tool.”

Andrew McCulloch, chief executive of the Mental Health Foundation, added: “CBT is widely recognised as one of the most effective methods for treating depression, yet there is a major shortage of therapists. Most people who want to try CBT have to join long NHS waiting lists or pay to see a therapist privately.

“While online CBT is not a replacement for face-to-face therapy, we need to start investigating other supporting treatments that with mental health problems can use.”

Nigel Brabbins, chief executive of Ultrasis, said that they hoped the free trial would help to raise awareness of available CBT therapy options.

“We want people to know that the tools and techniques for prevention and treatment are available without having to wait to see a therapist. Cost-effective online programs need to be more widely available and we hope to reach as many people as possible through the Mental Health Foundation’s website who may want help when NHS services are not available.”

In February 2006, the National Institute for Clinical Excellence recommended Beating the Blues and another package called FearFighter for people with mild panic and phobia.

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By Clare Raymond
Oct. 30, 2006
Daily Mirror

I WAS motionless, lying face down on the pavement. There was grit in my mouth and blood dripping from my hands and my bare feet.

It was the sight of blood that saved me. I knew then that I needed help - needed a hospital. As I levered myself up from the kerbside, I heard screaming and shrank back, terrified, clapping both my hands over my ears.

Then I realised that my mouth was open, that it was me making those terrible piercing sounds.

But who was me? I didn’t know my name, didn’t know who I belonged to or where I lived.

How did I get from where I was that night to the lodge gate of the hospital, where the night porter lifted me up?

The next thing I remember is somebody screaming again and the porter’s voice saying: “There, there, love. You’re in good hands now.”

“Please stop the screaming,” I said, choking the words into his chest.

“That’s just what we’re going to do now,” a different disembodied voice replied, “and then you’ll have a good night’s sleep.”

Later, I learned that during those first two weeks they attached electrodes to my temples and gave me several rounds of ECT - electroconvulsive therapy.

Later still, I was informed I’d had “a complete nervous breakdown”.

Even in the midst of that mental anguish, I wanted to get back on the set of Coronation Street, I wanted to feel Bet Lynch’s wind beneath my wings, and fly off to that oasis where I always left Julie Goodyear - and all her troubles - behind.

It was 1973 and I was 31 when my nervous breakdown followed a second marriage that didn’t even survive the wedding day.

HAVING bundled me into the wedding car after the ceremony, the bridegroom left with the best man and returned to his mother’s apron strings.

Our guests, including most of the cast of Coronation Street, were all left waiting and the wedding reception hadn’t even got underway.

I had only been in Coronation Street for two years when, in 1972, I had the misfortune to meet Tony Rudman.

We met at the White Hart, a restaurant-cum-bar, near Heywood, Lancs.

When the courtship began, my mam was delighted, and my 12-year-old son Gary was thrilled, too.

A softly-spoken accountant, Rudman was being a hands-off gentleman then, so we were not having an affair, just enjoying each other’s company. Looking very determined one evening, he asked me to marry him and I said yes.

I was saying it for Gary to have a father figure as much as anything, and I hoped this would finally mean having some stability in our lives. Because Tony owned his bungalow, I thought it was only right that I should put half the amount it had been valued at into it. I also put my bank account into our joint names.

On the day of my wedding to Tony, lots of members of the cast were there, including Doris Speed, who played Annie Walker, and Pat Phoenix, who played Elsie Tanner.

It really was a big occasion and I was in a magnificent gold dress.

Things got off to a bad start because the vintage car that was taking me and my father to the church in Bury broke down - as if that wasn’t enough to create a feeling of foreboding, I discovered that my bouquet had been left on the bed in the bungalow.

When I finally arrived, I couldn’t believe the crowds. There were even several Saracen tanks because I’d been to Belfast in 1972 to do a moraleboosting visit to our troops.

It was like a royal occasion and knowing my son was about to sing with the choir while his mother was getting married brought a lump to my throat.

The service went without a hitch and as we made our way out of the church, arm in arm with my new husband, the crowds parted with a deafening roar and the Saracen tanks rumbled through.

I could now see that some of the soldiers had suffered terrible injuries since I’d met them in Ireland. One had lost an eye, several had limbs missing. It was a terrible shock. I felt I had to stop and have a special word with one or two of them.

That was when Tony’s hand tightened like a vice on my arm. Then I felt it move to the small of my back, followed by a discreet but hefty shove.

“Get in the car,” he hissed through clenched teeth. This was a face I didn’t recognise, wearing a vicious expression I’d never seen, but I still thought I must have misheard what he said. Wrong! As I looked up at him, bewildered, he repeated in another frenetic hiss: “Get in the damned car!” I was stunned. I had no idea what had happened to upset him and I couldn’t bear the idea of any of our guests knowing we were having a tiff. Was it the service? The tanks? The soldiers? The cast of Corrie? The fans?

I knew something was wrong and my first instinct was to get through the post-ceremony motions double quick so nobody would know. Tony waved all the photographers aside and beckoned the car, with its streamers of white ribbons, forward and hustled me into it. He wasn’t talking to me, his was face set like granite, his eyes staring straight ahead.

The moment we got to the reception, Tony leaped out of the car and, leaving me on my own, disappeared inside the building. When I entered, a smile painted on my face for the benefit of the waiting staff and a few people with cameras, he was nowhere to be seen. His mother had also disappeared.

Too late, then, I began to have suspicions. Maybe he wasn’t just being a gentleman when he made no attempt to nudge our relationship on to a more intimate basis. Perhaps he was terrified of consummating the wedding night? Maybe he was impotent but hadn’t the courage to tell me?

I was in such a state of shock I couldn’t even take it in, and I kept expecting him to reappear. He didn’t.

I think I gave one of the best performances of my life that day. Excuses were made for my missing bridegroom, the best man and his mother.

I was convinced he’d be back at the little bungalow waiting for me, feeling very sorry and sheepish, but he wasn’t.

The big treat, which I’d paid for myself, was a week’s honeymoon in Paris. We were due to go the next morning and I’d arranged for a car to collect us from the bungalow.

AT that stage I so wanted to put things right I was more than ready to make endless excuses for his behaviour.

I got into the car and drove to his mother’s house. There she was, his little mum who I’d grown so fond of, still wearing the suit I’d bought her for the wedding.

“Yes, what is it?” she barked, nothing like the woman I’d met so many times before.

“Is Tony in?”

“Yes, he is. And I’ve only just managed to get him off to sleep,” she replied and slammed the door in my face.

Dazed, I turned around, got into my Mini, and drove back to the bungalow. I stayed at my kitchen table for most of the week, only getting up to go to the loo. I was too ashamed to speak to anybody.

Tony Rudman had married me under false pretences for a reason I’ll never know. But he kept my half of the value of the bungalow and enjoyed using our joint bank account for a time. He never attempted to communicate with me after our wedding day. And, as I have now heard that he died some years ago, he won’t do so now.

Once I went back to work, it was a case of getting on with it amid all the usual post-wedding nudge-nudge wink-wink jokes of, “Good honeymoon, was it? Get any sleep? Eh…”

I played along with it. But when I got back from the studios it was brandy and soda time. I’d never drunk so much alcohol in my life.

ONE day when I wasn’t needed at the studios, I spent some time alone in the little bungalow with thoughts circling endlessly around my tortured mind.

Then, suddenly, it all came to a head. There was a white-out followed by red mist and everything blanked out. It was as if somebody had swung a lever and switched me off.

The next thing I remember was being dressed in a bloodied nightie in the street, somehow knowing that I had to get to the nearest hospital.

I was admitted to an NHS hospital first, then Granada got involved and I was moved from there to Cheadle Royal, a private clinic that specialised in mental health problems.

I spent four weeks there and one of the last questions the doctor asked me was, I thought, a very surprising one.

“Have you, by any chance, ever had a relationship with a woman, Julie?”

“What do you mean?” I replied, genuinely puzzled.

“A sexual relationship,” he answered.

“Good God no!” I replied, shocked.

But my next relationship was with a woman, I thought it was worth a try.

EXTRACTED by Clare Raymond from Just Julie by Julie Goodyear, published by Macmillan on November 3, £18.99.

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Author William C. Styron Dies at 81

By JULIA WELLS

William Styron, the acclaimed novelist and leading literary figure of his generation whose summer home on the Vineyard Haven harbor has long been the hub of the area known colloquially as writer’s row, died Wednesday at the Martha’s Vineyard Hospital. He was 81.

The cause of death was pneumonia. Mr. Styron had been in failing health for a number of years.

Often called the heir to William Faulkner (although he rejected the characterization), Mr. Styron was originally from the South, and he won critical acclaim early on for his first novel, Lie Down in Darkness. A brooding meditation on a young girl’s suicide, the book was published in 1951 when Mr. Styron was 26. In 1955 he published The Long March, originally a novella about his experiences in the U.S. Marine Corps. In 1954, after a year in Italy, he published his second novel, Set This House on Fire, a portrait of a group of Americans in Italy.

The Confessions of Nat Turner followed in 1967, a fictional account of a real rebellion led by the slave Nat Turner in 1831. The violent rebellion took place near where Mr. Styron had grown up in Virginia. In 1968 it won the Pulitzer Prize for fiction and in 1970 it captured the William Dean Howells Medal of the American Academy of Arts and Letters. His other works that earned acclaim included Sophie’s Choice (1979), the story of a fictional Polish Catholic woman who survives internment at Auschwitz, later made into a major motion picture, and Darkness Visible: A Memoir of Madness (1990), a chronicle of his depression in 1985.

Unconventional in routine, tall and handsome with a piercing gaze, relaxed in his family and social life, Mr. Styron was one of the rare authors who was both a literary and commercial success. He had lived on the Vineyard seasonally since 1959, and his contributions to the Island were also largely literary. He spoke at library lecture series and wrote graceful book reviews, including a review that was published in the Gazette in 1991 of the memoir Deadline, by New York Times columnist James Reston.

In 1982 he told a reporter for the Gazette that he found the Vineyard a good place to work, a place where he liked to walk for miles and think. Asked how he got anything done in the summer, he showed a brief glimpse of his characteristic macabre humor.

“I hear the bump of the tennis balls,” he said. “I hear the sails luffing in the harbor and I take a perverse delight in eschewing all those wonderful pleasures and hunkering down in my damp little mildewed studio in Vineyard Haven and saying, ‘I’m doing my work while they’re playing.’”

He wrote in longhand on yellow legal pads, never kept a notebook and read voraciously. He liked to sleep until noon, putter at errands and daydream before settling down to work each day. On the Vineyard he wrote on an old school desk that he bought in Vineyard Haven for $15 in 1965, soon after buying his summer home. He drank heavily and smoked cigars until the summer of his 60th birthday in 1985, when he decided that alcohol no longer agreed with him and gave it up. But the abstinence triggered mood disorders which required medication, and the drugs in turn brought on a deep, enduring and suicidal depression that required him to be hospitalized for more than two months.

The experience prompted him to write Darkness Visible: a Memoir of Madness, after he had recovered.

The book earned Mr. Styron a whole new set of followers. “I think it causes people to realize two things,” he told the Gazette in an interview in 2001. “That this is a pain that afflicts a lot of people; it’s universal and if I could describe it in this way and people could relate to it, it meant they weren’t alone; and the second thing - almost as important or more important - is stressing the truth that people can get well, and that it’s not by any means fatal.”

Depression continued to stalk him for the remainder of his life.

William Clark Styron Jr. was born on June 11, 1925 in Newport News, Va.; his father was a marine engineer. He had a happy childhood, was an early reader and was socially outgoing. His mother, Pauline Margaret (Abraham) Styron, died when he was 13. He later acknowledged her death as a cause of the depression that gripped him for more than two decades.

In 1940 his father sent him to Christchurch, a small Episcopal preparatory school in West Point, Va., for his last two years of high school. He graduated in 1942. Following high school he joined the reserve officer training program for the United States Marine Corps, and enrolled at Davidson College. He was unhappy there and through the Marines transferred to Duke University in June of 1943. In October of 1944 he was called to active duty and in late July 1945 was commissioned a second lieutenant. He was assigned to participate in the invasion of Japan; a month later the atomic bomb attacks forced the surrender of Japan and he was discharged.

He returned to Duke University where he was influenced and guided by his friend and writing mentor Prof. William Blackburn. Mr. Styron graduated in 1947, determined to become a novelist.

He moved to New York city, and after finishing Lie Down in Darkness, did another three-month stint in the Marines. Then Lie Down in Darkness won the Prix de Rome, which meant a year’s paid expenses at the American Academy in Rome. During his year in Rome he became reacquainted with Rose Burgunder, whom he had met in Baltimore the year before and who was enrolled at the American Academy.

They were married in Rome in May of 1953, and had three daughters and one son.

The Styrons raised their family in a farmhouse in Roxbury, Conn., and spent their summers on the Vineyard, where their many friends included the Buchwalds, the Herseys, the Wallaces, the Hackneys, Lillian Hellman, Jacqueline Kennedy Onassis, Katharine Graham and the Clintons. The Styron home became a well-known setting for social gatherings large and small, with cocktails and fried chicken on the porch overlooking the outer harbor in the Island’s main port town. At one such gathering in 1959, Mr. Styron told a Gazette reporter that he had given up television and also The New Yorker. “It seems to me that J.D. Salinger is about the only writer The New Yorker has who is allowed to write just as he wants to,” he said.

Mr. Styron was an active Democrat and was involved in many political causes over the years. He felt it was a natural outgrowth for a writer and commented more than once on the power of art and writing as forces for political change. “Corrupt governments are terrified of the artist’s power to expose what’s wrong in society,” he told the Martha’s Vineyard Magazine in a 1989 interview. He also said: “Men of power in the United States have almost never given a shake for writing. I think it is accurate to say that George Bush has probably never read a book in the last four or five years.”

He is survived by his wife Rose and daughters Alexandra Styron of Brooklyn, N.Y., Susanna Styron of Nyak, N.Y., and Paola Styron of Sherman, Conn; a son, Thomas Styron of New Haven, Conn., and eight grandchildren.

The funeral service is private, and memorial services will be held on the Island and in New York at a later date.

Donations may be made in his memory to the Martha’s Vineyard Hospital Building Fund, P.O. Box 1477, Oak Bluffs, MA, 02557. Arrangements are under the care of Chapman, Cole and Gleason Funeral Home in Oak Bluffs.

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