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Undercurrents: A Therapist's Reckoning with Her Own Depression

by Martha Manning

June 1996
Review by Jerilynn Brezil Hoy, Froma Lippmann, and Kyle Wheeler for the NAMI Literature Committee.

Undercurrents, an autobiographical account of a woman's encounter with major depression, is one of those rare books that manages to be funny, intense, and frightening all at once. Although her subject matter is serious, the author, Dr. Martha Manning, views the vagaries of life with a wry sense of humor that leavens the frightening story she tells. When depression descends on Martha, a psychotherapist living near Washington, D.C., she falls down the slippery slope as helplessly as anyone. Undercurrents describes her journey into despair and the dramatic steps she took to save her own life.

This eminently readable book chronicles 20 months of Martha's life through a series of journal entries. Early on, hints of her impending depression creep into her entries. She begins to experience sleep disturbances; she loses interest in doing things; overall, as she describes it, she feels as if her "transmission is slipping." Remarkably, her entries continue, even in her darkest moments.

Manning's family is also ravaged by the effects of her illness. Martha vividly describes the frustration of her husband_-also a psychotherapist_-who can do nothing to "fix" her. Her daughter, on the cusp of adolescence, observes her mother's descent into depression with bewilderment and anger. In her journal, Martha describes with great pain the several miscarriages she's had and mourns her inability to have more children.

Martha starts seeing a therapist herself, Dr. Kay Jamison, who has written a book about her own struggles with manic-depression. She describes a time when she is both therapist and patient, helping others and seeking help. She also meets regularly with a psychopharmacologist who prescribes antidepressants. Martha has many problems with the antidepressants, and she and her doctor try to find the right medication and dosage. All this intervention is not enough, and Martha continues to decline.

The depression becomes so debilitating that Martha finally considers electroconvulsive therapy (ECT). Obsessed with thoughts of dying, she feels she has no choice but to try it. Even through her hospitalization and six ECT treatments, she continues to write. Martha's description of her emergence from darkness as the pain of depression slowly recedes is extremely moving.

A year after the treatment, Martha still has problems, not only with depression but also with short-term memory loss. Her writing reveals an understanding that she will never be the person she was before her illness and an acceptance of that fact.

Throughout her remarkable journey, Martha writes in a style that is a pleasure to read. For those of us who seek to understand depression, Martha Manning has done a great service by writing a beautiful, honest, and ultimately hopeful account of her own illness.

Undercurrents: A Therapist's Reckoning with Her Own Depression by Martha Manning. HarperCollins, 1995. 197 pp.

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