Life B: Overcoming Double Depression

“Through her own compelling personal story, Patrick's book will certainly illuminate an aspect of depression that is still little known and understood.”

In this brave and candid memoir, Bethanne Patrick looks back on her life with a new understanding, one born of a fairly recent diagnosis of double depression, which Patrick defines as a mental illness "in which chronic depression spirals into major depressive episodes during times of great stress." In less clinical terms, Patrick writes, "What all this boiled down to for me was bad days, bad days, bad days, and some worse days."

For Patrick, double depression has been a life-long challenge, even as throughout her childhood and the majority of her adulthood she had no diagnosis, and therefore few lastingly successful treatments. Genetics, or epigenetics in Patrick's calculations, likely caused or exacerbated her illness, as she sees her condition as "one leaf on a twig" of the family tree.

Her maternal grandmother, who lived with Patrick's family, was "never right," according to family lore, and had spent time in psychiatric institutions and undergone electroconvulsive therapy (ECT); she likely had borderline personality disorder. Her grandmother's condition was kept secret from outsiders, even as it created tension in the home. Patrick's paternal grandmother suffered depression, and her sister, Ellen, was bipolar, with borderline personality disorder (the first is a mental illness, Patrick explains, the latter a personality disorder), whose manic behaviors tormented Patrick.

While her family was working class and of modest means, Patrick's mother had high aspirations for her daughter, providing her with violin lessons and music camp, and saving to send her to elite Smith College. Soon after graduating, partly as a means to avoiding a return to her childhood home, Patrick married a West Point graduate and became a military wife, first stationed in West Berlin, a situation that isolated her.

The frequent moves necessitated by her husband's military career disrupted Patrick's own ambitions to earn a Ph.D. In spite of the frequent moves, the stifling role of military spouse, the lingering patterns of her family of origin's serious dysfunction, and Patrick's base level of depression, which dipped, at times, into more debilitating bouts. Patrick managed to earn a master's degree, establish a writing career, become an influential book critic, and raise two daughters. She calls herself a "high functioning" depressive, not unlike a high-functioning alcoholic.

At the age of 52, after four months of working with a new psychopharmacologist, Patrick finally receives the diagnosis of double depression, which her doctor describes as "cycling depression that is a combination of chronic and major episodes." This is a turning point for Patrick, one that eventually leads to a treatment that helps, and ultimately to a newfound ability to experience joy and feel the love of her family, even as she still struggles with episodes of depression, especially triggered by grief and loss.

Most importantly perhaps, and most poignant in this harrowing tale, is that Patrick is finally able to understand how her depression affected her daughters as they were growing up. This is a hard reckoning, but one that Patrick faces with courage and deep honesty.

Patrick covers a tremendous time span in this somewhat short memoir (176 pages), including childhood, her genealogy as it pertains to mental illness, her marriage and the many geographical moves because of her husband's military career, motherhood, and her own career—over five decades of her life recounted through the lens of mental illness.

This horizontal approach powerfully reveals the life-long challenge of depression, and how astonishing it is that Patrick fared as well as she has in her life. But the broad span of time covered in the narrative leaves some facets of her life summarized rather than explored with more depth. Still, to say that the reader might want more material in a book about depression, a difficult subject, attests to the appeal of Patrick's measured and honest voice. Through her own compelling personal story, Patrick's book will certainly illuminate an aspect of depression that is still little known and understood.