THE SCAR

An insightful account of the significant physical and emotional scars caused by depression.

In 1983, Cregan (English/Barnard Coll.) gave birth to a daughter who died of a heart defect two days later. Plummeting into despair, she attempted suicide and then found herself in a locked psychiatric ward, diagnosed as suffering from a “major depressive episode, with melancholia.” In her absorbing debut memoir, the author returns to that dark time—“the worst days of my life”—both to understand what happened and to offer support to others confronting anguishing “internal forces.” Mining her medical records, her journal, family recollections, and a wide range of sources, Cregan examines her own experiences in the context of evolving psychiatric practices. Although initially doctors assumed that she was depressed in response to her child’s death, the author realized that she had endured periods of depression from the age of 16 that were unacknowledged in her Irish culture of “self-suppression, stoicism, and silence.” Moreover, depression had afflicted many members of her extended family, strong evidence of a genetic connection. As she discovered from research into the history of diagnosis and treatment, there has been much debate about whether the disorder arises from the mind or the body, whether it is a “maladaptive response” to life circumstances or a biological mood disorder associated with chemical imbalances. During her monthslong hospital stay and after, Cregan was offered psychotherapy, tricyclic drugs, and electroconvulsive therapy, which she describes in chilling detail. ECT, much maligned at the time because of One Flew over the Cuckoo’s Nest and the writings of psychiatrist Thomas Szasz, for her was “a life-saving treatment.” Equally lifesaving were the support and understanding she felt from other patients and the hospital staff. By the 1990s, psychiatry’s “new and expansive definition of depression” spiked diagnoses, and drugs like Prozac publicized depression as caused by “an imbalance in brain chemistry.” Although the efficacy of such drugs is controversial, Cregan attests to their positive effects. Much, she acknowledges, is still unknown about the debilitating disorder, but she shines much-needed light.

Inspiring and illuminating testimony.