"In severe depression, everything goes to gray and takes an effort," says Manning, whose yearlong bout with the illness brought her to the brink of suicide in 1990. "You think about swallowing, about how many muscles it takes to smile. You're a nonreactor. You could win the lottery and you'd think, 'So?' "
A clinical psychologist and former professor of psychology at George Mason University in Fairfax, Va., Manning, 42, managed to keep a journal during her descent and recovery. Her recently published memoir, Undercurrents: A Therapist's Reckoning with Her Own Depression, has won praise for its blend of humor and pain. It has also stirred debate over electroconvulsive therapy, the often-vilified shock treatment that Manning believes saved her life.
"It's barbaric—I've seen hundreds of patients with brain damage from it," contends psychiatrist Peter Breggin (TalkingBack to Prozac), one of ECT's vocal critics. But many mental-health professionals, citing improvements in its safety and efficacy, consider ECT the therapy of choice for people who respond to no other. The way Manning sees it: "Losing a few memories, which is what it did to me, can't compare to what I lost in depression."
The fog that descended on Manning in the early months of 1990 seemed without a specific cause, though in the preceding three years "I'd had two miscarriages, and who knows how vulnerable that made me," she says. Her decline was hard for others to notice at first, in part because she was determined not to let depression defeat her. Born in Chicago to an FBI agent and his artist wife, Manning had grown up wanting to be a nun. She was a perfectionist and so conscientiously Catholic that as a girl she once confessed to adultery after playing a game of dressing up as an adult. Marriage (to her University of Maryland sweetheart Brian Depen-brock), motherhood (daughter Keara is now 17) and a Ph.D. in clinical psychology (from Catholic University in Washington) broadened her outlook, but she still saw a kind of virtue in suffering. "I wasn't depressed growing up, but I had a darkness to me—life seemed like Christmas afternoon, the good stuff was over so fast," she says. "When this depression hit, I assumed it had value—I was a good Catholic. If I fought hard enough, I could win."
Marshaling the tools of her trade—psychotherapy and antidepressant drugs—Manning did fight, but her agony only deepened. Though she forced herself to keep teaching and seeing patients, by the summer of 1990 she was sleeping just 2 hours a night. Several different types of antidepressants failed to reverse her slide. Husband Brian, a social worker, and Keara watched helplessly.
Manning says that she would have killed herself if not for her daughter. "Keara belts out songs in the shower," she says, "and I'd lean against the door and think, 'I may be half-dead, but this kid is 110 percent alive. I can't have a part in silencing that song.' " In October, at her therapist's recommendation, she agreed to try ECT.
Manning spent two weeks in a northern Virginia hospital, undergoing a course of six one-second shock treatments under anesthesia. Each time she awoke after 15 minutes with a pounding head and some lingering fuzziness about the last book she'd read or who had visited her. Her ability to sleep and her appetite returned, and within weeks, she says, "I felt like I'd recovered about 30 IQ points." Four months after the treatments, which were bolstered with antidepressants, Manning found herself in a grocery aisle, utterly delighted by the fragrant herb teas. "One of the great dividends of darkness," she writes, "is an increased sensitivity to the light."
However Manning's life is not entirely without shadows. A recurrence of her depression necessitated more ECT in 1993, and she expects to take medication for the rest of her life. Because the effect of the drugs on pregnancy remain unknown, she and Brian have decided against conceiving a second child. She has stopped teaching and closed her clinical practice as well. "I always found being a therapist tremendously draining," Manning says. "And when I got depressed, I saw therapy alone couldn't fix it. It was like practicing a religion and finding out when you die that it wasn't the right one. Psychotherapy is extraordinarily useful, but it may not be a cure."
Today, writing is Manning's profession of choice. Undercurrents, for which she received a $300,000 advance, has been optioned for a possible TV movie, and she spends 8 hours a day crafting essays for her next book, Chasing Grace. "I'm feeling more even than ever before," she says. To those who saw her through hell, it shows. "When Martha was depressed, those expressive eyes went hollow," says Brian. "Now they're back, and blazing."
LINDA KRAMER in Arlington
- Linda Kramer.
FOR PSYCHOTHERAPIST MARTHA Manning, the little things fell apart first. Her Arlington, Va., home began reeking of potatoes left too long in the broom closet. Cheese grew fur in the fridge; library books racked up fines on the floor; laundry sat in the basement. God, they say, is in the details, but all Manning could see was torment.