Tuesday, April 20, 2010

Dallas woman writes book about her struggles with depression to help others, combat stigma

From The Dallas Morning News:

By all accounts, Julie Hersh (pictured) had the ideal life: loving husband, two kids, a large house, lots of friends and plenty of money. Yet, in spite of the picture-perfect life, she was fighting debilitating depression that led her to try to kill herself three times.

During a nine-month period in 2001, Hersh battled a series of depressive episodes that led to visits with doctors, rounds of medications and stints in psychiatric wards. After each stay, she appeared to be better or told doctors she was well. Each time, however, the thought of killing herself returned.

After years of such treatment, including electroconvulsive therapy, she realized that depression would be a lifelong battle.

Since then, Hersh has spoken openly about her struggles, winning praise from mental health advocates. She has used her position as president of the board of the Dallas Children's Theater to help support productions about mental health topics. She has written about her experience in a book she just published with Dallas' Brown Books called Struck by Living: From Depression to Hope. Her hope is that it will encourage others who are battling depression to seek help.

She also wants people to understand what it's like for those who are suffering with depression – a disorder she says it too often misunderstood and, like other forms of mental illness, not given enough attention.

"I think people can look at me and say, 'Wow, here's someone who's done a lot in the community, who seems like a stable person most of the time, and this can happen to her? Maybe this is a disease,' " Hersh says.

The public perception of mental illness is difficult to overcome, she says. Movie portrayals such as One Flew Over the Cuckoo's Nest and uninformed media reports about people who are mentally ill don't help.

In her book and when speaking in the community, Hersh doesn't shy away from the topic. At first, some people felt uncomfortable with her openness, she says. But Hersh has a strong network of family and friends who rallied around her during her darkest moments, starting with her husband, Ken.

"It's almost like because I'm open about it, it gives people permission to be open about it," she said. "And what I found is almost everybody I meet is either suffering from mental illness or one step removed from it."

Benaye Rogers, president of CONTACT Crisis Line in Dallas, says she admires Hersh for speaking out. "When we find people who are willing to share that, it opens up the minds of people. Depression is much more serious than we think."

Although all three of Hersh's suicide attempts took place in 2001, she says she first experienced the symptoms of depression her freshman year in college after a breakup with a boyfriend.

She lost interest in school, rapidly lost weight and begged her parents to let her return home. When she visited her family doctor that summer, he told her she'd "stressed her body to an unhealthy state." He suggested she might be suffering from depression.

For the next decade, she experienced other personal trials, including the deaths of her father, age 58, and her husband's grandmother. She had been close to the grandmother and cared for her in her final years.

Her role as a caretaker made her reflect more on her other obligations, such as raising two children; attending functions with her husband, an energy investment executive; and maintaining their 11,000-square-foot home. Those duties seemed insurmountable for Hersh.

In April 2001, she was outside her North Dallas home with a knife in her hand when her husband walked up to her. Within days, he admitted his wife to the psychiatric ward at the former Zale Lipshy Hospital in Dallas (now UT Southwestern University Hospital).

"I knew she was not well, but she didn't open up to me and say, 'I'm thinking of killing myself,' " Ken Hersh says. "She wasn't articulating that until she was actually out back with a knife."

After her stay at Zale Lipshy, she entered Sierra Tucson Treatment Center in Arizona, which treats addictions and behavioral disorders. Then, during a family getaway that summer in Santa Fe, N.M., Hersh meticulously prepared for another suicide attempt, hiring a baby-sitter to watch her children while she went hiking. In reality, she wanted to jump off a cliff.

She changed her mind at the last minute and told her husband days later. Later that summer, she sat in her SUV in the family's garage with the engine running. That plan didn't work either. (She learned later that the garage was designed so air could not get trapped inside.)

That was when her psychiatrist suggested she try electroconvulsive therapy, or ECT, a process in which bursts of electricity are sent through the brain, causing a brief seizure. It's often used as a last resort when all other treatments have failed. She's had several rounds now, the most recent in 2007.

Ken Hersh says his perception of mental illness has evolved because of his wife's experience.

"I didn't appreciate all the subtle variations. There was the general feeling that you should be able to tell someone to snap out of it," he said.

Depression can strike anyone at anytime regardless of class, race, gender or education level. There are roughly 33,000 suicides in the United States each year, nearly twice the number of homicides, says Margie Wright, executive director of the Suicide and Crisis Center of North Texas. It's also the second leading cause of death for people ages 15 to 24.

Wright believes suicides are underreported. She calls Hersh's decision to tell her story courageous.

"I think the fact that she's well known and active in the community gives the story of her severe depression more credibility," Wright says. "I'm really hopeful that the stigma of depression and suicidal thoughts will dissipate somewhat with her story."

Robyn Flatt, executive artistic director of Dallas Children's Theater, describes Hersh's involvement in the organization as a positive experience. Before Hersh became board president, she told Flatt and other members about what she was going through. In recent years, the theater has tackled weighty subjects for kids such as bullying and dating violence.

"She knows deeply and personally why it's important to raise these issues," Flatt says. "These are not lucrative projects, but this is right at the heart of what we need to be doing."

Hersh says there's no way to know whether she'll have relapses. She has learned to manage the illness with medication and by asking for help if she begins to feel depressed.

"There is a genetic propensity, and if I ignore it, I'm going to endanger myself," she said. "So I need to try to think a little more proactively."