The Search for a Way Out
Because depression robs its victims of objectivity more drastically than most other illnesses do, it's often up to family members or friends to take action ó though sometimes those people too lose objectivity and fail to recognize depression's gravity.
For Cappetta, who manages technical support for a private school, intervention came from her colleagues. "My husband was too busy taking care of our daughters to see how bad things had gotten," she explains. "My coworkers were the ones who saw I was sick, talked to my parents and friends, and got me into treatment."
A network beyond the family circle can also be a potent antidepressant. Cappetta, while expecting her second child, found a support group for pregnant women with depression (see "Help and Information"). And Novitz cherishes a group of acquaintances that she met online while pregnant.
Different people respond differently to psychotherapy and medication, and the ideal treatment plan would allow the patient to see which worked best, says Dr. Kelsey. (While it can take anywhere from a few days to two months ó four weeks is typical ó for someone to feel some effects of medication, psychotherapy takes longer. That's why medication is usually recommended up front for severe depression: It is currently the fastest form of intervention.) A patient's beliefs are also important. Brown thinks therapy was the key to her recovery ó though she was also on medication for a year. "The therapist listened and took my fears and guilt seriously."
Novitz tried several antidepressants, but none were a "magic bullet." She thinks that therapy is what pulled her out of the danger zone and helped her gain strength.
For Duffy and Cappetta, however, antidepressants had miraculous effects after only a few weeks. Duffy, who has had a long history of psychotherapy, marvels at how resistant her therapists were the few times she asked them about medication. (Her physician wrote her first prescription.) "The drug took a while to work, but gradually I felt myself rising through the layers of my depression," she says. "I'd never been able to really play with Mimi and Davey because I was too sad to do anything as spontaneous as impersonate a teddy bear. But now I can let go and be silly."
It was amazing, Duffy says, to find herself "in a place I'd never been before. It suddenly struck me as I was crossing the road one bright winter day: 'So this is what people enjoy about being alive.'"
Award-winning health writer Julia Glass won the 1999 Pirate's Alley Faulkner Society Medal for best novella.