Anatomy of a Nervous Breakdown by John D. Halliwell
I would like to relate my experience in the throes of a major mental illness. The stage for my descent into severe melancholic, psychotic depression was set over several decades of alcohol and substance abuse. The final factor that ignited the firestorm in my mind was stress. There are strong indications that my descent into a clinical, debilitating depression was the inevitable result of a collision between lifestyle and an inherited biochemical vulnerability to depressive illness. The episode and residual effects I am about to relate have lasted for approximately six years.
My ordeal, which took me down into and then slowly back up the walls of what many others before me have referred to as “the abyss”, began in the early fall of 1994 and reached its nadir with forced hospitalisation in a psychiatric ward in March 1995. For quite some time, I had been feeling a constant and unrelenting sadness. My perspective on life had become devoid of any anticipation or feeling for the future. I looked at a calendar and saw the upcoming months as empty spaces in which I had no future. In my view, all human endeavour seemed futile and meaningless.
When someone in a normal mental frame of mind looks at a photograph, reads an article, watches television news, or listens to a radio program detailing some human tragedy or natural disaster, their mind always retains a protective frame of reference. One can distinguish the difference between their own psychological/ emotional state and the plight of the reported victims. Normal individuals will experience empathetic yet somewhat detached feelings. However, that person who suffers from severe depression has completely lost the luxury of such an inner perspective boundary. For the depressive, there is a total dissolution of the thin distancing line between their own melancholic reality and the condition of the outside world. All aspects of life seem to be one endless tragedy to a distorted mind that is falling into a deep mental depression.
My decline into major depression began with increasing days, weeks, and finally unaccountable months where I was overwhelmed with feelings of a dreadful, all encompassing sadness and an overwhelming sense of hopelessness. There was a complete absence of pleasure or any kind of enjoyment in life. The distant snow capped mountains appeared eternally bland. Melody and harmony of music, much loved, appreciated, and a source of hope and dreams throughout my life, had completely vanished and lost its appeal. I would find myself lying awake at the start of each morning dreading the first light of dawn. By noon each day, I would seek short relief from my despair in alcohol. I would then drink all afternoon and into the evening.
For more than a decade and a half I had been living out my life in almost total isolation. Alone in my apartment each evening and on weekends, drinking and smoking marijuana, listening to music while idealising and dreaming of some far distant past. Often in the late afternoon on such weekends, especially Sundays, I would be ravaged by feelings of intense melancholy. My only escape was to finally pass out. I would wake up the next morning, go downtown, and wait for the pub to open at nine. In the end drinking had no effect except to reinforce my loss of spirit and sense of being.
With the further deterioration of my mental condition, deep depressive feelings gave way to more severe delusional thought patterns, and finally acute cognitive distortions. As my delusional thinking became more severe, I felt increasingly powerless. My thoughts seemed to gradually come under the domination and control of a dark, sinister, inner voice. Over time, this foreboding inner voice became a familiar kind of warped censor. It would only permit the negative to fill any empty space in what I then still felt inside as my basic psyche or soul. Along with a rushing sound and feeling in my right ear, the voice would take hold of my thoughts each evening as darkness settled in: “I am going to crush you bit by bit, this is only the beginning, you are worthless and a total failure, you have destroyed your family”. I found myself consumed with overwhelming guilt and remorse over past events throughout my life. Over time I became convinced that my increasing loss of sanity was a well-deserved punishment for the decades of addiction I had accumulated as an alcoholic and frequent substance abuser. I became obsessed with the idea of becoming homeless and having to live in a park, under a bridge, or a doorway in some industrial alley.
The physical experience of a nervous breakdown can accurately be compared to a complex computer system that slowly shuts itself down one program at a time. For myself, the ability to read and write was the first cognitive casualty. I distinctly recall reading a newspaper article featuring a working mother describing her slow mental burnout in analogy to her computer crashing one program function at a time. The final sentence of the article ironically became the last words I would be capable of reading and comprehending for quite some time.
Clinical research has established that the spiral decline into major depression is actually a slow symptomatic progression. The symptoms first appear as persistent feelings of insurmountable sadness, or what is clinically referred to as reactive depression. The sufferer then moves further down into a continued, deeper state of hopelessness or endogenous depression. This rapidly increasing, downward mental spiral culminates in perpetual state of depressive psychosis. In clinical terminology, these symptoms which grow in disabling magnitude are progressive depressive seizures. The consciousness and feeling of “self” or “I” is almost completely depleted through this sequence of depressive seizures.
The deepening of my depression felt like one prison door clanging shut, then opening into yet another ad infinitum, as my mind went on a downward free fall into a permanent inner prison of mental anguish. I recall my most severe depressive seizure occurring in the middle of yet another sleepless night, with the startling sensation of a popping sound and feeling in my head. It felt as if the left and right side of my brain had abruptly merged. I was left with the mental image and permanent sensation of two brass rings that have quickly melted at one point, and then remain joined together for what seemed to be all of an eternity.
Throughout my illness and into the final weeks before hospitalisation, I was unable to sleep, eat or bathe. I could not figure out how to get the shower to go from cold to warm without scalding myself, I would stand for hours in the bathroom, desperately trying to figure it all out, staring in bewilderment and anguish at what had happened to my mind. There was a complete lack of personal hygiene that lasted throughout the worst of my ordeal. There had occurred a complete break with reality. In my tormented state of mind, I was afraid to move farther than the perimeter of my couch. I would sit or lie there hour after hour, weeks carrying on into months. I felt mentally frozen in an unrelenting and debilitating state of panic and fear.
A total disintegration of the normal perception of space and time had occurred. It seemed as if the familiar inner boundaries of time had completely crumbled and disappeared. I was left with the unrelenting experience of a reality that seemed like “Never and Forever”. I felt like a prisoner in the middle of some sort of bizarre mental infinity. Day to day consciousness had become a place and a perpetual feeling similar to what astronomers and cosmologists have identified as “black holes” in the universe. My mind felt as if it was permanently confined within a circle where absolutely nothing could be transmitted from within to the outside world. It felt as if I had crossed over a one way border. I did not have the will power to return. My dark inner voice assured me that I would only fall deeper into this black hole, never to return to any semblance of sanity and reality as I had ever known it. In the end, I found myself at that horrifying final point in a depressive illness where daily consciousness has been reduced to simply existing in total terror. For the depressive sufferer, this insidious state of being only worsens without proper medical treatment, to the point where one will grasp at anything (eg. suicide) to be freed from this seemingly eternal, hellish state of reality.
I recall that it was New Years eve day 1994. Both my parents had been staying with me since just before Christmas. My father had stayed longer, desperately trying to obtain proper medical attention for my rapidly deteriorating mental and physical condition. My delusional reality had degenerated into a state of almost total paranoia. I was completely overwhelmed with unfounded fears of the outside world. My mind had become thoroughly convinced that my father and my best friend/business associate intended to kill me. I could not comprehend the possibility of, let alone seek out proper medical treatment.
At wits end living in the nightmare of my bizarre behaviour, my father insisted that we go to the hospital emergency. This ultimatum seemed to confirm that one of my worst delusional nightmares was coming true. I was going to be put away. The authorities would find out what I had done, and I would be imprisoned for some vague, yet enormous crime I had committed. So reluctantly I went, totally petrified. At the triage desk, I was fixated with two police officers talking to a nurse. I tried to get the words out to confess, and tell them how my father was going to kill me. As I continued through the emergency admission process my fear mounted. When I reached the examining stretcher and was asked to remove my clothing, the terror completely overcame me. I went into a total panic and began to struggle feverishly with several security people who quickly held and strapped me down. A doctor gave me an injection which immediately took effect and calmed me. For the next eight hours I received an intravenous infusion of fluids, nutrients, and antipsychotic medication. This brought a brief restoration to my cognitive faculties and relief from distorted perception. My mind seemed to return to a near normal sense of being.
I was released that evening into the care of my father. The nutrients and medication wore off overnight, and with the dawn of New Years day 1995, my mind and body were locked back into the same desperate condition. To add insult, my jailer of darkness seemed to be there waiting in cruel amusement for my return to hell. Overall, it felt as if I had lost my life then miraculously regained it, only to abruptly loose it again. I have recently read, and can strongly relate to the book Awakenings. Which chronicles the lives of survivors of the “encephalitis lethargic epidemic”, the so-called “sleepy sickness” that struck world wide around 1918. This autobiographical account explores the experiences of individuals who have lost the most basic ability to communicate with the rest of the world, and brings into question the “unthinkable” possibility that there is a conscious-but-incommunicado existence of people whose mental status is unknown.
I continued to languish for another two months completely isolated in a reality that seemed to have collapsed into a fixed pinpoint upon a bleak horizon. Suicide was no longer an ideation but a given fact of my daily existence. Having been without taste or appetite for so long, the inner voice assured me that I would die a slow, insidious death from malnutrition and dehydration. “Will they load my body into the back of a garbage truck?”, “should I lie down in my storage trunk or the walk- in closet of my apartment, and wait for death’s liberation?”; such thoughts circled relentlessly in my mind each hour day and night. My distorted mind’s eye began to read cryptic death messages (eg. my beheading) into my father’s solitaire card games and crossword puzzles. I began to believe that I was responsible for ruining my father’s life; rendering him destitute, ill, confused, and left alone to a solitary death from the elements in a damp, gray, Northwest winter.
Our lives had become intertwined in a monotonous, asylum like existence that would push any normal mind to the edge. My father finally reached his limit and informed me that he would shortly be returning home to Los Angeles. He would leave me some money to survive on, By then it was well beyond my comprehension to go to the corner grocery store, yet alone make change for any purchase over twenty-five cents. After his departure, I simply remained seated in a chair or lying on the couch foetal like, in a catatonic state, waiting to die.
It was my sister, with direct knowledge of mental illness through the experience of a long time school friend, who suggested that perhaps my enigmatic symptoms might be something more than the effects of lengthy alcoholism. With this added perspective, both my parents immediately flew back to Vancouver and called 911. Squad 58, a mental health response team consisting of paramedics and police responded. I was taken by ambulance and police escort to the same hospital emergency as before. This time my demon of delusions convinced me that I was going to be experimented upon, again. I totally freaked out and had to be restrained by several security staff. I was strapped to the examining stretcher until a sedating injection took effect. I next recall the dull terror and awful consciousness returning, as I lay on a bed in the hospitals locked psychiatric ward.
I spent approximately thirty days in hospital under observation and receiving proper treatment for my condition. I began to slowly recover with enhanced nutrition and medications which included Zoloft and Clozenipam among several other drugs. I recall the day I took my first shower and was able to shave without confusion or inner terror. One by one each disturbed cognitive faculty returned to a semblance of normality. During my illness and in ensuing years in recovery, I experienced instances of incredible memory loss. In hospital I got up one Monday morning and glanced at a daily newspaper that indicated it was actually Tuesday. I had some how lost a day that I have never been able to account for.
Upon my release, I was given a prognosis of full recovery, obtained through various diagnostic tests, which indicated that there had been no irreversible liver or neurological damage, Any apparent damage would naturally heal if the patient completely abstained from the use of alcohol.
It took least two years before I was able to begin to appreciate and enjoy nature, art, music, ideas, and understand comedy. It was nearly five years before I regained the full cognitive abilities required in reading, writing, forming ideas, opinions, and planing for a near and distant future.
Through personal experience and extensive follow up research, I have come to understand that my bout with depressive illness was the cumulative result of lifestyle, an inherited vulnerability to depressive illness, and a chemical imbalance in the brain. Alcohol and substance abuse spanning several decades, and severe long-term stress proved to be the original cause and then catalysts to relapse.
In recent family discussions, I have discovered a fairly extensive history of depressive illness, often coinciding with drug and alcohol abuse. My great maternal grandmother spent the last part of her life in a Scottish asylum, a maternal aunt spent the last five years of her life in a catatonic depression, a second cousin committed suicide with a drug overdose, another alcoholic relative committed suicide by inhaling auto exhaust, a second cousin’s son followed the same path through drug addiction and suicide by overdose.
The most profound and disturbing residual effect from my experience in the insidious grasp of a mental illness, has been the intuitive felling of the passage of time. Having lived at length in a reality that seemed far beyond the normal boundaries of human experience, I look at events in terms of the larger, cosmic time frame of the universe, as opposed to the short, butterfly “moments of human being”. Once having travelled to a place that the ancients referred to as the “Underworld”, one inherits certain twisted perceptions and intuitive understandings. I felt like a space explorer who has gone to the edge of a mental universe in a bizarre form of time warp. One’s view and experience of life is forever altered in a unique, often bizarre and uncomfortable way. The unfathomable, unthinkable seems to be intuitively understood. To know infinity is not meant for the mortal, human mind, only God.
Today the most pleasurable effect of intuitive time consciousness has been mastering the art of living in the moment, and within the overall context of the twenty- four hour day. I now maintain my daily sanity and sobriety through service to others. Through writing and speaking, I hope to assist in de- stigmatising depression and help people overcome the initial stumbling blocks to recognition and proper medical attention before matters spiral beyond help and hope.
*Copyright J.D. Enterprises March 2001