尋找治療，打破代際憂鬱循環 | Finding Treatment and Breaking the Cycle of Intergenerational Depression
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發佈日期：2023 年 10 月 16日
作者：Damon Devine
我的曾祖母因憂鬱症與自殺失去了她的丈夫、兩個兒子和兩個孫子。而她也差一點失去我。
Fishel 奶奶在我動盪不安的童年與青春期，一直是我最堅定的支持者。她的家成了我的避風港，是我遠離自己居住的家和就讀學校的安全空間——那些地方讓我很難融入，也讓我明白自己與別人不同。
她總喜歡用溫馨而帶點復古趣味的小擺設，為生活帶來光亮與歡樂。我相信，這樣的環境深深影響了我，塑造了我一生對「老好萊塢」紀念品，以及像 Mae West 和 Yma Sumac 這類個人偶像的喜愛。
尋求幫助
憂鬱症從我 11 歲起，就成了我不受歡迎卻始終揮之不去的同行者。那不是人們在生活中正常會經歷的情境性低潮，而是一種令人動彈不得、長期存在、卻找不到明顯「原因」的慢性憂鬱。伴隨著憂鬱而來的，甚至在那樣年幼的時候，就已經有了自殺的念頭。到了青少年時期，這些想法對我來說已經變得稀鬆平常。我對周圍每個人看起來都那麼輕鬆地過日子感到憤恨，而我卻像是站在窗邊，看著別人在外面快樂生活。
23 歲那年，我開始服用抗憂鬱藥物。那時我剛搬出去，第一次獨自生活；我知道，若想活下去，我需要幫助。承認這一點對我自己而言已經很難，更不用說告訴別人——尤其是在一個從不談心理健康的家庭中長大，儘管我們家族的男性一直籠罩在自殺這個「家族詛咒」之下。但我想要感覺好一些，也想在新的社交和工作環境中正常運作。當醫生認真看待我的狀況時，我真的鬆了一口氣。第一種藥物大約幫助了我六個月。那段時間我覺得整個人輕鬆了許多，對人也更溫和，互動更多，也能在關係中付出更多。
但後來，憂鬱症狀和自殺念頭又回來了——接著便是應對副作用、嘗試不同劑量與藥物組合的掙扎。很多年裡，這就是我管理憂鬱症的日常。現在回頭看，就算有藥物，我其實從未真正覺得自己是正常的（如果所謂「正常」真的存在的話）；只是我的存在沒有那麼可怕而已。有時候我感覺自己接近「還可以」，但現在我明白，其實我從來沒有真正好過。
TMS：打破循環的治療
2018 年對我來說是一段非常糟糕的時期，而藥物已經無法幫助我撐過去了。就在我絕望地想嘗試別的方法時，我想起一段時間前，醫生曾提過一種非藥物治療，叫做經顱磁刺激（TMS）療法。當時我沒有太放在心上，但當我再次想起這個建議時，我告訴自己，我一定要試試看，因為我至少還欠自己最後一次嘗試的機會。就算沒有效，至少我可以說，我真的給過它一次機會。
TMS 會利用磁脈衝刺激大腦，所以它不是另一種藥物，而這一點對我非常有吸引力。一想到還要再面對另一種藥物，我就感到絕望。如果那是我唯一的選擇，我相信自己可能早就放棄了。
我在南加州住家附近找到一間專門提供 TMS 療法的診所，值得慶幸的是，那裡的醫生判定我是很適合接受這項治療的人選。一開始，當他們告訴我必須連續七週、每個工作日都去治療時，我其實很害怕。那時候連起床都很困難，更別說離開家、走進這個世界。但我逼自己去。幾天之後，我開始覺得，自己終於在為自己做一件正面的事，於是我每天都去，持續了整整七週。
每天接受 TMS 治療的實際過程與感受，其實都相當可以承受。診所會配合我的時間安排療程，而每天為我治療的那位專業人員也非常好。她會先幫我在舒適的治療椅上坐好，並確保我接受到精準、處方規定的磁脈衝劑量。大約 20 分鐘的時間裡，我坐在椅子上，感受到頭部靠近磁線圈接觸頭皮的地方，有一種規律的「答、答、答」敲擊感，那就是磁脈衝進入的感覺。
好轉，讓我感到驚訝
我並不確定自己會多久開始感受到改變。醫生告訴我，每個人都不一樣。我最先注意到的改變是，那些我每天都會出現的自殺念頭，停止了。大約做了 10 次治療之後，我迎來了我稱之為「爆開日（Pop Day）」的那一天。顏色似乎變得更明亮了，我甚至會注意到黃昏時交通號誌亮起來有多麼好看；我會在做完 TMS 回家的路上拍花，開始在周遭的一切裡看見美。我的身體也感覺輕盈了許多。得了憂鬱症時，你會覺得自己總像揹著一大袋沙子在生活，而那種沉重感消失了。
當它真的起作用時，我簡直不敢相信。直到現在，有時我還是不敢相信。自從五年前那個「爆開日」之後，一切都再也不是從前的樣子。即使到了今天，我仍會坐下來想想自己現在的感受，然後驚嘆其中的差別。我發現自己如今可以適應那些在過去看來幾乎無法承受的處境。
治療能救命
從憂鬱中走出來，就像是走出監獄一樣，儘管我什麼錯也沒有做。那個一直被困在悲傷、焦慮與疲憊之中的人，終於走了出來。我一直都知道，在那一切的深處，其實住著一個很不錯的人。
對我來說，TMS 就是那個真正有效的治療，而它也可能對你有效。重要的是，要開口求助，也要鼓起力量把治療走完。不論是 TMS，還是其他方式，你都不必等到自己陷入像我當年那樣危險的處境才開始。我不太想說那句被說爛了的話——「如果我做得到，你也做得到。」但這的確是真的。我不是什麼特別的人，但我是一個你可以產生共鳴的人，我理解那種感受。
Damon Devine 是一位心理健康倡議者，他希望讓人們知道：精神疾病不是你的命運，也不是你的身分。他鼓勵每一個人在危機來臨之前，就先了解自己有哪些治療選項。
Date Published：October 16, 2023
Author: Damon Devine
My great-grandmother lost her husband, both sons and both grandsons to depression and suicide. And she almost lost me.
Grandma Fishel was my constant supporter during my tumultuous youth and adolescence. Her home became my refuge, my safe space away from the house I lived in and the school I attended — places where I struggled to fit in and knew I was different.
She surrounded herself with cozy kitsch to bring light and cheer into her life. I’m convinced this environment was influential in shaping my lifelong love of “Old Hollywood” memorabilia and personal idols like Mae West and Yma Sumac.
Asking For Help
Depression had been my unwelcome, relentless companion since age 11. Not situational depression that people experience as a normal part of life, but immobilizing, chronic depression with no obvious “reason.” Along with depression, even at that tender age, came thoughts of suicide. By the time I was a teenager, those thoughts were normal for me. I was resentful of how casual everybody seemed about daily life, while I was looking out a window at everyone else having fun.
At age 23, I started taking antidepressant medication. I had just moved away and was on my own for the first time; I knew I needed help to survive. It was hard admitting this to myself, much less anyone else — especially growing up in a family that didn’t talk about mental health, despite “the family curse” of suicide among our men. But I wanted to feel better and function in my new social and work environment. I was so relieved when the doctor took me seriously. The first medication helped for about six months. I felt much lighter, was much nicer to people, interacted more and could give more in my relationships.
Then the depression symptoms and suicidal thoughts came back — followed by the struggle of dealing with side effects and experimenting with doses and medication combinations. For many years, this was my routine to manage my depression. Looking back now, I never felt normal (whatever that is), even with medication; my existence just wasn't as horrific. Sometimes I felt close to ok, but now I see that I never truly was.
TMS: The Treatment That Broke the Cycle
2018 was a really bad time for me, and the medications weren’t getting me through it. In my desperation to try something different, I remembered that some time back, my doctor had mentioned a non-drug treatment called transcranial magnetic stimulation (TMS) therapy. At the time, I hadn’t paid too much attention, but when I recalled the suggestion, I thought to myself that I must do this because I owe myself one last thing to try. If it didn’t work, I could at least say I gave it a chance.
TMS uses magnetic pulses to stimulate the brain, so it’s not another medication, and that appealed to me a great deal. The thought of facing another medication filled me with despair. If that had been my only option, I believe I would have given up.
I found a practice that specializes in TMS Therapy near where I live in Southern California, and thankfully, the doctor there diagnosed me as a good candidate. At first, I was intimidated when they told me I would have to come in every weekday for seven weeks. It was a struggle to get out of bed, much less leave the house and go out into the world. But I forced myself to go. After the first few days, I felt like I was doing something positive for myself, and I went every day for seven weeks.
The actual process and sensation of the daily TMS treatments were quite manageable. The office worked with me to schedule times that were convenient, and the practitioner I saw every day was wonderful. She got me settled into the comfortable treatment chair and made sure I received my exact, prescribed dose of magnetic pulses. For about 20 minutes, I sat in the chair and felt a tap-tap-tap sensation on my head where the magnetic coil touched my scalp and delivered the pulses.
Getting Better Surprised Me
I wasn’t sure how soon I would start to notice a difference. The doctor explained it’s different for everyone. My first sign was that the suicidal thoughts, which I had been having every day, stopped. After about 10 treatments, I had what I call my “Pop Day.” Colors seemed brighter, and I caught myself noticing how pretty traffic lights glow at sunset, photographing flowers on my way home from TMS and seeing beauty everywhere around me. I felt physically lighter, too. With depression, you feel heavy, like you're carrying around a big bag of sand all the time, and that was gone.
When it worked, I couldn't believe it. I still can't believe it sometimes. Ever since Pop Day five years ago, things have never been as they were before. Even now, I'll sit and think of how I feel today and marvel at the difference. I find myself adapting to situations that would have seemed insurmountable back then.
Treatment Is Lifesaving
Coming out of depression felt like coming out of prison, even though I'd done nothing wrong. The person I always knew was deeply trapped in all that sadness, angst and exhaustion came out. I always knew there was a pretty cool person in there.
TMS was the treatment that worked for me, and it might work for you. The important thing is to ask for help and muster up the strength to follow through. Whether it’s TMS or something else, you don’t have to wait until you’re in as dangerous a place as I was. I hate to say the overused phrase, "If I can do it, you can." But it’s the truth. I’m no one special, but I am somebody to relate to, and I understand.
Damon Devine is a mental health advocate who wants people to know that mental illness is not their destiny or their identity. He encourages everyone to be aware of their treatment options before they’re in crisis.
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