Dying to be alive
Writer went to the brink of death and back to treat depression — and it worked
The lowest point for Heather B. Armstrong came when she developed the habit of hiding in a closet to call her mother and vent that she wanted to be dead.
It was an increasingly frequent thought that kept her from visiting her psychiatrist because, as a single mother of two daughters, she worried her thoughts would sound alarms. But it had to be done. She had treatment-resistant depression, a condition when at least two methods of treatment do not help anymore.
Armstrong tried a lot of medication over the years, so it was a surprise when a new option came up. A new study was happening. Participants were needed. She would be a perfect fit. She would just have to let doctors turn off her brain activity and take her, in her words, to the brink of death. It was an unanticipated option after years of exhausting depressive suffering.
Armstrong battled depression since childhood. She was diagnosed in college and treated with the antidepressant drug Zoloft until the birth of her first child. It was then things “went haywire.” She suffered from postpartum depression and had a brief hospital stay where she started talk therapy and switched to a cocktail of drugs for depression, anxiety and insomnia.
The challenges of life complicated that effort. After the birth of her second child, Armstrong says her marriage failed, her ex-husband moved away, her dog died and she struggled with body issues. A writer and self-proclaimed perfectionist who once thrived in the mommy blog world, she saw the influencer landscape change and neuter authentic voices. She took up speaking engagements to cover the bills and added exhausting travel to her plate.
Armstrong tried to push her worsening depression aside and instead pushed her limits. She maintained a vegan diet and challenged herself to complete the Boston Marathon, even though she didn’t like running. She hit her wall not long after the finish line and found herself in the throngs of a depressive episode she couldn’t climb out of.
“I had given up hope that I was ever going to feel better,” Armstrong says. “I sort of resigned myself that I was going to be sad for the rest of my life.” Hope would come when Armstrong’s psychiatrist connected her with the study that she likened to being taken to a near-death state, something her doctor more gently described as “a really deep induced coma that makes you feel better about yourself.” The drug to do that would be Propofol, a powerful anesthetic often used by anesthesiologists in the operating room, not common in mental health treatment.
Scott Tadler, lead anesthesiologist for the study at the University of Utah, says that while the idea of having an anesthetic involved in mental health treatment seems unusual, the science of what it can do aligns with another longstanding method of treatment, electroconvulsive therapy (ECT).
In experiencing ECT — put simply — a patient seizes, the brain doesn’t like it and works to turn it off. This leads to burst suppression, effectively a brain quieting that lasts for under 30 minutes and allows pathways in the brain to strengthen. It is a common treatment, but side effects can be harsh.
“Drugs like Propofol can induce that suppression,” Tadler says. “Propofol is very well tolerated. Patients wake up relatively clear.”
Armstrong compares it to “rebooting the computer” that is the brain. The study included 10 participants with moderate to severe treatment-resistant depression. Each received 10 Propofol infusions to suppress brain activity for 15 minutes, with their brain activity monitored throughout.
Only the third patient treated, Armstrong would later document the