Narrative Inquiry in Bioethics

The first time I had a major depressive episode I was 20, on summer break between my sophomore and junior years of college. I had some idea of what was happening to me, that it was not within the “normal” ups and downs of everyday life; that the intractable nature of my sadness and anxiety had rapidly become a black hole whose gravity I could not escape. But the word “depression,” in the clinical sense, was not something I recognized—in myself or others. I simply thought that my mind, which has always been overly imaginative on the one hand, and prone to catastrophic thinking on the other, was in a temporary state of imbalance that I would have to pull myself out of. But as getting out of bed became increasingly difficult each morning, and the sensation of being underwater relative to the rest of the world permeated every social interaction, I came to the uneasy realization that this was different. I could see the “normal” world and level of perception I had existed in for most of my life, and I felt a world—a whole universe apart. Every day felt like a year, and the simplest tasks became monumental. For a high-functioning person like me, this was even more devastating.

I had met my birth mother earlier that year, and through a series of discussions and interactions learned some pieces of my health history I had never known before. Like the fact that she had been an alcoholic for 17 years, barely surviving the disease intact. She had never used the words “clinical depression” with me in her descriptions of what had led her to self-medicate through alcohol in the first place, but I knew that addiction comes out of sadness and anger—both emotions closely tied to depression. And she told me once that, beginning when I was six, and for years afterwards, she would tell her family, my aunts and uncles and grandmother, that she was coming for me, that she was “going to get her.” Then they would have to convince her that she couldn’t do that, would never find me anyway, that she would have to let the loss go somehow, some way, sometime. But some losses you never really recover from. I believe that relinquishing me for adoption was that kind of loss for my birth mother. And that although she might not have known it, she was drawn to alcohol because of the deep clinical depression she suffered because of my adoption.

I began talking to a therapist during that summer, the summer I was 20, and I told her of this family health history, the pieces that I knew anyway. [End Page 109] I also told her the other piece I had discovered the year before; that my birth father had died in a high-speed police chase when I was six. I knew his family was in Detroit, and had even spoken to my grandfather, his father, on one occasion, but that was pretty much all the information I had about him at that point. It was only later that I would meet my aunt, who would tell me that my father had suffered from what she termed “severe emotional problems,” and that he had gone AWOL in the Air Force. Having that information, along with the knowledge of my birth mother’s addiction and probable clinical depression, was what finally led me to get on medication for depression and anxiety when I was 26, and suffering my second major bout of clinical depression. At that point, I had been struggling through severe depression and anxiety for more than a year, which had been triggered by a break up with a man I was engaged to.

Weekly talk therapy sessions were having minimal to no effect, and I began to fear that I would never be able to get myself out of that alternate universe of pervasive sadness and anxiety. My therapist had suggested medication on more than one occasion, but I had declined, insisting that I wanted to “work...