In December 2016, Heather B Armstrong phoned her mother from her kitchen floor in tears and told her that she wanted to be dead. With her children thousands of miles away spending Christmas with their father, Armstrong’s ex-husband, and having been abandoned by a date, the blogger-turned-author was alone at home when she felt “overcome with a really bad feeling”.
It was not the first time that she had made such a call, but this felt different. “It’s the night that I called her and I said I don’t feel like I can hold on any more,” says Armstrong, 43, whose website Dooce once earned her the title “queen of the mommy bloggers”.
Her mother kept her on the phone for 40 minutes while she rushed to her daughter’s home in Salt Lake City and stayed the night to take care of her. The following morning she forced Armstrong, who had been suffering from severe depression for a year and a half, to book an appointment with her psychiatrist – a call that within months would end up transforming her life.
Just a few months later she was taking part in a pioneering world-first study that would plunge her into a deep sleep that would help relieve her depression within weeks.
Today Armstrong, who has documented her experiences with depression in the new book The Valedictorian of Being Dead: The True Story of Dying Ten Times to Live, credits her mother’s actions with saving her life. “I didn’t overtly want someone to intervene, but I think subconsciously I knew that if I didn’t reach out and have someone do it that this was going to destroy me. And she knew that,” she says matter-of-factly.
今天，阿姆斯壮将她与抑郁症的经历写进了她的新书《已逝者的告别 : 为一生而十死的真实故事》，她把她能活下来归功于母亲的行为。“我并不希望有人干预我，但潜意识里我知道，如果我不伸出手，让别人来干预，这将毁了我。” 她知道这一点，”她实事求是地说。
Over breakfast at her hotel in New York, where she is joined by her partner, Pete Ashdown, for moral support, she says she can trace her first experiences of depression back to high school, when she remembers a teacher shaking her shoulders and telling her: “You’ve got to let go.” She first started taking antidepressants in college, when she had a breakdown during her sophomore year, and was hospitalised after experiencing suicidal feelings following the birth of her first child.
在纽约的酒店里，她与伴侣Pete Ashdown共进早餐，寻求精神上的支持。她说，她的第一次抑郁经历可以追溯到高中，当时她记得一位老师摇着她的肩膀对她说:“你必须放手。” 她第一次服用抗抑郁药是在大学二年级的时候，当时她的精神崩溃了，在第一个孩子出生后，她经历了自杀的感觉，因此被送进了医院。
The most recent started while training for the Boston Marathon. She thought her gruelling training regime was the cause of her sadness, but when the race was over she realised it was something else.
She was so anxious that she couldn’t sleep or stop worrying about simple day-to-day tasks. “It was a state of panic that I lived in for 18 months. Constant state of fire. Fiery panic,” she says. Most of the time Armstrong, who is dressed in a black suit and her earlobes decorated with little gold bull head studs, speaks with remarkable composure and steady eye contact. But now her voice trembles and she looks up to the ceiling as if holding back tears. “Yeah. Which I wanted to end. I thought, if I’m dead then I don’t have to feel this fire any more. I’m not going to be dead, but wouldn’t that be great? Wouldn’t that be great?” After a pause, she adds: ”I’m so glad I don’t feel that way any more.”
持续焦虑状态，极度恐慌，”她说。 阿姆斯特朗身穿黑色套装，耳垂上装饰着金色的小牛头钉。大多数时候，她说话时都异常镇定，目光坚定。 但现在她的声音颤抖，她抬头望着天花板，好像要忍住眼泪。 想要结束吗?是的，我想就此结束。我想，如果我死了，我就不用再感受这种煎熬了。 我不会死，但那不是很棒吗? 那不是很棒吗? 停了一会儿，她补充道:“我很高兴我不再有那种感觉了。”
Unlike previous life experiences (such as postpartum depression, leaving Mormonism and work – which in 2002 got her fired) which she has often written publicly about in real time on Dooce, she was frightened to talk to anyone apart from her mother about it for fear of losing custody of her two daughters, Leta, 15, and Marlo, nine.
不同于以往的生活经验(如产后抑郁,2002年离开摩门教和工作——他们把她解雇了), 她经常事时公开写Dooce, 她害怕任何人除了她母亲谈论它, 害怕失去她的两个女儿的监护权,Leta,15岁,Marlo, 9岁。
It also put her off seeing her psychiatrist until her mother’s intervention left her with no option. When, in February 2017, she finally saw him, he suggested she take part in a pilot study at the University of Utah into the potential antidepressant effect of general anaesthetic Propofol. For the first time in over a year she felt optimistic.
这种恐惧也推迟了她去看心理医生的时间，直到她母亲的介入让她别无选择。 2017年2月，当她终于见到他时，他建议她参加犹他大学的一项试点研究，研究麻醉剂-异丙酚的潜在抗抑郁作用。 一年多来，她第一次感到乐观。
I was just so devoid of caring because all of my energy was consumed by worry
But as only the third person in the world to undergo the treatment, was she not scared? “Oh, I didn’t feel anything at that point … you could have dropped me out of a plane and I wouldn’t have flinched,” she says. “I was just so devoid of caring because all of my energy was consumed by worry, of how do I unload the dishwasher, how do I fold clothes. It sounds so stupid … it’s not a woe is me situation, it’s just the day-to-day was so overwhelming and unrelenting that I didn’t know how to escape it.”
但作为世界上第三个接受这种治疗的人，她难道不害怕吗? “哦，那时候我什么都没有感觉到……你可以把我扔下飞机，而我都不会颤抖，”她说。 她说:“我完全不关心别人，因为我所有的精力都花在焦虑上了，担心怎么放置洗碗机，担心怎么叠衣服。 这听起来太愚蠢了……我的处境并不是一种悲哀，只是日复一日的生活负重让我不知所措，让我无法逃离。”
The following month she started going into hospital three times a week to be put into a deep state of anaesthesia (although, according to Dr Brian Mickey, who ran the study, not close to death, as her book suggests) for 15 minutes to see if it had an antidepressant effect. While she slept, doctors monitored her brain’s “burst suppression”, an electrical pattern formed of a flatline interrupted by bursts every few seconds, before waking her up again.
For the first four of the 10 treatments she felt the same, but after the fifth she felt dramatically different. “I just walked into my house and wanted to sort of, like, dance,” she laughs. “It was a very strange feeling because I wasn’t tired, I was ready to go. I had put on makeup that day, I had brushed my hair, taken a shower and I thought: ‘I want to go out!’ which was a very strange sensation.” The next morning, she awoke without her usual anxiety and felt like “something had switched in my brain”.
那天我化了妆，梳头，洗了个澡，然后我想:‘我想出去! 这是一种非常奇怪的感觉。 第二天早上，她醒来时没有了往常的焦虑，感觉“我脑子里好像有什么东西变了”。
Of the 10 people who took part, Armstrong was one of six for whom their depression score decreased by 50% or more. Mickey, associate professor of psychiatry at the university, says they don’t yet know how it works, but adds: “We know that there’s definitely evidence that modulation of Gaba (gamma-Aminobutyric acid) and glutamate, these neurotransmitters in the brain, in some cases can trigger an antidepressant response. So because Propofol works on Gaba and glutamate systems, we suspect that that could be a mechanism.”
在参与调查的10人中，阿姆斯壮是他们的抑郁指数下降了50%或更多的6人之一。 米基是这所大学的精神病学副教授，他说他们还不知道它是如何工作的，但他补充说:“我们知道，有明确的证据表明，在某些情况下，大脑中调节性的神经递质伽马氨基丁酸和谷氨酸，可以触发抗抑郁反应。” 因此，由于异丙酚作用于伽马氨基丁酸和谷氨酸系统，我们怀疑这可能是一种机制。”
Further trials are needed, he says, but if it is found to be effective, it could provide an alternative to electroconvulsive therapy, which he claims is effective but for many people the procedure, which uses electric current to induce short seizures, comes with side-effects such as memory loss.
Two years on from being treated with Propofol, Armstrong says she continues to take medication but no longer feels like anything is insurmountable. “I just don’t ever have the feeling like, ‘I can’t do this.’ I don’t ever have that thought, which was the defining factor of my life for 18 months.” She started seeing Ashdown, 52, president and founder of internet provider XMission, a few months after her treatment. In August, Armstrong and her daughters moved in with him and his 13-year-old daughter.
在接受异丙酚治疗两年后，阿姆斯特朗说她继续服药，但不再觉得有什么是无法克服的。 “我从来没有那种感觉，‘我做不到。 “我从来没有这样的想法，这是我18个月生活中的决定性因素。 52岁的阿什当是互联网服务提供商XMission的总裁兼创始人，在经过了几个月的治疗后的8月，阿姆斯特朗和她的女儿搬进了Ashdown和他13岁的女儿的家。
Her memoir, she hopes, will provide others with a language to talk about mental health and raise awareness of the study. While she has received positive messages from fans online, she says she is still anxiously waiting for the verdict of her father, who she writes frankly about in the book.
After over a decade of posting regularly on her site, she took a step back from blogging in 2015, declaring the way it had been monetised by brands a “health hazard”. She has since returned to her blog, but now she says she works with companies on her own terms.
Next she plans to focus her attentions on removing the stigma around mental health and improving services, especially for children. “My brother’s son goes to a high school where last year there was six suicides. Six. Something’s going on and we’re not addressing it. We’re not funding it, there’s no money in it and it’s a disaster.” She wants to see more insurance companies covering mental health and seminars and free counseling in high schools. “If the family can’t afford $130 an hour where does that kid go? We need to overhaul the complete system, and Utah’s the perfect place to start.”