Is It Depression--or a Tumor?

Like many others, I have battled depression throughout my life. A combination of psychotherapy and antidepressants had been enough to keep me living a relatively normal and contented life—until about 10 years ago. Then I became increasingly unhappy, and no amount of drugs or therapy seemed to help. In 2002, the depression became so severe that I experienced my first strong suicidal urge. On the recommendation of my psychiatrist, I was hospitalized.

The psychiatrist was so concerned about my condition that he wanted an MRI done to ensure that nothing was wrong with my brain. The neurologist who ordered the MRI found something surprising: a meningioma, a type of brain tumor that is generally benign. I was horrified. But the neurologist wasn't. He assured me that the growth was benign, and too small to be concerned about. He said that meningiomas were often discovered during autopsies, but had caused no problems for the people who had them. Moreover, he insisted that the tumor had nothing to do with my depression, and he relayed that conclusion to my psychiatrist. His advice was essentially to leave it alone for the time being but to let him know if I began to experience headaches or seizures, a sign that the tumor was growing.

The psychiatrist released me from the hospital on the condition that I go live with my son in Arizona. But I became even more depressed there and, after a few months, I returned to my home state of Georgia, where I lived mostly with friends. Still, I could not shake the depression. It was so bad that I could not work. I am a writer, but I found I could no longer write. Some days the depression was so profound that I could hardly get out of bed. My friends and family were deeply concerned about my condition, but we all believed that my depression had simply gotten out of control. I continued to take my antidepressants and to go to therapy, but they had little effect. I made two serious suicide attempts and was hospitalized each time. Dying seemed to be the only answer, and I could not understand why people who loved me objected to my desire to end my life.

I was getting sicker and sicker. In the summer of 2006, I moved to Las Vegas to live with my other son, hoping it might help. But I soon made another suicide attempt and began a series of psychiatric hospitalizations in that city. Over a few weeks, my symptoms deepened. I could not walk straight and my thinking became blurry. In fact, my memory was so foggy that I completely forgot that I had a brain tumor. (And anyway, I had been convinced by what the neurologist had told me four years earlier: that the tumor was nothing more than a small, insignificant growth.)

By late November, I could say only a few words, none of which made sense. I could not stand up. Sometimes I did not remember my own name. I knew I was dying, but I did not care.
Finally, the psychiatrist I had been seeing in Las Vegas consulted a neurologist, telling him, "I think she's demented." That neurologist  saved my life. He told the psychiatrist that I needed immediate medical care. I do not remember that doctor's visit, but I do remember being put in a wheelchair and rolled across the psychiatric hospital's parking lot. There I was lifted into a mobile imaging truck where I had another MRI.

That test revealed a brain tumor that was large enough to be fatal. It had grown from approximately one centimeter in size, when it was first diagnosed, to six centimeters. I was immediately transferred to a primary-care hospital where, on Dec. 4, the tumor was removed in an emergency operation. I awoke with almost no hair, a monstrously swollen head, and a nine-inch incision across the left side of my scalp held together by staples.

I had to learn to walk again. I also had to regain my short-term memory. But mostly I celebrated that the tumor-caused depression was totally gone. My mind was back, and my wit and humor quickly returned. In short, the brain surgery was a remarkable success.

Friends and family called the surgery and my recovery miraculous. In his surgical report, the neurosurgeon wrote that I had gone "from being completely unresponsive to a walking, talking, normal human being again."

I rejoice in that medical triumph, but I also regret losing more than 10 years of my life to deep sadness and confusion. Concern for people who may be enduring what I went through haunts me. How many people with crippling depression have an undiagnosed brain tumor? How many deaths would be prevented if suicidal people had MRIs or other brain tests that could reveal problems?

The job of ensuring proper diagnosis and treatment falls largely to psychiatrists and neurologists. Many of them now work more closely together, but that cooperation must expand. People who suffer from unexplained depression also must do their part. When therapy fails to correct the problem and medications prescribed by psychiatrists fall short, patients must ask for a neurological consultation before the depression overwhelms them. And take a lesson from my experience: If a doctor says you have a brain tumor but tells you not to worry about it, get a second opinion.

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