Undercurrents: A Therapist's Reckoning with Her Own Depression

Undercurrents: A Therapist's Reckoning with Her Own Depression

by Martha Manning

Depression transformed Martha Manning from a happy, healthy, and successful wife, mother, professor, and psychotherapist who "lived with the innocent arrogance that [her] life was the simple product of [her] effort, will, and design" to a sleepwalker haunted by thoughts of suicide, "a house of cards, held precariously by the fragile conspiracy of wind, weight, and…  See more details below


Depression transformed Martha Manning from a happy, healthy, and successful wife, mother, professor, and psychotherapist who "lived with the innocent arrogance that [her] life was the simple product of [her] effort, will, and design" to a sleepwalker haunted by thoughts of suicide, "a house of cards, held precariously by the fragile conspiracy of wind, weight, and angle." Undercurrents chronicles this transformation through Manning's startlingly funny, deeply affecting, and always honest journal entries. Outlining the depths and dimensions of severe clinical depression, Manning's quick wit and razor-sharp powers of observation allow us to laugh at and empathize with the mounting disarray in her life: insurmountable household clutter, nightly insomnia, manic, caffeine-fueled efforts to meet deadlines. We understand her terror as she evaluates a new patient only to realize that she herself meets all of the textbook criteria of depression, and feel her nowhere-to-turn despair as she is forced to acknowledge that the love of her family, the support of her therapist, and the exhaustive drug treatments administered by her psychiatrist are not succeeding in stemming the tide of her disease. Finally, Manning agrees to electroconvulsive therapy, or ECT. Notorious for its past abuses, its safety and efficacy open to debate, this controversial treatment becomes her last resort and only hope.

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Editorial Reviews

Los Angeles Times
A brilliant combination of wit, irony, and despair....Undercurrents is absolutely as good as it gets.
Dallas Morning News
Full of unexpected delights...honest, hilarious, full of hope.
Philadelphia Inquirer
Humor, candor, and a respect for the power of image and metaphor to heal.
Washington Post
A moving and engaging journal....I found myself laughing out loud.
New York Times Book Review
A convincing testament to the inexorable cruelty of depression and a frightening reminder of its unprejudiced choice of victims.
USA Today
An absolutely absorbing read.
Whitney Scott
This powerfully gripping account of a therapist's reckoning with her own severe depression is a breathtaking gem of a book, heartrending, hilarious, extraordinarily human. Written in diary form, it takes us through Manning's deepening downward spiral of despondency to despair as she loses interest, appetite, the ability to sleep, and the will to live and winds up in fetal position on her therapist's couch. No combination of antidepressants and tranquilizers releases her from the excruciating torture, the nameless, faceless dread she endures and articulates: "The emptiness of depression. . . . Every inch of me aches. I can't believe a person can hurt this bad and still breathe. All escapes are illusory--distractions, sleep, drugs, doctors, answers, hope." The mention of shock therapy may bring to some memories of Sylvia Plath's Bell Jar" and of Thomas Eagleton's political demise, but it is only a series of electroconvulsive therapy treatments administered over time in an inpatient setting that literally brings Manning back from the edge of death. In writing of her ordeal, she manages an antic, graveyard humor, peppered with stunningly perceptive observations, which inspires faith in the healing powers of humor just as her extraordinary book inspires hope for the human spirit.

Product Details

HarperCollins Publishers
Publication date:
Edition description:
1st ed
Product dimensions:
5.54(w) x 8.51(h) x 0.80(d)

Read an Excerpt

Chapter One

Ring the bells that still can ring.
Forget your perffect offering.
There is a crack in everything.
That's how the light gets in.

Leonard Cohen, "Anthem"

January 5, 1990

My nine-year-old patient Stephanie and I sit on the floor of my office playing Sorry. Sorry is one of those wonderful games that is easy even for young children to master, but often difficult for the most mature of adults to tolerate. You can be so close to Home, and be bumped so precipitously by your opponent all the way back to Start. Positions shift quickly. The sure winner loses and the loser triumphs.

Stephanie whoops loudly as she beats me for the third time. Each time she bumps one of my pieces back to Start, she croons "Sooorrryyy" with considerably more delight than remorse. I glance at the clock and let her know that we are close to being out of time. We pack up the box and she places it back on the shelf. I stand up. Without warning, my slip drops to the floor and lands on my shoes. We both stare at it, stunned. I stammer, "Oh my goodness!"

Stephanie, a rather solemn child, is seized with paroxysms of laughter, which become contagious. I step out of my slip and stuff it into my briefcase. Stephanie tries to catch her breath and exclaims, "My perfect Dr. Manning is coming apart!"

She bursts into the crowded waiting room and graphically describes the scene to her parents. It is clear that the entire waiting room enjoys this story. I can see them smiling and smirking behind their Ladies Home Journals and National Geographics. My friend Ed passes me in the hall between our offices and asks casually, "Thatwouldn't be your Freudian slip, would it?"

January 8, 1990

My desk is littered with too many things that are getting too little attention. Papers wait passively in the "to do" pile. They've been there so long they are beginning to discolor. Four Diet Coke bottles sit half-filled with warm flat brown liquid. A crusty coffee cup holds the remnants of old candy bars, abandoned midway in fits of guilt. The phone bill is two months overdue and three Medicare forms are screaming for attention. I've been so busy lately, I've started a "to read" pile for the mail I have yet to open. Each evening I leave the office with the magical thought that the night will bring order to the chaos and transform it all by morning. But that is like shoving the box of aluminum foil back into the haphazardly organized closet and closing the door quickly, before it can slide back out. I always hope that time will somehow settle the contents of the closet, and I'm always surprised the next time I open the door when the package slides right back out and smacks me in the head.

I picture a woman who has it all together. She processes things completely the first time they cross her desk. She is up-to-date with bills, Pap smears, and teeth cleanings. She knows that her children's drawers are filled with clean, folded clothes. She knows what her family will be having for dinner three days in advance. She is complete. Able to go to sleep each night without the weight of any old business on the agenda. Everything on her list is crossed off. I hate her.

January 9, 1990

I am on a blitz. A week ago I heard about the National Institutes of Health offering grants for beginning researchers. Since then, it has been constant and frenetic activity: liaison with the grants office, designing the study, estimating budgets, getting endorsements, consultations, statistical input. I'm on my second day of no sleep and I actually feel great. I'm running on fumes with the nutritional support of Diet Coke, coffee, and Hostess powdered-sugar doughnuts. In the middle of the night, hunched over my computer, with the rest of the house dark and quiet, I feel a certain moral superiority to the sleeping world. Even with all this effort, I'm not sure the proposal will be finished by the deadline. But my foot is on the accelerator and I plan to push it to the floor. That's never failed me yet.

January 12,1990

The grant proposal gets in, with three minutes to spare before the 5:00 P.m. deadline. The department chair dispatches a lab assistant to hand-deliver it to NIH. As we madly collate and staple, I notice a typo and almost start to cry. But it is too late for changes. I whip off a cover letter, pack the damn thing, and send the lab assistant on his mission, encouraging him to consider all speed limits and stoplights as suggested guidelines rather than rigid driving rules. He promises to call me the minute the package is stamped "Received."

For the next hour I put in my time as academic adviser to the parade of students outside my office. I jump when the phone rings. The lab assistant tells me he got it in just under the wire. I thank him profusely and promise that I will never push a proposal to the limit like that again. Before the words fully leave my mouth, I'm aware that I am lying.

January 14,1990

There is something about flying through time, as I have over the past week, that makes me think that I am exempted from the laws of gravity. But the way I feel today lets me know that I'm not. I have done another of the crash-and-burns that are the price for my blitzes. I am grounded, heavy, and slow. I have overdosed on effort, and the hangover is horrible. I guess this is what I get for flying too close to the sun. Unfortunately, I never remember this part when I am aloft.

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What People are saying about this

Anne Lamott
One of my favorite books in a long time...brilliant, painful, beautiful. I laughed out loud.

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