Young Georgia woman battles back from major depression

- When 28-year old Tracy Collins of Lawrenceville, Ga, first came to Emory's Wesley Woods Hospital last fall she says she had no fight left in her.

"I was lower than I ever have been before," Collins remembers.  "And, coming back, and being where I am now, I almost started to cry."

Tracy was diagnosed with major depression at 14.  

Since then, she's tried talk therapy, dozens of medications, and she's even been hospitalized several times. 

Nothing helped.

"I contemplated suicide, I actually attempted suicide," Collins says.  "There was never, I never got it fixed."

Dr. Bill McDonald, the J.B. Fuqua Chair of Psychiatry at Emory School of Medicine, says treatment resistant depression, or TRD, is a really common problem.

"There are about 30 percent of people, maybe 1 in 3, who take an antidepressant and really don't respond to it."

By the time patients like Tracy Collins reach the Treatment Resistant Depression Clinic at the Emory Brain Health Center, Dr. McDonald says, they've tried and average of 10 depression medications without relief.

"When that happens over and over again, you get discouraged," says McDonald.  "You wonder, 'Is it me?  Do I really have this biological illness?'"

Because Tracy's depression was so severe, Dr. McDonald and his team recommended electroconvulsive therapy, or ECT.  

Tracy agreed to try it, knowing without a breakthrough, she might not survive.

"I can say that with 100% certainty, I would have died," she says.  "By my own hand."

Over several weeks, Tracy's father would drive her to Wesley Woods, where she'd be prepped and then placed under general anesthesia.   

Then, a psychiatrist would deliver small bursts of electrical energy into Tracy's brain to trigger a brief seizure.

The goal, McDonald says, is to dampen down certain overactive areas of the brain that play a part in depression.

"People talk about "resetting" the brain, resetting it and taking it back to its normal state," McDonald says. 

"The first treatment, I kind of felt like I'd been hit by a truck," Tracy says.  "Everything hurt. I was thinking, 'What did I just get myself into?"

But, by the fourth or fifth treatment, she says, she felt lighter, as if something had shifted inside her.

"I was actually kind of scared of it," Collins says.  "Because I'd never felt that way before. I felt like I'd been woken up."

Because ECT has risks,  it's typically reserved for patients with severe depression who haven't been helped by antidepressants.

For patients who can't tolerate the side effects of medication, a less invasive approach, transcranial magnetic stimulation, or TMS may help, McDonald says.

He says TMS is much less invasive than ECT, but it's also less effective.

Four months after Tracy Collins' last treatment, Tracy is undergoing psychotherapy and  she's taking antidepressant medication.

For the first time in years, she says, she feels good.

"I am doing much, much better," she says.

And she hopes her story will give someone else something she almost ran out of --- hope.

"Eventually, it will get better, and you will find something," she says.

For more information on Emory Healthcare's Treatment Resistant Depression program, visit

www.emoryhealthcare.org/trd.

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