My Battle with Depression — How Misdiagnosis and Medical Malpractice Almost Killed Me

The author, a UK writer on international affairs, describes how after falling into suicidal depression, malpractice at the National Health Service worsened his condition and drove him into temporary insanity, destroying his legal career and pushing him to within a hair’s breadth of taking his own life.

My experience with depression has convinced me that the way Western medicine treats depression is not merely wrong, but profoundly damaging.

In my own case, misdiagnosis and mistreatment made matters far worse, and played a critical role in destroying destroyed my old life and career, and very nearly cost me my life.

I fell into depression in autumn 2007, age 46. The reasons are mundane enough. I worked far too long hours in a stressful job as a legal advisor at the Royal Courts of Justice, led an unhealthy lifestyle with almost no physical activity, had no spiritual life to speak of, was disappointed in my personal life and single, left my job intending to change careers, got into debt, and when on top of this I also decided to single-handedly care for my 100 year old grandmother, who was herself descending into extreme dementia, it all became too much, and seeing no way out of my situation, (when in fact there were plenty), I fell into a very serious depression.

Before long I was no longer washing or eating properly, had suicidal thoughts, and found it stressful to leave my bedroom, let alone to go outdoors.

I nonetheless stirred myself up and contacted the British National Health Service (“the NHS”), whom I asked for help.

I was quickly diagnosed as suffering depression. The diagnosis, as I recall, was carried out in a few minutes by asking me a small number of questions pre-prepared on a circular consisting of one page.

I remember being surprised that no questions were asked about what the cause might be.

In keeping with what is the NHS’s invariable practice, treatment consisted of prescription drugs, in my case citalopram.

Its immediate effect was a very strong and uncomfortable physical reaction, which included the shakes. This lasted for around 2 weeks. It was then followed by alternating periods of intense euphoria, and periods of prolonged lassitude. My sleep pattern stopped matching the course of the day. I was rarely up before 1:30 pm in the afternoon, and only began to feel properly awake in the early evening.

Importantly the euphoria in no way corresponded to the realities of my actual situation. These realities, which had caused me to become depressed in the first place, continued unabated. In fact, as my detachment from reality grew, they became worse.

I asked for therapy. I was referred to a clinic where I was briefly interviewed by a receptionist with no medical training. He sent me a form to complete. It was the size of a small book. I was offered no help to complete the form, and was told I had to do it myself, otherwise no treatment could be provided.

Since at this time it took a serious effort of the will for me to make a cup of coffee, this was simply impossible. The result was that I didn’t get any therapy.

Since the NHS had previously accepted that I was a suicide risk, I now feel that this was frankly irresponsible.

The result was that the only treatment I received was the drugs I was being given. I was under strict orders to go on taking them, and was told that I should not stop taking them without permission from the doctor.

The result was a rapid descent into what I have no hesitation today in calling madness. I became increasingly delusional and detached from reality. I began to fantasise wildly, and disastrously I began to involve other people in my fantasies.

At the same time, as my outward behaviour became increasingly bizarre, thoughts of suicide grew, until they became all-encompassing. I found myself continuously planning how to kill myself, and composing letters explaining why I had done so.

Eventually I reached the point when I actually made serious preparations to take my own life. I was only called back at the very last moment by the unexpected presence of my cat. The presence of a creature for whom I was responsible made me think beyond myself, and brought me back. Some years later the woman I came to marry read to me “My cat Jeoffrey” by Christopher Smart, and I was intensely moved to read of another’s similar experience.

Directly after this incident I reported it to the NHS, providing a detailed written description of what had happened. So far as I know, it is still on my medical file.

Nothing changed. I continued to be prescribed citalopram. I was again sent to the same clinic. I was again asked to complete the same form. I was again unable to do so. Again the result was that I did not receive any therapy.

Meanwhile the external part of my life was approaching crisis.

I had previously worked as a senior legal adviser in the Royal Courts of Justice in London. Many of the people I had to advise there were mentally ill. One such person — who had previously been declared a patient under the British Mental Health Act — contacted me at the suggestion of the British Court of Appeal while I was still at the Royal Courts of Justice. I helped her get her son out of local authority care, and obtained for her and for her family rehousing at public expense.

Shortly after I left my job as part of a planned career change, this person’s lawyers contacted me and asked me to give evidence on her behalf in a court case in which she was being tried on a criminal charge, in which she faced a possible prison sentence.

I duly did so, and she was acquitted.

The person however now had my personal details. Following her acquittal she pressed me for help with another case she wanted to bring. I told her of my depression, and tried to persuade her to look for help elsewhere. She found it impossible to find lawyers to help her, and insisted on coming to back to me.

Now that I am able to think clearly I can see that her case was hopeless, and that this was the advice other lawyers were giving her. Had I been well I would have given her the same advice.

At the time, because my will had been undermined my depression, and because my judgement had become clouded by the effect of the drugs, I could not do so. Nor was I able to insist that she leave me alone, or take action to ensure that she did so.

Instead I fell back on fantasies, which by this point were becoming increasingly bizarre, and in which I increasingly involved her. What this involved was inventing increasingly fantastic scenarios, which I gave to this person in place of real advice or action. At one point I told her I had been kidnapped by the former Lord Chief Justice of England and Wales and that he had tried to bribe me.

The result inevitably was a complaint to the Bar Council.

This was best thing that could have happened.

After suffering years of neglect at the hands of the NHS, I at last came into contact with a powerful institution that was concerned about me and which took my condition seriously.

Once the Bar Council grasped that I had not acted out of malice or greed (I had never asked for or received money), and that my behaviour was caused by depression and drug-induced madness, they treated me with scrupulous kindness and fairness. Though in light of what had happened I had to be disbarred — something I asked for myself if only to protect myself — it was the Bar Council’s involvement that finally pushed the NHS to provide me with therapy instead of drugs.

In the event the therapy I was provided consisted of meeting for 3 hours twice a week a group of equally depressed people in a room. I was assured that this was genuine therapy and not an exercise in cost-cutting. That may be so, but I remain unconvinced that bringing together unhappy people in one room on a regular basis is good way to make them happy. Certainly it didn’t have that effect on me.

In part out of a sense of gratitude to the Bar Council, I persisted with this therapy for about a year. I then simply stopped going, when it became obvious it was going nowhere.

By this time the problems that had caused me to fall into depression had started to abate. My grandmother had died some years before. The woman I loved, who had never abandoned me, told me she wanted to marry me. I had found a sense of purpose through political writing. In addition the action of the Bar Council had had the salutary effect of bringing me back to reality.

Since then my health has rapidly recovered, and I am now well.

I cannot say however that my story has a happy ending. Though I am now well, I have to live with the fact that because of my actions other people have suffered, and my legal career, in which I believe I had much to contribute, has been thrown away.

Without denying my own responsibility I cannot help feeling his was all unnecessary, and that a critical moment in my life I was let down.

In my opinion the fundamental problem is that Western medicine thinks of depression as a form of illness, and treats it that way.

Since the typical way of treating illness is to prescribe drugs, the reflex response to depression is to try to “cure” it with drugs.

This approach of course has the active encouragement of the drugs companies.

I think it is completely the wrong approach.

There are many forms of depression. The commonest by far is however in my opinion not an illness at all. Rather it is the mind’s response to the extreme stress caused by what appears to be a hopeless situation.

If depression is simply a form of unhappiness, then trying to “cure” it through mind altering drugs is obviously the wrong thing to do.

Most people are unhappy for a reason. Giving them drugs to make them artificially happy doesn’t solve the problem. It fosters a flight from reality, which can only make the problem worse.

As someone who has spent 30 years dealing with other people’s problems, I can say that there are in fact very few that are so intractable that there is nothing that can be done about them. Good advice, a helping hand, support from friends, family and social networks, is the way to go.

Above all discouraging people from working — an invariable response of Western medical authorities to depression — is completely the wrong approach, since it is on the contrary outwardly directed activity that an unhappy person needs in order to stop thinking about themselves and to escape brooding, which is essential to build up the self-confidence needed to cope with problems.

Unfortunately this is precisely the sort of approach that the deeply atomised and bureaucratic societies of the West are least equipped for.

Instead in the West we medicalise unhappiness. This probably explains why, according to a 2007 survey, almost 10% of the US population was diagnosed that year as suffering from depression, whilst less than 1% of Nigeria’s population was.

As for myself, I will finish by saying that lost in my “dark wood” I found far more help and support from reading Dante and Dostoevsky — both sufferers from what we today call depression — than I did from anything the medical services had to offer me.

Above all it was thanks to my very own Beatrice that I finally came through — “to look once more upon the stars”.