The Valedictorian of Being Dead: The True Story of Dying Ten Times to Live

by Heather B. Armstrong

Author and blogger Heather B. Armstrong writes about her experience as one of only a few people to participate in an experimental treatment for depression involving ten rounds of a chemically induced coma approximating brain death.

For years, Heather B. Armstrong has alluded to her struggle with depression on her website. But in 2016, Heather found herself in the depths of a depression she just couldn’t shake, an episode darker and longer than anything she had previously experienced.

This book recalls the torturous eighteen months of suicidal depression she endured and the month-long experimental study in which doctors used propofol anesthesia to quiet all brain activity for a full fifteen minutes before bringing her back from a flatline. Ten times. The experience wasn’t easy. Not for Heather or her family. But a switch was flipped, and Heather hasn’t experienced a single moment of suicidal depression since. The Valedictorian of Being Dead brings to light a groundbreaking new treatment for depression.

Genres: Memoir, Nonfiction, Mental Health, Psychology, Audiobook, Biography, Biography Memoir

272 pages, Hardcover

First published April 23, 2019

About the author

Heather B. Armstrong is widely acknowledged to be the most popular “mommy blogger” in the world. Her website, dooce®, has twice been listed as one of the 25 best blogs in the world by Time magazine and Forbes listed it as a top 100 website for women. In the eighteen years that Heather has been shaping the internet writing community, she’s worked to create targeted content not only for fellow parents but also for numerous global brands—including Ford, Nintendo, and Clorox—and written a New York Times bestseller, It Sucked and Then I Cried. She lives in Salt Lake City with her two lovely daughters and an insane herding dog.

Reviews

[Nancy · Rating 2 out of 5]

I am so conflicted with this book.

The good is that the author is honest about her depression and describes it so very well. Her writing is compulsive and her relationship with words is enviable. I applaud anybody who is willing to write an honest memoir. But that is where my conflict comes in. It is certainly her choice to share what she wishes to share of her personal journey and I acknowledge that. What drove me crazy was the little tidbits that hinted of a much, much bigger story that is probably relevant to her journey but then, after one sentence, she drops it. Why mention it at all if it isn’t going to be fleshed out adequately for the reader? There are deep issues with her father and I respect her discretion as she has a continued relationship with him yet she intimates how very horrible he was to her in her childhood by making a reference to TV bombshell and then drops it.

I found the author very, very good at describing how it feels to be so depressed that she wanted to be dead but much of the book is a lot of description of the sounds of her mother’s shoes as she walks quickly, a conversation about constipation, how tired she is after a treatment, or the minutiae of making special sandwiches for her daughter’s. Her writing tends toward promising something deeper but leaves me wanting as it doesn’t deliver.

Apparently, there are also inside jokes or references that I didn’t get. I don’t like to feel stupid or excluded when I read a book. I enjoy an intellectually challenging read but the references were not that. They were inferences made within her mind, pop culture, or her blog. Truthfully, I’m not as trendy as she is.

I admire the author for who she is and what she has accomplished and continues to accomplish. Fans of her blog will probably understand a lot more than I did. My review is based on my frustration level and not on the author’s writing ability.

[Diane S ☔ · Rating 4 out of 5]

I had never heard of this young woman before reading this book. I've since learned she is a well known mommy blogger. So it is natural for her to write down her thoughts, and to share them with the world. Depression is an insidious disease, one I don't suffer from, though a few people very close to me have at one time or another in their lives.

In this candid memoir, Heather, chronicles her life during an eighteen month bout of a severe depression. As the single parent to two daughter, she simply wanted it all to end. The day to day struggle, the constant chores, she couldn't envision a time when she would feel happy. She loved her girls, knew deep down she needed to be around for them, yet knowing and feeling are two very different things.

In desperation she agrees to become part of a study, only the third participant. This is the story of her days, glimpses of her past, and the treatment she undertakes. Mental illness still has such a stigma attached, and this played into her fears as well. She has a wonderful mother and step father who were with her during every treatment and beyond. Family support is crucial. This country, among many I'm sure, need better psychiatric care, easier to attain and pay for. Awareness is key.

ARC from Edelweiss.

[Barbara · Rating 3 out of 5]

3.5 stars



Heather B. Armstrong

Heather B. Armstrong is a popular 'mommy blogger' who uses her website 'Dooce' to share posts about her family, personal life, pop culture, music, commercial products, and so on. Over the years Heather also wrote about her struggle with depression, which became more serious over time. By 2016 Heather had been suffering from an eighteen-month-long bout of a depression so deep that she wanted to be dead. Heather would wear the same yoga pants, sports bra, and T-shirt for days in a row, with her unshowered body topped by dirty hair. Feeling her normally trim body was out of shape, Heather writes: "I slept in my yoga pants because I didn't want to have to change my pants and see my alien body."

At the time Heather fell into the abyss, she'd been living in Salt Lake City, Utah for most of her life and was raising her two daughters Leta (13) and Marlo (7) alone.


Heather B. Armstrong with her daughters


Heather's daughters, Leta and Marlo

Heather's ex-husband Jon had moved to New York, and she was desperate to keep her depressive condition from him, fearing he'd demand custody of the children. Instead Heather would hide in a closet and call her mother, who lived nearby. Hoping the children couldn't hear, Heath would let loose, sometimes "making noises like a pig makes in a barn fire" and sometimes moaning "I don't want to be alive."



Heather could hardly bring herself to do laundry or unload the dishwater; got anxious when her boss emailed or called, knowing he'd want something completed; and was amazed that she could perform her 'mommy' job from day to day, which she describes as: "Make sure the girls have eaten; make sure they're showered and dressed; make sure they have their homework; is Marlo wearing socks? make sure to let the dog back in; make sure we have Cheerios for the next two breakfasts; make sure Leta has taken a pill for her allergies; make sure Leta has asked her friend for a ride to school tomorrow, since the other carpool just cancelled......and so on. Morning after morning after morning. And then again. And then again." Heather felt like she was barely hanging on.



Heather's psychiatrist, Dr. Lowry Bushnell, had prescribed many medications over the years, but her illness had become resistant to drugs - and pharmaceuticals no longer helped. When Heather visited Dr. Bushnell after a nine-month lapse, he looked at her and said "You don't have to tell me [how you feel]. It's all over your face. It has stolen your eyes." The psychiatrist then suggested that Heather participate in an experimental study with Dr. Brian Mickey, who was investigating the use of Propofol (the anesthetic that killed Michael Jackson) to treat depression.


Propofol

With this treatment, the patient is put to sleep - that is put into a REALLY DEEP INDUCED COMA (simulating brain death) - about three times a week for ten sessions. The purpose is to find out if "burst suppression" - quieting the brain's electrical activity - can alleviate the symptoms of depression.....sort of like rebooting a computer. Heather agreed to the Propofol regimen and this book describes each of her ten treatments, interspersed with anecdotes about herself, her children, her parents, her job, and more.

Heather's mother and stepfather stepped up to accompany her to each session, while her children - who didn't know exactly what was going on - quietly hoped for the best. Heather had to forego food and water prior to every therapy session, each of which went something like this: Heather arrives at the clinic; fills out a form assessing her level of depression; tells a nurse what drugs she's taking; has a 22-gauge needle inserted into her vein; lays down on a gurney; has sensors attached to her body; and passes out when a doctor starts the Propofol (plus other meds) drip. The medical team then inserts a breathing tube into Heather's throat, which is removed at the end of the session. When it's over, Heather is transported to a recovery room, where she wakes up confused and thirsty. A nurse then gives her apple juice and assesses her condition. When Heather demonstrates that she's compos mentis (knows her name and the year), she's allowed to go home with her folks.

Heather's mother and stepfather watched every procedure from beginning to end, her mom keeping an eagle eye on everything and everyone, making sure Heather's eyes were taped shut and substances that constipated her were left out (to Heather's eternal embarrassment).🙂

Heather notes that she started to feel better after treatment five.....and was on an upward trajectory from then on.

In the course of Heather's story we learn that she comes from a family plagued by depression; she left the Mormon Church; her biological father has an anger problem and traumatized her as a child (I would have liked to know more about this); her mother is an angel who helps with laundry, meals, babysitting.....whatever's needed; her kids have a full roster of activities, including school, piano lessons, and sports; she helped a blind man run a marathon; she wouldn't mind having a nice boyfriend who has a job; and she's eternally grateful to the medical team that treated her, all of whom volunteered their time and were immensely caring and helpful.



In an afterward, Dr. Brian Mickey, MD, PhD, writes that tens of millions of people around the world have treatment-resistant depression, and "this situation has inspired scientists like myself to search for new treatments." Dr. Mickey goes on to say "The study Heather participated in could be the beginning of something new. But the true benefits of Propofol for treatment-resistant depression remain unknown. Much work still needs to be done."


Dr. Brian Mickey

So far Heather continues to do well. With luck, she'll be a long term success story.



I found the story to be a bit repetitive (all those treatments) and would have liked to know more about Heather's upbringing. Nevertheless, the book is laudable for explaining a therapy that (eventually) might help a lot of people.

Thanks to Netgalley, the author (Heather B. Armstrong), and the publisher (Gallery Books) for a copy of the book.

You can follow my reviews at https://reviewsbybarbsaffer.blogspot....

[Erin · Rating 5 out of 5]

Thanks to Netgalley and Simon&Shuster Canada for a digital galley in exchange for an honest review.

Well, I never stray away from a tough subject in my reading material. I was seduced by the title and I stayed for the compelling and raw account of a woman's struggle to overcome the painful depression that enveloped her every moment. Heather B. Armstrong goes to a place that I never could have believed possible. In 2017 , the single mother of two and popular blogger, became the third participant in a scientific study in which the subject is given a huge dosage through anesthesia which would leave her nearly brain dead for 15 minutes. All done in an effort to quiet the electrical activity in her brain. She would go through this process TEN times.

Heather shares her family story and treatments in such a conversational manner that I felt I was talking with a friend over a cup of coffee. As I came to the end of Heather's story, I couldn't help but allow the tears to fall freely. As much pain as there is in this book, there lies within a message of hope. The Valedictorian of Being Dead: The True Story of Dying Ten Times to Live is one of my most memorable reads of 2019

Goodreads Review 19/04/ 19
Publication Date 23/04/19

[Michelle · Rating 5 out of 5]

Although author Heather Armstrong suffered from profound depression, she wasn’t suicidal and would never take her own life. In her fascinating medical memoir “The Valedictorian of Being Dead: The True Story of Dying Ten Times In Order To Live” (2019) it was this fact combined with other criteria that qualified her for a new cutting edge study and treatment: Armstrong would undergo a 15 minute chemically induced state similar to actual brain death while on a breathing tube. The treatments were designed to re-program her brain chemistry and cognitive function to (hopefully) reduce or eliminate depressive symptoms and behaviors and improve her quality of life.

As a single mother, Armstrong was overwhelmed with stress and anxiety; fearing her former husband would petition the courts and seek sole custody of their young daughter if he ever found out she was so ill. Unable to do simple tasks and basic life skills, she went for days on end without showering or changing her clothes, she would emotionally break-down, crying for extended periods over the phone while her alarmed mother consoled her—Armstrong simply did not want to be alive, and needed to feel better as soon as possible.

Some of these brain treatments seem risky and experimental: In Singapore researchers and doctors are using brain implants to treat opioid addiction (2019). Armstrong was very fortunate to have a caring family (especially her mother and step-father) that offered her unconditional love and full support before, during, and after treatment which greatly improved Armstrong’s chances for a full recovery.**With thanks and appreciation to Gallery Threshold Pocket Books via NetGalley for the DDC for the purpose of review.

[Deborah Stevens · Rating 2 out of 5]

Memoir consists of two things: the strength of the story being told, and the strength of the book.

The story here is very compelling because it concerns a topic we all know, some of us too well: depression. Considered the "common cold of mental health," almost everyone has experienced it. Yet in some it becomes so entrenched and treatment resistant that it endangers the life of the sufferer. This was the case for Heather B. Armstrong, leading her to try an experimental treatment involving being very deeply anesthetized, 10 times.

The book, however, is not strong. Armstrong does not take the time at the outset to introduce herself in any compelling way to her reader; perhaps she is writing more to her blog followers than to new readers such as myself. She is also wildly inaccurate in her description of her IV placements before each treatment, describing the 22 gauge needle as enormous (not the case, this needle is much smaller than those used in blood donation), and the medical professionals placing the needles as phlebotomists (we phlebotomists draw blood but do not place IVs. Ever. This would have been a certified IV Tech or an RN.). She lost all credibility with me here.

The strongest part of her narrative is her description of what it is like to be depressed, and this may appeal to those readers who are in relationship to a depressed individual and wish to better understand the hopelessness, lethargy, parenting lapses and poor hygiene that she describes. And the success that Armstrong experienced as a result of her treatment is such a ray of hope. I wish her continued health and strength.

With thanks to NetGalley and Gallery Books for the ARC in exchange for my honest review.

[Beth · Rating 4 out of 5]

Blogging must be such a weird way to make a living. You’re a good writer, so you start writing...about your job, your life, your kids. And then the ad money starts to roll and suddenly: commodification. And internet troll fury. Meanwhile, you’re still a good writer, so you keep writing. And your non-troll audience, who has been with you all along...through the having of babies and the getting of divorces and the moving of houses and all of it...keeps reading and rooting for you. And, in that odd way the internet connects us to strangers, keeps feeling invested in your life. So a book like this one—unsettling, smart, darkly funny, revealing—which from a different writer would be “shocking” and “pathbreaking” feels like a natural long-form extension of your stock in trade.

But this shouldn’t lessen the impact of this book’s power. Heather Armstrong’s voice and humor aren’t for everyone, but the life events she chronicles here are astonishing. And, in that odd way the internet connects us to strangers, my overwhelming reaction while reading it was pride and joy. I’m so proud of what Heather has accomplished—what a brave treatment to undertake—and her found happiness brings me joy.

[Lauren · Rating 2 out of 5]

Yikes. This was rough. I found this author to be insufferable. I kept reading because I was interested in learning about her treatment and how she felt about it, but the focus was never on that. It was mainly her random thoughts on her life and family, and a ton of complaining about things that every mom experiences. Honestly, I would have been fine with more complaining about her actual mental illness, but she mainly whined about shit like having to regularly get a baby sitter while she trained for a marathon that she so totally didn’t want to run?? Her humor was painfully unfunny, leaving me nothing to enjoy.

[Gretchen Rubin]

Haunting, powerful memoir of depression.

[Sarah · Rating 2 out of 5]

Thank you to the publisher via NetGalley for providing me with an e-arc for review, this has in no way influenced my opinion.

The Valedictorian of Being Dead is Heather B. Armstrong's recollections of her experience of undergoing an experimental treatment to attempt to lessen her depression symptoms. She is put into a state of brain death ten times over the course of a 3 week period, and has not had a relapse since.
The best part of this book was the afterword, written by the primary doctor leading the study, reiterating that this study is early days and that more money and eyes are required to holistically improve the lives of depressed patients.
I did not enjoy my time reading this book - not because it was triggering or anything like that, but for writing related reasons. Armstrong's voice, on paper, agitates me - I care for neither her style nor her "humour (Her "humour" isn't too dry or subversive for me; it's just absent, but she talks about it like it is a thing that exists).
The word valedictorian is used constantly, a weird tick coupled with the idea that being the valedictorian is somehow life's sole aspirational goal. I don't remember who was valedictorian at my graduation and I can't think of the last time I've even heard the word; maybe it's an American thing - like yearbook superlatives - to give a s*** about the role? I started feeling like Peter in that Family Guy episode wherein he draws attention to movies that mention the film title in dialogue, although he finds it enchanting.
Lastly, because Armstrong's life is so known to her fans, as someone new to her I was left feeling like I needed an in-book primer - I couldn't summon up the revulsion I think I was supposed to feel toward her father, ex-husband, or ex-boyfriends, creating an emotional gulf I couldn't cross, further compounding how little I was otherwise connecting with the memoir.
However, I think this book could be helpful to other people. The struggles of depression, single parenting, and dating are struggles that many people can relate to - even if Armstrong admittedly comes to these struggles with a moderate amount of privilege. There is value in showing that while privilege mitigates struggles, money and post-secondary education don't resolve everything on their own.
I hope the right audience finds this book and benefits from the anecdotes Armstrong has to impart.

[Ali Edwards · Rating 5 out of 5]

I'm going with 5 stars on this one because I think it's such an important read about depression + hope + life. It's Heather's own experience - not a prescription - showing a path she took to get out of a significant depressive episode. It's also a lot about understanding and kindness and asking for help and showing up for people. Really important read.

[Karrie · Rating 2 out of 5]

I am on Chapter 12. I have to start this review, bc there are several things that are driving me nuts that I’m trying not to forget, and it’s making it hard to read. Don’t read this if you don’t want vague corrections of the medical treatment she received. I don’t think it’s really a Spoiler, but if you do, then skip my comment.

I am making myself finish bc I’m ONLY interested in the procedure. I have had Major Depressive Disorder since my teens. OCD, eating disorders, PTSD, panic disorder, generalized anxiety disorder, and I’m probably forgetting something. Mental illness is NOT competitive so it doesn’t matter.

1) Valedictorian, in the definition, pertains to Academia. It’s impossible to be flippantly ”the best” in things that are the opposite of intelligent OR academic, and name yourself the best. Plus it’s the most irritating thing I have ever read.

1.5) The Velcro, just like any Velcro that you would buy, has a sticky side. The sticky side sticks to your forehead, while the Velcro side waits for something else that has Velcro to stick to it. She brings it up like 5 times.

Just like leads stick to your chest, for when they are monitoring your heart.

2) You NEVER had a needle sitting in your arm 😠

It’s a plastic catheter. The #22 gauge “needle” they use, is a small pink gauge that they use on small adults and older children. When you donate blood, you get a 20 or 18. The lower the number, the bigger diameter of catheter.

They haven’t used real needles for IVs in decades. The needle is to pierce the skin and find the inside of the vein, so you can slip the catheter into the vein. For the very purpose of not having to have a metal needle that could easily tear the vein.

The reason they had trouble in your left arm, most likely, os that you had valves in an area that usually doesn’t have valves. Your veins pump deoxygenated blood back to your heart. The Valves are there to make sure: 1) the blood doesn’t back-flow 2) are like tiny pumps to make sure the blood keeps moving “forward”, back to the heart to complete the circuit.

3) YOU WERE *NEVER* DEAD. It’s killing me the lack of understanding this author has of her medical procedure. I realize not understanding when you were depressed, but you think you would have throughly interviewed your Dr before putting out this book. Although you made it quite clear that you are known as a blogger and not a journalist or researcher.

When you have a seizure (which is basically what ECT is), your brain waves are frantic and all over the place due to the unstable firing of neurons. They do this to “reset” your brain so it can go back to firing normally.

The meds they gave her (fentanyl (opiate) and propofol (anesthetic)) caused respiration depression. This is what happens when you accidentally overdose: your muscles in your diaphragm can not contract, thus you stop breathing.

The only way a person dies is when their heart stops beating or you are permanently “brain dead” which is when your neurons stop firing. If they took you off the respirator, you would most likely die because your brain can not perform the basic functions like breathing without assistive devices.

Your heart NEVER stopped beating. They measured your brain waves as a ratio, and when you were at the ratio they wanted for 15 minutes, then they reversed the anesthetic.

You NEVER truly died. There ARE people who have died more than once. You are not one of those people that have died and came back.

4) Do NOT mistake your neuroses as symptoms of Depression. YOU may be afraid of dying alone. I’m not. That sounds like anxiety more than depression, but don’t generalize.

5) opiates cause constipation. Although it was probably out of your system in 2 days, if you weren’t rehydrating yourself properly to make up for that time you were NPO, and a quick search will tell you that propofol can cause constipation. I wish I didn’t have to waste my time reading that.

(There is so much boring details that people could care less about. This book advertised multiple deaths and depression. I don’t care about your Ex, your date life, or the chores that every family has to get done. She fills chapters in what could have been explained in 5 pages).

I don’t care for Mommy Bloggers. I think they are given a platform where (when big) can do more harm than good. I don’t know the author bc I don’t read those blogs. I have a BSN in Nursing and one child, so I would never need advice that I couldn’t figure out by doing real research, than seek advice of a virtual stranger.

I also don’t care for her attempt at humor. I don’t think she’s funny or cute whatsoever. It’s self-depreciation at its worst, completely annoying and flippant at its best. The kind of people I stay far away from.

[Karen R · Rating 3 out of 5]

A valiant effort chronicling a devastating illness, I feel for Armstrong and the strength it must have taken to face her demons head on via 10 experimental treatments despite scary complications. Gutsy as heck and her family support was unwavering and amazing. Thanks to Gallery Threshold for this ARC in exchange for my honest review.

[Ariel · Rating 3 out of 5]

Uuuugh, this is such a hard book to rate. There was a time in my life where I read a LOT of Heather's blog, Dooce. Then it fell off my radar and life went other places. All those things that made me a devotee to her internet space made this a great read (or listen in my case). She's got a great written voice. She's funny. She knows how to tell a good story. And, after all that time reading her blog, I feel weirdly invested in her and her family (the internet is so weird, why do I feel invested in a total stranger?). This topic and her story in this book is pretty wrenching. To hear her read it is really tough - the sadness, hopelessness, and then the elation and joy in her voice are all apparent. The story itself (of her experience with an experimental treatment) is compelling and the outcome is encouraging. Do I think it's a great book? Probably nah. It won't stay with me any more than her blog did. Was it a nice diversion? Yep. Do I feel like calling her intense, deeply emotional story "a diversion" makes me a jerk? Yep. The internet is weird and the whole thing makes me a little uncomfortable, to be honest. Ha!

[♏ Gina☽ · Rating 4 out of 5]

It took a great deal of courage to write this book, and for that I applaud Heather Armstrong. However, I also wish she hadn't had to suffer so much to have this story to begin with.

For many years, Heather struggled to control her depression, often hiding in a closet from her two daughters and smothering her screams. She knew her depression could be held against her and her ex-husband would attempt to get custody, and losing her children was not an option for her.

In 2016, she was in such a deep depression, she thought there would be no escape. For 18 months she struggled, each day getting worse and worse. Upon finding about a trial treatment for cases such as hers, she volunteered and was accepted.

The title of the book refers to this treatment. There are 10 doses of this treatment over a three-week period, and each time the person is given anesthesia drugs to render them unconscious, the goal being to give the brain a rest and to, in effect, "reboot" the brain. I won't say any more so as to prevent spoilers - suffice it to say it's a book worth reading.

[Katy O. · Rating 5 out of 5]

(free review copy) PHENOMENAL.

**Note that I think your prior knowledge of Heather and dooce before reading this book will factor heavily into your understanding of her life and your appreciation of her humor. I’ve loved her years and years and years based on dooce, so I had LOTS of background knowledge 😉

[Schizanthus Nerd · Rating 4 out of 5]

When you want to be dead, there’s nothing quite like being dead.

Heather B. Armstrong has lived with depression since she was a child but her experience in 2017 was more intense than anything prior. She spent eighteen months severely depressed, wanting to be dead but forcing herself to go through the motions, doing “All the Things Needing to Get Done”, because of her children.

It was during this time of desperation that Heather learned of an experimental study being run by Dr Brian Mickey. She was only the third person to qualify for and agree to participate in Dr Mickey’s study. About three times a week for ten sessions, Heather was put to sleep with propofol anaesthesia.

Dr. Bushnell would eventually clarify that they weren’t technically killing me; it was more of a really, really intense induced coma. They were just almost killing me.

Heather’s writing style is engaging, taking the reader on the journey with her: the good, the bad, the TMI, the scary and the funny. I met her family, some of her friends and the professionals treating her. I learned about the abyss and found the humour in Heather’s inability to recall what year it was when she was coming out of anaesthesia (1979 or 2012, every single time).

I particularly loved how candid Heather was in describing her depression, including the fact that she was able to hide its severity from many people for so long.

No one knew that I wanted to be dead. That’s how good I am.

Heather’s story not only showcases her perseverance and bravery, it also highlights how integral supportive family and friends are for people living with mental illness. I adored Heather’s friend, Stacia, who stayed the night with her when she didn’t have the internal safety to be alone.

However, Heather’s mother, Linda, and stepfather, Rob, were the ones who stole my heart. The practical and emotional support they offered almost had me ugly crying. They are everything you need family to be when you need help. I could have hugged Linda when she said:

“We have nothing else to do this month other than be there when you wake up.”

As I read, I kept thinking back to times when I’ve had suicidal ideation and the more I thought about it the more courageous Heather seemed. Regardless of how desperate I was, I don’t think I could have attempted a treatment option with a possible side effect (however rare) of death. That may sound absurd to you. Here I am saying I wanted to die yet I would have been too scared to try a treatment that might kill me. Isn’t that exactly what I wanted?

Well, yes and no. See, to submit yourself to an experimental treatment like Heather did, you would have to think that it’s the only or best option for you. But because it’s labelled as ‘treatment’ a part of you, even if that part is teensy, would hope that it might work. That’s the part that would have terrified me: the prospect of holding hope while knowing that hope could literally kill me.

It can be hard for a lot of people to ask for help when they need it. It’s especially difficult when your brain is lying to you, telling you that the people who love you would be better off without you. Heather’s recovery, with the help of the medical profession as well as her family and friends, will hopefully convince readers that it’s perfectly okay to ask for help and accept it when it’s offered.

Content warnings include mention of death by suicide, disordered eating, mental health and suicidal ideation.

Blog - https://schizanthusnerd.com

[Colleen Flaherty · Rating 3 out of 5]

Warning: the following review is based on completely unfair personal feelings of what is otherwise a very readable, interesting book.

I can break down my complaints into three categories. One, the most unfair complaint, is the way she writes is incredibly reminiscent of the many mommy blogs I've slogged through as a new mom and completely abandoned (it was completely unsurprising she lives in Utah). It's overly personal in a shallow way, pseudo-snarky, funny but not really, and constantly trying to seem self-deprecating while actually being self-congratulatory.

Which leads to my next complaint, the braggy stuff. Yes, it's quite something to have an honest rendition of the author's journey through crippling depression, but I have also learned she ran the NYC and Boston marathon, she's been to Peru and Zambia, she really cares about animals and has helped many nonprofits with good causes, she has body issues but is in fact thin and well-dressed, and her kids behave and have a great routine because she's that good a mother.

Which leads to my big whopper of a complaint that really gets to the core of why she wrote this book. At the end, it seems this memoir is a cause of hers (which she had to mention she took to Paris to write, why?). She is telling people about her journey so they can relate, learn and maybe check out this new treatment. In this honest telling, she says one thing that got under my skin so much I couldn't forget it - she said most people with crippling depression sleep all the time or have no energy, but she doesn't because she doesn't have the choice. Excuse me? As someone who has struggled with mental illness, that's not how this works! She wrote a whole book on how irrational and debilitating mental illness is, but then seems to imply you can get through the day and do what you need if you just...love you kids enough? Are ambitious enough? Just that good at everything? I can imagine someone really struggling with feelings of failure, especially as a parent, and reading this author's spectacular handling of all her parenting duties despite her suicidal ideation as actually quite shaming. But maybe that's just me.

[Kent Winward · Rating 4 out of 5]

***5/11/2023 Update***
I read of Ms. Armstrong's death by suicide in the New York Times this morning. The tragedy made my review from 2019 feel a little too glib and snarky, not about Ms. Armstrong, but about the treatments she underwent to try and resolve her mental health issues. In the interest of transparency, I'm leaving my original review untouched, but the doubt I expressed in the review about the treatment she was receiving was unfortunately prescient.
****

Sometimes you read books that intersect with your own life in ways you hadn't anticipated. This happened to be one of those books. Utah religion and environ-based--check. Mental health issues--check. Alternative? treatments for mental health issues--check. Old-school blogging--check. Throw in my underlying, but well-earned skepticism, and for me, the entire book ended up as a meditation on belief. In this, I may be unique from others who read this book. I may not. But that's where it took me.

First, some personal history: I, Kent, having been born of goodly parents, was raised on Utah's Wasatch Front within its predominant religious culture (Mormonism). In the mid ‘00s, blogging was a thing. I was blogging when I met my wife, an incredible writer who also blogged, J.A. Carter-Winward. That is another story for another time, but we were both writing, examining, and questioning in the way we had been taught: study things out in your mind, contemplate them, and look for the truth. The end result was a happy marriage--along with a platform--for us as we both questioned our core beliefs.

To make a long, complex story short, but to also give the nuance needed for this review, J.A. had suffered a brain injury in the mid 1990s which then led to a misdiagnosis of various mental illnesses by the psychiatric community. She was prescribed psychiatric medication that led to further head trauma. (Yes, psychotropic drugs can cause brain damage. See Brain Disabling Treatments in Psychiatry: Drugs, Electroshock & the Psychopharmaceutical Complex or if you are simply a child of the 1980's https://youtu.be/o5wwECXTJbg or J.A.’s video on one particularly unknown, but common, side effect, akathisia: https://youtu.be/UJPKzBCYbUs )

The net result for me, after over eleven years of studying, questioning, and examining the medical community--particularly psychiatry--I have come to the conclusion that humans want to believe. We will do anything to believe. Of course who we believe and what we believe is important. From the earliest times, humans were often saved by belief, particularly if the belief was shared. A community can be the greatest protection against the dangerous world. The timeline of a human life is short and even false beliefs inside an insular community, if they don't do too much harm, can protect. But the world is no longer insular, having become global and the danger of false beliefs has increased.

We scoff at medical leeches and ice picks, but write tomes to the beauty of "cure-by- medically-induced-near-death-coma (times ten)." And for Heather Armstrong, it worked. She has a loving supporting family. She had resources. She had multiple caring doctors who, I believe and she believed, clearly wanted what was best for her. She had a small community with shared beliefs from the phlebotomist to her parents to the doctors to her.



In the afterword, one of the doctors even brings this up as a possible reason the procedure worked. So, who am I to question the doctor on this more-than-likely possibility? Particularly when the trials showed a success rate of a star-MLB batter, which was 3 for 10. (A quick side note: the only real medical "theory" behind this procedure that I could discern was that her brain needed the equivalent of a frozen Windows 10 Ctrl-Alt-Del.)

I understand the motivation behind this memoir. Ironically, it's the same motivation that floods the shelves of Deseret Book (the Mormon bookstore) or evangelical bookstores with effusive and harrowing tales of conversion and finding Jesus, or another bookstore in SLC called Golden Braid, which carries New-Age tomes on the Law of Attraction. There's no "fiction/non-fiction" sections for them. They are under "Religion/Spirituality," because they are neither. They're all belief. All bullshit. Granted bullshit can make your garden grow beautiful flowers and robust fruits and vegetables, but fertilizer is fertilizer is bullshit. So the writer was saved and now altruistically wants to share the beauty with the world, but upon closer examination you can see (and smell?) the source of the beauty.

I felt my own belief structures kick in as I finished the book. The author undergoes countless medical traumas to get out of her depression. She describes depression and suicidality in a way that feels all-too (and frighteningly) familiar. Her conversion is complete: She died, saw the light, and returned to the world of the living. The author believes and then, to my own personal shock and horror, she gobbles down a drug cocktail her psychiatrist gave her to sustain the "success."

I can't help but insert this little Mormon story here. For those familiar with the religion, see if this sounds familiar: A man and his followers put together a book telling people "the truth" about how to live--truth from a source higher, more knowledgeable than them. The book gets supplemented continually with other volumes to get even closer to "the truth," based on new "revelations." The Book of Mormon, Doctrine and Covenants, Pearl of Great Price, the Ensign? Nope, DSM-II, DSM-III, DSM-IV (et. al.), and DSM-5. The science behind both sets of books is the same: clever observations of the human condition, backed by an arbitrary, ostensible "authority." Unlike in Mormonism, homosexuality was put up to a vote in the psychiatric world, with 5854 voting against pathologizing of same-sex attraction and 3810 voting that homosexuality was a disease. This was in 1973 and still took until 1987 for it to fall completely out of the DSMs. By 2013, the National Institute of Mental Health has disavowed the scientific validity of the DSM-5, yet it's still in every mental health professional's office. Despite its distinct odor of fertilizer.

The net result? I have a hard time believing. I believe anecdotal accounts of authors like Ms. Armstrong, just like I believe anecdotal accounts of personal spiritual accounts from my religious family members. I believe that they believe and belief alone may be enough for them. I hope it is. My concern is when the inevitable reality clashes against their beliefs. I'm completely for science, the enlightenment, and testing hypothesis, but I'm also completely for questioning my own assumptions that I base those experiences on.

My skepticism of psychiatry/religion/everything makes me question books like this. The author has a certain voice that many find appealing and the craft of her storytelling was fine, yet Armstrong flat-out admits that she decided to write this book at the behest of her therapist to bring hope to the single moms who are worried they will lose custody due to a mental illness diagnosis or to those who are disenchanted with the medical community. She wrote to convey hope to her core-audience: the mommy-bloggers and readers of "Dooce," who found in her blog commiseration and perhaps freedom from shame regarding their own struggles. But Ms. Armstrong's authority stems solely from belief and the shared beliefs of her audience and the medical community.

But death is not a respector of belief. Suicidality and depression kill people, and those desperate to find a way out of suffering need hope like they need food and water. Those deaths are real. We are all Valedictorians of Mortality, all graduating with the same inevitable honor.

When dealing with life and death, belief can bring us solace and comfort. But desperation will force people to do desperate things, and while "belief" is inherent in human beings where you place those beliefs can be a matter of life or death. So go ahead and place your belief in those places that bring comfort and joy into your life, but as for me, I’m going to strive to become the Valedictorian of Doubt.

[Feisty Harriet · Rating 5 out of 5]

I...needed this. Right now.

I also probably need to make an appointment with a psychiatrist. I've always known I had depression, but reading this made me realize FOR THE FIRST TIME that I might have Depression. Capital D. And that...like...I don't have to feel this way? That MOST people don't feel this way?

Anyway, lots of thoughts going around in my head right now.

[Librariann · Rating 4 out of 5]

This book proves that I still like Hi I'm Heather B. Armstrong and this is my website. I just find her voice so strong and readable. She's not everyone's jam, but if she is yours (even if you stopped regularly following her blog before Marlo was born), you will like this book.

If you have no dooce reference points, this is a good book for anyone who battles mental illness or know someone who does.

Now I'm wondering how Allie Brosh is doing....

[Emily · Rating 5 out of 5]

This book so closely resembles my experience with starting ketamine...the overachieving, the Mormon religion as the backdrop for my family, the persistent insistance on staying alive, not because I wanted to, but because everyone told me it would be worse for my kids if I was gone, and while I didn't want to believe them, I wasn't going to risk that as long as I could concentrate on "depressed Emily is better than dead Emily." (Also, hey, author and I both really enjoy writing in the third person sometimes.

[Karen Nelson · Rating 5 out of 5]

Just wow. This is an amazing book. Should I just stop there? Because all other statements may simply pale.

"Depression robs us of the ability to think of anything but the worst possible outcome. Period. It is inevitable. That is the logical end to every thought and action and sequence."


Heather B. Armstrong is a brave person to have written this saga of how depressions kills your soul. Let me just tell you now how I feel about those who don't believe there is such a thing as depression. It's real. It's debilitating. It's soul robbing. It's exhausting. It's scary. Depression has been a part of my life, unfortunately, for years. There is a long, unrecognized lineage in my own family of anxiety and depression. My father called them all "high strung". Yeah. That's the truth.

The author gives us a brilliantly written autobiography of how bleak life is living with depression, and all you ever want is peace. She talks about wanting to be dead, which is so relatable to those who also suffer. No plan, because that would require thinking, so just the wishing is all that is possible. I . Get. It.

Heather takes us on her journey through a research study to eliminate her depression by the use of "the Michael Jackson drug" propofol. We feel the heaviness of her depression in the beginning, and share her hopelessness. Told on the backdrop of a Mormon upbringing and single motherhood, we feel her struggle. Such a well written book, the reader becomes a cheerleader for Heather in her recovery. We read her descriptions of her awakening to a world that allows her to once again live and love her life.

This book is a must read. Period. If you know someone that has depression, this book may help explain how the illness itself impairs the patient to help themselves to help themselves. If you suffer, just go buy this book. You will cry many times in recognition of your own thoughts. I applaud the author for her honesty to bare her soul. A total five star read. I will be adding this to my book club read for October 2019.

Thank you to #NetGalley and the publisher for an advanced review copy of this book in exchange for an honest review. And most of all thank you to the author #HeatherBArmstrong and all the medical personnel who commit their lives to helping those of us who have mental health disorders.
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"Help us find our way up and out and back to the truth that you would not be better off without us."

[Kristina · Rating 5 out of 5]

This book is so powerful. Heather can be a polarizing figure to the haters out there, but damn if this isn't one of the most powerful and important stories I think a "mommy blogger" has ever shared. Normalizing mental health is so damn vital to the well-being of so many people out there and she's done it beautifully and poignantly. It left me with hope that there is help out there for all who so desperately need it.

Thank you to Edelweiss for the ARC.

[Tim · Rating 3 out of 5]

As coincidence would have it, at the same time as I was reading this book, my computer had developed the unfortunate habit of freezing up at inopportune times. As a stop gap measure that allowed me to continue using the computer until I could determine the cause of this behaviour, I would turn the computer off, wait a few moments, and then turn it back on again. It is an appropriate analogy for the experimental treatment for clinical depression the author of this book subjected herself to: they turned her brain off and then back on again on ten separate occasions. It appears to have fixed a problem that was immune to both therapy and prescription medicine:

'As of August 2018, I haven't experienced any sort of relapse or bout of depression in eighteen months. I haven't had a single thought resembling, “It would be nice to be dead right now.” In fact, I still feel like I've been given a second chance at life. I'm still hopeful. I'm energetic, and dare I say this out loud? I'm happy.'

As I imagine is the case with everyone on the planet, I have had bad days. I have also had bad weeks. And I have even had bad years. Yet I have never suffered from treatment-resistant depression. One of the more illuminating aspects of this book was the author's many descriptions of what it is like to be depressed from the inside. An example:

'Depression extinguishes our purpose in life – the purpose of anything in our lives – making it quite literally impossible to handle anything. Every day and hour and minute is an obstacle course of things we are supposed to handle; most people do so without any effort, but we can't even see around the first corner. And so we collapse. Or we sleep for days on end. Or we yell at people who don't deserve it. Some of us drink ourselves into a stupor. Others scream into a pillow or crawl into a corner to rock back and forth. Some of us retreat to a closet to call their mother and say, “Please, let me be dead.”'

It cemented for me my belief in how erroneous the notion some people carry around that individuals who are depressed are really nothing but a bunch of whiners who need to stop moping around, give their head a shake, and get on with their lives is. While I acknowledge there may be some people who are entirely capable of doing that who do need to take steps to escape the gravity well of self-pity, to think that major depression is just some vague malaise you can shake off because it is a mental rather than a physical phenomenon is only slightly less scientifically illiterate than thinking the earth is flat. Given the current state of our knowledge, maintaining that mental illness has no biological correlates – that it is indeed 'only in your head' – is just plain wrong. Unfortunately for the author, one of her parents evidenced that very mind set:

'I still don't think my father acknowledges that the mind is just as susceptible to disease and disorder as any other part of the body: the heart, the lungs, the penis. Even today he doesn't understand that his two children have to struggle with feelings of hopelessness, and that two of my brother's kids, two of my sister's kids, and both of my children suffer from depression and anxiety. My sister had to come up with an alternate explanation as to why her son had deferred his mission, because she couldn't tell my father that he might be suicidal. That would be preposterous. No, actually, not preposterous. Wrong word. That would be weak, and his grandson was not weak.'

Some people can shrug these things off and get on with their lives. Here's a possibility: perhaps they are capable of doing that because they have a brain of the sort that makes them capable of doing that. Why assume de facto that everyone has a brain that is wired in such a way as to make them capable of doing that? You might as well assume we all have identical fingerprints as well. The author seems to be acknowledging something similar when she writes: 'I have developed better ways of thinking about life. The treatment got my brain back to a place where I could start making these cognitive changes.'

I suppose I should not oversell the point here. Although there is a large body of evidence that indicates that brain states produce mental states, there is also a large body of evidence that mental states can alter the physical brain. If ever there was a relationship worthy of the status 'It's complicated,' it is the relationship between the mind and the brain. It is also worth noting that depression is not, as some maintain, a modern phenomenon caused by living in a western secular society (though perhaps it might be exasperated by that?) In the past it went by a different name, acedia, and was understood in a spiritual rather than a medical context.

Last year I read a book called Switched On: My Journey from Asperger’s to Emotional Awakening that documented the experiences of a man seeking to correct some of the more socially detrimental aspects of Asperger's Syndrome by applying directed pulses of electromagnetic energy to specific areas of his brain. Part of the appeal of both that book and this one is that the efficacy of these unconventional treatments in altering psychological states are a potent reminder of how much we still have to learn about what human beings are and how we work.

[Susan · Rating 5 out of 5]

I am shocked and amazed by this story. I almost don’t have words for this book yet somehow I find myself talking to everyone about it. Our local library likely has a long waiting list for it because I have recommended it so much. You can’t help but be intrigued by the summary and as soon as I heard about it I was dying to get my hands on it. I was not disappointed because it absolutely blew my mind! I had been woefully ignorant about treatments for depression and I honestly didn’t even know that Electroconvulsive Therapy was something that was still used today, much less the even more terrifying new treatment that the author undergoes. It makes sense in a way because pretty well every piece of technology can be fixed by unplugging it and then plugging it in again. I never imagined that rebooting would do the same for the brain!

I’ve never suffered from depression but with what seems like the recent rash of celebrity suicides I am very aware of just how deadly this disease can be. Heather does an amazing job of describing her disease and her mindset during this time. She is brutally honest and remarkably open about her experiences. I think we can all relate to how hard it is to ask for help, and to do it when in the depths of despair is quite remarkable. To what lengths would you go to save your own life and to feel joy again? In Heather’s case dying ten times then being brought back seemed like a reasonable if last resort option.

At first I wasn’t sure I was going to enjoy Heather’s voice. It took me a bit to get her sense of humour, and there are many parts that are very funny. I could completely relate to her perfectionism and need to be the best at everything. No one can be the best at everything but for perfectionists anything less feels like total failure. One of the hardest lessons I had to learn was to let go of “being the valedictorian.” It’s okay to not do everything perfectly. Sometimes it is enough to just get the things done! This aspect of Heather’s stress was 100% my stress. Thankfully I’m fine now and I think she is too. This story is such an inspiration to everyone who thinks that things will never get better. You will have to ask for help and you might have to go to extremes but things will get better. No low is ever permanent. If it takes dying ten times to get out of it then go for it! I’m such a nerd for this but I have to quote John Lennon: “Everything will be okay in the end. If it's not okay, it's not the end.”

Thank you to Simon & Schuster Canada and Gallery Books for providing an Electronic Advance Reader Copy via NetGalley for review.

[Heidi · Rating 3 out of 5]

I really thought this would be a little more "dramatic" considering the severity of this clinical trial, but maybe it's just because the author has a very self-deprecating sense of humor about everything that I never felt the "gasp" moments I thought I would. I have never experienced clinical depression. I know a few times I have been "depressed", but it was situational and did resolve on its own. So, being that I can't relate to that, her level of repeating constantly how hard it is to be a single mom was a little annoying. I am a single mom, and while I don't do it with my ex living thousands of miles away, I also pretty much still do it all myself. That being said, I do appreciate how she acknowledged that her drive to get better was almost exclusively for her children and to not let them down. I think this book could help a lot of people. I'm just not one of them.

[Heather · Rating 5 out of 5]

I've written and rewritten an opening sentence for my review. It all sounds trite and too fluffy.

Read this book and have everyone you know read this book. Let's have the difficult conversations about chronic depression and suicide ideation out in the light where they need to be and give people the support they need.

[Leanne · Rating 4 out of 5]

As someone who battled depression for over two decades, I was really interested to dive into this book after it was recommended by friends, and I was delighted to immediately get access to the audible version on Libby. Then.......I started listening to Heather describe her depression.

I didn't make it through the second chapter before I knew this wasn't a healthy read for me. To explain: I've been on an extremely happy and healthy trajectory for the last two years. I'm even off all antidepressants after being on them for 20 years. That said, Heather's story, her words, hit too close to home. Definitely triggering.

So I jumped to the last chapter and the afterward by her doctor. Yay! Heather is doing great....which I don't consider a spoiler....or how could she have ever written the book?

I'm giving the book 4 stars because being candid about mental health is crucial. Also I believe that the book is an excellent example of what depression feels like if you are wanting to either understand it because you don't struggle with it or find a fellow struggler if you actually do struggle with it.

Presently I'm thankful for my own recovery, and although I am an open book about my own depression experiences (in fact I got my coaching endorsement to help others), I don't want to purposely evoke triggers for myself. I am, however, delighted to learn that there are more options being discovered to help others, and will happily recommend the book!

[Maryse · Rating 4 out of 5]

I used to read Heather’s blog years ago when she was just starting out. I loved her voice and her ability to be vulnerable and so open. Back then she wasn’t so much the mommy blogger, she was just hilarious. I had read about her struggles with depression and constipation - the first with interest, the latter with less, so I was eager to read this book.

It was great to hear her voice again. I envy her ability to express herself. I am definitely not the valedictorian of that. And I was interested in hearing more about this study. I was diagnosed with anxiety and depression 8 years ago after a particularly tough time in my life. But in retrospect I think I’ve been depressed and anxious since childhood. Plus I love anything research-y.

So here’s the thing. I would have liked the book to be longer. I get the impression that this book was written/edited assuming that the reader would be familiar with her story, a reader of her blog, and that is unfortunate. I stopped reading her blog when she went all mommy on us, and not knowing what happened since then probably is why I felt that I was missing something.

I always feel a little sad when someone has the opportunity to do something so great and somehow falls just a little short. Like they will never get a chance to make it better. And that’s how I felt about this book.