Treatment Resistant Depression Disorder Recovery and Euthanasia

By Meghan Schrader

Meghan Schrader

Meghan is an autistic person who is an instructor at E4 Texas - University of Texas (Austin) and an EPC-USA board member.

In his 2015 essay “Treatment Resistant Depression Disorder and Assisted Dying,” Udo Schuklenk says that people with treatment resistant depression should be helped to die by suicide not only because the disorder can be excruciatingly painful, but because the person essentially has “two selves”: a real self that existed prior to the onset of the clinical depression, and a depressed self that has taken over the person’s life.  He asserts that for some people this former “real self” is never coming back, and so the kindest thing is to give them the option of being put out of their misery.

Indeed, as someone who has experienced episodes of treatment resistant depression since my teens, I must say that the most painful thing about my disorder is that I have not felt like myself. Between the ages of about seven and 16, before my mental illness started, I was considered unusually mature, wise, caring and polite for my age. So how did I go from that to the F word being every other word out of my mouth? Why was I yelling at people all the time and sharing whatever immature or rude thought that came into my mind? I had always been a good student, so why was my mind so cloudy now, like I was trying to think through static? I was a talented vocalist, so why didn’t I have the energy to sing anymore? Why was my impulse control suddenly so bad that I impulsively did foolish things that “the real me” would never do?

These changes in myself caused deep hurt. When I was about nine, my mom’s good friend told me that everyone had a metaphorical “love light” inside of them that guided how they treated others, and she kindly remarked that my “love light” was very bright. But in my late teens I began thinking and acting in ways that made me feel as though my “love light” had gone out or was constantly flickering. The real me was still “in there somewhere,” but I couldn’t put her back in the driver’s seat. The mental illness was always at least partially in control, and the intense dysphoria that it caused was like a stalker that wouldn’t leave me alone. This change in myself has sometimes been very difficult to understand.

There are, however, some logical explanations for why I’ve felt as though my “love light” isn’t functioning properly. I’m an adoptee, and since meeting my biological family about 10 years ago, I’ve learned that a lot of these issues are genetic. My bio family has a lot of terrific people in it and I’m glad that they are my family, but also many of those terrific people have suffered from severe mental illness. So, clearly there is a biological component to my symptoms that would exist no matter what, and that’s one of the reasons that I’ve experienced the sense of my “love light” not burning brightly anymore.

The other reason for that change is lack of accommodation for my Nonverbal Learning Disability. The disability is not painful by itself, but it causes a severely impaired sense of direction, slow processing speed, and various executive functioning weaknesses. However, despite that disability coming from a mild brain injury that I got when I was being born, people often don’t believe me when I tell them it exists. Usually that disability is not accommodated properly, no matter how many times I patiently explain what accommodations I need. That situation causes toxic stress: I experience getting hopelessly lost in public and having to constantly ask strangers for help, panic-induced autistic hand-flapping, making loud exclamations of despair that everyone around me hears, and having people stare at me because of these embarrassing behaviors. That situation naturally incites anger and depression; indeed, these kinds of circumstances lead to many neurodiverse and disabled people having suicidal thoughts. (Link) And of course those kinds of feelings get in the way of adding fuel to one’s “love light.”

This lack of accommodation for my neurological impairment and its impact on my “love light” is cruel. It’s not a situation that I chose, it’s a result of how the world has been designed. I firmly believe that I would have landed in the psychiatric hospital far less often-and maybe not at all-if only people would stop complaining about what a terrible hassle accommodating me is and just consistently do it.

But, in the last few years, a wonderful thing has happened to me and my “love light.” A mentor who loves me helped me find my job at the University of Texas’s postsecondary program for people with intellectual disabilities. I get all the accommodations that I need for my learning disability, so much of the environmental impetus for depression has been removed. My employer basically allowed me to create my own job mentoring students, advocating at the Texas state capitol, and offering lessons in ethics, the fine arts, independent living and peer support. In 2021 I accompanied a student who had a diabetic crisis to an emergency room and stayed with him until his family arrived. I consoled another student who was having suicidal thoughts. Last year I helped a student advocate for a bill to add disability history to the Texas state history curriculum. I take students to music performances at UT’s school of music to expose them to opera and symphonies and Caribbean music. This year I helped a student who was struggling with incontinence when she had an embarrassing accident. And this is the best part of my job: because of my work with these students, I have felt as though my “love light” has been turned back on, and the real me is alive again.

In Schuklenk’s world, mentally ill people should die — I should have died — because their (my!) unaccommodated disorders contributed to people's “love lights” going out. What a terrible waste it would have been if policies created by Schulenk and his pals had been able to shape my fate in such a heartless, thoughtless, evil way!