Recovering "with" Psychosis

By Ted Little, Regis '12

Meet Theresa*, a young woman who lives in Omaha, Nebraska.  Over the past few years, she has learned to drive, earned her college degree, and taken up the diet she had planned in high school.  She loves reading and animals, and has, in fact, just gotten a job managing an animal hotel, the realization of a girlhood dream.  


One more thing: she has Recurrent Major Depression. 

Though Theresa has now learned to live with her ailment, the road to her present state proved long and hard.  As with most sufferers of depression, her symptoms began to manifest in her mid-teens.  At the age of fifteen, she “became a moody teenager,” according to a case study provided by her psychiatrist Dr. Dennis McCrory (Regis '50).  She would “sit on her front porch and cry and hang onto [her] cat.” However, her first bout of “major depression” surfaced in her freshman year of college, when one day, after class her Philosophy professor confronted her, and asked her, “Are you depressed?”  This exchange brought on an avalanche that swept her from her feet, forcing her to return home before the close of the school year. 

This is the context in which Dr. McCrory first met with Theresa in August of 2001.  With the help of an anti-depressant (prescribed by her Primary Care Physician), psychotherapy, and Dr. McCrory’s supervision, her depression did “remit” in time for her to return to school the next year. 

But as her college graduation approached, her depression recurred and reached near suicidal levels; she ingested a non-lethal dose of pills that resulted in hospitalization.  This dismal start characterizes the dark nature of her second major depression, in which her negative self-image came to torment her. 

More significantly, though, is the mere fact of her recurrence.  It suggests, in Dr. McCrory’s words, “a persistent biological vulnerability to [depression].”  She, therefore, needed to learn to recover “with” her condition, rather than “from” it.   

This distinction intrigued one student, who thrust his hand into the air and asked, “Then what is the best way to try to treat her?”


Dr. McCrory leaned forward with bright eyes.  “The one thing about Theresa is that she kept it all to herself.  You have to keep it under control.”  


Here he begins to delve into his key to recovering “with” mental illness: management.  To overcome illness a patient must remain “ever vigilant,” to stay cognizant of one’s “internal dynamics.”  This awareness allows a patient to recognize the precursors to an episode and to better prevent them.

This prompted the conversation’s focus to shift to a more fundamental question: how does one become depressed in the first place?  Dr. McCrory prefaced this discussion with another wise distinction, pointing out the difference between a mood and a psychological condition.  In other words, most people know “depression” as an emotion, while a smaller number (about one in ten) have experienced “depression” in its more clinical sense.  He then goes on to say that clinical depression emerges from the integration and interaction of a number of factors, primarily genetics, environment, and personal emotional tendencies.  Many depressed people have a genetic propensity for the condition.  Without this “biological vulnerability” one can still experience symptoms, but that person would tend towards a less serious form of depression, unless under a substantial amount of stress.  Furthermore, Dr. McCrory remarked that a vulnerability can arise from personality traits.  Pessimists, for example, may fall more easily into a state of despair, from which serious depression may result.

According to these criteria, Theresa had the odds stacked against her.  Both her mother and father suffered from depression; her body-image issues made her self-critical and pessimistic; and the dramatic shift from high school to college, for which she was not prepared, put her under an immense amount of pressure.  These factors working in concert broke her, and she did not learn how to suppress them for years.


But then  she learned to drive.  While this may seem small and almost irrelevant, the freedom and autonomy of driving herself around town gave her self-confidence the jump-start it needed to take on bigger issues.  Next, she finished her degree work at a local community college, and, finally, she tackled her most painful insecurity: her weight.  After her graduation, a classmate asked her to be a bridesmaid, but she was so embarrassed of her weight that she would not even go for a gown fitting.  However, she forced herself to go on a diet that she had put off for years, and lost the weight she wanted. 

Theresa is not, and will not be, “cured.”  But she has learned to cope with her condition through the application of the optimism and hopefulness she has learned in the past few years.  She has finally, recovered “with” her depression.


*The patient's name and other identifying features have been changed to protect her anonymity.


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