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After a year of putting off the decision and being accepted and then declined and then accepted once again, I entered a research study at the New York State Psychiatric Institute (NYSPI) to receive free treatment in exchange for allowing tests to be run on me. The agreement was to allow the doctors to perform a spinal tap (a lumbar puncture) and a pet scan on me, both involving having to be completely off any and all medications. Being off medication is both a big challenge and a potential danger for anyone who has found medication to provide relief and sanctuary from life threatening symptoms and harmful personal attitudes.

My battle has been with depression and suicidal feelings and I first went on medication in May of 2000, having gone through three hospitalizations in less then a year. So the allure of a purportedly comprehensive free treatment program at the expense of only two or three weeks of being off medication, in a controlled and safe environment, was an attractive one. Contact with top-notch doctors, being supplied with free medication and being given excellent treatment seemed to be the promise of the research program. So I chose to enter the program as a kind of emergency effort to get me out of my hole and back into some kind of normal life.

The actual experience has been different than what I imagined it might be, however, and I feel I've made a big realization about how to treat depression. I believe I've encountered another possibility, but that I was deluding myself by thinking that an extended in-patient stay would cure my illness. The main benefit I've received is having had an official diagnosis of my condition, depression, rather than the theory that I might be schizoaffective. The research itself here at the Psychiatric Institute has no bearing on my treatment and the actual treatment itself has taken longer than I thought it would, even possibly extended by the inimical feeling of being in a locked ward.

The staff here has been quite professional but I do feel the program itself needs some new features to get people back on their feet, strong and vital. Not only is the institutional environment difficult to endure on a day to day basis for two to three months, but there is also the stamina needed for waiting for things to occur biochemically, the lack of one-on-one psychotherapy, and the general waste of time to contend with, especially on weekends. I have learned more about my condition from doctors and patients alike and I'm glad I was able to offer my spinal tap as something that will contribute to research that will help find a cure for future generations. My primary doctor, Elizabeth Lequesne, and my research doctor, Michael Grunebaum, have both been exceptional. But being an in-patient for three months has been an endurance test and I feel that I might have benefited more from creating more structure in my life on the outside rather than depending on the fixed hospital program.

I want to paint a portrait of a hopeful alternative for mentally ill people looking for a cost-effective and important next step, but I want to make clear that this type of program, at the least the one I've participated in here at the Psychiatric Institute, is not a place to get cured or to expect miracles, although they do happen. Medications, psychotherapy, and these programs are all tools to improve your health but are not, in and of themselves, the cure. I feel this program has been a pit stop in what can be the dark labyrinth of depression and mental illness and I point to the fact that psychiatric institutes are designed as holding tanks rather than therapeutic, get-well places as one of the main flaws in the system. As one of the head doctors here mentioned, people are here to stay alive not necessarily to get better. I think he knows that the majority of the recovery must happen outside the institute and that only so much can be done for a person's psychological well being at a hospital. Eventually, people living with mental illness must develop the skills needed in order to survive and thrive as adults.

These are still puzzling and uncertain times in the treatment of depression and mental illness, mine being quite tricky to deal with, so, in some respects, it is still the blind leading the blind, with an appropriate nod of respect to the doctors who do work hard to alleviate suffering. I believe that there are healthy paths to recovery and that there is much hope for depression and mental illness but my advice is to thoroughly research anything before you choose it as a method of removing yourself from the morass of mental illness. Research programs, at least this one, that I've personally experienced, are either extended suicide-prevention protocols with brief interludes reserved for tests and conferences or holding patterns for frustrated patients, exceptions being made for the patients who actually do benefit from certain treatments. What has been needed in this program is more intensive one-on-one therapy and more focus on returning to work or starting a new job or career, two things that instill hope and strength in patients. NYSPI does provide group therapy, dialectical behavioral therapy (DBT), and other skills groups but a more serious effort is needed to get people back to a superior functioning state, not a perfect state, but superior to a state that is merely adequate or is designed to just get them by.

I think my mistake was looking to the program as I have to so many of the treatment options I've encountered-as a miracle panacea. I've always hoped for a cure-all to emerge suddenly from out of nowhere like a ray of light from Heaven and I'd be back to a normal state of mind. I suppose this has something to do with our innate American belief in salvation and victory. My recommendation is to stick with rigorous psychotherapy, personal discipline of your mind, and healthy habits that promote connections to the rest of the world. Modern treatment of depression cannot really cure people, but the key practices I just mentioned are the foundation of any kind of recovery. Use the research programs as emergency stops of last resort. Work at your depression outside the hospital with the various support systems and treatments available, because empowering yourself with your own mind, rather than looking to outside help, is one of the pivotal elements to a full recovery.