A Shock to the System Long dismissed as more cruelty than cure, electrotherapy to 'fix' the charge in depressed people's brains is gaining new respect among psychiatrists.

December 28, 1998|By Patricia Meisol | Patricia Meisol,SUN STAFF

Until this year, Bob Cadmus was too afraid of people to speak to them.

He had it all worked out so he wouldn't have to. He sought solitary jobs -- house painter, bus driver, boardwalk funnel-cake cook. He had a room at home where he could hide at the first sign of conflict. He didn't have friends, other than a few guys he met in kindergarten who didn't mind that all he said was "yeah" and "yeah."

His face fixed in a smile, he appeared as a pleasant, jolly, working man; older than 46, perhaps, his skin toughened by ocean sun and salt, but contentedly in his prime. That's how he hoped people saw him, anyway, so they wouldn't pry.

Quiet and shy, some said. His wife thought so, too.

Nobody knew how depressed he was until 10 years ago, when the darkness took over his mind and he lost control. He swallowed too many pills and woke up in a psychiatric hospital.

It was a scene that was to repeat itself many times throughout the decade. His wife and daughter became accustomed to his on-again, off-again stays in psychiatric hospitals, his fear of strangers so intense he couldn't join them at church. Finally, they left him alone in his room.

Eventually, doctors agreed on a diagnosis: socio-phobia and post-traumatic stress syndrome. They gave him a nickname, too: the Smiling Depressant. But the drugs they paraded out one by one did nothing for him. Inside was a man who could think only bad things. Outside, a man so quiet that even his therapist fell asleep.

The dark place is gone now. Cadmus no longer hides in his room. He rejoices in simple things: the singing of birds he now hears each morning out on his porch in Berlin, where he takes his coffee and smokes a cigarette.

Why did he have to wait all these years for help? Surely his smile tripped him up, but so did social attitudes about what ultimately helped him: shock therapy.

Public fear and distrust of shock therapy was sealed when it was portrayed as a savage punishment in the 1975 movie "One Flew Over the Cuckoo's Nest." For years, the treatment receded into the remote corners of psychiatry.

Now, quietly, steadily, electroconvulsive therapy, ECT, is returning to mainstream therapy -- lifesaving news for people like Bob Cadmus.

Defining the problem

When Cadmus arrived at Baltimore's Sheppard and Enoch Pratt Hospital last March after a second suicide attempt, the doctor asked what he asks all patients: "What are you depressed about?"

Cadmus answered the way many patients do: describing a social problem. Often in depression cases, experts believe, a social problem eventually triggers a chemical problem, an imbalance in the brain. Many years ago, as Cadmus sought to make sense of alcoholic parents who kept him up all night with their fighting, his brain began to go awry.

His smile was his protection.

Underneath was a nervous, anxious child. Rarely did he speak and rarely did he remember what he read. His mind drifted. He was held back grade after grade. School didn't much matter to Cadmus in the '50s in Ocean Grove, N.J., because he knew what he was coming home to -- fighting parents or nobody. One year he went to school only 45 days. The rest of the time he hung out on the boardwalk in Asbury Park.

And smiled.

"That was just my way of hiding things from people," Cadmus says. "So I didn't have to deal with other people's questions."

When he finally dropped out at age 16, he hadn't passed seventh grade. In his 20s he began seeing a psychiatrist and taking anti-depressants. He worked odd jobs, but his self-image was so poor that when his childhood dream of driving a bus came within reach, he let it slip through his fingers.

In the early 1970s, pushed by his then-psychiatrist, Cadmus went so far as to borrow a bus from a school, learn to drive it, pass the test and get himself hired as a bus driver in New York City. But on the first day, even before he sat behind the wheel once, he quit. Driving wasn't the problem; it was the idea of doing anything.

He went back to the odd jobs. For a while he ran a backhoe and dug ditches for a shore town in New Jersey. Standing around made him anxious, though, so he quit to wash windows, a job he says was "made for me." Early every morning, before opening hours, he worked alone.

Along the way, he met a woman in a pool hall, Patti, and married her in 1976. In the mid-1980s, when their daughter was 5, Cadmus persuaded his wife to move to the Eastern Shore because crime was lower and living cheaper.

There, seven years ago, Cadmus finally succeeded in obtaining his dream job -- driving a bus. Few people understood how he could be so happy about carrying drunken, singing vacationers up and down the streets of Ocean City.

A few years later, Cadmus says, "things just started going downhill again. ... I kinda self-destructed."

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