A CEO's Radical Treatment for a Lifetime of Depression (Guest Column)

Illustrations by Jason Ford

Paul Greenberg, the leader of digital video firm Butter Works, reflects on his childhood demons and a solution after decades of ineffectual therapy: "Please don't give up."

When I was 13, I tried to take my own life by hanging myself in my school’s locker room. The pipe around which I tied my necktie broke under my own weight when I jumped off the windowsill to the floor. Scared and alone, I ran out of the locker room, trying to sort out my muddled thoughts.

After the necktie incident I started seeing a psychiatrist. It helped to some extent. However, my depression and suicidal urges remained, often growing stronger for long periods of time and never waning much.

Recently, two public figures have taken their own lives. Kate Spade and Anthony Bourdain had both built successful careers, enjoyed great wealth and, to the outside eye, appeared to be living their best lives. We — the public — loved them, but they also had friends and family who loved them. Each had a daughter about the same age as my own daughters. In truth, despite these important relationships, they found their lives too painful to bear. When I read the news, I thought, I know what that’s like. I fought for my own life for decades, and I’ve only recently benefited from a treatment that has finally helped lift the fog of my lifelong depression. We are losing too many people to this illness, yet it’s something we don’t talk about. People are suffering silently all around us. If we are going to fight against it, and to conquer, that has to change. That’s why I want to tell you my story.  

After college, I tried antidepressant medications, which never helped. I worked with four different psychopharmacologists and many other psychiatrists in the hopes of finding a combination of drugs and therapy that would alleviate my suffering. Nothing worked. As you can see, I didn’t leave many medication stones unturned:

Throughout all of this, very few people outside of my immediate family, and maybe one or two close friends, knew that I was depressed. I pushed hard through the almost constant pain, and I was and still am fortunate to have a remarkably wonderful family, great friends, and a very successful career. I worked in the hard-charging media industry, running digital media companies, and eventually started my own business. I worked nearly three decades of ten-hour days during which none of my colleagues knew that I was struggling. Sometimes the work was a solace; other times it was simply a massive burden I had to endure.

Although fighting the depression could grow time-consuming with doctors’ appointments and periods of time that I wasn’t myself, I told almost no one at work because I was concerned about the stigma. Would people think I was weak? If I was in the running for a new job running a digital media company, which is what I’ve done for the last few decades, would the people making the hire discover my health issue and judge me unfit or unreliable? Would friends abandon me?

I always understood that my depression and suicidal urges are an illness, and I didn’t stop looking for a treatment that could help. For me, perseverance was critical. More than three decades after my descent into that dark world, I was fortunate enough to meet a triumvirate of incredible doctors who finally were able to help me. In 2013, they convinced me to undergo ECT — electro-convulsive therapy — previously known as electro-shock therapy. Frankly, I was scared to do it. I wasn’t sure what side effects I’d suffer — short-term memory loss, bad headaches, and nausea are the most common, although they go away after the treatment ends. I didn’t know if it would affect my work or if I could even go into the office while the bulk of the treatment (approximately 3-6 weeks) was going on. I didn’t know if it would hurt. Fortunately in the last decade or so, ECT has become much easier to undergo, as patients are given a general anesthetic and a muscle relaxant, and techniques have vastly improved. It’s nothing at all like the “One Flew Over The Cuckoo’s Nest” version. From the time of my adolescence until approximately four years ago, I was extremely depressed and often suicidal.

Lo and behold, it actually worked. After a month or so of having three treatments per week (early in the morning so I was able to go straight to work with no one the wiser) and very fortunately suffering few side effects, I suddenly felt better. I was in the playground with my daughters one Sunday, and almost magically I felt the absence of the albatross that had hung around my neck for so many years. My mind felt clearer. I had no more suicidal impulses. I actually felt happy. I hadn’t experienced a feeling like that in my adult life, and it suddenly opened up all the remarkable possibilities that life holds. Without changing my inner self, I felt like a new person. ECT was, for me, a medical miracle.

I continued tapering the treatments for the next eight months to ensure that the effects were as permanent as possible. I may have to go for “touch-ups” over the years since the depression can come back after a time, but now that I know there is something that will help, I don’t mind.

ECT isn’t recommended for everyone, but it is indicated for those with depression who haven’t responded to medication and, to some extent, those with bi-polar disorder. In any case, it was my proof that not giving up paid off.

Winston Churchill called his depression his “black dog,” a comparison that has always stuck with me because depression did feel to me like an outside force that can’t be reasoned with, and that attacks seemingly whimsically. It bares its teeth when it feels like it, and there is no way to control it. Other analogies are just as apt: Sylvia Plath’s bell jar, Franz Kafka’s mice, etc. All describe being in the throes of a terrifying, relentless power.

By its very nature, depression makes people feel alone. When that is compounded by the fact that people feel ashamed of their condition, it becomes unbearable. If you’re depressed, keep hope. Ask for help, and keep trying. Try new techniques that you haven’t before. Money can certainly be an issue, although if you have insurance, those companies are getting more liberal in what they cover. Often there are public resources that can help.

Similarly, if you suspect someone you know or care about is depressed, ask how you can help. Refer them to suicide prevention hotlines and/or hospitals. No one should suffer like this, and no one should have to go through it alone.

Depression does not discriminate. It can affect anyone. It’s time to bring it into the light and allow those who need treatment for it to get it unburdened by prejudice. Just because it isn’t visible doesn’t mean it isn’t painful. It’s no different from a heart, muscle or bone condition. It needs to be treated and can’t be wished away. 

The following cartoon sums up a lot for me:

The number for the Suicide Prevention Hotline in the U.S. is 1-800-273-8255, or you can visit the National Suicide Prevention Lifeline.

Please don't give up. 

A version of this story first appeared in the July 18 issue of The Hollywood Reporter magazine. To receive the magazine, click here to subscribe.

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