My brother, Marc, was a fun, curious child; a virtuous, hardworking adult; and an exceptionally strong and gifted athlete. Yet I watched him struggle for nearly 30 years with every fiber of his body against the insidious, dark demon of chronic depression, until he had no more left to give.
I watched him struggle through nearly every known treatment and through endless hours of psychotherapy. I watched him ingest more medications than any human ever should—SSRIs, TCAs, MAIOs, barbituates, anxiolytics, stimulants—which often caused severe, debilitating side effects. I watched him undergo numerous hospitalizations and be placed in horrid, dehumanizing conditions, forced to cope with policies and processes that have not changed since the early part of the last century. I watched him endure multiple medically induced comas, brought to the brink of respiratory failure in the desperate hope of altering his brain chemistry. I watched him cope with the effects of multiple rounds of electroconvulsive therapy.
In the end, none of it worked. Marc was left exhausted and in despair, with nowhere left to turn.
To be sure, there were good times, too. We had great fun together as kids. He is and will remain my best friend. His keen intellect allowed him to reach academic heights few can aspire to regardless of their circumstances—graduating from college magna cum laude and completing law school at the University of Virginia. He worked for justice in his daily life and as an assistant district attorney in the state of Colorado. He was an accomplished skier, rock climber, wrestler, boxer, and martial artist. He derived enormous joy from nature and the splendor of the world. He traveled and saw many beautiful places and had many adventures.
Most important, Marc formed incredible, long-lasting friendships.
His pure soul, piercing judge of character, unconditional acceptance, easy manner, and dogged loyalty allowed him to accrue a large cadre
of true friends.
I try to imagine how he must have felt to ultimately be driven to violate our most basic instinct—self-preservation. I know I will never be able to truly imagine it, but I try. I think of no sleep for days, causing you to lose focus and to have to apply tremendous concentration to accomplish the most basic tasks; vast feelings of sadness and disconnection from the world, loss of daily enjoyment, sluggishness of thought and action, side effects from medication, voices in your head incessantly telling you that you are worthless or to harm yourself; and the weight of the never-ending concern, frustration, and urging of family and friends when you falter—even a little. Compounding all that are enormously high personal expectations—the need and desire to function and achieve.
Ours is not the only family that has helplessly watched a loved one suffer and ultimately die as the result of chronic, treatment-resistant depression. It is all too common. Our challenge, and the motivation behind the formation of Tomorrow: The Marc Guerette Foundation, is to find meaning in Marc’s suffering and death by being a vanguard for significant advances to fight this disease. Together we can galvanize the strength needed to take on this challenge. Together we can increase awareness of this stigmatized, mysterious scourge, and increase acceptance of those afflicted with it. We can support investigation and development of evidence-based treatments to catalyze medical advances. We can introduce and influence the enactment of legislation to better protect and advocate for the rights of victims of depression. We can offer meaningful support to victims and their families. We can do more to save others from the tragic clutches of chronic depression.
If we can do this, Marc’s death will stand for something and, in accordance with this last wishes, serve as a beacon for positive change. It will be heroic. Marc is my hero.
A Beacon of Hope
By Nathan Guerette, MD