“…it had taken from me the energy I would have needed to kill myself, and it would not kill me.”
For quite some time, two profound and direct statements from a TED talk by Andrew Solomon (@Andrew_Solomon) – professor of Psychology at Columbia University and president of the American PEN – have been too vivid in my mind: a). “The opposite of depression is not happiness, but vitality…” and b). “You don’t think in depression that you’ve put on a grey veil and are seeing the world through the haze of a bad mood. You think that the veil has been taken away, the veil of happiness, and that now you’re seeing truly.”
I am glad I picked up his National Book Award-winning and Pulitzer Prize finalist The Noonday Demon: An Atlas of Depression (2001), a scientifically elaborate yet deeply personal study of the subject, written with great attentiveness to the subtleties of human feeling. Solomon, who has himself suffered from severe depression, researched and wrote this book so that it may “eliminate some pain for some people”. Many of us have heard about the therapeutic benefits of writing (see this Observer article “As easy as ABC” from July 2002 by British journalist Jim Pollard) but Solomon is quick to point out that the project was not a vehicle of cathartic release for him (writing under depression can be sad and lonely and stressful); the project was undertaken more for literary pleasure. Nonetheless, he hopes that the knowledge will be useful to others – an uplifting thought.
While he was writing this book, Solomon published the article “Anatomy of Melancholy” in the January 12, 1998 issue of The New Yorker. He was flooded with letters. It is “frighteningly easy” to collect material on depression, says the author; it seems to be anybody’s and everybody’s dark and dirty secret (husband or wife, lawyer or teacher, rich or poor, children or the elderly). But the confidences were often anonymous or accompanied by a desperate “Don’t tell anyone!”. We fear egress because we think our admission would be taken as a sure sign of weakness. Depression is a public health disaster. Ending the prejudice around mental illness is one of the civil rights battles of our generation. This book aims to clear the stigma around the affliction – encourage empathy. Its second goal is that of order. Much has been written about the subject: “Science, philosophy, law, psychology, literature, art, history, and many other disciplines have independently taken up the cause of depression” but there is chaos in the kingdom. Solomon aims to provide a synthesis based as closely as possible on empiricism rather than on sweeping generalisations.
It is difficult to describe and explain depression. Solomon employs several metaphors and analogies. The huge vine that attaches itself to and smothers a confident tree. “Grief is depression in proportion to circumstance”, he says, but “depression is grief out of proportion to circumstance”. Mild depression, if the soul were iron, is rust; large depression is the startling collapse of the whole structure – the stuff of breakdowns. What happens in depression? The chemical make-up of your brain is considerably altered and affects your body. You may not like to bathe or breathe. You are unable to answer phone calls or reply to letters. You cannot even fix a piece of lamb in your fork by yourself.
Why does depression occur? Often when a certain genetic vulnerability meets external stress. Loss of a loved one, physical disease, poverty, encounter with racial prejudice, the rejection of one’s sexual orientation, geographical displacement, political oppression, the demands of modern life – the triggers are many. For the author, the death of his mother, his homosexuality, a sudden realisation of his mortality when he was a child and even his being a breach birth have all, in some way or another, contributed to the condition. Despite having researched deep and well into the phenomenon, Solomon maintains intellectual humility. He writes:
Let us make no bones about it. We do not really know what causes depression. We do not really know what constitutes depression. We do not really know why certain treatments may be effective for depression. We do not know how depression made it through the evolutionary process. We do not know why one person gets a depression from circumstances that do not trouble another.
Solomon discusses the two broad modalities for treatment available in detail: talking therapies and physical intervention (which included pharmacological care and electroshock or electroconvulsive therapy). Religion/faith is a third, significant tool which people use to cope up with the horror – but because it is difficult to collect data on this front, it is generally not made the subject of scientific study. In the middle of his discusses on a variety of hormones and drugs like Prozac, Valium, Xanax, Solomon touches upon the many “alternative” remedies in use – rigorous bodily exercise, New Age-y massages, plants like St. John’s Wort. A set of treatments that work for one may not work for another. Sometimes even remedies that don’t have scientific backing seem to do just fine.
The Noonday Demon features a large cast of depressed characters. Most of them American, some foreign – like the valiant Cambodian lady Phaly Nuon, a survivor of the Khmer Rouge and later, humanitarian. A grand historical tour of the subject is also provided, easily running from Aristotle to Virginia Woolf. The ancient Greeks found melancholy a result of bodily disturbances (not very different from our modern understanding), the Middle Ages moralised it, took it to be a manifestation of God’s disfavour, the Renaissance glamorised it, found it a sign of creative genius and man’s desire for spiritual fulfillment. The Age of Reason consigned depressives to the lunatic asylum but by Romanticism, melancholy started being translated into deep insight. Now “the truths of the world were not happy; God was manifest in nature but his precise status was in some doubt; and the stirrings of industry bred the first strains of modernist alienation.” The melancholic individual had something very important to say. Other critical discussions in the book include the ways in which depression overlaps with substance abuse and suicidality, how political rhetoric – the definition of depression in vogue – influences the treatments available, where and when and to whom. Example, if it is deemed a simple organic disease like cancer, it will be probably covered by insurance but if it is declared a defect of one’s character, it will receive no more protection than does, say, stupidity. (The Guardian has a great set of articles on the subject seen from various perspectives). I believe such polarisations are not very helpful and one must take a nuanced view of the matter. Perhaps examining depression on a case-by-case basis may be more useful.
The author ultimately believes that love and will play significant roles in keeping depression at bay. Love gives form and shape to our lives. We are busy and occupied when we have an object of affection or a healthy attachment. Solomon writes: “In good spirits, some love themselves and some love others and some love work and some love God: any of these passions can furnish that vital sense of purpose that is the opposite of depression.” Then, the will – as manifested in adherence to a strict regimen of therapy and medication – saves us again and again. We need to be constantly alert, both proactive and reactive in this fight. Solomon concludes:
…depression is a season, and I cycle through it as through winter, over and over…I not only organize for winter in summer, but also have learned to picture spring while I’m freezing…Summer, like winter, will come again. I have learned to envision feeling well even when I’m at my lowest – and that dearly learned skill invades the demonic blackness like the light of noonday.
I wonder if there is another book available on depression that is as wide-ranging and unflinching and moving as this one (it has saved lives!). Though voluminous and at times challenging, The Noonday Demon is a storehouse of information. A carefully wrought blend of narratives and facts that will be invaluable to those who suffer from this terrible affliction or those who suffer from a loved one’s suffering of it. Depressives can be anywhere – at school, at work, at home. They may not possess the energy required to lobby for their cause. They need to be befriended, understood, helped. Urgently.
Enjoy these two TED talks by Andrew Solomon. This one on depression…
This…on adversity and meaning-making.
A video from the World Health Organisation (October 2012) on depression made by the Australian author, illustrator and public speaker Matthew Johnstone. Following Winston Churchill, he imagines depression as a “black dog.”
Employing the same “black dog” metaphor, psychologist Glenn D. Wilson (New Zealand-born, now based in the UK) gives a lecture on the causes of and cures for depression at Gresham College in London. Video from October, 2013.
Featured Image: The Giant/The Colossus (1814-1818), etching by Spanish artist Francisco de Goya (1746-1828), Wikipedia
Preview The Noonday Demon: An Atlas of Depression by Andrew Solomon.