The Noonday Demon (2 page)
Authors: Andrew Solomon
—Larry McMurtry, Pulitzer Prize–winning author of
Lonesome Dove
“Solomon’s highly readable, tag-all-bases new book . . . gives us nothing less than an evolving portrait of who, collectively, we are . . . ambitious and broadly synthesizing . . . [written with] considerable stylistic grace. . . . Solomon is knowledgeable, trenchant, and an admirable distiller of facts and perspectives.”
—Sven Birkerts,
The New York Observer
“With unflinching humanity and empathy, Solomon has written a landmark work about the universal experience of chronic grief. The book is so beautifully documented and widely researched that it helps to reinvigorate the dying tradition of the public intellectual. And for so many women who are the more likely gender to experience lasting depression, whose grief is so often trivialized,
The Noonday Demon
will be a valued sourcebook, even a lifeline.”
—Naomi Wolf, author of
The Beauty Myth
and
Primogeniture
“Chronicling a vast array of human experience (including his own), Solomon weaves together a deeply poetic, yet always honest, vision of depression. Investigating the cultural, political, and economic influences affecting human moods worldwide, he debunks some of the myths about the disease—for example, that it is primarily a modern middle-class affliction. A must read for all who seek a better understanding of the dimensions of suffering.”
—
Tikkun
magazine
“Andrew Solomon’s new book on the descent of melancholy is, strange as it sounds, charming, lively, intelligent, and, in its diligent fascination with what turns out to be a permanent feature of the human condition, never the least bit depressing.”
—Adam Gopnick, author of
Paris to the Moon
“
The Noonday Demon
is an eloquent, harrowing account of melancholy and dread. It informs deeply, in every manner—personal, scientific, historical, and political—about the roots, experience, and treatment of clinical depression. It is an important book about suffering, but an even more important one about hope.”
—Kay Redfield Jamison, professor of psychiatry, Johns Hopkins School of Medicine, and author of
An Unquiet Mind
and
Night Falls Fast
“The melancholic, Freud observed, has ‘a keener eye for truth than others,’ and Solomon is a case in point. Interweaving personal experiences with scientific reporting, he has produced a meditation on the human capacity to suffer—but also to prevail.”
—
The New Yorker
“Andrew Solomon’s
The Noonday Demon
succeeds brilliantly. This is the best lay guide ever written for understanding and surviving depression.”
—Dr. David Nathan,
Barron’s
A
LSO BY
A
NDREW
S
OLOMON
A Stone Boat
The Irony Tower:
Soviet Artists in a Time of Glasnost
SCRIBNER
1230 Avenue of the Americas
New York, NY 10020
www.SimonandSchuster.com
Copyright © 2001 by Andrew Solomon
All rights reserved, including the right of reproduction in whole or in part in any form.
First Scribner trade paperback edition 2003
SCRIBNER
and design are trademarks of Macmillan Library References USA, Inc., used under liscense by Simon & Schuster, the publisher of this work.
DESIGNED BY ERICH HOBBING
7 9 10 8
The Library of Congress has cataloged the Scribner edition as follows:
Solomon, Andrew, 1963–
The Noonday demon : an atlas of depression / Andrew Solomon.
p. cm.
Includes bibliographical references and index.
1. Depression, Mental. 2. Solomon, Andrew, 1963–. 3. Depressed persons—Case studies. I. Title.
RC537.S598 2001
616.85′27′0092—dc21
[B] 2001018884
ISBN 0-684-85466-X
0-684-85467-8 (Pbk)
eISBN-13: 978-1-45167-688-4
The copyright page continues after the index.
For my father,
who gave me life not once, but twice
Everything passes away—suffering, pain, blood, hunger, pestilence. The sword will pass away too, but the stars will still remain when the shadows of our presence and our deeds have vanished from the earth. There is no man who does not know that. Why, then, will we not turn our eyes toward the stars? Why?
—Mikhail Bulgakov,
The White Guard
T
he writing of this book has been my life for the past five years, and it is sometimes hard for me to trace my own ideas back to their various sources. I have attempted to credit all influences in the notes at the back of the book, and not to distract readers with a cascade of unfamiliar names and technical jargon in the main text. I asked my subjects to allow me to use their actual names, because real names lend authority to real stories. In a book one of the aims of which is to remove the burden of stigma from mental illness, it is important not to play to that stigma by hiding the identities of depressed people. I have, however, included the stories of seven people who wished to remain pseudonymous and who persuaded me that they had significant reason to do so. They appear in this text as Sheila Hernandez, Frank Rusakoff, Bill Stein, Danquille Stetson, Lolly Washington, Claudia Weaver, and Fred Wilson. None of them is a composite personality, and I have taken pains to change no details. The members of Mood Disorders Support Groups (MDSG) use first names only; these have all been changed in keeping with the private nature of the meetings. All other names are actual.
I have allowed the men and women whose battles are the primary subject of this book to tell their own stories. I have done my best to get coherent stories from them, but I have not in general done fact-checking on their accounts of themselves. I have not insisted that all personal narrative be strictly linear.
I have often been asked how I found my subjects. A number of professionals, as noted in the acknowledgments, helped me to gain access to their patients. I met an enormous number of people in my ordinary life who volunteered, upon learning of my subject, their own copious histories, some of which were extremely fascinating and ultimately became source material. I published an article about depression in
The New Yorker
in 1998 and received over a thousand letters in the months immediately
following publication. Graham Greene once said, “I sometimes wonder how all those who do not write, compose, or paint can manage to escape the madness, the melancholia, the panic fear which is inherent in the human situation.” I think he vastly underestimated the number of people who do write in one way or another to alleviate melancholia and panic fear. In responding to my flood of mail, I asked some people whose correspondence had been particularly moving to me whether they would be interested in doing interviews for this book. Additionally, I spoke at and attended numerous conferences where I met consumers of mental health care.
I have never written on any subject about which so many people have so much to say, nor on any subject about which so many people have chosen to say so much to me. It is frighteningly easy to accumulate material about depression. I felt in the end that what was missing in the field of depression studies was synthesis. Science, philosophy, law, psychology, literature, art, history, and many other disciplines have independently taken up the cause of depression. So many interesting things are happening to so many interesting people and so many interesting things are being said and being published—and there is chaos in the kingdom. The first goal of this book is empathy; the second, which has been for me much more difficult to achieve, is order: an order based as closely as possible on empiricism, rather than on sweeping generalizations extracted from haphazard anecdotes.
I must emphasize that I am not a doctor or a psychologist or even a philosopher. This is an extremely personal book and should not be taken as anything more than that. Though I have offered explanations and interpretations of complex ideas, this book is not intended to substitute for appropriate treatment.
For the sake of readability, I have not used ellipsis marks or brackets in quotations, from spoken or written sources, where I felt that the omitted or added words did not substantially change meaning; anyone wishing to reference these sources should go back to the originals, which are all cataloged at the end of this book. I have also avoided use of “[
sic
]” in the eighth chapter, where historical sources use obsolete spellings. Quotations for which citations are not furnished are from personal interviews, most of which were conducted between 1995 and 2001.
I have used those statistics that come out of sound studies and have been most comfortable with statistics that have been extensively replicated or frequently cited. My finding, in general, is that statistics in this field are inconsistent and that many authors select statistics to make an attractive ensemble in support of preexisting theories. I found one major study, for example, that showed that depressed people who abuse substances
nearly always choose stimulants; and another, equally convincing one that demonstrated that depressed people who abuse substances invariably use opiates. Many authors derive a rather nauseous air of invincibility from statistics, as though showing that something occurs 82.37 percent of the time is more palpable and true than showing that something occurs about three out of four times. It is my experience that the hard numbers are the ones that lie. The matters that they describe cannot be defined so clearly. The most accurate statement that can be made on the frequency of depression is that it occurs often and, directly or indirectly, affects the lives of everyone.
It is hard for me to write without bias about the pharmaceutical companies because my father has worked in the pharmaceutical field for most of my adult life. As a consequence of this I have met many people in that industry. It is fashionable at the moment to excoriate the pharmaceutical industry as one that takes advantage of the sick. My experience has been that the people in the industry are both capitalists and idealists—people keen on profit but also optimistic that their work may benefit the world, that they may enable important discoveries that will put specific illnesses into obsolescence. We would not have the selective serotonin reuptake inhibitors (SSRIs), antidepressants that have saved so many lives, without the companies that sponsored the research. I have done my best to write clearly about the industry insofar as this is part of the story of this book. After his experience of my depression, my father extended the reach of his company into the field of antidepressants. His company, Forest Laboratories, is now the U.S. distributor of Celexa. To avoid any explicit conflict of interest, I have not mentioned the product except where its omission would be ostentatious or misleading.