[ed. A classic essay on the effects of depression. This article originally appeared in the January 1998 edition of The New Yorker.]
Depression afflicts millions of American each year, and many don't know where to turn when it strikes. The author recalls the greatest struggle of his life.
I did not experience depression until I had pretty much solved my
problems. I had come to terms with my mother's death three years
earlier, was publishing my first novel, was getting along with my
family, had emerged intact from a powerful two-year relationship, had
bought a beautiful new house, was writing well. It was when life was
finally in order that depression came slinking in and spoiled
everything. I'd felt acutely that there was no excuse for it under the
circumstances, despite perennial existential crises, the forgotten
sorrows of a distant childhood, slight wrongs done to people now dead,
the truth that I am not Tolstoy, the absence in this world of perfect
love, and those impulses of greed and uncharitableness which lie too
close to the heart — that sort of thing. But now, as I ran through this
inventory, I believed that my depression was not only a rational state
but also an incurable one. I kept redating he beginning of the
depression: since my breakup with my girlfriend the past October, since
my mother's death; since the beginning of her two-year illness; since
puberty; since birth. Soon I couldn't remember what pleasurable moods
had been like. (...)
In June, 1994, I began to be constantly bored. My first novel had recently been published in England, and yet its favorable reception did little for me. I read the reviews indifferently and felt tired all the time. In July, back home in downtown New York, I found myself burdened by phone calls, social events, conversation. The subway proved intolerable. In August, I started to feel numb. I didn't care about work, family, or friends. My writing slowed, the stopped. My usually headstrong libido evaporated.
All this made me feel that I was losing my self. Scared, I tried to schedule pleasures. I went to parties and failed to have fun, saw friends and failed to connect; I bought things I had previously wanted and gained no satisfaction from them. I was overwhelmed by messages on my answering machine and ceased to return calls. When I drove at night, I constantly thought I was going to swerve into another car. Suddenly feeling I'd forgotten how to use the steering wheel, I would pull over in a sweat.
In September, I had agonizing kidney stones. After a brief hospitalization, I spent a vagabond week migrating from friend to friend. I would stay in the house all day; avoiding the street, and was careful never to go far from the phone. When they came home, I would cry. Sleeping pills got me through the night, but morning began to seem increasingly difficult. From then on, the slippage was steady. I worked even less well, cancelled more plans. I began eating irregularly, seldom feeling hungry. A psychoanalyst I was seeing told me, as I sank lower, that avoiding medication was very courageous.
At about this time, night terrors began. My book was coming out in the United States, and a friend threw a party on October 11th. I was feeling too lacklustre to invite many people, was too tired to stand up much during the party, and sweated horribly all night. The event lives in my mind in ghostly outlines and washed-out colors. When I got home, terror seized me. I lay in bed, not sleeping and hugging my pillow for comfort. Two weeks later — the day before my thirty-first birthday — I left the house once, to buy groceries; petrified for no reason, I suddenly lost bowel control and soiled myself. I ran home, shaking, and went to bed, but I did not sleep, and could not get up the following day. I wanted to call people to cancel birthday plans, but I couldn't. I lay very still and thought about speaking, trying to figure out how. I moved my tongue, but there were no sounds. I had forgotten how to talk. Then I began to cry without tears. I was on my back. I wanted to turn over, but couldn't remember how to do that, either. I guessed that perhaps I'd had a stroke. At about three that afternoon, I managed to get up and go to the bathroom. I returned to bed shivering. Fortunately, my father, who lived uptown, called about then. "Cancel tonight," I said, struggling with the strange words. "What's wrong?" he kept asking, but I didn't know. (...)
Once upon a time, depression was generally seen as a purely psychological disturbance. These days, people are likely to think of it as a tidy biological syndrome. In fact, it's hard to make sense of the distinction. Most depressive disorders are now though to involve a mixture of reactive (so-called neurotic) factors and internal ("endogenous") factors; depression is a seldom a simple genetic disease or a simple response to external troubles. Resolving the biological and the psychological understanding of depression is as difficult as reconciling predestination and free will. If you remember the beginning of this paragraph well enough to make sense of the end of it, that is a chemical process; love, faith, and despair all have chemical manifestations, and chemistry can make you feel things. Treatments have to accommodate this binary structure — the interplay between vulnerability and external events.
Vulnerability need not be genetic. Ellen Frank, of the University of Pittsburgh, says, "Experiences in childhood can scar the brain and leave one vulnerable to depression." As with asthma, predisposition and environment conspire. Syndrome and symptom cause each other: loneliness is depressing, but depression also causes loneliness. "When patients recover from depression by means of psychotherapy," Frank says, "we see the same changes in, for example, sleep EEG as when they receive medication. A socially generated depression does not necessarily need psychosocial treatment, nor a biologically generated one a biological treatment.
by Andrew Soloman via: The Noonday Demon, originally published in the New Yorker (January, 1998) | Read more:
Depression afflicts millions of American each year, and many don't know where to turn when it strikes. The author recalls the greatest struggle of his life.
I did not experience depression until I had pretty much solved my
problems. I had come to terms with my mother's death three years
earlier, was publishing my first novel, was getting along with my
family, had emerged intact from a powerful two-year relationship, had
bought a beautiful new house, was writing well. It was when life was
finally in order that depression came slinking in and spoiled
everything. I'd felt acutely that there was no excuse for it under the
circumstances, despite perennial existential crises, the forgotten
sorrows of a distant childhood, slight wrongs done to people now dead,
the truth that I am not Tolstoy, the absence in this world of perfect
love, and those impulses of greed and uncharitableness which lie too
close to the heart — that sort of thing. But now, as I ran through this
inventory, I believed that my depression was not only a rational state
but also an incurable one. I kept redating he beginning of the
depression: since my breakup with my girlfriend the past October, since
my mother's death; since the beginning of her two-year illness; since
puberty; since birth. Soon I couldn't remember what pleasurable moods
had been like. (...)In June, 1994, I began to be constantly bored. My first novel had recently been published in England, and yet its favorable reception did little for me. I read the reviews indifferently and felt tired all the time. In July, back home in downtown New York, I found myself burdened by phone calls, social events, conversation. The subway proved intolerable. In August, I started to feel numb. I didn't care about work, family, or friends. My writing slowed, the stopped. My usually headstrong libido evaporated.
All this made me feel that I was losing my self. Scared, I tried to schedule pleasures. I went to parties and failed to have fun, saw friends and failed to connect; I bought things I had previously wanted and gained no satisfaction from them. I was overwhelmed by messages on my answering machine and ceased to return calls. When I drove at night, I constantly thought I was going to swerve into another car. Suddenly feeling I'd forgotten how to use the steering wheel, I would pull over in a sweat.
In September, I had agonizing kidney stones. After a brief hospitalization, I spent a vagabond week migrating from friend to friend. I would stay in the house all day; avoiding the street, and was careful never to go far from the phone. When they came home, I would cry. Sleeping pills got me through the night, but morning began to seem increasingly difficult. From then on, the slippage was steady. I worked even less well, cancelled more plans. I began eating irregularly, seldom feeling hungry. A psychoanalyst I was seeing told me, as I sank lower, that avoiding medication was very courageous.
At about this time, night terrors began. My book was coming out in the United States, and a friend threw a party on October 11th. I was feeling too lacklustre to invite many people, was too tired to stand up much during the party, and sweated horribly all night. The event lives in my mind in ghostly outlines and washed-out colors. When I got home, terror seized me. I lay in bed, not sleeping and hugging my pillow for comfort. Two weeks later — the day before my thirty-first birthday — I left the house once, to buy groceries; petrified for no reason, I suddenly lost bowel control and soiled myself. I ran home, shaking, and went to bed, but I did not sleep, and could not get up the following day. I wanted to call people to cancel birthday plans, but I couldn't. I lay very still and thought about speaking, trying to figure out how. I moved my tongue, but there were no sounds. I had forgotten how to talk. Then I began to cry without tears. I was on my back. I wanted to turn over, but couldn't remember how to do that, either. I guessed that perhaps I'd had a stroke. At about three that afternoon, I managed to get up and go to the bathroom. I returned to bed shivering. Fortunately, my father, who lived uptown, called about then. "Cancel tonight," I said, struggling with the strange words. "What's wrong?" he kept asking, but I didn't know. (...)
Once upon a time, depression was generally seen as a purely psychological disturbance. These days, people are likely to think of it as a tidy biological syndrome. In fact, it's hard to make sense of the distinction. Most depressive disorders are now though to involve a mixture of reactive (so-called neurotic) factors and internal ("endogenous") factors; depression is a seldom a simple genetic disease or a simple response to external troubles. Resolving the biological and the psychological understanding of depression is as difficult as reconciling predestination and free will. If you remember the beginning of this paragraph well enough to make sense of the end of it, that is a chemical process; love, faith, and despair all have chemical manifestations, and chemistry can make you feel things. Treatments have to accommodate this binary structure — the interplay between vulnerability and external events.
Vulnerability need not be genetic. Ellen Frank, of the University of Pittsburgh, says, "Experiences in childhood can scar the brain and leave one vulnerable to depression." As with asthma, predisposition and environment conspire. Syndrome and symptom cause each other: loneliness is depressing, but depression also causes loneliness. "When patients recover from depression by means of psychotherapy," Frank says, "we see the same changes in, for example, sleep EEG as when they receive medication. A socially generated depression does not necessarily need psychosocial treatment, nor a biologically generated one a biological treatment.
by Andrew Soloman via: The Noonday Demon, originally published in the New Yorker (January, 1998) | Read more:
