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by John Q McDonald --- 20 August 2015

The Noonday Demon

An Atlas of Depression

by Andrew Solomon

"The most important thing to remember during a depression is this: you do not get the time back. It is not tacked on at the end of your life to make up for the disaster years. Whatever time is eaten by a depression is gone forever. The minutes that are ticking by as you experience the illness are minutes you will not know again. No matter how bad you feel, you have to do everything you can to keep living, even if all you can do for the moment is to breathe." -- Andrew Solomon in "The Noonday Demon"

Are you bummed out? Sad? Depressed? In the past few decades, depression has become almost fashionable as an illness, affliction, an excuse for inactivity and alienation. But it isn't new. Depression, or its sister, melancholy, has been around for as long as history. Studies show that an astonishingly large portion of the population is afflicted with depression from mild to severe. The prescription of anti-depressant drugs has exploded, from both psychologists and general practitioners. One only has to watch TV for an evening to see the many commercials for mood-altering drugs of all sorts. Ask your doctor. At the same time, most non-depressed people find it extraordinarily difficult to deal with depressed people. Responses vary from indifference ("just cheer up!") to misunderstanding, to merely avoiding the depressing experience of being around depressed people. Depresssion is not generally seen as the psycho-physiological syndrome that it really represents. Unlike most other illnesses, depression is a complex social, medical, cultural and psychological issue. Author and depression sufferer, Andrew Solomon, bravely tackles the many issues around depression in this sprawling, personal and engaging book.

Solomon reveals the complex suffering he experienced during a depressive breakdown not long after his mother's illness and death. It is an extreme experience and difficult to read about. From there, he explores the history, pharmacology, culture, politics, evolution and other aspects of depression. As overwhelmingly gloomy as the subject appears on first glance, Solomon's writing is equally sympathetic, compassionate, and full of hope for the sufferers of depression. The book is full of interviews with patients and doctors, sociologists and politicians, all who feel the need to share their experience and concern for this illness. Solomon is hopeful. He is confident in the pharmacological solutions available now and promised for the future. He himself benefits from those drugs. His father worked for drug manufacturers, so the reader can be forgiven for thinking Solomon leans too heavily on the chemical solution. On the other hand, Solomon recognizes the wide variety of symptoms, severity and expression of this illness. He sees, even, the positive aspects of sadness and melancholy to the human condition. He sees, too, that sufferers respond differently and find many different solutions to their illness. He is right, though, that those who suffer the most severe depression are unlikely to come through on their own, without some kind of professional help. Severe depression is, after all, extremely dangerous to those prone to self harm.

The book is a heroic journey for Solomon, who deserves a medal for heading down this rabbit hole. The cultural experience of depression varies widely, and this book goes far toward laying out the successes and failures of our mental health system, and our cultural response. There are notes of hope, and vast chasms through which sufferers and patients fall. In many ways, our health care system fails our citizens. We know that mental health has many costs to society, and we respond with wildly varying levels of systematic care. Or lack thereof. Solomon highlights the successes, because he wants us to see depression as a common and treatable illness. But one can see the failures, and it is easy to despair of improvement in our political system. In the meantime, the drug companies research ever more subtle and effective anti-depressants. The trick is getting them, affordably, to the people who most need them.

In the end, the book has many rewards, despite its daunting topic. It is a broad and appealing story, even if it is a bit of an endurance test for the reader. Highly recommended.

(For this book, Solomon was awarded the 2001 National Book Award for nonfiction. This mini-review refers to that version of the book, though a new edition is now available, expanded with further details on newly available treatments, along with an update to the author's own experiences with depression since the publication of the first edition.)

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See Also: [Against Happiness by Eric G. Wilson]