The author of an award-winning book on depression tells his story.
By: Jillian Kalonick
At the height of his depression, Andrew Solomon could not summon the effort to turn over in bed.
"The anxiety was intolerable … I felt all the time this terrible, paralyzing fear and I knew there was nothing to be afraid of," said Mr. Solomon, during a lecture at Princeton House, The Medical Center at Princeton’s psychiatric hospital. He was addressing more than 90 people at grand rounds, the monthly meeting of Princeton House’s mental health professionals. His talk, "Depression: An Hour of Introspection," detailed his own struggle with the disease, as well as the stories of the patients he interviewed for his National Book Award-winning "The Noonday Demon: An Atlas of Depression" (Scribner).
Mr. Solomon’s depression was triggered by his mother’s illness and subsequent death. A writer and Yale-educated heir to a pharmaceutical fortune, he appeared to have every reason to be happy, but was far from it. After being treated with medication and enduring several more episodes of depression, Mr. Solomon began to write his book, a comprehensive work detailing his own battle with the disease its history and evolution, treatments, occurrences of depression in various populations, and the politics and policies on mental illness.
"I wanted to disprove the idea which to me seemed so obviously wrong but obviously popular that depression is a modern Western middle-class illness by showing that it has existed across cultures. It has existed, at least as Hippocrates described it, since 2500 B.C., and it has existed across classes," Mr. Solomon said.
He interviewed a range of people plagued with depression, from mobile home residents in rural Virginia to Inuit people in Greenland. He went to Senegal and was treated for his depression with a ndeup, an animist ritual in which he was smeared with ram’s blood and surrounded by hundreds of singing, drumming villagers.
"One of my objectives was to bring together what I saw as a very diffuse body of medical writing and health writing and philosophical writing and poetics, and try and make something a little bit coherent out of all of that for people who are actually going through the experience of depression," Mr. Solomon said.
He shared correspondence he had exchanged with Laura Anderson, a bipolar woman living in Texas. "It is 10 o’clock in the morning and I am already overwhelmed by the idea of today," she wrote. Her desperation is emblematic of victims of depression, who often experience intense fear and anxiety that cannot be quelled.
By telling his story and the stories of others, Mr. Solomon hopes to provide depressed people with information so that they can interact better with their doctors, and give doctors a better perspective on their depressed patients.
Dr. David Nathan, course director of the Continuing Education Program for the department of psychiatry at The Medical Center at Princeton, had this objective in mind when he invited Mr. Solomon to speak.
"(Mr. Solomon) is one of the most eloquent individuals who has suffered from depression and gone on to tell his story," Dr. Nathan said. "One of the strongest points of his book is the way he’s able to convey complicated psychiatric issues in a clear and comprehensive manner."
Mr. Solomon’s best-selling book stemmed from an article in The New Yorker, "The Anatomy of Melancholy," and has received critical acclaim. He acknowledges that writing the book was a difficult, painful process, but also one that allowed him to come to terms with his disease.
"I was much more able to tolerate my depression after writing the book," he said. "I understood it."
If those who suffer from depression have trouble understanding their condition, those who have never experienced it are often ignorant or even intolerant of the suffering of depression’s victims. Although 19 million people in the United States have the disease, including two million children, depression is widely misunderstood.
"I think there’s an enormous amount of stigma still associated with depression, and that the more people come out and talk about it openly, the less stigma there is," Mr. Solomon said. He has heard from thousands of victims of depression since his book was published, verifying the idea that depression is "the family secret everyone has."
Now seen as the depression guru by many of his readers, Mr. Solomon was stopped by a reader on the street on his way to a reading at Micawber Books and asked his opinion about her medications. He is perhaps a better person to consult about the effects of psychotropic drugs than a doctor; he has tried more than a dozen antidepressants for his depression, and takes a number of them on a daily basis. He emphasizes that medication is just one of many treatment options for depression, but overall, he sees antidepressants as a positive force. He compares the drugs to a rough focus knob on a microscope, allowing other type of therapies to provide a closer focus.
Mr. Solomon admits that antidepressants are often prescribed unnecessarily. He calls depression "the most underdiagnosed and overdiagnosed disease in America." But he would rather see more people being treated for depression than not enough people being treated. "While taking the medicine does not appear to have immediate severe negative effects of any kind, having depression most certainly does," he said.
His book had been an invaluable source for those suffering from depression, and he has served as an example that one can have a rich and successful life while dealing with the disease.
"I have to go on seeming like I’ve dealt with this well and courageously … sometimes it can be a burden," Mr. Solomon admitted. "It was my biggest hope when I wrote the book that it would actually be helpful to people. While the burden of providing additional help is there, the gratification of knowing I’ve provided some degree of help is really enormous. It’s what I wanted in the first place."
What Mr. Solomon did not want was to write a self-help book.
"I realized that what I did not like about self-help books is that they are always about typical people. I felt there were two problems with this: There are no typical people. They’re very boring," he said.
Some of the most affecting passages in "The Noonday Demon" tell the story of the indigent depressed. Lolly Washington, the mother of 11 children, escaped her abusive husband and overcame a childhood in which she was sexually abused and raped to begin a new career and a new life. Ruth Ann Janesson, who was raised in an abusive household and had her first child at 17, now owns a house and her own business.
When Mr. Solomon told these stories in a feature for a news magazine, he was told by editors that the stories were implausible these women’s lives were too horrible, and their recovery from depression too quick and complete.
"The truth I had discovered was intolerably stranger than fiction," he writes.
That was the point of the stories: "What I wanted to do was to try and write a book that was about remarkable people, and people that had been able to engage with or deal with or emerge from their depression in some remarkable way," he said.
Mr. Solomon is one of these people. In the last chapter of his book, "Hope," he admits, "I may wake up sometime next year without my mind again; it is not likely to stick around all the time." This is true for many victims of depression.
However, telling the story of his ndeup to the Princeton House staff, he pointed out what is perhaps the immediate need of those suffering from the disease: "Everyone in the village acknowledged my problem. They wanted me to get better."