To shrug would be wrong. Andrew Solomon‘s The Noonday Demon: An Atlas of Depression deserves so much more. Noonday Demon brings so much advocacy, scholarship, and personal truth to its tale that I cannot help but recommend this highly for those with an open mind and feelings.
Noonday Demon examines depression, mental illness, and anxiety. He explores a number of his own experiences with the disease, as well as that of his mother. The non-fiction narrative looks into other cases upon which Andrew Solomon is familiar and conversant. This is the first book that I’ve read that treats this subject both firsthand and with some academic rigor (at least from my reckoning).
There were several areas that stuck with me as noteworthy and memorable. I will quote a few passages that were forceful and compelling.
Solomon quotes George Brown at the University of London, a founder of Life Events Research, on the nature of depression and anxiety:
“Our view is that most depression is anti-social in origin. There is a disease entity as well but most people are able to produce major depression given a particular set of circumstances. Level of vulnerability varies, of course, but I think at least two-thirds of the population has a sufficient level of vulnerability. According to the exhaustive research he’s done over 25 years, severely threatening life events are responsible for triggering initial depression…Depression is a response to past loss and anxiety is a response to future loss.“
Ellen Frank from the University of Pittsburgh gets into the potential causes of depression, in a sense almost blaming those who suffer for their illness:
“I do not believe that if the causes of your problem were psycho-social that they would require a psycho-social treatment nor that if the causes were biological they would require a biological treatment.”
Solomon pulls no punches in his unapologetic disagreement for this as well as for the weak evidence for claiming that these suggestions indicate a path for returning those suffering back to health.
“It’s fashionable for psychiatrists to tell you first the cause of your depression…and second, as if there a logical link to cure; but this is poppycock.”
Solomon takes on the notion of self-medicating as a means of trading the pain you do not understand for one that you do. Emotionally, I find it hard to judge the decision-making, even though I hope for better.
“Pains are not destiny. If you take drugs, you do it deliberately. You know when you’re doing it. It involves volition. And yet, do we have choice? If one knows that there is ready relief for immediate pain, what does it mean to deny oneself?
Part of what is so horrendous about depression and particularly about anxiety and panic is that it does not involve volition. Feelings happen to you for absolutely no reason at all.
One writer has said that substance abuse is the substitution of comfortable and comprehensible pain for uncomfortable and incomprehensible pain, eliminating uncontrollable suffering which the user does not understand in favor of a drug-induced dysphoria which the user does understand.
In Nepal, when an elephant has a splinter or spike in its foot his drivers put chili in one of his eyes and the elephant becomes so preoccupied with the pain of the chili that he stops paying attention to the pain in his foot and people can remove the spike without being trampled to death. And in a fairly short time the chili washes out of his eye.
For many depressives, alcohol or cocaine or heroin is the chili, the intolerable thing the horror of which distracts from the more intolerable depression.”
After describing four types of suicide, and then staking out approval for one particular type, Solomon brings the case home by paraphrasing Sigmund Freud:
“Freud himself said that we have no adequate means of approaching the problem of suicide. One must appreciate his deference to this subject. If psychoanalysis is the impossible profession, suicide is the impossible subject.”
The bringing together of a compelling narrative is Solomon bringing his argument together for recognizing that there is a politics of mental health. The cases strikes me, as a layperson, as strong. While this argument aims at speaking to the people of the United States, the case for helping a demographic in need is emotionally compelling.
“The question of what constitutes mental illness and who should be treated rides very much on the back of public perceptions about sanity. There is such a thing as sanity and there is such a thing as madness and the difference is both categorical and dimensional, of kind and degree. Ultimately there is a politics of what one asks of ones own brain and of the brains of others. The problem is not so much the politics of depression as our failure to recognize that there is a politics of depression.
A particularly disturbing recent op-ed article [at the time of writing] in The New York Times written by a psychiatrist at a conservative think tank in Washington in response to the new Surgeon General’s report on mental health proposed that helping the mildly ill would deprive the seriously ill as though mental health care were a finite mineral resource. She stated categorically that it was not possible to get unsupervised people to take their medications and proposed that those mentally ill who end up in prison probably need to be there.
At the same time she proposed that the 20 percent of the U.S. citizenry who carry the burden of some kind of mental illness in many instances do not need therapy and therefore should not get it. The key word here is need because the question of need turns on quality of life rather than existence of life.
It is true that many people can stay alive with crippling depression, but they can also stay alive, for example, with no teeth. That one could manage okay on yogurt and bananas for the rest of ones life is not a reason to leave modern people toothless. A person could also live with a club foot but these days it is not unusual to take measures to reconstruct one.
The argument in effect comes down to the same one that is heard over and over again from outside the world of mental illness, which is that the only people who must be treated are those that pose an immediate expense or threat to others.”
Should there be more help? Is there no help because people choose to not understand? This is the political animal that Solomon says exists. To shrug at this would be wrong. My call to you is one of awareness; compassion; pressure applied smartly and in astute ways.
(Quotation from Noonday Demon)
I too, am saying that I rate this book highly. I give Noonday Demon 4.5-stars out of 5 stars.
Matt – Friday, July 14, 2017