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WHY WRITE a
book on depression? Well, one of the oddest, and most oddly
entertaining, books in English literature is Robert Burton's The
Anatomy of Melancholy (1620), and now comes Andrew Solomon's superb new
study. It's a fair bet that many readers of this newspaper will have
had a brush with at least mild depression. It seems to be endemic to
our way of life. Solomon writes that it is the acute awareness of
transience and limitation in our lives that constitutes mild
depression. That comes with being human, and is not necessarily
depressing. Most marriages and love affairs and works of art and
photograph albums are organised with a recognition of transience and
limitation. To efface this sense, as Solomon seems to suggest, by
kindly medicaments would be a human disaster, not an alleviation.
But the book soon gets to the hard stuff of severe depression. There is
a harrowing account of Solomon's own breakdowns and the horrors of
insomnia or excessive sleeping, almost total lack of energy,
withdrawal, lost abilities to work or read, self-loathing, and - most
awful - the feeling of near death. As the author points out, his has
not been a particularly tragic life. His early feeling of sexual
ambiguity and the death of his mother may have contributed to his
illness, but in his detailed account of the chemical changes in the
brain and body of those suffering from depression, he seems to point to
some chemical malfunction in the brain. In his case, life has been made
at least bearable by medication.
There is much in the book on medical treatments and on psychological
counselling. Alternatives to mainline therapies are dealt with wisely
and wittily ("the emperor has a whole new wardrobe in this business").
Among the alternatives described is a bizarre animist ritual called
"ndeup" that Solomon travelled to Senegal to undergo. To the
accompaniment of drums, the rite involves the rubbing of the body with
millet and bathing in the blood of a sacrificed animal. This impressed
him more than some group therapies practised in the United States.
Many things, however seemingly absurd, can help with depression, if
they are believed in. The danger is that they may come to be seen as
gods that fail, and plunge the depressive into even darker gulfs.
What is depression? Solomon says that each person's depression is
different. What is the use of the word then, except as a clinician's
catch-all? The older words more precise: anguish, despair, grief,
terror, panic, anxiety, guilt. Depression may combine any or, most
terribly, all of these. And they would all appear to be necessary in
some way.
Without grief, we would not have love. We would abandon our dead where
they lie and walk away without a care. These emotions are wired into
our minds to be used. Perhaps the uses have changed so that in our
modern society, they somehow fire at the wrong times and result in the
confusion we call depression?
Then again, the symptoms are the same as Hippocrates described in the
fifth century BC, that Durer showed in the famous engraving,
"Melancolia", that Chaucer called "The Sin of Accidie". The same
feelings Samuel Johnson and Winston Churchill named as "black dogs".
But somehow this illness seems far more widespread today. Solomon has
fascinating sections on how different populations tend to have higher
rates of depression: gays, in a largely heterosexual world; Jews in
Gentile societies; blacks in white-dominated countries; women in a
male-run world. The Inuit of Greenland have a disproportionately high
rate: they endure long dark winters, and tend to live in quite large
family groups in enclosed surroundings, where the only thing to do for
the dark months is to "watch the walls melt". Perhaps hell is other
people.
Andrew Solomon writes that he suffered a third breakdown while
finishing this book. He left a message on his answering machine that he
was "temporally unreachable". That seems as good a description as any
for the wretched state of depression.
I hope that troubles are truly temporary, for he has given us will
surely be a definitive study of depression, combined with a most moving
personal narrative. Let his be the last words: "Every day, I choose,
sometimes gamely sometimes against the moment's reason, to be alive. Is
that not a rare joy?"
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