The Noonday Demon: An Atlas of Depression

Dear Jim,

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I've never read Robert Burton's Anatomy of Melancholy (1621). But Andrew Solomon's description of it--as a "subtle, self-contradictory, badly organized, hugely wise volume" that synthesizes existing scientific knowledge and the author's own experience of depression--convinces me that it was the model for The Noonday Demon.

Except that Solomon's book is very deftly organized. Solomon is a novelist in his late 30s, family-oriented, Yale-educated, smart, intellectually and physically vain, bisexual, adventurous, unmarried, rich (or so one gleans from his descriptions of jetting off to house parties in England), and not prone to boozing or drugs. He believes his first breakdown--a real doozy--was occasioned by his mother's death in 1991. He's had two depressions since, one major, one minor.

But this is not just a late-arriving crazy-person memoir of the sort that Elizabeth Wurtzel, Caroline Knapp, and Michael Ryan were writing five or 10 years ago. One gets the feeling (and it's a funny feeling to get from a novelist) that Solomon distrusts "mere" stories. His bent is more scholarly than literary. He's read most of the literature on depression and suicide, and The Noonday Demon can be read as a commonplace book of Great Thoughts on Blue States, from Coleridge, Goethe, A. Alvarez ("There is, I believe, a whole class of suicides who take their own lives not in order to die but to escape confusion, to clear their heads"), and Primo Levi.

Solomon's own story forms a hub from which his explorations of depression radiate. He starts by describing his breakdowns and those of others. Sleeping for 18 hours at a stretch, unable to stand upright, vomiting. ... No one will close this book doubting that depression exists. (No one will open this book doubting that depression exists, either, but that's another story.) An implicit attack on those who don't think of depression as a "real" medical ailment is about the only agenda this book has.

Solomon is admirably reticent, though, about exactly what depression is. The model he follows throughout is that it's a disease of both the mind and the brain. It's obvious that brain disorders affect what you think, but only recently has science come around to the idea that what you think can reshape your brain. So the romantic vision of depression (that a trauma or "deep thoughts" can provoke it) and the scientific one (as a deficit of certain neurotransmitters) are not at odds. Good for Solomon! What I admire most about this book, aside from its overall agendalessness, is that it's forever slapping the mental-health conventional wisdom vigorously in the face. The chemical fetishism of newsweekly readers--the scientific folklore that depression's relationship to low serotonin, say, is as straightforward as diabetes's to low blood sugar--richly deserves such a slap.

Solomon moves on to treatments, from different classes of anti-depressants (Prozac, Elavil, Nardil, Effexor) to shock therapy (he's a fan) to talking cures to Senegalese ndeup therapy (which seems to involve mud baths, drinking blood, and the company of women). This, surprisingly, is one of the least satisfying parts of the book: first, because he doesn't know (any more than anyone else does) exactly how these treatments work. And second, because they lure him into a wonkish, term-paper prose that vitiates long stretches here and elsewhere. He really makes the reader pay for his insights with sentences like: "Many substances are said to help contravene the sexual side effects of antidepressants: serotonin antagonists such as cyproheptadine and granisetron; alpha-2 antagonists such as yohimbine and trazodone; cholinergic agonists such as bethanecol; dopamine-enhancing drugs such as bupropion, amantadine, and bromocriptine ..." And on and on.

From there he looks at different subpopulations' relationship to depression. He's excellent on the aged ("The elderly depressed are chronically undertreated, in large part because we as a society see old age as depressing") but p.c. on race ("Unlike gender or age in depression, ethnicity does not appear to harbor biological determinants"--this optimism is belied by Solomon's own interviews with the Inuit and will strike anyone who has spent time in Ireland as dubious) and inexplicably chicken about challenging crackpot feminist theories of depression (Dana Crowley Jack's assertion that marriage--per se!--is a depression trigger strikes Solomon as just a "moment of excess").

Solomon again gets verbose and wonkish in his chapter on the history of depression--as sloth and accidie, spleen and Weltschmerz--but the results are better this time. In particular, there's fascinating material on medieval delusions, such as the belief that one's buttocks are made of glass and will break if one sits on them. (Your ass is glass!) His chapter on politics is excellent, much less tendentious than his demographics chapter. Particularly fruitful is his riff on the politics of coerced treatment, of whether it's better "to imprison some people who should be free, or to free some people who will destroy themselves." (Although, since he asserted a "right to suicide" earlier in the book, it's illogical--and wrong--of him to urge that we err on the side of imprisonment.)

Before closing, Solomon has a chapter called "Evolution." This is the core of a deep and wide-ranging discussion of why depression exists and what it does for us. Quite a lot, Solomon would say. However much he fears his depression, he's clearly proud of it on some level--and he's not necessarily wrong to be. He is, after all, of the people of Tolstoy and Churchill. This chapter is yet another example, by the way, of how evolution has become our metaphysics. As the sermon was in the 18^th century and the novel was in the 19 ^th, it's the venue for discussing the Big Questions of human existence in a generalist way. But we'll save that for another time.

What I'd most like to talk about tomorrow is Solomon's disturbing account of his mother's assisted suicide, which he is probably right to see as the proximate cause of his depression. But maybe you'd like to take a crack at that first.

Best,
Chris

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This week, Slate's Book Clubbers wade into Andrew Solomon's The Noonday Demon: An Atlas of Depression. Click here for an explanation of our format, here to read an excerpt, and here to buy the book.

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