The Noonday Demon: an Anatomy of Depression
Andrew Solomon
Chatto & Windus £20, pp560
Buy it at a discount at BOL
'Depression is the flaw in love. To be creatures who love, we must be creatures who can despair at what we lose, and depression is the mechanism of that despair,' says Andrew Solomon at the start of his magnificent book.
In his first sweeping sentences, he gathers up the themes and even the words that will resonate through the following pages of linked autobiography, history, science, analysis, wrenched and luminous meditation on life and pain. Love, loss and despair ring out their melancholy notes. In depression, he says over and over again, life loses its meaning; the 'only feeling left in this loveless state is insignificance'.
Yet The Noonday Demon stands as a testament to all those qualities that are lost during times of deathly meaninglessness: it describes numbness with vitality, wretchedness with poetry, lovelessness with passion, fear with exuberance, slack-jawed horror with wit and tenderness, deadly silence with this fervent outpouring of words. Depression is a country that the undepressed can't enter, but Solomon, who has travelled there and knows it well, bends all his energy and talent as a writer to sending us snapshots from this terrifying land (mood, he writes, 'is a frontier like deep ocean or deep space'). The result is scary but far from dispiriting; at times, Solomon's voice, calling to us from beyond the frontier, achieves a lonely rapture.
Solomon writes that depression can only be evoked by metaphors (the abyss, the edge, the darkness). The first that he uses himself is of a tree wrapped around by a vine; at some point, the vine squeezes the life out of the tree. Then he talks of angels and demons: grief is like a humble angel that leaves us with a clear sense of our own depth; depression is the (noonday) demon that leaves you appalled.
Mild depression is gradual, like rust; it is too much grief at too slight a cause. Major depression is the stuff of breakdowns, not rust, but the startling collapse of the whole system. He has been gripped by major depression himself, when he was 'asphyxiated', 'split and racked', and 'every second of being alive hurt'. There was not even enough life left for tears, just 'the arid pain of total violation'. As you fall towards this living death, he says, the first thing that goes from you is happiness. The next is the sadness that led you here. Then your sense of humour, the belief in and capacity for love. You smell sour to your self, and thinned. Your face comes apart in the mirror. You have no ability to trust, to touch, to grieve: 'Eventually, you are simply absence.'
There were many days when he couldn't move, couldn't swing his legs out of bed, couldn't control his bodily functions; he could only lie in a corner and weep. He wanted to die but didn't have the energy to kill himself. He did, however, pick up gay men whom he thought might be HIV positive and have sex with them, in the hope he, too, would become infected. Solomon is well aware of the 'preposterousness' of his depression and the uselessness of tracking its causes.
He is a wealthy, white American, a privileged, healthy, admired writer, envied by many for his success, his wealth, his luck, his apparent gaiety and ease. He has many friends. He was reasonably happy as a child, although confused about his sexuality and sometimes gripped by panic. His first major breakdown occurred after the death of his beloved mother (an assisted suicide because of her terminal cancer. He, his father and brother sat by her bed and held her hands and wept while she swallowed handfuls of pills and told them how dearly she loved them) and the publication of his first novel.
But nothing 'explains' how three times he came to be laid so low, and how now he takes pills and sees a therapist to keep the demon at bay. He offers a set of simple instructions to other sufferers (listen to people who love you, seek out memories, block out terrible thoughts as they approach, be brave, exercise, eat). His book, he insists, was not cathartic, but a way of reaching out to others in their isolation, a way of explaining them to us. At its heart, it is deeply idealistic in its intent: 'Words are strong and love is the other way forwards.'
Solomon's experience of depression, which comes like a gale force wind and departs quietly, forms only part of The Noonday Demon, though it is the emotional undertow through the whole of it. He portrays the pain of others, in different cultures and histories, showing that far from being a disease of the wealthy and the leisured classes and of modernity, it has always been with us under different names. Hippocrates wrote about it, as did Homer, Galen, Thomas Aquinas, Shakespeare, Baudelaire, Keats, Virginia Woolf and Freud.
The poor feel it (but, although depression cuts across all the classes, treatment of it does not), as do the the war-torn. He goes to Cambodia (where he was 'humbled down to the ground' by the courage of the people he met) and meets people who have lived through war and loss such as he can hardly imagine. One woman teaches him that the way through the darkness is by 'forgetting, working, loving'. He goes to Greenland, where up to 80 per cent of the population are depressed and the suicide rate is 0.35 per cent per year. He visits elderly people in homes; he goes to hospitals and slums.
He looks at the medical and alternative cures - anti-depressants, anxiety controllers, St John's Wort, exercise, work, food, massage, homoeopathy. He tries out different therapies (psychoanalysis, he says, is good at expressing depression, not good at changing it - it's like firing a machine gun at an incoming tide). He goes to talk groups. He gathers stories from all over the country, from sufferers and doctors, from people who have cut their flesh to ribbons and drunk themselves into stupors, from people who have been terribly abused, from people who have come out the other side.
More young people die of depression than of Aids, heart disease, pneumonia, cancer and strokes put together. One in 10 people in America is on drugs to help their moods. Five per cent of its teenagers are clinically depressed. Fifteen per cent of people who are depressed eventually kill themselves.
Some people kill themselves, Solomon says, to simplify things. He remembers thinking that he himself didn't have the energy to wash the dishes or take a shower, so he might as well go and die rather than face the mundane tasks that make up a day, a life. But while 'living death is not pretty, unlike dead death, it offers the hope for amelioration'.
Solomon is inclusive in his theories as well as his stories. There has long been a discussion about whether depression is an illness or an extreme version of ordinary sadness, whether it reveals or assaults a personality. Both, he says. What are the boundaries of identity, what do we mean by 'self'? If depression is 'just' chemical, so, too, is love. Medicine might release a sufferer from the trap, but it does not reinvent him or her. Depression springs like a beast from outside, yet is wired in the brain and runs through the veins. 'The real me lives in the world; the self exists in the narrow space where the world and our choices come together.' The depression he experiences is part of the man that he is.
What Solomon unequivocally and with a raw, sometimes disturbing, romanticism, believes in is the authenticity, even the gift, of his endured pain. To be happy all the time is a spooky, even terrifying idea or a form of idiocy. He quotes a Russian expression: if you wake up feeling no pain, you're dead. He quotes Ovid: 'Welcome this pain.' He believes his own grief and darkness have shown him the 'acreage and reach' of his soul. He writes that 'the individuality of each person's struggle is unbreachable' and that depression, 'like sex, retains an unquenchable aura of mystery. It is new every time'.
It is 'fire in the blood'; it nearly kills him but it produces from him words and poetry that he would not otherwise have uttered, and teaches him a better way of living and loving.
By the end of the book's long journey, he claims that he has learnt to love his depression as a way of learning to love himself. He knows it is lurking inside him still, and will one day probably ambush him again, but he closes with ardent, melancholy optimism: 'Each day I choose to be alive. Is that not a rare joy?'
