The Noonday Demon

by Andrew Solomon

You could pump a gallon of serotonin into the brain of a depressed person and it would not in the instant make him feel one iota better,

Most people have had moments of inexplicable despair, often in the middle of the night or in the early morning before the alarm clock sounds.

If such feelings last ten minutes, they’re a strange, quick mood. If they last ten hours, they’re a disturbing febrility, and if they last ten years, they’re a crippling illness.

it is a mistake to confuse numbers with truth,

28 million Americans—one in every ten—are now on SSRIs (selective serotonin reuptake inhibitors—the

studies that include milder depression show that 2 to 4 percent of depressives will die by their own hand as a direct consequence of the illness.

the surest way out of depression is to dislike it and not to let yourself grow accustomed to it. Block

There are ways to lead a good life with depression.

I called home once a week,

I complained to the selfsame analyst that a loss of feeling, a numbness, had infected all my human relations. I didn’t care about love; about my work; about family; about friends.

Depression dawns as gradually as adulthood.

And then something seemed to snap in me. Standing in the middle of my cubicle in the New York Hospital emergency room, I began to scream. They put a shot of morphine into my arm. The pain abated. Soon enough, it returned: I was in and out of the hospital for five days.

I had begun to feel that no one could love me and that I would never be in a relationship again. I had no sexual feelings at all. I began eating irregularly because I seldom felt hungry. My analyst said that it was still depression, and I felt tired of that word and tired of the analyst. I said that I was not crazy but was afraid I could become crazy and did she think I was going to end up on antidepressants, and she told me that avoiding medication was courageous and that we could work everything through.

That conversation was the last one I initiated; those were my last feelings for a long time.

Major depression has a number of defining factors—mostly having to do with withdrawal, though agitated or atypical depression may have an intense negativity rather than a flattened passivity—and is usually fairly easy to recognize; it deranges sleep, appetites, and energy. It tends to increase sensitivity to rejection, and it may be accompanied by a loss of self-confidence and self-re...

uncharacteristic behavior of matter that is determined by hidden variables.

Your senses slowly abandon you in depression. “There’s a sudden point when you can feel the chemistry going,” Mark Weiss, a depressive friend, once said to me.

good friend had volunteered to throw a book party for me on October 11. I love parties and I love books, and I knew I should have been ecstatic, but in fact I was too lackluster to invite many people, and too tired to stand up much during the party.

I could not get up the following day. I knew I could not go to any restaurant. I wanted to call my friends and cancel, but I couldn’t.

You are in touch with the real terribleness of your life. You can accept rationally that later, after the medication sets in, you will be better able to deal with the terribleness, but you will not be free of it. When you are depressed, the past and future are absorbed entirely by the present moment, as in the world of a three-year-old. You cannot remember a time when you felt better, at least not clearly; and you certainly cannot imagine a future time when you will feel better. Being upset, even profoundly upset, is a temporal experience, while depression is atemporal. Breakdowns leave you with no point of view.

the brain that has gone into depression a few times will continue to return to depression over and over.

In the field of depression, psychological stress transduces to biological change, and vice versa. If

In the meanwhile, there is a terrible cycle: the symptoms of depression cause depression. Loneliness is depressing, but depression also causes loneliness. If you cannot function, your life becomes as much of a mess as you had supposed it was; if you cannot speak and have no sexual urges, your romantic and social life disappear, and that is authentically depressing.

I have a son who suffers from this disease, and I don’t want him to think that it’s a reason for not having a good life. I get up every single day,

anything emotional, good or bad, sets me off.

The existence of medication has increased social intolerance. “You got a problem?” I once heard a woman say to her son in a hospital. “You get on that Prozac and get over it and then you give me a call.”

Since the world is flawed, perfectionists tend to be depressed.

When you’re so far down that love seems almost meaningless, vanity and a sense of obligation can save your life.

After any given depression comes the time to uncrack the eggs and to put the spilled milk back in the container.

New York. It was a

Here’s what I knew that saved me: act fast; have a good doctor prepared to hear from you; know your own patterns really clearly; regulate sleep and eating no matter how odious the task may be; lift stresses at once; exercise; mobilize love.

am so tired, so exhausted of trying to figure out who I am when I’m ‘fine’—what is normal or acceptable for me.”

Depression takes away whatever I really, really like about myself (which is not so much in the