Jun 08

Andrew Solomon–“Noonday Demon: An Atlas of Depression” Update

Andrew Solomon‘s 2001 multi-award-winning and bestselling The Noonday Demon: An Atlas of Depression has recently been rereleased with an added new chapter “on recently introduced and novel treatments, suicide and antidepressants, pregnancy and depression, and much more.”

Several available articles by Andrew Solomon offer a peek into this newer material. Last year, for instance, Solomon expressed his opinion (to NPR) that the most radical breakthrough in the treatment of depression has been deep brain stimulation

For his thoughts on specific dilemmas regarding the use of antidepressants, there’s “The Secret Sadness of Pregnancy with Depression” (New York Times) and “A Bitter Pill” (his website), in which he states, “The danger is that in seeking to prevent antidepressant-related suicide, we will increase depression-related suicide.”

What about his own struggles with chronic and relapsing depression? Solomon told an interviewer for MensDepression.org a couple years ago that he continues an ongoing regimen of medication and talk therapy. Also, “I try to structure my life in a positive way and to avoid extreme stresses. I am fiercely protective of my sleep. I avoid alcohol and caffeine. I exercise regularly.”

Andrew Solomon’s highly popular TED talk (2013) on depression can be seen below—or skip ahead to read some of the best quotes:

Selected TED Talk (by Andrew Solomon) Quotes

And one of the things that often gets lost in discussions of depression is that you know it’s ridiculous. You know it’s ridiculous while you’re experiencing it. You know that most people manage to listen to their messages and eat lunch and organize themselves to take a shower and go out the front door and that it’s not a big deal, and yet you are nonetheless in its grip and you are unable to figure out any way around it…

And then the anxiety set in…It was the feeling all the time like that feeling you have if you’re walking and you slip or trip and the ground is rushing up at you, but instead of lasting half a second, the way that does, it lasted for six months. It’s a sensation of being afraid all the time but not even knowing what it is that you’re afraid of. And it was at that point that I began to think that it was just too painful to be alive, and that the only reason not to kill oneself was so as not to hurt other people.

The chemical cure and the psychological cure both have a role to play, and I also figured out that depression was something that was braided so deep into us that there was no separating it from our character and personality.

Depression is the flaw in love. If you were married to someone and thought, “Well, if my wife dies, I’ll find another one,” it wouldn’t be love as we know it. There’s no such thing as love without the anticipation of loss, and that specter of despair can be the engine of intimacy.

Depression is the result of a genetic vulnerability, which is presumably evenly distributed in the population, and triggering circumstances, which are likely to be more severe for people who are impoverished. And yet it turns out that if you have a really lovely life but feel miserable all the time, you think, “Why do I feel like this? I must have depression.” And you set out to find treatment for it. But if you have a perfectly awful life, and you feel miserable all the time, the way you feel is commensurate with your life, and it doesn’t occur to you to think, “Maybe this is treatable.” And so we have an epidemic in this country of depression among impoverished people that’s not being picked up and that’s not being treated and that’s not being addressed, and it’s a tragedy of a grand order.

It’s a strange poverty of the English language, and indeed of many other languages, that we use this same word, depression, to describe how a kid feels when it rains on his birthday, and to describe how somebody feels the minute before they commit suicide.

The opposite of depression is not happiness, but vitality, and these days, my life is vital, even on the days when I’m sad. I felt that funeral in my brain, and I sat next to the colossus at the edge of the world, and I have discovered something inside of myself that I would have to call a soul that I had never formulated until that day 20 years ago when hell came to pay me a surprise visit. I think that while I hated being depressed and would hate to be depressed again, I’ve found a way to love my depression. I love it because it has forced me to find and cling to joy. I love it because each day I decide, sometimes gamely, and sometimes against the moment’s reason, to cleave to the reasons for living. And that, I think, is a highly privileged rapture.

Jun 17

“The Noonday Demon”: Andrew Solomon Examines Depression

Listen to the people who love you. Believe that they are worth living for even when you don’t believe it. Seek out the memories depression takes away and project them into the future. Be brave; be strong; take your pills. Exercise because it’s good for you even if every step weighs a thousand pounds. Eat when food itself disgusts you. Reason with yourself when you have lost your reason. Andrew Solomon, The Noonday Demon

Recently I posted about Andrew Solomon‘s new TED talk “Forge Meaning, Build Identity.” Also pertinent to Minding Therapy is his 2001 The Noonday Demon: An Atlas of Depression, a book that’s both personal and sociocultural in scope.

Solomon’s own severe bouts of depression began in his senior year of college. Jan Scott, M.D., The New England Journal of Medicine, explains:

By his own account, he grew up as a healthy, happy, white American from a privileged background. He enjoyed positive relationships with his family and had a strong network of friends. Yet, in the early 1990s, depression crept up on him and took over his life, so that even getting out of bed and going to take a shower became an overwhelming challenge that he frequently failed to overcome. Despite success in his career, he became unable to undertake the simplest tasks, had frequent periods of intense anxiety, and avoided social contact with friends. Solomon can give no easy explanation of why he is vulnerable to recurrent depression, and he does not associate any specific events with the onset of the episode he describes in detail. However, he clearly had all the classic symptoms of a major depressive episode and was so debilitated by this disorder that he returned to live with and be cared for by his 70-year-old father. Solomon describes the incredible sense of loneliness that characterized this time in his life, and he writes graphically about the despair and hopelessness he felt. He tried a number of treatments, including psychoanalysis (which he says was ‘like firing a machine gun at the incoming tide’) and various types of medication (some of which he used simply to obliterate the day). Not wishing to kill himself by more conventional means, he decided, with the logic that characterizes a man on the edge, that indulging in frequent unsafe homosexual sex with strangers would put him at high risk for AIDS. He reasoned that if he contracted AIDS, he could finally escape his miserable existence, but he could also die in a way that would cause his family less distress than a sudden suicide and, he believed, would be more acceptable to the rest of society.

Last year he gave the following TED talk, “Depression, The Secret We Share”:

If you’ve neither watched the above talk nor read The Noonday Demon, you may be interested in some of these quotes from The Noonday Demon:

The Opening Lines

“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.”

The Nature of Depression

“Antonin Artaud wrote on one of his drawings, ‘Never real and always true,’ and that is how depression feels. You know that it is not real, that you are someone else, and yet you know that it is absolutely true.”

“Grief is depression in proportion to circumstance; depression is grief out of proportion to circumstance.”

“The most important thing to remember about depression is this: you do not get the time back. It is not tacked on at the end of your life to make up for the disaster years. Whatever time is eaten by a depression is gone forever. The minutes that are ticking by as you experience the illness are minutes you will not know again.”

What Helps Depression  

“The people who succeed despite depression do three things. First, they seek an understanding of what’s happening. They they accept that this is a permanent situation. And then they have to transcend their experience and grow from it and put themselves out into the world of real people.”

“A sense of humor is the best indicator that you will recover; it is often the best indicator that people will love you. Sustain that and you have hope.”

“It is important not to suppress your feelings altogether when you are depressed. It is equally important to avoid terrible arguments or expressions of outrage. You should steer clear of emotionally damaging behavior. People forgive, but it is best not to stir things up to the point at which forgiveness is required. When you are depressed, you need the love of other people, and yet depression fosters actions that destroy that love. Depressed people often stick pins into their own life rafts. The conscious mind can intervene. One is not helpless.”

Being on Medication

“Since I am writing a book about depression, I am often asked in social situations to describe my own experiences, and I usually end by saying that I am on medication.
“Still?” people ask. “But you seem fine!” To which I invariably reply that I seem fine because I am fine, and that I am fine in part because of medication.
“So how long do you expect to go on taking this stuff?” people ask. When I say that I will be on medication indefinitely, people who have dealt calmly and sympathetically with the news of suicide attempts, catatonia, missed years of work, significant loss of body weight, and so on stare at me with alarm.
“But it’s really bad to be on medicine that way,” they say. “Surely now you are strong enough to be able to phase out some of these drugs!” If you say to them that this is like phasing the carburetor out of your car or the buttresses out of Notre Dame, they laugh.
“So maybe you’ll stay on a really low maintenance dose?” They ask. You explain that the level of medication you take was chosen because it normalizes the systems that can go haywire, and that a low dose of medication would be like removing half of your carburetor. You add that you have experienced almost no side effects from the medication you are taking, and that there is no evidence of negative effects of long-term medication. You say that you really don’t want to get sick again. But wellness is still, in this area, associated not with achieving control of your problem, but with discontinuation of medication.
“Well, I sure hope you get off it sometime soon,” they say. ”Life with Recurrent Depression

“The opposite of depression is not happiness, but vitality and my life, as I write this, is vital even when sad. I may wake up sometime next year without my mind again; it is not likely to stick around all the time. Meanwhile, however, I have discovered what I would have to call a soul, a part of myself I could never have imagined until one day, seven years ago, when hell came to pay me a surprise visit. It’s a precious discovery. Almost every day I feel momentary flashes of hopelessness and wonder every time whether I am slipping. For a petrifying instant here and there, a lightning-quick flash, I want a car to run me over…I hate these feelings but, but I know that they have driven me to look deeper at life, to find and cling to reasons for living, I cannot find it in me to regret entirely the course my life has taken. Every day, I choose, sometimes gamely, and sometimes against the moment’s reason, to be alive. Is that not a rare joy?”

May 26

Andrew Solomon: Recent TED Talk “Forge Meaning, Build Identity”

When I introduce TED talks on this blog I usually stick to the shorter ones, recognizing that many readers lack the time or inclination to go bigger. Today, however, is a holiday, and thus I’m hoping you can fit in Andrew Solomon‘s recent “How the Worst Moments in Our Lives Make Us Who We Are.” About 20 minutes long, it’s a moving, eloquent, and personal presentation from an accomplished gay male about resilience in the face of adversity.

If you don’t already know writer Andrew Solomon, his most recent book is Far From the Tree (2012), a highly praised volume that “tells the stories of parents who not only learn to deal with their exceptional children but also find profound meaning in doing so.” When it came out I did a series of posts on it, which you can see here.

Here’s the TED talk, filmed in March and received with much acclaim:

Some Highlights

Okay, so you skipped watching it, but you still want to know what it was about.

To begin with, it’s about finding meaning in one’s life experiences—or, rather, forging meaning, in his estimation. Emphasis on making it versus looking for it.

Solomon talks about being disliked and bullied in childhood, particularly for being, or seeming to be, gay. He was once the only kid who (purposely) wasn’t invited to a classmate’s party, for instance. He also, throughout his school years, was continually ridiculed for being different.

As a result of his marginalizing experiences, Solomon learned to keep his own company. “I survived that childhood through a mix of avoidance and endurance.”

He also put a lot of effort into trying not to be gay, eventually putting himself through a type of sexual surrogacy therapy that of course didn’t work.

In adulthood Andrew Solomon has worked not only to forge meaning but also to build identity. He gives several interesting examples of how oppressed individuals across the world have done this. “Forging meaning is about changing yourself, building identity is about changing the world.”

About himself: “I’m lucky to have forged meaning and built identity, but that’s still a rare privilege, and gay people deserve more collectively than the crumbs of justice. And yet, every step forward is so sweet.”

Toward the end of the talk Solomon speaks about marrying his partner as well as having kids. He now regularly feels joy in his life, a feeling he’s not sure he’d now have were it not for his history of victimization and his quest to create meaning and identity from it.

Then he talks about the party thrown last year for his 50th birthday. In the midst of the celebration, his 4-year-old son George insisted on giving a speech. After getting everyone’s attention, he said, “I’m glad it’s Daddy’s birthday; I’m glad we all get cake; and Daddy, if you were little I’d be your friend.”

In closing, Solomon encourages us to share our struggles and identities with others. Why? Because it makes an important difference.

“Forge meaning, build identity,” he says. “And then invite the world to share your joy.”

Nov 23

Genius As Possible Disability in Andrew Solomon’s “Far from the Tree”

Prodigies are able to function at an advanced adult level in some domain before age 12. ‘Prodigy’ derives from the Latin ‘prodigium,’ a monster that violates the natural order. Andrew Solomon, Far from the Tree, on the “disability” of genius

In an essay Andrew Solomon adapted from his book for the New York Times, he notes that prodigiousness is most often seen in the areas of athletics, mathematics, chess, and music. Considering that we marvel at such gifted kids, why is being gifted with geniussometimes seen as a disability?

These children have differences so evident as to resemble a birth defect, and it was in that context that I came to investigate them. Having spent 10 years researching a book about children whose experiences differ radically from those of their parents and the world around them, I found that stigmatized differences — having Down syndrome, autism or deafness; being a dwarf or being transgender — are often clouds with silver linings. Families grappling with these apparent problems may find profound meaning, even beauty, in them. Prodigiousness, conversely, looks from a distance like silver, but it comes with banks of clouds; genius can be as bewildering and hazardous as a disability. Despite the past century’s breakthroughs in psychology and neuroscience, prodigiousness and genius are as little understood as autism. ‘Genius is an abnormality, and can signal other abnormalities,’ says Veda Kaplinsky of Juilliard, perhaps the world’s pre-eminent teacher of young pianists.  ‘Many gifted kids have A.D.D. or O.C.D. or Asperger’s. When the parents are confronted with two sides of a kid, they’re so quick to acknowledge the positive, the talented, the exceptional; they are often in denial over everything else.’

In pointing out how prodigies are still indeed children after all and not the adult-like creatures they may sometimes seem, Solomon offers this striking example: “One prodigy I interviewed switched from the violin to the piano when she was 7. She offered to tell me why if I didn’t tell her mother. ‘I wanted to sit down,’ she said.”

About the parenting of prodigies, Solomon draws this conclusion from his research:

Half the prodigies I studied seemed to be under pressure to be even more astonishing than they naturally were, and the other half, to be more ordinary than their talents. Studying their families, I gradually recognized that all parenting is guesswork, and that difference of any kind, positive or negative, makes the guessing harder. That insight has largely shaped me as a father. I don’t think I would love my children more if they could play Rachmaninoff’s Third, and I hope I wouldn’t love them less for having that consuming skill, any more than I would if they were affected with a chronic illness. But I am frankly relieved that so far, they show no such uncanny aptitude.

Nico Muhly, from Far from the Tree:

Nov 22

People with Schizophrenia: Susan Weinreich, Elyn Saks

Please hear this: There are not ‘schizophrenics,’ there are people with schizophrenia. And each of these people may be a parent, may be your sibling, may be your neighbor, may be your colleague. Elyn Saks, author of The Center Cannot Hold: My Journey Through Madness

Among people with schizophrenia who are open about it and have been managing it is Susan Weinreich, an artist diagnosed with paranoid schizophrenia. From Andrew Solomon‘s Far from the Tree, meet Weinreich:

Another woman who has come out about her schizophrenia is Elyn Saks—attorney, professor, founder of the Saks Institute for Mental Health Law, Policy, and Ethics, author of The Center Cannot Hold (2007), and speaker of the above-cited quote.

Here’s a brief video clip of Saks telling some of her story and views:

Saks explains how she’s survived (from CNN):

Everything about my illness says that I shouldn’t be here. But I am. And I am, I think, for three reasons. First, I’ve had excellent treatment, both psychoanalytic psychotherapy and medication. Second, I have many family members and close friends who know me and who know my illness. Third, USC Law School is an enormously supportive workplace which has been able not just to accommodate my needs, but to embrace my needs. Even with all of that — excellent treatment, wonderful friends and family, enormously supportive work environment — I did not make my illness public until relatively late in my life. And that’s because the stigma against mental illness is so powerful that I didn’t feel safe with people knowing…

Her story is also available as a TED talk of longer length: