Book Review: The Noonday Demon: An Atlas of Depression
Review by David Yarian, Ph.D.
This is, strange to say, a beautiful self help book about depression. Andrew Solomon writes of his own struggles with major depression, his daily feelings of hopelessness, his mother's assisted suicide as she was dying of cancer -- all with great feeling, perspective and compassion.
In the book he alternates between recounting his own experiences of depression and wide-ranging research on the phenomenon of depression. His descriptions of the experience of being depressed are poetic, elegaic -- rivaling the beautiful language of William Styron's great memoir of depression, Darkness Visible.
"Mild depression is a gradual ... thing that undermines people the way rust weakens iron," Solomon says. Later: "If one imagines a soul of iron that weathers with grief and rusts with mild depression, then major depression is the startling collapse of a whole structure."
One study places the number of Americans who suffer from chronic depression at 19 million, some 3% of the population. Two million of these are children. In addition, manic-depressive illness (bipolar disorder) afflicts some 2.3 million Americans.
Solomon charts the territory of depression, telling his own story and the stories of other depressed persons he has come to know. He ranges widely over history, quoting the Bible, Greek philosophers, Enlightenment scholars, poets, artists, writers, musicians and scientists. The book is an encyclopedic survey of what has been thought, believed and felt about depression over the last two thousand years.
He describes the multiplicity of treatments which have been used to treat depression, including anti-depressant medications, electro-convulsive therapy, exercise, support groups, survival courses, lobotomies, EMDR, hospitalization, psychotherapy, herbs, vitamins, sleep deprivation, religious faith and prayer, anti- anxiety and anti-psychotic drugs, cognitive-behavioral therapy, nutrition, massage, marijuana, magnetic therapy, light therapies, energy therapies, acupuncture and more. Interestingly, in his exhaustive research he does not mention yoga or meditation, both of which have been shown to have positive effects with some types of depression.
Solomon devotes several chapters to probing the relationship of depression to addiction, poverty, and other at-risk populations -- including women (twice the rate of depression of men), children, the elderly, the chronically ill, minorities, homosexuals, persons living under repressive political regimes (e.g. Jews in Berlin in the 1920's), Inuit peoples of Greenland, and many more.
There are no simple explanations offered in this book for the complex phenomenon that is depression. Solomon interviewed University of Michigan researcher Arnold Sameroff, a developmental psychiatrist who studies depression in children. Sameroff told him that there are over 200 factors listed in the research literature that may contribute to high blood pressure, a relatively simple biological phenomenon. "If there are two hundred factors influencing it (blood pressure), think how many factors must influence a complex experience such as depression!"
This is not a how-to book or a self help manual on how to deal with the symptoms of depression. There are no tips or techniques here. But there is, upon reading this beautifully written book dense with stories, a growing sense that when one is dealing with depression, one is in company with many, many others around the world, and throughout history. While there are no simple answers given, Solomon is a wise guide to the range of factors which may contribute to depression and the variety of treatments available.
This is, in fact, a hope-filled book. Solomon pays tribute to the wisdom he has gained through his own suffering and the suffering of those he came to know in the course of writing his book. In his final chapter, entitled "Hope" he writes: "The opposite of depression is not happiness but vitality, and my life, as I write this, is vital, even when sad. ... 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."
The Noonday Demon can be useful to depressed people who want to understand more about what they are experiencing. In some ways, the book is a support group between the front and back covers. The multiplicity of stories Solomon tells -- about his own struggles, and about the many other people he comes to know around the world who are struggling with depression -- may be comforting, even encouraging. Knowing that one is not alone is a powerful thing, and in reading this book, the person living with depression finds that he or she is in good company.
This self help book may also be quite helpful to family members of those who are depressed. It can broaden your understanding of the experience of depression and give needed perspective on the difficulties and challenges of living in close proximity to depression.
Andrew Solomon has given us a rare and beautiful book, learned and loving at the same time. This is good literature as well as valuable information for the depressed and those who love them.