The Noonday Demon: An Atlas of Depression
Andrew Solomon uses his own experience of cataclysmic depression and depression in general as lenses, exploring one through the other. This book is a comprehensive survey of the emotional, medical, spiritual, and human content of the condition called depression.
512 pages (687 with bibliography and index)
During the tour to promote his first novel, Andrew Solomon had a severe depressive episode. He was unable to function as a human being. It lasted weeks. Then he wrote a book about depression. His method is synthetic, aiming to unite the insights of literature, history, philosophy, medicine, and the rough-and-ready spirituality that emerges when all psychological supports are removed.
Mental Health Warning: If you suffer from mental illness and you are not currently stable, do not read this book.
Violence: The most awful kind of violence is described. Suicide by overdose is described sympathetically.
Spiritual Content: A shamanistic North African ritual is described in detail. The author is open, but ambivalent regarding God.
Sexual Content: The most awful kind of sexual abuse is described, and promiscuous sex of various kinds is mentioned.
Drugs/Alcohol Use: Substance abuse of all kinds of drugs is discussed, and there is extensive interaction with medications used to treat mental illness.
Positive Content: This book is a sympathetic portrait of depression that is alive to the complexity and nuance of human existence.
For a book that is thick and rich with insight and human wisdom, Solomon’s view of depression can be summarized in two essential points: (1) people with depression deserve our compassion and tolerance; and (2) depression is both a physical and mental phenomenon, and its treatment must handle both the mind and the brain. These points seem obvious, but Solomon shows that they have passed in and out of fashion with doctors and general society across the last three thousand years.
The greatest strength of the book is the skill of its sympathy. Solomon knows depression from the inside and he describes it with prose that trembles under the depth and precision of its honesty. Reading this book helped me understand the texture of my own depression. It gave me a toolbox of words and concepts that Solomon has assembled from dozens of people. Here is an example, chosen by opening the book at random:
“The insistence on normality, the belief in an inner logic in the face of unmistakable abnormality, is endemic to depression. It is the everyman story of this book, one I have encountered time after time.The shape of each person’s normality, however, is unique: normality is perhaps an even more private idea than weirdness.”
Solomon walks through his own experience with depression, and the experiences of many people he interviewed over a period of years. Many people first enter depression because awful things have happened to them, and these triggers are reported with a journalistic restraint that makes them almost unbearable to read. The prose could weep and wail; instead it only says a few words and looks away, like a tombstone caught in conversation.
His method is carefully synthetic. Perspectives and ideas from many different sources are assembled and used to build on one another. Solomon narrates many fascinating stories about dealing with depression from different people and different cultures; for example, he spent six pages going through the Senegalese ndeup ceremony, which he found powerful, fascinating, and psychologically useful.
Solomon has to work largely from anecdote because it is so hard to generalise. With depression there are no skeleton keys, no ideas that help us understand everything at once. The best thinking at the moment is that people have varying levels of susceptibility to depression, influenced by genetics and childhood health and environment. But that doesn’t get us very far in understanding depression itself.
Solomon is comfortable with the dual languages of evolution and divine creation in a way that few writers are today. He connects depression with the range of human emotion: if we are to feel, we must have the susceptibility to feel too much or too long. His suggestions in this area remind me of C.S. Lewis’s defense of suffering in The Problem of Pain — which would probably be a good book to read alongside this one.
When the topic turns to medicine, Solomon does a good job keeping things as comprehensible as possible. The gist is that state-of-the-art treatment for depression is a moving target, changing year to year and increasingly separating into two different arts: psychoanalysis (talking therapies of all kinds) and psychopharmacology (drugs and other treatments with wildly different effects upon the brain).
Solomon wants these two brought back together. The adaptation the brain makes over weeks of talking therapy are similar to the effect of some neurotransmitter re-uptake inhibitors, suggesting that the two arts of treatment are converging on the same objectives. Mind and brain need to be treated together.
The only point at which Noonday Demon lost me was Solomon’s discussion of his mother’s death at her own hand in the face of a cancer relapse. He describes how his mother, like many other sick people, achieved a sense of control and ability to endure by having the option of euthanasia. He speaks movingly about suicide as a choice that can be the last exertion of control.
But Solomon does not fully confront the consequences of suicide. The gap between his own description of the effects and his analysis of suicide is staggering; I’m surprised an editor did not point it out. In the aftermath of his mother’s death, Solomon detects a strange impulse towards suicide in himself and in his father:
“I understood then what suicide epidemics were all about.”
I think he pulls back from this fact because it reveals that an individual’s choice to die is not only a choice for them. It is an act of control, just like Solomon says: personal control over the circumstances in which we will allow ourselves to be part of the world. It says I will not exist in such conditions.
The death of Jesus warns Christians against suicide. The way God saved us and crowned his Son as king was through lonely death. The cross shows us that nothing is too strange, too terrible, too painful, or too humiliating for it to be lovely in the eyes of God. To take up the cross and follow Jesus means accepting that we will not always understand what is happening to us; just as the disciples did not understand what was happening to Jesus.
This book is still really good at talking through depression, better than most Christian discussions (I suspect because depressives rarely become church leaders). I would recommend it to anyone who wants to understand depression better, with two caveats. One, you have to be willing to disagree with the author — violently at times. And two, you need the energy to invest in a dense but deeply rewarding book.
+ Extends and strengthens sympathy for those suffering with depression
+ Not hostile to the existence and importance of God
- Curious blind spot about the ripple effects of suicide