Andrew Solomon: The Noonday Demon

By MARGIE THOMSON

If ever proof were needed of the illogicality of depression, Andrew Solomon is it. Wealthy, white, loved "generously" by his family, educated at Yale and Cambridge, and with early success as a writer, there were no real indicators that this brilliant, handsome, popular young man - dubbed "Prozac's poster-boy" by one reviewer - would find himself lying frozen in bed day after day, full of fear, the past and the future swallowed up by his horrific present. What could he have to get depressed about?

As he writes in his magnificent, Bible-scale "anatomy of depression", he became depressed just at the point where he had "pretty much solved" his problems. He had, he thought, come to terms with his adored mother's death three years earlier, was publishing his first novel. There seemed no obvious "reason" why he should begin this descent into the void. He has since endured three episodes of depression - the most recent, and the mildest as he was completing this book - and now accepts that despite undesirable side-effects he must keep taking his daily cocktail of legal drugs to keep his bete noir at bay.

Anyone who has suffered depression will need no reminding of the experience; even so, Solomon's account of it is rich and deepening, wise and poetic. The only way to understand it for people who have not experienced it is through metaphor, a device Solomon employs with luminous effectiveness: depression becomes an ancient tree suffocated by a conquering vine; a soul of iron that "weathers with grief and rusts ... " Major depression is the startling collapse of a whole structure, a "demon who leaves you appalled". The title of the book is a biblical metaphor, contained in the 90th psalm, presumed to refer to melancholia, against which only God can save you.

As a thumbnail explanation, however, he offers the following: "Perhaps depression can best be described as emotional pain that forces itself on us against our will, and then breaks free of its externals. Depression is not just a lot of pain; but too much pain can compost itself into depression. Grief is depression in proportion to circumstance; depression is grief out of proportion to circumstance. It is tumbleweed distress that thrives on thin air, growing despite its detachment from the nourishing earth."

Depression as a human condition with recognisable symptoms has always been with us, "for as long as man has been capable of self-conscious thought," Solomon says. It is not, he shows us with a wealth of historical, literary and geographical evidence, a luxury of modern, western self-obsession, although "the climbing rates of depression are without question the consequence of modernity".

Some readers may balk at Solomon's strong advocacy of drug treatment for depression - they fear the subsuming of the real "I" into a body-snatched "Prozac" personality, or feel there is something heroic about fighting depression simply with the sheer force of one's id.

Telling the tale of his own first descent into the void, Solomon writes: "A psychoanalyst I was seeing told me, as I sank lower, that avoiding medication was very courageous." When, in crisis, he is taken to see her by his father, she takes one look at him, says, "I'm sorry," and calls a psychopharmacologist (Solomon, being rich and living in New York, has a range of professionals at his beck and call).

Solomon's advocacy of drug treatment is not knee-jerk or simplistic (despite his family fortune being founded on pharmaceuticals, a fact he openly declares). Quite simply, he believes and demonstrates that anti-depressants can transform people's lives. There can be few who have gone into these matters on such deep philosophical levels as he within such a popular format: huge questions such as the nature of personality, of chemistry and the construction of all our attributes, are approached fearlessly and affectionately.

In the end, he simply doesn't buy the idea that drugs can make you into something you are not. "All the medicine in the world can provide no more than a way for you to reinvent yourself. The medicine will not reinvent you. We can never escape from choice itself. One's self lies in the choosing ... "

His commitment to understanding depression led him to those who have had very different lives to his own. "It is often said that depression is a thing to which a leisured class falls prey in a developed society; in fact, it is a thing that a certain class has the luxury of articulating and addressing," he says.

He makes the powerful point that "depression cuts across class boundaries but treatment doesn't ... Little work has been done on depression among the poor. This is curious, because depression occurs more often among people living below the poverty line than in an average population ... In our rage to medicalise depression, we have tended to suggest that real depression occurs without reference to external materiality. This is simply not true ... Indigence is a good trigger for depression; relief of indigence is a good trigger for recovery ... It is sometimes more feasible, however, to relieve the depression than to fix the indigence ... Treating the depression of the depressed indigent often allows them to discover within themselves ambition, competence, and pleasure."

Solomon has a fairly open mind on many of the alternative treatments available; in the interests of research he has tried most of them. He is humane, tolerant and positive, particularly on the subject of religious faith. "It is enormously difficult to write about faith because it trades in the unknowable and the indescribable," he admits. But he speculates that human consciousness is bound by the sides of a triangle: the theological, the psychological and the biological. Therapy and medication are now the most accessible treatments for depression, but "you survive depression through a faith in life that is as abstract as any religious belief system." Depression is the most cynical thing in the world, but it is also the origin of a kind of belief, he writes. "To endure it and emerge as yourself is to find that what you did not have the courage to hope may yet prove true."

While The Noonday Demon obviously owes its existence to Solomon's own experience of depression, it is no limited confessional. Its scope is breathtaking: his own story weaves intermittently around those of many people of all kinds from many countries, across literature and the ages.

He has spoken to health professionals, carers, policy makers, activists - people with almost unbelievable stories of abuse and misery, and others whose apparently easy lives were, like his own, blighted by something over which they had no control.

"I have chosen to write about people I admire," he says. "The people in this book are mostly strong or bright or tough or in some other way distinctive. I do not believe that there is such a thing as an average person, or that by telling a prototypical reality one can convey overarching truth. The quest for the non-individual, generic human being is the blight of popular psychology books. By seeing how many kinds of resilience and strength and imagination are to be found, one can appreciate not only the horror of depression but also the complexity of human vitality."

This is not a self-help book, although in its wisdom it contains much that will be inspirational both to those who suffer from depression, and those who don't but who are nevertheless interested in ways of considering the living of life.

Chatto and Windus

$75

* Margie Thomson is an Auckland journalist.