Foreword
Depression is a far more widespread and long-standing human affliction than we think. Half the population may experience some depressive condition in their lifetime, and 10% will have an episode of major depression – and that’s just the portion that seeks medical confirmation. Couples each confide their depression to a third party while keeping each other in the dark; the poor, the pre-modern civilized, suffer from depression and even harsh treatment by society, but are not confronted with it for too long. The depressed people who hide themselves with fear and trepidation may be our friends and relatives, or even ourselves. The author, Andrew Solomon, is a “veteran” depressive, a PhD psychologist with a knack for writing, and comes from a family of drug developers. In this book, The Noonday Demon: Depression is a Secret You and I Share, he pours out his own experiences as well as the current and historical aspects of depression. The author gives thoughtful answers and warm inspiration to the perplexities associated with depression. For example, one wonders why there are always people who are happy and affluent by societal standards who suffer from depression.
1
I actually got a physical taste of depression only after I had basically solved my own problems.
In 1994, my mother had been dead for three years and I was coming to terms with that fact. I was in the process of getting my first novel published, had a good relationship with my family, had just gotten out of an intense two-year relationship, had bought a beautiful new house, and was writing for the New Yorker. My life was finally on track, and any excuse for despair was gone, when depression crept in with the lightness of a cat’s foot and ruined everything.
I feel deeply that there is really no excuse for falling into depression in this situation. It’s one thing to fall into depression when you’re going through a traumatic experience and your life is a mess, but it’s very disturbing to sit around waiting for depression when you’re finally out of the trauma and your life is getting organized. Of course, you can perceive some deeper reasons: a long-standing existential crisis, a forgotten wound from a distant childhood, a small mistake against another person who has passed away, the loss of a friendship due to your own indiscretion, the fact that you are not a literary master like Tolstoy, the fact that there is no perfect love, the fact that the impulses of greed and malice are so close to your heart… …and so on and so forth.
And now, looking back at what happened, I think my depression was both justified and incurable.
I’ve never had a hard life in terms of certain important material conditions. Most people would have been quite happy to have the hand I was dealt at the beginning. By my own standards, I’ve had good times and bad times, but those brief ups and downs aren’t enough to explain what happened to me. Had my life been a little more difficult, I might have a very different understanding of my depression. But the truth is that I had a pleasant childhood, my parents loved my brother and me dearly, and we brothers got along well with each other. My family was so close that I never even imagined my parents getting divorced or having any real conflict because they loved each other so much, and although they did fight about little things like this and that from time to time, they never doubted their wholehearted devotion to each other and to my brother and me. Our life was never rich.
I wasn’t very popular in elementary and middle school, but by the end of high school I had my own circle of friends and was happy with them. I also always did well academically. As a kid, I was a bit of a shy kid, afraid of rejection in public – but who isn’t? By the time I was in high school, I was aware that I was sometimes emotionally unstable, but that’s not unusual for an adolescent. Then I went to college, where I had an incredibly happy time and met a lot of close friendships that continue to this day. I studied hard, had fun, and expanded emotionally and intellectually to a whole new breadth. There are moments when I am alone and I suddenly feel a sense of loneliness or even fear. This happened only occasionally and had no serious consequences.
Then I went to England for my master’s degree, and when I finished my studies, I began to write professionally. I lived in London for a few years, had many friends, and experienced some love affairs. In many ways, everything was pretty much as it had always been.
I’ve been making a good living, and I’m grateful for that. To the outside world, I was doing well.
So where is my depression coming from? I had to find out where it came from, whether it had always been there, but had previously been hidden under the surface, or whether it had come on suddenly like food poisoning.
2
After my first meltdown, I spent several months uninterruptedly and originally documenting the difficulties I had experienced in my early years. Only slowly did I find some hidden “clues” in the past.
I was born in a breech birth, and some authors believe there is a correlation between breech birth and early trauma. I have dyslexia, but my mother recognized it early and started teaching me ways to compensate for it when I was 2 years old, and it never really bothered me. As a child, I was verbal but uncoordinated. I asked my mother about my earliest traumatic experiences, and she said that I didn’t learn to walk easily, and that while I learned to talk seemingly effortlessly, motor control and balance developed late and not very well. She told me that I was always falling down and that it took a lot of encouragement to even just get me to try to stand up. Naturally, I wasn’t very athletic after that, and that didn’t make me very popular in elementary school. Not being understood by my peers certainly made me sad, but I always had a few friends and always enjoyed the company of adults, who also liked me.
I have many weird and messy memories of my childhood, but almost all of them are happy. A psychoanalyst who had been treating me told me that there was a vague thread of early memories that I was not very aware of myself, which in her opinion could mean that I had been sexually abused as a child. This is certainly possible, but I have never been able to string together a convincing recollection of this, nor can I find any other evidence. If anything happened, it must have been very minor because adults inspected me very carefully as a child and if there were any bruises or injuries, they would have seen them.
However, I remember a trivial scene that happened at summer camp when I was 6 years old, and I suddenly fell into fear for no reason that is still vivid in my mind: the tennis court in front of me, the dining hall on my right, and a large oak tree about 50 feet away from the dining hall, under which we were sitting listening to a story. Suddenly, I couldn’t move a muscle. I couldn’t help feeling that something terrible was going to happen to me sooner or later, and I couldn’t get out of it as long as I was alive. Until then, life seemed to have been a solid ground on which I was grounded; but suddenly the ground softened and caved in, and I began to slip down into it. If I stood still, I might be okay, but if I moved, I would be in danger again. Whether I should move left, right or forward seemed to be an unusually important choice, but I didn’t know which direction would save me, at least not at the time.
Fortunately, an instructor came up to me and told me to hurry up, that I was already late for the swim event, which broke that emotion, but for a long time I remembered that feeling and just hoped it wouldn’t come back.
I don’t think it’s uncommon for small children to experience this type of thing. While existential anxiety in adults can be painful, it can usually be fought with self-awareness; the first realization of human frailty, the first learning that people will eventually die, is too cruel and devastating an experience for a child. I have seen this happen to my nephew and several godchildren. It would seem too romantic and silly to say that at Camp Grant Lake in July 1969, I understood that I would eventually die; but I did discover then, unintentionally and for no apparent reason, that I was vulnerable, that my parents were not in control of the world and everything that happened in it, and that I would never be in control of it.
I have a bad memory, so ever since that incident at summer camp, I was always afraid of what the passage of time would take away, so I would lie in bed at night and try my best to remember the events of that day so I could keep them – it was an invisible possession. I especially cherished the goodnight kisses my parents gave me before I went to bed, and at one point I slept with a layer of tissue paper under my pillow, thinking that if those kisses slipped off my face, they would still be caught in the tissue so I could tuck them away and keep them forever.
I’ve been aware of my sexual confusion since high school, and I think it’s been the most difficult emotional challenge of my life to deal with. I used my sociability to cover these things up so that I didn’t have to face them head on, a basic defense that lasted until I graduated from college. For a few years I wasn’t quite sure of my sexuality and had emotional experiences with both men and women for quite some time, which especially complicated my relationship with my mother.
Every now and then I would fall into an intense anxiety without a specific object, strangely mixed with sadness and fear that came from nowhere. This feeling assaulted me, sometimes on the school bus when I was a kid, sometimes when the raucous noise of college Friday nights drowned out the hidden darkness, sometimes when I was reading, sometimes when I was having sex. This feeling always hit me whenever I left home, too, and it’s still incidental to every departure I make. Even if I’m just going out for a weekend, it will enter abruptly the moment I lock the door and turn around. When I return home, it usually comes in as well. My mother, a certain girlfriend, and one of our dogs would greet me when I came home, and I would be so sad that the sadness would frighten me. My way of coping was to force myself to interact with people, which almost always distracted me. I had to play upbeat tunes all the time to escape this sadness.
I had a mild breakdown the summer after I graduated from college, but I didn’t know what it was at the time.
I was traveling in Europe and having the summer I had always dreamed of. That could also be considered a graduation gift from my parents. I spent a wonderful month in Italy, then went to France, and then to Morocco to visit a friend. When I arrived in Morocco I was intimidated. I seemed to be free from too many of the usual restrictions and had become too free, which made me feel nervous every moment, like waiting backstage before the opening of a school play. I went back to Paris, saw some friends, happily revisited our old times, and then went to Vienna, the city I always wanted to visit. I couldn’t sleep in Vienna, however: when I arrived, I checked into a B&B, met up with some old local friends, made plans to go to Budapest together, and we had a good time all night; afterwards I went back to my place and stayed awake all night, horrified by the mistake I thought I had made – even though I didn’t know exactly what mistake I had made.
The next day, I was still too fidgety to eat breakfast in a room full of strangers, but after going out, I felt better and decided to visit some artworks, thinking in my mind that maybe I had overscheduled earlier. My friends had other plans for dinner, and when they told me, I felt a jolt in my heart, as if they were telling me a murderous plan. They promised to meet me for a drink after dinner. I didn’t have dinner, I just couldn’t walk into a strange restaurant and order my own food (even though I used to) or talk to any of them. When I finally met my friends, I was shaking all over. We went out for drinks, and I had never had so much to drink before, and felt temporarily calmer. I stayed up all night again that night, with a splitting headache, a churning stomach, and an unstoppable worry about the voyage to Budapest.
Then I made it through another day, and by the third night I couldn’t sleep, I was so scared all night that I couldn’t get up to go to the bathroom. I called my parents and said, “I’m going home.” They were surprised, because before this trip I had been haggling with them for an extra day and an extra place to go, hoping to extend my stay abroad as long as possible.
They asked, “Is something wrong?” All I could say was that I wasn’t feeling well and that nothing about the trip was as exciting as I had expected. My mother was sympathetic and said, “It’s really not easy to travel alone. I was thinking before that you were meeting friends; but even that can be exhausting.” My father said, “If you want to go home, just swipe my card and buy a ticket back.”
I bought the ticket, packed my bags, and returned home that afternoon. My parents picked me up at the airport. “What’s wrong?” They asked. All I could say was that I couldn’t stay any longer. Their hug made me feel safe for the first time in weeks. I cried as if I were relieved. When I got back to the apartment where I grew up, I was depressed and felt stupid. I had screwed up my big summer trip and had to return to New York, where there was nothing to do but the usual chores. I didn’t even get to see Budapest. I called a few friends and they were surprised to learn I was back. I didn’t even want to explain what had happened. I stayed home the rest of the summer, and even though I had some pleasant times with my family, I still felt bored, bored, and mopey.
Over the next few years, I gradually forgot about these events. After that summer I went to England for my master’s degree and started a new life in a new country, at a new university, without panic. I quickly adapted to my new life, made new friends, and did well in my studies. I loved the UK and nothing seemed to intimidate me anymore. The anxious me from before stayed in college in the US and was replaced by a strong, confident, easy-going me. If I throw a party, everyone wants to come. I could talk to my closest friends (who are still my best friends to this day) at night and enjoyed the deep and quickly established intimacy. I called home once a week, and my parents noticed that I was happier than ever. I sought out companionship when I felt restless, and I always found it.
I was happy most of the time during those two years, and only unhappy when the weather was bad, when I had trouble getting everyone to like me right away, when I was sleep deprived, when I started losing my hair, and other situations. The only depressive tendencies came from nostalgia: unlike Edith Piaf, I was remorseful about everything simply because it was no longer there; as early as age 12, I was already lamenting the passage of time. Even at my best, it seemed like I was wrestling with the present, trying in vain to prevent the moment from becoming a thing of the past.
Eighteen months after completing my master’s thesis, I decided, almost on a whim, to become an adventurer. I began traveling between Moscow and London, and while in Moscow, I illegally drifted into abandoned houses with local artists.
One night I was robbed in Istanbul, I resisted successfully and the robbers ran away without taking anything from me. I gave myself permission to consider every sexual possibility, leaving behind most of my repression and fear of eroticism. I grew my hair long and cut it short. I performed with a rock band a few times and went to the opera. I had developed a desire to have all kinds of experiences, and I went to as many places as I could afford to get as many experiences as I could. I fell in love and had a pleasant living arrangement.
3
In August 1989, when I was 25 years old, my mother was diagnosed with ovarian cancer and my world, which I thought was impeccable, began to crumble.
I’ve since thought that if she hadn’t gotten sick, my life would have been completely different; if the story had been less tragic, maybe I would have been depressed all my life but not broken; maybe I would have broken down later in life and let depression be part of my midlife crisis; or maybe I would still have broken down at the same time and in the same way.
If the first part of my emotional journey is the precursor phase, then the second phase that follows is the trigger phase. Most severe depression has mild precursors to depression, many of these precursors go unnoticed or for unknown reasons. Of course, there are many people who have never suffered from depression who, when they look back at their life experiences, can find periods of time that can be called precursors to depression, periods that are forgotten because the illness they may have triggered never really developed.
I won’t go into detail about how everything falls apart a little bit. For those who understand this consuming disease, it is clear; for those who don’t, it is probably inexplicable, as it was for me at age 25. In 1991, my mother died at the age of 58. I was devastated. Despite the many tears I shed and the great sadness I felt, and despite the loss of someone I had relied on for so long, I was fine in the time after my mother’s death. I was sad and angry, but I did not lose my mind.
That summer, I began to undergo psychoanalysis. I told the female analyst that I needed a commitment before I could start: unless she was seriously ill, she would carry on with the analysis until we finished it, no matter what happened. She was nearly 70 years old at the time, and she agreed. She was a charming, intelligent woman who sometimes reminded me of my mother. I depended on our daily meetings to keep my grief in check.
In early 1992, I fell in love with a smart, beautiful, kind and generous woman. During the time we dated, she was both wonderfully unbelievable and difficult to be around. Our relationship was turbulent, but mostly happy. in the fall of 1992, she became pregnant and had an abortion, which caused me to feel a sudden loss. in the fourth quarter of 1993, a week before my 30th birthday, we negotiated a breakup that was painful for both of us. Another cog in my life slipped away.
In March 1994, my analyst told me she was retiring because the long commute between her home in Princeton and New York was exhausting her. I had already felt that I was disconnecting from both of us and had considered ending my analysis; but when she broke the news, I still couldn’t restrain myself from crying for an hour. I’m not a frequent crier, and I hadn’t cried that hard since my mother died. I felt utterly alone and betrayed. Then, before she retired, we spent several months (she wasn’t sure how long it would take, and it ended up taking over a year) finishing up the analysis.
Later that year, in March, I told the analyst that I had lost my sensibility and that a certain numbness had affected my relationships with everyone. I no longer cared about love, about work, about family, about friends. I wrote slower and slower, and finally stopped altogether. The painter Gerhard Richter once wrote: “I know nothing, can do nothing, understand nothing. Completely and utterly. And such misfortune does not even make me feel particularly unhappy.”
I, too, found that all strong emotions were gone, leaving only restless anxiety. I’ve always had a strong lust (Libido) and often gotten into trouble for it, but that urge seemed to evaporate completely. I was accustomed to the desire for skin-to-skin contact or affection, but at this moment I could not feel any of it, neither the beings on the street, nor the acquaintances I once knew and loved, could attract me. Even in the midst of the sex scene, I kept wandering, thinking about what I hadn’t bought and what work I hadn’t done. I felt that I was losing myself, and I couldn’t help but be frightened. So I “arranged” a little pleasure into my life.
I went to parties throughout the spring of 1994 to try to cheer myself up, but it didn’t work; I went to see friends to try to get closer to them, but that didn’t work either; I bought expensive things that I had always wanted in the past, but they didn’t satisfy me; I pushed myself to do extreme things that I had never tried before, watching pornographic movies and buying extreme services from pornographers to try to awaken my lust. These new attempts did not particularly frighten me, but they did not give me any pleasure, or even any relief.
My analyst and I discussed the situation and came to the conclusion that I was depressed.
Together we tried to find the root of the problem, while at the same time I felt the disconnect slowly but relentlessly growing. I began to claim that the messages on my answering machine were taking my breath away and haunting me: I saw that someone had called, usually a friend, and I saw it as a weight. Every time I returned a call, more would call in. I also started to dread driving. When I drive at night, I can’t see the road and my eyes get drier and drier. I always felt like I would suddenly veer off and hit a guardrail or another car. Driving on the highway, I would suddenly realize that I didn’t know how to drive and would have to pull over in a panic, in a cold sweat. To avoid driving, I started staying in town for the weekend. The analyst and I reviewed together where this restless melancholy came from.
It occurred to me that maybe I had broken up with my girlfriend because I was in an early stage of depression, or maybe the end of the relationship had somehow triggered my depression. I tried to identify the root of the problem and kept redefining when the depression started: from the breakup, or from the time my mother died, from the two years after she became ill, from the end of the previous relationship, from adolescence, or from birth? Soon, I just felt that all moments, all behaviors, were signs of depression. But at that time I was still experiencing only neurological depression, more anxious sadness, and had not yet lost my mind. The situation still seemed to be under my control, and what I was enduring seemed to be some kind of continuation of past suffering, an experience with which many healthy people are also familiar to some degree. The onset of depression was as gradual as the onset of adulthood.
By June 1994, I began to feel a constant boredom. My first novel had been published in England, and despite the rave reviews, I felt nothing. I read the reviews indifferently and felt exhausted all the time, and in July I returned home to New York to find that socializing had overwhelmed me and that even conversation had become a burden. Everything didn’t seem worth the effort. The subway ride was even more unbearable. My analyst, who had not retired at the time, said I was suffering from mild depression. We discussed the causes of depression as if naming a beast would tame it. I knew too many people and did too many things, and I thought I’d try to cut back a bit.
In late August, I had a sudden kidney stone, a discomfort I’d had once before. I called my doctor and he assured me that he would notify the hospital and get me into the emergency room as soon as possible. However, when I arrived at the hospital, no one seemed to have received any notification. The pain from the kidney stones was excruciating, and as I sat there waiting, it felt as if someone had soaked my central nerve in acid that had eaten layer upon layer into the nerve’s naked core. I complained several times to several of the nursing staff about my pain, but no one did anything. Then it was as if something had suddenly snapped inside me. Standing in a cubicle in the emergency room of a New York hospital, I started screaming. They gave me a shot of morphine in my arm. The pain subsided, but soon returned. For five days, I was in and out of the hospital with four catheters; finally, the morphine dose was maxed out, and I had to have dulcolax injected every few hours.
The doctor said that my kidney stones were not showing clearly, so I was not a candidate for the faster-acting extracorporeal lithotripsy. Surgery was possible, but it would be painful and perhaps dangerous. I didn’t want to bother my father, who was on vacation in Maine; but now I wanted to contact him because my mother had been in this hospital before, and he knew the area well and might be able to help me make some arrangements. Yet he didn’t seem worried. “It’s a kidney stone, and it will drain out. I’m sure you’ll be fine. I’ll see you when I get home.”
During that time, I was getting less than three hours of sleep a night, still writing an extra-long article on political policy for deaf people, and drowsily communicating with fact-checkers and editors. I felt like I was about to lose control of my life. I said to a friend, “If this pain doesn’t stop, I’m going to kill myself.” I had never said anything like that before.
After I was discharged from the hospital, I was scared all the time. Both the pain and the painkillers were damaging my mind. I felt that the stones might still be in me and might come back. I was afraid to be alone. I went back to my apartment with a friend, grabbed some things and moved out. It was a week of wandering, and I moved from one friend’s house to another. They almost always had to go to work during the day, so I stayed at their house, stayed off the streets and took care never to stray too far from the phone. I was still taking prophylactic painkillers and feeling a little out of my mind. I felt angry at my father, an irrational, capricious, nasty anger. I chastised him for being indifferent to me, and he apologized, trying to explain that he was just trying to express his relief at learning that I was not terminally ill. He said I was quite bashful on the phone and made him feel at ease.
Instead, I went into a hysterical state and to this day I don’t understand how I became that way at that moment. I refused to speak to him or tell him where I had been. I called him from time to time and left messages on the answering machine, usually with the first line, “I hate you, and I wish you were dead.” I survived night after night on sleeping pills. Then I had a mild relapse and went back to the hospital, which wasn’t really serious, but scared me half to death. Looking back, all I can say is that I completely lost my mind that week.
That weekend I went to Vermont for a friend’s wedding. It was a beautiful late summer day. I had almost cancelled the trip, but then I heard about a hospital near the wedding and after learning more about it, I decided to give it a try. I arrived Friday night, just in time for dinner and the square dance (I didn’t go dancing). I met a semi-acquaintance that I knew in college ten years ago but had very little interaction. We talked and I felt the richest emotions I had felt in those years. I felt so radiant and intoxicated that I didn’t even think anything bad would happen again. My transition from one emotion to another was almost absurd.
After the Vermont wedding, I was on a downward spiral again. My work situation got worse and worse. I canceled my plans to go to England for another wedding, feeling that the trip was completely out of my control, even though a year earlier I had been traveling back and forth to London frequently without much trouble. I began to feel like no one would ever love me and felt like I would never enter a relationship again. I completely lost my sex drive and my diet became irregular because I rarely felt hungry. The analyst said that was also depression. I started to get tired of the word and the analyst. I said I wasn’t crazy, but was afraid I would go crazy. I asked her if she thought I would end up having to take antidepressants, and she told me that avoiding medication was the brave choice and that we could overcome everything together.
That conversation was the last one I initiated, and those feelings were the last ones I felt for a long time.
4
On October 11 of that year, a friend helped me throw a book celebration. I love parties and I love books, and I knew I should have been ecstatic, but the truth is that I had absolutely no interest in inviting many people and was too exhausted to stand for long at the party. The parts of the brain that govern memory and emotional function are distributed throughout the brain, but the frontal cortex and the limbic system play key roles. When the limbic system, which is responsible for emotions, is affected, memory is affected as well.
In my memory, the party is only a blurry outline and dark colors: gray food, earthy figures, and muddy light in the room. What I do remember is that I was sweating throughout the party and just wanted to escape the scene in a desperate attempt. I wanted to blame it all on stress. I was determined to maintain my image at any cost, and that impulse sustained me. I did, and no one seemed to notice anything different. I made it through that night.
I came home that night and began to feel scared. I lay in bed, unable to sleep, hugging my pillow for solace. Over the next two and a half weeks, things went from bad to worse.
Shortly before my 31st birthday, I had a complete breakdown. My whole being seemed to cave in. I stopped going out with anyone. My father offered to organize a birthday party for me, but I couldn’t stand the idea and we finally decided to just go out to dinner at one of my favorite restaurants with four of my closest friends. The day before my birthday, I only went out once to buy some side groceries. Just on the way home, I suddenly couldn’t control the small of my back and got a fecal stain all over it. I hurried home and felt the filth spreading. As soon as I walked in the door, I tossed the shopping bags aside, rushed into the bathroom, stripped off my clothes, and went to bed.
I didn’t get much sleep that night, and I couldn’t get up the next day. I knew I couldn’t go to any restaurants. I tried to call my friend to cancel the appointment, but I couldn’t do that either. I lay motionless, trying to talk, trying to figure out what to do. I moved my tongue, but couldn’t make any sound. I had forgotten how to speak. Then I started to cry, but there were no tears, just a staccato sound. I lay on my back and tried to roll over, but I couldn’t remember how to roll over. I tried to figure out how to roll over, but it seemed like an incredibly difficult task. I thought maybe I was having a stroke and cried some more. By about 3:00 p.m., I was able to get out of bed and go to the bathroom, and then I was back in bed shaking. Fortunately, my father called.
I answered the phone and said in a shaky voice, “You have to cancel tonight.”
“What’s wrong?” He kept asking me, but I didn’t know what was wrong.
My father had come to my apartment with a friend of mine and brought my brother and his fiancée with him. Luckily, my father had a key. I hadn’t eaten in almost two days and they wanted me to have some soup. Everyone thought I must have contracted some terrible virus. I took a few sips, then threw up all over myself. I couldn’t stop crying. I hated where I lived, but I couldn’t leave it. The next day, I managed to find a way to get to the analyst’s studio. I searched painfully for words and said, “I think I need to start taking my medication.”
“I’m so sorry.”
She said, and called a psychopharmacologist who was available to meet with me in an hour. My analyst died recognizing that we needed to seek help. A psychoanalyst I know, thinking back to the 1950s, said his supervisor told him that if he started a particular patient on medication, he had to stop analyzing that patient. Perhaps it was this outdated notion that kept my analyst encouraging me to avoid medication? Or did she also believe in the state I was struggling to maintain at that time? I will never know.
The psychopharmacologist, who was in his 70s, smoked a cigar, spoke with a Central European accent, and wore fuzzy slippers, asked me a series of questions: How did I feel in the morning compared to the afternoon? How difficult is it to laugh at anything? Do I know what I’m afraid of? How has my sleep and diet changed? I answered him to the best of my ability.
After I spilled the beans about my horrible experience, he calmly said, “Well, um, that’s typical indeed. Don’t worry, we’ll get you better soon.” He wrote a prescription for Xanax (Alprazolam) and rummaged around for a “newbie packet” of another drug, Zoloft (Sertraline), and then gave me detailed instructions on how to start taking it.
“It takes a while for the Zoloft to kick in, but Xanax will relieve your anxiety right away. Don’t worry about drug addiction or anything like that; now is not the time to think about it. Once we’ve relieved your anxiety, we’ll be able to see your depression more clearly and fix it. Don’t worry. Your set of symptoms is very common.”
5
The first day I started taking the medication, I moved into my father’s apartment. My father was nearly 70 years old at the time, and most people that age have a hard time tolerating huge shifts in their lives. I want to praise my father, not only for his selflessness, but also for his flexibility of mind and spirit in understanding how to support me during that difficult time and for being my pillar of support with great courage. He took me home from the doctor’s office. I didn’t bring a change of clothes, but I didn’t really need to because I barely got out of bed for the next week.
At that time, panic was the only thing I felt. If I took a full dose of Xanax, it would ease the panic, but a full dose would be enough to put me into a coma, muddled and dreamy. That’s how I spent those days: I woke up knowing I was in the middle of an extreme panic attack. I just wanted to take enough anti-panic medication to fall asleep again, and I wanted to stay asleep until I got better. I woke up again a few hours later and wanted to take more sleep aids. Whether it’s suicide or dressing, it’s too complicated for me to spend hours trying to figure out how to do something like that. All I wanted was for “it” to stop, and I couldn’t say exactly what “it” was. I can barely speak.
I had always felt intimate with words, when they suddenly became complex and incomprehensible metaphors that took far more energy to use than I was capable of. Julia Kristeva writes: “Melancholy ends in the loss of meaning …… I grow silent until I die …… The melancholic speaks their native language and also like a stranger. Their lifeless language foreshadows their suicide.”
Depression, like love, is a cliché, difficult to speak without using those sweet, popular words; the experience of depression is so vivid that it seems utterly impossible for others to understand any similar feelings. Emily Dickinson’s description of this breakdown is perhaps the most delicately written and moving to date
I felt a funeral in my head.
I felt a funeral in my head, a mishmash of mourners going and coming.
I felt a funeral in my head, a clutter of mourners’ feet, stepping – stepping – until
The feeling burst out of the cocoon…
When everyone is seated.
The ceremony begins, like a drum…
Beat it – beat it – until
I felt my heart grow numb –
Then I heard them carrying the coffin.
Wearing the same leaden boots.
And once again, through my soul, creaking.
And then the air – the bells rang out.
As if all the heavens had become a bell of death.
existence is but an ear.
And I, with the silence, am an alien race
Here, wrecked, standing alone…
Then a plank of sanity suddenly broke off and
I fall down, fall down…
Each time I fall, I hit a world.
And then, with each fall, I hit a world, and perception overwhelmed…
I remember lying motionless in bed crying because I was too scared to get up and take a shower, but at the same time I knew there was nothing to be afraid of. I kept repeating in my mind a series of individual steps: you get up, put your feet on the floor, stand up, walk from the bed to the bathroom, open the bathroom door, walk to the tub, turn on the shower, stand underwater, wipe your body with soap, rinse off, step out of the tub, dry yourself, walk back to the bed. 12 steps that were as hard for me as the crucifixion that Jesus carried on his back. But rationally I knew that showering was easy, I had showered every day for years, did it very quickly, took it very much for granted, and had absolutely nothing to say. I knew the 12 steps were perfectly doable. I also know that I can even get someone else to help me do a few of the steps and I’ll have a few seconds of breathing time to not think so much about it and someone else can help me get the bathroom door open. I think I could do about two or three of these steps on my own, and with all my strength, I could sit up, turn around, and put my feet on the floor; but then I would feel so weak and scared that I would just turn around and flop down, with my face buried in the bed and my feet still on the floor.
Sometimes I would start crying again, not only because I was incapable of doing this, but also because this inability made me feel incredibly stupid. Everyone in the world is showering, so why can’t I, why? Then I’d think about all the people who had families, jobs, bank accounts, passports, dinner plans, and problems of their own – real problems, like cancer, hunger, failure, children dying, loneliness …… My problems were nothing compared to mine. My only problem was that I couldn’t turn over and had to wait a few hours until my father or one of my friends would walk in and help me lift my feet back into bed.
By this time, the idea of a shower had become silly and unrealistic, and I would be relaxed because my feet were back in bed and I could continue to lie in the bed that gave me a sense of security while feeling ridiculous inside. Sometimes, in a quiet corner of my heart, there is a little laughter that laughs at this absurdity. I feel now that it is because I can still see this that has gotten me through it all. In the back of my mind, there was always a calm and clear voice that said, stop being so sentimental and stop fooling around. Take off your clothes, change into your pajamas, go to bed; get up in the morning, get dressed, and do what you need to do.
I always hear this voice that sounds like my mother. When I think about what I’ve lost, I feel only a sadness and a terrible loneliness. “If I quit this war of attrition, would anyone – not the hotshot cultural centers, but anyone, even my dentist – really care?”
In a confessional essay, Daphne Merkin wrote of her own depression: “Would people mourn for me if I never returned and never played my part again?”
By late afternoon, I can usually get up. Most depression has a diurnal pattern; it gets worse during the day, wanes at night, and then gets worse again the next morning. I couldn’t eat at dinner, but would get up and sit in the dining room with my father, who had canceled all other arrangements in order to keep me company. By this time I was able to talk and would try to explain my condition. Some nights, my father would read me the stories he had told me when I was a child. I would stop him and say, “I published my novel two weeks ago!” And then turn around and say, “I used to work 12 hours a day and then rush to four parties at night. What’s wrong with me?”
My father would still optimistically assure me that I would soon be back to being like I was before. But it was as if he was telling me that I would soon be able to knead a helicopter out of dough and fly it to Neptune.
It was obvious to me that my real life, the life I used to lead, was gone for good. Every now and then, the panic would rise for a while, and then a sense of calm despair would strike. It was all unexplainable, illogical. It was hard to tell people that I was depressed – my life was going so well, I had so much love, and I was materially wealthy. To everyone except my close friends, I invented an “unidentified tropical virus” that “I must have caught on my trip last summer”.
In depression, you are always told that your judgment will be compromised, and part of depression is that it involves perception. Just because you’re falling apart doesn’t mean your life isn’t a mess. There are issues you’ve managed to bypass and avoid for years in the past, but at the moment they all come out of nowhere, staring you right in the face. One aspect of depression is that you come to the profound realization that all those doctors who tried to reassure you and say you were misjudged were wrong. You are indeed touching on the real scary parts of life. Afterwards, after the medication has taken effect, you are rationally able to accept the blows and cope better, but you cannot escape them.
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