Tour de force might seem an overwrought description of most works, but when it comes to Andrew Solomon’s 2001 book, The Noonday Demon: An Atlas of Depression, his book lives up to its billing. Quite literally, the book delves into every possible facet of depression (and to a somewhat lesser extent, anxiety), including its history, its treatments (as well as alternative treatments), its political and evolutionary contexts, and interspersed throughout is a duality of Solomon’s own biographical story and struggle with depression, and his journalistic endeavor, having interviewed numerous people who also struggled with depression. He also covers the dual diagnosis of substance use disorder and depression, how depression is particularly pervasive among the poor and aging populations, and all the while, he globe-trots from a state mental health institution in Pennsylvania to an alternative treatment experience where he is doused in sacrificial lamb’s blood in Senegal to an incredibly impressive woman, Nuon Phaly, who helped other women in the wake of the brutal Khmer Rouge in Cambodia under Pol Pot in the 1970s. I forget how I came to know about Solomon’s seminal book about depression, but I wasn’t ready for it until this past week. When I first tried to read Solomon’s work, I was still in the throes of depression and suicidal ideation. The book didn’t yet seem accessible as a result (is that ironic?), and admittedly, the book is still not the most accessible book I would recommend to someone who has struggled with depression and/or would like to better understand depression because it’s such a dense, sometimes in-the-scientific-weeds tome. All the same, even written more than 20 years ago, I found Solomon’s work to be an important addition to my understanding of depression as of one of its many victims.
Solomon’s mother contracted cancer in the early 1990s, and subsequently, when it was apparent that she would die from it, she took her own life. That led to Solomon’s first mental breakdown and deep depression. Solomon’s depression is perhaps the one we most think about it when conjuring up an image of depression: the debilitating kind, where the person is unable to get out of bed, to function day-to-day, and even to take care of themselves in any basic way. Solomon was so depressed and willing to die, albeit unwilling to directly do the act himself — he made a relatable point that for the depressed person, depression “had taken from me the energy I would’ve needed to kill myself, and it would not kill me.” — he began seeking out very public rendezvous with men in order to contract HIV and die that way. It didn’t work, and then he got scared about passing the HIV on to others. Fortunately, Solomon had a doting father, brother, and a slew of friends who helped him get back to mental wellness.
I found much of Solomon’s book compelling, but chief among them was him reaching back to the days of Hippocrates in the 5th century B.C.E. to Aristotle a couple centuries later to the Roman period, the Middle Ages, the Renaissance, the Enlightenment, right up to the pre-industrial and Industrial Revolution, and our modern era of (at the time for him) faxes, emails, and cell phones. In other words, philosophers and physicians alike have been trying to understand what was then called melancholia since humans have been philosophizing and trying to heal each other. To put a finer point on it: Depression is not a manifestation of our capitalist (or how some would derisively call it, late capitalist) society. Depression, or the darkness as it has been likened to dating back to antiquity, has seemingly always been a feature (or a bug?) of human consciousness, which is why Solomon devotes a chapter to evolution and what, I think today, would be called evolutionary psychology (the field started in the 1980s, but I don’t think it became fashionable until after Solomon’s book was published). That is, why would natural selection select for the gene that brings us such despair and often, lessens reproduction? Perhaps its apiece with grief, a related cousin of depression, as an adaptive measure to both shield us and allow us to love and experience joy in even greater measure. Like other issues evolutionary psychology has tackled, such as human violence, or our fight or flight response, those were evolutionary adaptive strategies at one point in our past as a species, but they don’t largely don’t serve any use today, and that could be the case with depression. I think Solomon believes that, but also leans into the idea, especially pronounced at the end of the book, that depression is “good” for us in that it makes people of good character better, if they are able to survive depression, that is. He also points to the idea that humans are the only ones (save some primates) who have developed the three brain stages of reptilian, limbic (the emotional), and neocortex (the rational), and that subsequently gave us consciousness and self-consciousness, resulting in melancholia. In any event, I do think Solomon somewhat contradicts himself by later blaming much of modern society (he overemphasizes the dangers of overpopulation, for example) — to be fair, he also hedges with how much he adores modern society and its conveniences — for the rise in depression and suicides.
One area of depression that Solomon didn’t dive deeply into, and which more reflected my reality, is the functional depressive. The one who can get out of bed, generally take care of themselves and their environment, continue on with work, and some semblance of relationships with family, friends, and coworkers, but all the while, they are ravaged by depression and suicidal thoughts. That was my experience. Solomon himself, and those he interviewed were more besieged by the total inhibitor kind of depression, and the one that even leads to hospitalization. Nonetheless, I was also pleasantly surprised that Solomon was supportive of SSRIs, or selective serotonin reuptake inhibitors, and in general, pharmaceutical remedies for depression, anxiety, and suicidal thoughts. Because they saved his life. They also saved my life. And on the whole, I think such antidepressant medications, and others beyond the SSRIs, have been one of the most important medical advancements of the last 100 years. But of course, talking therapy matters, too! And sadly, there are also those who have run the gambit of every known medication and dosage, and talking therapy and endured hospitalization, and still can’t seem to extricate themselves from their mental disorders. That is where the book gets into particularly thorny territory exploring involuntary hospitalization. Solomon doesn’t know what the answer is, which I appreciate him admitting he doesn’t know where he lands on that question or what the right answer may be for society and its individuals. For the record, my civil libertarian mind recoils at any thought of involuntarily committing someone to a hospital because I absolutely, and rightly I think, worry about anyone having such power and delineating what is and isn’t a mental illness and what rights those deemed mentally ill have. Somehow, more than 20 years later, much of the conversation is still salient, especially the aspect Solomon mentions of the mentally ill and the rare violent events that occur in society, like public mass shootings. In other words, the tension that exists between “protecting” society from violent individuals, but also protecting the mentally ill from stigma and ostracization.
Just as people underestimate, for example, their chances of becoming homeless at any given moment, owing to seeing those who are homeless as stricken by their own character flaws and our own maneuvering through the world as with an impervious character of virtue, Herbert Kleber of Columbia, makes the astute point in the book that people “are very poor judges of their own susceptibility” when it comes to drug addiction (the context is Solomon’s chapter on dual-diagnosis and addiction). In other words, nobody seeks out to be homeless, nor does anyone seek out to be an addict. I thought that was worth interjecting here, as nobody is also choosing to be bed-ridden by depression.
Solomon’s chapter on suicide was interesting, of course, but I wasn’t totally sure of his point that “suicidality has been treated as a symptom of depression when it may in fact be a problem that coexists with depression.” I don’t see how to extricate suicidality from depression and vice versa, barring rare exceptions. That said, Solomon is right that it makes sense the ancient thinkers would think of depression as an overproduction of “black bile” (which doesn’t actually exist) because of the view that depression and suicidal thoughts feel like an invasion from a virus, or as Solomon poignantly describes his suicidality, “I had been hijacked by strangeness.” I was particularly intrigued to read Solomon describe skydiving as a “para-suicidal” activity. Solomon, like me, has been skydiving, and like me, felt in some sense that it was a “para-suicidal” activity. In other words, if he or I were not as depressed as we were, we likely wouldn’t have been able to overcome our traditional fear of jumping out of a plane to skydive.
Related to suicide, I’ve already mentioned, in part, two of the three facets for “beating” depression (I think it’s more accurate to say you can beat it into remission, but it’s never gone), psychologically and biologically, but the third facet is just as interesting: faith. Naturally, for centuries, any talk of suicide was heretical against it as a sin in the eyes of the Church. Admittedly, I don’t know where I gained this prevailing idea, but I’ve thought about hell, if it were to be a thing, not as a manifest place where the Devil dwells, but rather, as the absence of God. To be in a world without God is hell enough, an unfathomable hell. In that vein, early Christians saw depression as the “noonday demon” sent by God to punish sinners, and Solomon signals that as the gestation of stigma against those with mental illness. Dang, that is fascinating! I never put two-and-two together on such a throughline. I also didn’t realize Judas committed suicide, and if Judas was melancholic enough to commit suicide, then it follows (in the eyes of Christians of the time) that those with melancholia are “Judas-like in their carnality.” “Noonday demon” itself comes from Psalm 91:6: The destruction that wasteth at noonday. Solomon took that as the title because it’s an apt understanding of depression: it doesn’t come at night; it comes in the light of day to wreak its havoc.
However, I would also be remiss if I didn’t mention I absolutely understand the appeal of turning to faith when in a depressive and suicidal state. I’m not religious, but I do find it appealing that no matter how low my self-esteem and estimation of myself may be, Jesus still loves me. God still loves me. Warts and all.
Interestingly, Solomon talks to a number of representatives of both political parties who at the time were championing mental health and trying to convince their colleagues of its importance, mainly, with regards to budgetary funding. One of the representatives he talked to struggled with depression in her early 20s. She and Solomon mention how taboo it is to talk about depression as a politician, so as to not seem weak or ineffectual, or that you would be unable to perform your duties. I was surprised Solomon said he doesn’t think someone with depression could be president. That doesn’t seem fair. Nonetheless, more than 20 years later, politicians are still not exactly known for openly talking about their mental health. Only recently did the junior Senator from Pennsylvania, John Fetterman, make headlines by openly talking about being committed to a hospital for his depression. Good for him.
One of my favorite aspects of Solomon’s work is how he interjected poems and sayings about depression throughout the book. Just as philosophers and physicians have been trying to understand and explain depression for thousands of years, so, too, have they and poets, artists, and others, been trying to explain depression through words and their art. I could fill up pages of those insights, but some of the ones I appreciated follow (the ones without citation I believe came from Solomon himself), including the opening quote from the book by Mikhail Bulgakov’s The White Guard:
Everything passes away — suffering, pain, blood, hunger, pestilence. The sword will pass away, too, but the stars will still remain when the shadows of our presence and our deeds have vanished from the earth. There is no man who does not know that. Why, then, will we not turn our eyes toward the stars? Why?
Grief is depression in proportion to circumstance; depression is grief out of proportion to circumstance.
The man who kills a man kills a man
The man who kills himself kills all men.
As far as he is concerned, he wipes out the world.
– G.K. Chesterton
The opposite of depression is not happiness, but vitality.
Indeed. It is not happiness necessarily that I sought when depressed, it was vitality. To not feel like I was carrying around a crushing weight every second of every day. To not be behind the veil of suicidality every second of every day. And in a sense, Solomon is right at the end of his book, in his last chapter, “Hope,” that going through depression and coming out with more vitality than before, almost makes depression a worthwhile experience, if one can think of it in that fashion. I feel like since becoming mentally well after my own long-standing bout with depression and suicidality has served to make me more animated and energetic in living live to the fullest than ever before.
If you made it this far, thank you. It is a long book, and to do it any kind of justice in my review necessarily requires a lot of words. I think even more than 20 years after its publication, there is much someone who has gone through depression can appreciate and learn from Solomon’s tour de force of a book. I also wish those who don’t yet understand depression would read it, but as I previously said, unfortunately, I’m not sure it is accessible to the unconverted, as it were.