Human experience of depression

The beauty of anything that’s written in the form of a set and specific story is that it transcends the existing normative meaning. It also transcends understanding of the existing social phenomenon and the respective contours of individual consciousness and psychological make-up. The book in the current context falls in the same sphere of scratching the surface of being (temporizing and rationalizing) in the conflict of modern fast driven life and the concurrent crisis young people beget in their adrenaline surcharged identities. Immediately fascinated by the post-modern anecdotal title of the book Noonday Demon-An Atlas of Depression, much of the story gets into the reader as how and why the lifestyle makes person’s identity altered in the same space and time slices. Book then starts with the trajectory of protagonist being cast in an environment which is full of gory and at the same time existential realities of our everyday life. There is a dialectical relationship that springs up in the portrayal of psychopathologies and simultaneously the author’s confrontation with the depression setting the scene for the structure of the book. This relativizing of the inner and external dissociation further makes the subjects more disillusioned and at times thoughts of self-harming, in bouts, continuously hover over their heads day in and day out.

Time Magazine remarked on the book as “the book for a generation, elegantly written, meticulously researched, empathetic, and enlightening”. The Times lists the book as ‘Best Hundred Books of the Decade’ This book is a result of 5 years effort of author on charting the basic and quintessential aspects of depression spanning nearly 600 pages with twelve dense chapters and 35 page bibliographies covering more than 700 sources.

An Atlas of Depression

Andrew Solomon is a professor of Clinical Psychology at Columbia University having  his PhD form Cambridge University in psychology writes regularly for  the New Yorker, Guardian, , and the New York Times. The bestseller book under review has won the National Book Award (2001) and was a finalist for the Pulitzer Prize(2002), and published in twenty-four languages. Solomon has profoundly been active in the mental health, education and the arts activism and has lectured about the depression from TED talks to the institutions of high reputation and excellence like Princeton, MIT, Cambridge, Harvard, Yale, Library of Congress etc. The book is laden with thorough and incisive philosophical, literary and most important empirical commentary on the depression through personal, cultural and scientific prism. The book immaculately draws the labyrinth of depression with the lyrical prose and delightful flow. The reader immerses in the lines like “Every morning and every night, I look at the pills in my hand: white, pink, red, and turquoise. Sometimes they seem like writing in my hand, hieroglyphics saying that the future may be alright and that I owe it to myself and live on and see”(p.30).  Solomon thinks of depression as a demon as “it was eating me alive” There is the mapping and spatial contouring  of depression behaviours and geographies being accounted from Senegal to Aztec rituals for coping with depressive disorders thus the book’s sub-theme –An Atlas of Depression. Kirkus Review while reviewing the book considered it “reader’s guide to depression, hopelessly bleak yet heartbreakingly real” as one gets engrossed into the depressing tales of case studies and burgeoning manifestations of  conflicting yet realistic encounters of modern day ephemeral positioning of individual and socio-psychological sensitivities of life. The unique speciality of the book lies in its condensing and translating the huge information into the meaningful and riveting story about the ‘concept’ that is as ubiquitous as the air we breathe.

Debating Depression

The elusive explanation of depression has always been a source of academic debate for quite a long time as depression for most part of the human history was not codified fully into the medical manual as other disease of the body. As profession of psychiatry became a specialised and systemic field in 20th century but still the diagnosing in psychiatry and clinical psychology is unable to categorise the psychiatric and psycho-pathological conditions with precision given the dynamic and enigmatic basis of Descarte’ian Mind/Body dualism. Today, depression—the clinical condition, also known as major depressive disorder—is defined by the American Psychiatric Association in its Diagnostic and Statistical Manual-5 as a mood disorder. The reliability of diagnosis is measured with a metric (kappa coefficient) that ranges from 0 to 1. Kappa of 1 signifies that two clinicians agree each time whether the person has the disease or not. If the kappa is 0, then the two clinicians never agree, and the system of diagnosis is completely unreliable. A kappa of 0.7 is considered to be good. The kappa for Major Depression in the DSM-5 is 0.28 and for Alcohol Use Disorder it is 0.40. This is a bewildering fact that psychiatrist’s cannot diagnose depression accurately as one registering it as depression and another might consider it as bi-polar or schizophrenic disorder Equally qualified, yet both have different labels for the same person. The book deals with the same theme in the first two chapters of ‘Depression” and “Breakdown”.

Stigmatising Depression

The next meandering course book takes is diving into the past and future of subject’s illusions, disillusions and the curtaining up of the innermost desires and their tussles with the mores and regimented social codifications. Success and brilliance of any book lies in its author’s experiential wisdom and his grip on the radiating dynamics of intrinsic/extrinsic fabric and Andrew Solomon has impeccably lived up to that measure of dissecting this psychodynamic conflict. The book then frays into the onset of upheavals that depressive persons undergo which never get into their familial and active social consciousness. From the transitional shifting of low level stresses to coming into the scene of entering into the more fleeting temporal and psychological graduations the reader is set on in an interesting spree of happenings in the same set of initial conditions. Getting straight into the swinging acquaintances with the author’s life running into episodes from the intense cravings to the quizzical dull afternoons where he thinks of running far away from this chaotic whole. In every book there is a moment of intense twist and that centrality sets the book and backscatters the coming reflections and mostly is the moment where the character trajectory just becomes serious and the shadows of main topicality get lit up. In this book the moment just drops in when the author uses his own experiential tryst with the depression as he feels life jumping into the fast life and bubble environs of  life with his targets and inner desires come into antagonistic terms and is just caught unawares of the happenings that strike him. Just like   South-Asian   mentality of hiding their overstressed and depression bouts there are numerous examples where the subjects of this memoir resonate with the same stigma being attached in having the signs of wheeling into the web of depressive pits. There are the scenes of intra-psychic confrontations pushing the people into the   existential trap of nothingness and nihilistic bubble with depression being far more ‘chemical imbalance’ (as the Solomon says) and biological than emerging from the hubris of existential angst which the author has thoroughly deliberated upon. That’s why book is laced with the thoughts interspersed from the literary expressions of thinkers like Ovid, Shakespeare, F. Scott Fitzgerald, Anton Chekov, Primo Levi, Emily Dickinson, T.S. Eliot, Pliny, Schopenhauer, in the situations of their own experiences with depression or their knack of depicting it so clearly. The more one houses this perforating enigma into his individual fettered self, more the psychic discord becomes intensified. The psychological fluctuations and the ‘expectation’ line of thought turns the disabling self into the relative picture of vibrant and sociable being letting the mind dig into his uneven fate. Everything that keeps you restless and depressed reaches to a stage where you try to keep yourself afoot and find the comforting positions. Likewise Author speaks out everything about recounting his experience from counselling where initially he at times gets more fed up and in this process he tries to becalm himself waiting for the light to shine on his abysmal self by considering every ray as the new lease of life. The chapter ‘Populations’ surveys the age and gender specific dimensions of depression and post-partum forms of depression  and also lucidly elucidates the political, racist and societal causality of depression richly  illustrated through the martial law imposition of Poland in 1981(p.201) and the endemic linked depression in  Inuit(p.210) This book is a real treasure trove as the author has quoted more than 80 scientific experts from the fields of psychiatry, psychology, genetics, psychopharmacology, substance abuse, neuroimaging sociology, anthropology etc. The honesty and flawless approach of Solomon gets perspired at every instance without any ‘agenda’ while acknowledging and embracing the sincerity and willingness to novel, less-known ideas. ‘Addictions’ and ‘Suicide’ chapters discuss the underlying conditions linked to depression. The chapters of ‘History’, ‘Poverty’ and ‘Politics’ address the historical, socio-economic and political dimensions of depression ranging from ancient genealogy of depression to the modern day therapeutic  and social/juridical  responses to the depression.

Hope

The book goes beyond the reductionist perspective of depression and examines the historical and alternative ‘treatments’ for this psychological aberration while cataloguing the  genetic approach, treatment validation, evolutionary basis, herbal cures, electroconvulsive therapy, and Freudian psychoanalysis  in ways that are fundamentally exact and fathomable to the from the educated to lay reader. The books ends with ‘Hope’- closing chapter by the same name where the Solomon draws from his own story and his friends’. It is an inspiring read not only for those who are suffering from depression, but for every-one of us. Dealing with depression effectively is a mark not of weakness, but of strength as Solomon narrates the hopeful and sometimes meaningful detours of living with shadows of depression.

Tailpiece

The book closes with a testimonial to Solomon’s personal strength, resilience, and resolution. “I cannot find it in me to regret entirely the course my life has taken. Every day, I choose, sometimes gamely and sometimes against the moment’s reason to be alive. Is that not a rare joy?”(p. 427).Andrew Solomon continuing his pursuit of making people aware about the mental health has been active during this pandemic too and ‘Noonday Demon’ sales have increased as people have been confronted with both isolation and stress during these times also being referred to as   ‘lockdown blues’ .

Mir Sajad is a researcher, University of Kashmir