Woe Is Me 'The Noonday Demon' by Andrew Solomon Reviewed by Ana Marie Cox Sunday, June 24, 2001; Page BW08 THE NOONDAY DEMON By Andrew Solomon Scribners. 569 pp. $28 People often think of depression as a loss of self. But feelings of invisibility and isolation should not be confused with selflessness, or a lack of self-regard. Far from it: Depression is a paradoxically self-centered affair - a black, sucking hole of inward attention that turns the entire world into a gray backdrop against which one's own pain stands out in agonizing hyperreality. In fact, Freud proposed that depression stems from a kind of pathological egotism in which a fear of abandonment turns both love and hate inward toward the one person that will never leave: yourself. In his memoir-cum-cultural-history The Noonday Demon: An Atlas of Depression, pharmaceutical scion Andrew Solomon, himself a depressive, provides for acute sufferers of Freud's diagnosis a measure of hope that such solipsism does not have to prevent recovery. Even judged solely by the standards of the memoir, The Noonday Demon is remarkably self-indulgent. As an "atlas," it depicts a world view whose cardinal points are me, myself and I. It is difficult to criticize a book in which the author repeatedly reminds the reader of the harrowing mental anguish experienced while writing it; critical reproaches are, one fears, the epitome of kicking someone while he's down. And yet few books on depression deserve to be criticized as much as this one, all the more because it is poised to become definitive. The product of a million-dollar advance, blurbed by such luminaries as Adam Gopnik, Harold Bloom, William Styron and Kay Redfield Jamison, The Noonday Demon presents its 500-plus-page self as an exhaustive tour of the low-lying landscape of depression. But the book misses many things along the way, and we see everything through the author's expansive lens of "I." Solomon can be commended for undertaking what was undoubtedly intensive research, and for even attempting to tackle the profusion of forms depression takes, reaching into the realms of biology, philosophy, politics, gender and - a category often ignored - class. His chapters on these subjects handily summarize much of the existing literature, and give some context to the many debates (on treatment, on government policy) that depression raises. His report on the astoundingly unequal coverage insurers provide for treatment of mental disorders, as opposed to what some people still insist on calling "real" diseases, and the cost of that lack of coverage is particularly devastating. So, too, is his discussion of the paucity of mental health options available to the poor, who suffer depression at twice the rate of the rest of the population. But the presentation of this data suffers from Solomon's extraordinary ability to make any given piece of information relate to him. A discussion about the fitness of depressives for the workforce becomes an opportunity for Solomon to declare that "I couldn't be president, and it would be a disaster for the world if I were to try." The chapter on suicide occasions the insight "If I ever attempt suicide, I'd like someone to save me. . . ." The pseudo-clinical manner of these proclamations reaches a disturbing apogee when Solomon, again using himself as the prism through which all meaning is refracted, discusses the connection between violence and depression. He confesses that during one depressive episode he "became enraged" at a friend and beat him badly enough to break the friend's jaw and send him to the hospital. But, Solomon says, "part of me does not rue what happened, because I sincerely believe that I would have gone irretrievably crazy if I had not done it." Well okay, then. This smugness has a more global component as well. Solomon is fairly upfront about his rather intimate connection to the drug industry - he is the son of Forest Laboratories' CEO Howard Solomon, whose company distributes the antidepressant Celexa, and he follows through on his prologue's promise to minimize mention of his father's company and its products. He is, however, unabashedly in favor of ongoing pharmaceutical treatments of depression, advocating antidepressants constantly and castigating those "cynics who keep suffering patients from essentially benign cures." At one point, he goes so far as to laud pharmaceutical companies, which last year made about $10.4 billion off of anti-depressant medications and spent $90 million lobbying against prescription drug benefits in Medicare, stating that "it is perhaps nobler to make a profit by inventing cures for the ill than by inventing powerful armaments or producing pandering magazines." This is an interesting example of moral relativism, and a revealing one. Solomon also fails to consider how pharmaceutical companies influence our understanding and definitions of depression. In recent years, drug manufacturers have pushed out the boundaries of depression to include premenstrual syndrome and "social anxiety," or shyness. His blindness on this score is the book's greatest disservice. Writing a book about depression in the modern age and not even mentioning the impact of drug advertising specifically or consumerism generally is like leaving whole continents out of an atlas - though Solomon does that, too. He gives almost no notice of the experiences of Asians, Africans or South Americans (or, indeed, of most non-Christians) in his chapter on the history of depression, while paying only the briefest lip service to them in a chapter on "populations." Somewhat bizarrely, he does devote a passage of special attention to Jews and depression in his section on violence, hypothesizing that Jewish men experience a higher rate of depression because they are a "population particularly disinclined to violence." More than by its omissions and its persistent defects of tone, The Noonday Demon is undone by Solomon's resolutely narrow method of inquiry. I have no doubt that he experienced painful and debilitating bouts of depression. Like about 19 million other Americans, I have as well. And I understand the temptation, despite the figures, to cling to depression as a hallmark of some kind of perverse blessedness. But part of recovering from depression, and part of keeping it at bay, is coming to terms with pain and suffering as a human experience, not just one's own. At one point, Solomon writes of the starving hordes in Bangladesh, for whom "there is almost no prospect of improvement. And yet they go on living!" You can almost hear him sigh as he confesses in a swoon of self-admiration, "Depressives have seen the world too clearly, have lost the selective advantage of blindness." The idea that depression grants its sufferers deep insight into truth is a damaging myth. That we suffer and yet want to go on living anyway is the delicate irony that sustains us all. Ana Marie Cox is a senior editor at the Chronicle of Higher Education. � 2001 The Washington Post Company
