Book Review: "The Noonday Demon: An Atlas of Depression" by Andrew Solomon
Andrew Solomon states “…there is chaos in the kingdom” and this book was his attempt to bring order to a wide range of topics concerning depression. In the Noonday Demon, Solomon charts the way through his own breakdowns to general population issues with depression. He analyzes depression through the context of history, poverty and politics. From poets, to doctors, to scientists, to peers, Solomon gathers the information and put it together eloquently.
Solomon devotes two chapters in his book to deal with standard treatments and alternative treatments for depression. In his chapter on standard treatments he notes there have been a “number of studies showing that therapy is not nearly as effective as drugs for taking people out of depression, but that therapy has a protective effect against reoccurrence.” However, finding the right medications or the right therapist is not necessarily easy. Solomon states he has taken numerous medications at different levels and at different times for his mental health. During his second breakdown he searched through ten therapists before finding one he liked. It is evident from his book, he is not alone in the difficulties of finding the right combination of therapies.
In these two chapters, Solomon explores through interviews and, in some cases personal experience, at least 30 different therapies. Some are common therapies like diet, exercise, labor, cognitive-behavioral therapy and interpersonal therapies. Other familiar remedies discussed included various synthetic medications (SSRIs, tricyclics, MAOIs and atypical antidepressants) and natural remedies like St. John’s Wart and SAMe. More controversial treatment discussed included Electroconvulsive Therapy (ECT) and Cingulotomy, a modern-day type of lobotomy.
Statistics on Depression and Treatment
Available research, at the time of the book (2001), estimated that 19 million people, including children, had chronic depression and that number was escalating. Solomon notes that “Poverty is depressing and depression is impoverishing, leading as it does to dysfunction and isolation.” Depression among welfare recipients is cited as three times higher than the general population, yet Solomon indicates little work has been done in this area.
While twice as many women are diagnosed with depression as men, nearly 4 times the number of men as opposed to women are likely to commit suicide according to Solomon’s research, Solomon notes in his chapter on suicide, “someone in a first depressive episode is particularly likely to attempt suicide; a person who has lived through a few cycles has in general learned to live through cycles.”
Given the number of people who have depression, it was startling to read John Greden’s, director of the Mental Health Research Institute at the University of Michigan, statement that “it’s between 1 and 2 percent who get really optimal treatment for an illness that can usually be well-controlled with relatively inexpensive medications that have few serious side effects.” After reading Solomon’s book, I agree such a small percentage of people getting optimal help is in part a result of lack of organization in dissemination of research and practice. There is also the interference of stigma, poverty and politics.
It should be noted that Solomon, and this author, do not believe pills alone will help those have experienced major depression or that everyone with depression needs pills. However, we both acknowledge that medication, in addition to “talk” therapy, have been important components to our recovery.
National Suicide Prevention Lifeline
The National Suicide Prevention Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week, across the United States. Link through or call 1-800-273-8255.
Social Stigma of Depression
In his chapter on politics, he talked about social stigma still being one of the biggest barriers to progress. Many people Solomon interviewed for his book asked that their names not be used. While the National Alliance for Mentally Ill (NAMI) and the National Depressive and Manic-Depressive Association continue to educate, inform and lobby on behalf of individuals with depression, Solomon notes “we are blind to the epidemic proportions of depression because the reality is so seldom uttered…”
This book is an eye-opening and comprehensive resource about a wide range of topics related to depression. My copy of the book is well-worn with notations and highlights throughout the book. I have read the book (571 pages) more than once as much for its literary merit as well as the information on depression. The book won the 2001 National Book Award and was a Pulitzer Prize finalist. The book was updated in 2015.
© 2018 Kathy Burton