I actually heard Solomon talking about another book on the John Stewart Daily Show but this National Book Award Winner was alluded to and I thought it would be both interesting and informative. It's clearly not about a very happy subject, depression, but Solomon, who also suffers from this disease, speaks about it in both personal and clinical terms, so that he makes it understandable to the laymen, to the sufferer of depression as well.
This is not an easy book to read, mostly because depression is so debilitating and there's no easy cure to it as Solomon's experience shows. He writes about it poetically, comparing depression to a vine that winds itself around a tree, slowly almost unknowingly choking off its life. He also compares mild depression, the kind that does not require hospitalization as as a "soul of iron that weathers with grief and rusts with mild depression...it takes time for the rusting iron-framed building to collapse, but the rust is ceaselessly powdering the solid, thinning it, eviscerating it. The collapse (large depression), no matter how abrupt it may feel, is the cumulative consequence of decay." He continues: "Depression starts out insipid, fogs the day into a dull color, weakens ordinary actions until their clear shapes are obscured by the effort they require, leaves you tired and bored and self-obsessed. The worst part, the sense that you are a burden to others, that you don't count, a belief that must be fought and experience shows, is not accurate or true. Most people, especially family, are sympathetic and caring, willing to help in any way they can. Often, however, the sufferer, does not see this, so obsessed are they in their condition, making it difficult to see clearly and truthfully."
For Solomon, "depression was both a birth and death. The vine is what is born. The death is one's decay, the cracking of the branches that support this misery. The first thing to go is happiness. You cannot gain pleasure from anything...but soon other emotions follow happiness into oblivion: sadness as you had known it, the sadness that seemed to have led you here; your sense of humor; your belief in the capacity for love. Your mind is leached until you seem dim-witted even to yourself. All these images describe, forcefully, the depression most feel. The road back to health involves hacking through the vines, with drug therapy but that's only half of the problem, the rest comes from the individual, perhaps with a therapist. Rebuilding of the self in and after depression requires love, insight, work, and most of all, time."
I found most compelling his description of the self, "neither peach, with a solid core, hidden by the fruit, or an onion, which once the skin is peeled, nothing remains." For Solomon, "There is no essential self that lies pure as a vein of gold under the chaos of experience and chemistry. Anything can be changed, and we must understand the human organism as a sequence of selves that succumb or choose one another. Thus, we are constantly changing, the self is never the same and for someone in therapy, treatment does not alleviate a disruption of identity, bringing you back to some kind of normality; it readjusts a multifarious identity, changing in some small degree who you are. So, we can never go back to who we were; we change, a result of experience, perhaps chemistry, constantly renewing our identities, according to the choices we make and their consequences."
Three percent of Americans suffer from depression, some 19 million and it's growing. And it may be the biggest killer on earth, greater than cancer or heart disease. And two million of those who suffer are children. Suffering from depression, for Solomon, became a way of life, too. "Depression is something to do." He quotes Schopenhauer: "We find pleasure much less pleasurable, pain much more painful than we had anticipated...we require at all times a certain quantity of care or sorrow or want, as a ship requires ballast, to keep on a straight course." Interesting thought, reinforcing Zorba's belief that 'life is trouble.' And a Russian proverb reinforces this view: "If you wake up feeling no pain, you know you're dead." Not very encouraging for any of us.
"LET US MAKE NO BONES ABOUT IT. WE DO NOT REALLY KNOW WHAT CAUSES DEPRESSION. WE DO NOT REALLY KNOW WHAT CONSTITUTES DEPRESSION. WE DO NOT REALLY KNOW WHY CERTAIN TREATMENTS MAY BE EFFECTIVE FOR DEPRESSION. WE DO NOT KNOW HOW DEPRESSION MADE IT THROUGH THE EVOLUTIONARY PROCESS. WE DO NOT KNOW WHY ONE PERSON GETS DEPRESSION FROM CERTAIN CIRCUMSTANCES THAT DOES NOT TROUBLE ANOTHER.
In other words, depression is a baffling disease of the mind, one which we know little about, understand less, yet it affects millions of people. And unfortunately, society has little room in it for moping. Finally, he tries to answer the question how to treat the disease:
"We would all like Prozac to do it for us, but in my experience, Prozac doesn't do it unless WE HELP IT ALONG. "Listen to the people who love you. Believe that they are worth living for even when you don't believe it. Seek out the memories depression takes away and project them into the future. Be brave; be strong; take your pills. Exercise because it's good for you even if every step weighs a thousand pounds. Eat when food itself disgusts you. Reason with yourself when you have lost your reason." He adds, "These fortune-cookie admonitions sound pat, but the surest way out of depression is to dislike it and not to let yourself grow accustomed to it. Black out the terrible thoughts that invade your mind...I rebuilt myself enough to be able to keep swallowing my funeral instead of enacting it. A lot of talking was involved. I believe that words are strong, that they can overwhelm what we fear when fear seems more awful than life is good. I have turned with an increasingly fine attention to love. Love is the other way forward." I think this is an amazingly strong and honest admonition from Solomon.
He quotes three mantras from a women who has suffered more than most (her family a victim of Pol Pot's genocide) 1. I teach them to forget; we can teach ourselves to forget the depression even though it is right there. 2. I teach them to work, any kind of work, where they learn to do things well with pride. 3. I teach them to love...themselves first, by taking pride in their physicality, then by interacting with others, to avoid the isolation of depression. FORGETTING. WORKING. LOVING.
"Welcome pain, for you will learn from it," Ovid once said. We all need pain to feel alive "but it is the walking-death quality of depression that we must try to eliminate from our lives. There are always ways to lead a good life with depression," and the book is written as "an artillery against that depression."
Medication and therapy are the two tools most often used to combat depression; one without the other, however, is too often applied. Both are often necessary for depression.
A sense of humor is, for Solomon, the best indicator that the sufferer will recover; exercise and diet also play an important role. And, he adds, " A really serious workout is just about the most disgusting idea I can imagine when I am depressed, and it's no fun doing it, but afterward I always feel a thousand times better. Exercise allays anxiety, too; nervous energy gets used up by sit-ups."
Finally, if YOU have a friend who is going through an episode of depression, do the following: "Blunt their isolation. Do it with cups of tea or long talks or in sitting in a room nearby and staying silent or in whatever way suits the circumstances but do that. And do it willingly."
This is a book everyone should read.
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