Hype and help

It’s nearly impossible to avoid.

If you aren’t able to generate deep-seated doubts about your psychological well-being on your own, legions of mental-health advocates are ready and willing to appear on Dr. Phil or Oprah to introduce a few you might never have considered on your own.

Do you really need any more nagging little voices?

In spite of widespread acclaim, when Scribner first published Andrew Solomon’s The Noonday Demon: An Atlas of Depression in 2001, some expressed a similar concern about the “cultural cottage industry” that has emerged in response to our growing awareness of mental health—or lack thereof.

So, when Simon and Schuster recently published a paperback edition of Solomon’s “exhaustive” compendium, cynicism regarding the fine line between public awareness and aggressive marketing seemed inevitable. It is too easy to dismiss Solomon’s account of the depths of depression as the self-absorbed whining of the leisure class. It is even easier to discount the book’s unequivocal promotion of chemical intervention as essential treatment of nearly every form of depression—especially in view of the fact that the author’s father is the chairman of a large pharmaceutical company.

The personal histories, including Solomon’s, undeniably bring a sense of intimacy and authenticity to this well-researched and extensively annotated work. Still, it is hard not to wonder how people who cannot feed or bathe themselves are able to recount the litany of pharmacopoeia and clinical conditions affecting their daily existence.

Covert marketing and cynicism aside, The Noonday Demon is a compelling study covering social, economic and historical bias; treatments and alternatives; breakdowns; and hope. From interviews with Khmer Rouge survivors, Holocaust descendants and Greenland natives to case histories of the abused, the impoverished and the elderly, Solomon takes apart “highly politicized rhetoric” and sheds new light on the darker corners of what is easily the most prevalent mental illness of this century. Simply stated, “Grief is depression in proportion to circumstance; depression is grief out of proportion to circumstance.”

This book seriously challenges our belief in external triggers, the virtue of sucking it up and toughing things out, and the valor of fighting to regain self. The idea that people who have it all—family, friends, respect, professional recognition and material comfort—can fall prey to the debilitating and self-destructive effects of depression is more than just annoying; it is frightening.

Could this be you?

According to Solomon, “The elderly depressed are chronically under-treated, in large part because we as a society see old age as depressing.” And in a capitalist culture, we almost demand that the poor be unhappy. Unfortunately, although money can’t buy happiness, the middle-class and the destitute have the least access to appropriate mental-health care because of HMO constraints, limited diagnostic services, prohibitive pharmaceutical costs and ineffective follow-up services.

In the end, this is a book filled with insight and compassion. Whether you have the blues or have hit the brink of the blackest depths, The Noonday Demon offers incredibly useful, basic advice.