Hence, Loathed Melancholy.(The Noonday Demon: An Atlas of Depression)(Review)

The Noonday Demon: An Atlas of Depression, by Andrew Solomon (Scribner, 569 pp., $28)

The readers of the future may dub our time the Age of Mental Illness. Our writers are not more tortured than those of previous generations, but they are the first to attribute their suffering to their brains' neurochemistry.

Prozac, which works on that neurochemistry, was introduced in 1988. Today, an amazing one in ten Americans takes this drug or one of the other antidepressants it spawned. These rates are likely to rise, because only half of those with depression currently receive any treatment. Depression is "the family secret everyone has."

Andrew Solomon's interest in depression began with his own breakdown, which he describes with eloquence and humor. One of my psychotherapy patients who read this book said that the passage below helped her put into words what she had never been able to express:

My depression had grown on me as that vine had conquered the oak; it had been a sucking thing that had wrapped itself around me, ugly and more alive than I. It had had a life of its own that bit by bit asphyxiated all of my life out of me . . .

If Solomon had stopped there, this book would be just the most recent addition to the rapidly growing genre of mental-illness memoirs. But because Solomon is a reporter (part of this book appeared in The New Yorker, and sparked over a thousand letters), the book is also a solidly researched investigation into what appears to be a silent plague.

Depression is not new. Hippocrates declared depression a brain illness, while Plato thought its origins were to be found in childhood; their disagreement parallels the modern debate between psychopharmacologists and psychoanalysts. Obviously, the depressed have both brains and minds-and both need treatment. Not surprisingly, research shows that "the combination of drugs and therapy works better than either one alone." One of Solomon's themes is that the interaction between the brain and mind is complex, even mysterious; neither can be reduced to the other.