Solomon

"Recent research linking depression to other illnesses is beginning to carry weight with lawmakers and even with HMOs. If untreated depression does makes you more prone to infection, cancer, and heart disease, then it’s an expensive illness to ignore...John Wilson, a onetime candidate for mayor of Washington, D.C., who committed suicide, once said, “I believe that more people are dying of depression than are dying of AIDS, heart trouble, high blood pressure, anything else, simply because I believe depression brings on all these diseases.”

"I went to Capitol Hill to share the experiences related in the last chapter. I was there in a strange capacity, an accidental activist as well as a journalist. I wanted to know what was being done, but I also wanted to persuade the American government to press forward with reforms that would serve the interests of the nation and of the people by whose stories I had been so deeply moved. I wanted to share my insider’s knowledge. Senator Reid had a real grasp of the situation: “A few years ago, I dressed myself up in disguise, like I was homeless, baseball hat and old bum clothes, and I spent an afternoon and a night in a homeless shelter in Las Vegas and then the next day did the same in Reno. You can write all the articles you want about Prozac and about all the modern miracle drugs that stop depression. That doesn’t help this group of people.” Reid himself grew up in poverty and his father killed himself. “I have learned that had my dad had someone to talk to, and some medication, he probably wouldn’t have killed himself. But we’re not legislating for that at present.”

"When I met with Senator Domenici, joint sponsor of the Mental Health Parity Act, I laid out for him the anecdotal and statistical information I had collated, and then I proposed fully documenting the tendencies that seemed so obviously implied by these stories. “Suppose,” I said, “that we could put together incontrovertible data, and that the questions of bias, inadequate information, and partisanship could all be fully resolved. Suppose we could say that sound mental health treatment for the severely depressed poor population served the advantage of the U.S. economy, of the bureau of Veterans Affairs, of the social good—of the taxpayers who now pay cripplingly high prices for the consequences of untreated depression, and of the recipients of that investment, who live at the brink of despair. What, then, would be the path to reform?” “If you’re asking whether we can expect much change simply because that change would serve everyone’s advantage in both economic and human terms,” said Domenici, “I regret to tell you that the answer is no.”

"Most of the people who battle for the mentally ill in Congress have stories of their own that have brought them to this arena. Senator Reid’s father killed himself; Senator Domenici has a schizophrenic daughter who is very ill; Senator Wellstone has a schizophrenic brother; Representative Rivers has a severe bipolar disorder; Representative Roukema has been married now for almost fifty years to a psychiatrist...“It shouldn’t be this way,” Wellstone said. “I wish I’d gained my understanding of this subject solely through research and ethical inquiry. But for many people, the problems of mental illness are still utterly abstract, and their urgency becomes apparent only through intense involuntary immersion in them. We need an education initiative to pave the way for a legislative one.”

"We have now overhauled welfare with the cheery thought that if we don’t support the poor, they’ll work harder...and the terrible, wasteful, lonely suffering goes on and on and on".

"Part of the difficulty in getting better services to these people is the blockade of disbelief. I wrote an early version of this chapter as a feature for a wide-circulation newsmagazine, and they told me that I had to rewrite it for two reasons. First, the lives I described were implausibly horrendous. “It becomes comical,” one editor said to me. “I mean, no one can have all this stuff happening to them, and if they do, it’s no surprise they’re depressed.” The other problem was that the recovery was too quick and too dramatic".

"Politics plays as big a role as science in current descriptions of depression. Who researches depression; what is done about it; who is treated; who is not; who is blamed; who is coddled; what is paid for; what is ignored: all these questions are determined in the sancta of power".

Andrew Solomon