Life is fraught with sorrows: no matter what we do, we will in the end die; we are, each of us, held in the solitude of an autonomous body; time passes, and what has been will never be again. Pain is the first experience of world-helplessness, and it never leaves us. We are angry about being ripped from the comfortable womb, and as soon as that anger fades, distress comes to take its place. Even those people whose faith promises them that this will all be different in the next world cannot help experiencing anguish in this one; Christ himself was the man of sorrows. We live, however, in a time of increasing palliatives; it is easier than ever to decide what to feel and what not to feel. There is less and less unpleasantness that is unavoidable in life, for those with the means to avoid. But despite the enthusiastic claims of pharmaceutical science, depression cannot be wiped out so long as we are creatures conscious of our own selves. It can at best be contained — and containing is all that current treatments for depression aim to do.

Highly politicized rhetoric has blurred the distinction between depression and its consequences — the distinction between how you feel and how you act in response. This is in part a social and medical phenomenon, but it is also the result of linguistic vagary attached to emotional vagary. Perhaps depression can best be described as emotional pain that forces itself on us against our will, and then breaks free of its externals. Depression is not just a lot of pain; but too much pain can compost itself into depression. Grief is depression in proportion to circumstance; depression is grief out of proportion to circumstance. It is tumbleweed distress that thrives on thin air, growing despite its detachment from the nourishing earth. It can be described only in metaphor and allegory. Saint Anthony in the desert, asked how he could differentiate between angels who came to him humble and devils who came in rich disguise, said you could tell by how you felt after they had departed. When an angel left you, you felt strengthened by his presence; when a devil left, you felt horror. Grief is a humble angel who leaves you with strong, clear thoughts and a sense of your own depth. Depression is a demon who leaves you appalled.

Andrew Solomon

I returned, not long ago, to a wood in which I had played as a child and saw an oak, a hundred years dignified, in whose shade I used to play with my brother. In twenty years, a huge vine had attached itself to this confident tree and had nearly smothered it. It was hard to say where the tree left off and the vine began. The vine had twisted itself so entirely around the scaffolding of tree branches that its leaves seemed from a distance to be the leaves of the tree; only up close could you see how few living oak branches were left, and how a few desperate little budding sticks of oak stuck like a row of thumbs up the massive trunk, their leaves continuing to photosynthesize in the ignorant way of mechanical biology.

Fresh from a major depression in which I had hardly been able to take on board the idea of other people's problems, I empathized with that tree. 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. At the worst stage of major depression, I had moods that I knew were not my moods: they belonged to the depression, as surely as the leaves on that tree's high branches belonged to the vine. When I tried to think clearly about this, I felt that my mind was immured, that it couldn't expand in any direction. I knew that the sun was rising and setting, but little of its light reached me. I felt myself sagging under what was much stronger than I; first I could not use my ankles, and then I could not control my knees, and then my waist began to break under the strain, and then my shoulders turned in, and in the end I was compacted and fetal, depleted by this thing that was crushing me without holding me. Its tendrils threatened to pulverize my mind and my courage and my stomach, and crack my bones and desiccate my body. It went on glutting itself on me when there seemed nothing left to feed it.

Andrew Solomon

Every second of being alive hurt me. Because this thing had drained all fluid from me, I could not even cry. My mouth was parched as well. I had thought that when you feel your worst your tears flood, but the very worst pain is the arid pain of total violation that comes after the tears are all used up, the pain that stops up every space through which you once metered the world, or the world, you. This is the presence of major depression.

Andrew Solomon

All I wanted was for “it” to stop; I could not have managed even to be so specific as to say what “it” was. I could not manage to say much; words, with which I have always been intimate, seemed suddenly very elaborate, difficult metaphors the use of which entailed much more energy than I could possibly muster. “Melancholia ends up in loss of meaning . . . I become silent and I die,” Julia Kristeva once wrote. “Melancholy persons are foreigners in their mother tongue. The dead language they speak foreshadows their suicide.” Depression, like love, trades in clichés, and it is difficult to speak of it without lapsing into the rhetoric of saccharine pop tunes; it is so vivid when it is experienced that the notion that others have known anything similar seems altogether implausible.

Andrew Solomon

In the middle decades of the twentieth century, two questions troubled the neuroscience of depression. One was whether mood states traveled through the brain in electrical or in chemical impulses. The initial assumption had been that if there were chemical reactions in the brain, they were subsidiary to electrical ones, but no evidence supported this. The second was whether there was a difference between endogenous neurotic depression, which came from within, and exogenous reactive depression, which came from without. Endogenous depressions all seemed to have precipitating external factors; reactive depressions usually followed on a lifetime of troubled reactions to circumstance that suggested an internal predisposition. Various experiments “showed” that one kind of depression was responsive to one kind of treatment, another to another. The idea that all depression involves a gene-environment interaction was not even entertained until the last quarter of the century.

Andrew Solomon