Andrew Solomon is a writer and lecturer on politics, culture and psychology. His book, The Noonday Demon: An Atlas of Depression (Scribner, 2001), won the 2001 National Book Award for Nonfiction, was a finalist for the 2002 Pulitzer Prize, won twelve other national awards, and was included in the London Times list of one hundred best books of the decade. A New York Times bestseller in both hardcover and paperback editions, The Noonday Demon has also been a bestseller in seven foreign countries and has been published in twenty-two languages. In 2008, Solomon received the Society of Biological Psychiatry’s Humanitarian Award for his contributions to the field of mental health, and in 2010, the Brain and Behavior Research Foundation’s Productive Lives Award.
Ryan: Since writing The Noonday Demon, over a decade ago, have you been able to keep yourself from relapsing into another depressive episode?
Solomon: Depression is a chronic condition, and it is always waiting to rear its head. I had depression in 2004, triggered by some events in my personal life. When I went through the very stressful process of publishing my book, I had another episode this past autumn. Because I’ve had depressions before, I now know how to handle them, and neither of them escalated to anything like what I’d dealt with way back when. But they are always there, threatening to reemerge.
Ryan: How have you managed to keep your depression at bay?
Solomon: I take medication twice every day; I visit with my psychopharmacologist to tweak the dosages from time to time; I do weekly talk therapy; I try to structure my life in a positive way and to avoid extreme stresses. I am fiercely protective of my sleep. I avoid alcohol and caffeine. I exercise regularly.
Ryan: What are your suggestions for people with treatment resistant depression – especially when medication does not work?
Solomon: There is very little depression that is truly treatment-resistant. Anyone who is having that experience would be well served by working with a really gifted psychopharmacologist. That’s not always so easy to do in our flawed healthcare system, but it makes a vast different. I am on 5 medications, which is what it took to get the balance right, helping the depression and not overwhelming me with side effects. In more extreme cases, there is ECT, and in the most intransigent, deep brain stimulation. But I also think that regulating your life helps. See the answers to question 2.
Ryan: Lack of energy/motivation is the hardest challenge. Any suggestions on how to overcome this?
Solomon: It’s part of the whole syndrome and is to be addressed however an individual patient wishes. But it’s important to keep doing as much as you can when you’re depressed–not to the point where it stirs up new anxieties, but not to let too much of your life slip away from you. Ironically, exercise, the last thing anyone wants to do when feeling devitalized, can be very helpful in improving one’s energy.
Ryan: Talking about depression with another person has been huge for me in that no one else knows what I have gone thru…can this kind of one on one talking with another depressive alleviate many forms of depression and help with recovery?
Solomon: There are people who have said that talking about depression depresses them, but my belief is that depression is fundamentally a disease of loneliness, and that knowing others have been through the same things can be very helpful. That’s the idea of the book I wrote: to give people access to other like experiences. But while I hope the ones in the book can offer some help, there is nothing that measures up to having another person who can understand, and provide comfort.