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The Noonday Demon: An Atlas of Depression [Anglais] [Broché]

Andrew Solomon
4.3 étoiles sur 5  Voir tous les commentaires (6 commentaires client)
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Description de l'ouvrage

2 avril 2002
The Noonday Demon examines depression in personal, cultural, and scientific terms. Drawing on his own struggles with the illness and interviews with fellow sufferers, doctors and scientists, policy makers and politicians, drug designers and philosophers, Andrew Solomon reveals the subtle complexities and sheer agony of the disease. He confronts the challenge of defining the illness and describes the vast range of available medications, the efficacy of alternative treatments, and the impact the malady has on various demographic populations -- around the world and throughout history. He also explores the thorny patch of moral and ethical questions posed by emerging biological explanations for mental illness. With uncommon humanity, candor, wit, and erudition, award-winning author Solomon takes readers on a journey of incom-parable range and resonance into the most pervasive of family secrets. His contribution to our understanding not only of mental illness but also of the human condition is truly stunning.

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Extrait

Chapter One: Depression

Depression is the flaw in love. To be creatures who love, we must be creatures who can despair at what we lose, and depression is the mechanism of that despair. When it comes, it degrades one's self and ultimately eclipses the capacity to give or receive affection. It is the aloneness within us made manifest, and it destroys not only connection to others but also the ability to be peacefully alone with oneself. Love, though it is no prophylactic against depression, is what cushions the mind and protects it from itself. Medications and psychotherapy can renew that protection, making it easier to love and be loved, and that is why they work. In good spirits, some love themselves and some love others and some love work and some love God: any of these passions can furnish that vital sense of purpose that is the opposite of depression. Love forsakes us from time to time, and we forsake love. In depression, the meaninglessness of every enterprise and every emotion, the meaninglessness of life itself, becomes self-evident. The only feeling left in this loveless state is insignificance.

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.

Depression has been roughly divided into small (mild or disthymic) and large (major) depression. Mild depression is a gradual and sometimes permanent thing that undermines people the way rust weakens iron. It is too much grief at too slight a cause, pain that takes over from the other emotions and crowds them out. Such depression takes up bodily occupancy in the eyelids and in the muscles that keep the spine erect. It hurts your heart and lungs, making the contraction of involuntary muscles harder than it needs to be. Like physical pain that becomes chronic, it is miserable not so much because it is intolerable in the moment as because it is intolerable to have known it in the moments gone and to look forward only to knowing it in the moments to come. The present tense of mild depression envisages no alleviation because it feels like knowledge.

Virginia Woolf has written about this state with an eerie clarity: "Jacob went to the window and stood with his hands in his pockets. There he saw three Greeks in kilts; the masts of ships; idle or busy people of the lower classes strolling or stepping out briskly, or falling into groups and gesticulating with their hands. Their lack of concern for him was not the cause of his gloom; but some more profound conviction -- it was not that he himself happened to be lonely, but that all people are." In the same book, Jacob's Room, she describes how "There rose in her mind a curious sadness, as if time and eternity showed through skirts and waistcoats, and she saw people passing tragically to destruction. Yet, heaven knows, Julia was no fool." It is this acute awareness of transience and limitation that constitutes mild depression. Mild depression, for many years simply accommodated, is increasingly subject to treatment as doctors scrabble to address its diversity.

Large depression is the stuff of breakdowns. If one imagines a soul of iron that weathers with grief and rusts with mild depression, then major depression is the startling collapse of a whole structure. There are two models for depression: the dimensional and the categorical. The dimensional posits that depression sits on a continuum with sadness and represents an extreme version of something everyone has felt and known. The categorical describes depression as an illness totally separate from other emotions, much as a stomach virus is totally different from acid indigestion. Both are true. You go along the gradual path or the sudden trigger of emotion and then you get to a place that is genuinely different. It takes time for a rusting iron-framed building to collapse, but the rust is ceaselessly powdering the solid, thinning it, eviscerating it. The collapse, no matter how abrupt it may feel, is the cumulative consequence of decay. It is nonetheless a highly dramatic and visibly different event. It is a long time from the first rain to the point when rust has eaten through an iron girder. Sometimes the rusting is at such key points that the collapse seems total, but more often it is partial: this section collapses, knocks that section, shifts the balances in a dramatic way.

It is not pleasant to experience decay, to find yourself exposed to the ravages of an almost daily rain, and to know that you are turning into something feeble, that more and more of you will blow off with the first strong wind, making you less and less. Some people accumulate more emotional rust than others. Depression starts out insipid, fogs the days into a dull color, weakens ordinary actions until their clear shapes are obscured by the effort they require, leaves you tired and bored and self-obsessed -- but you can get through all that. Not happily, perhaps, but you can get through. No one has ever been able to define the collapse point that marks major depression, but when you get there, there's not much mistaking it.

Major depression is a birth and a death: it is both the new presence of something and the total disappearance of something. Birth and death are gradual, though official documents may try to pinion natural law by creating categories such as "legally dead" and "time born." Despite nature's vagaries, there is definitely a point at which a baby who has not been in the world is in it, and a point at which a pensioner who has been in the world is no longer in it. It's true that at one stage the baby's head is here and his body not; that until the umbilical cord is severed the child is physically connected to the mother. It's true that the pensioner may close his eyes for the last time some hours before he dies, and that there is a gap between when he stops breathing and when he is declared "brain-dead." Depression exists in time. A patient may say that he has spent certain months suffering major depression, but this is a way of imposing a measurement on the immeasurable. All that one can really say for certain is that one has known major depression, and that one does or does not happen to be experiencing it at any given present moment.

The birth and death that constitute depression occur at once. 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 t...

Revue de presse

Richard Bernstein The New York Times All encompassing, brave, and deeply humane...It is open-minded, critically informed, and poetic at the same time, and despite the nature of its subject it is written with far too much élan and elegance ever to become depressing itself.

Gail Caldwell The Boston Globe Both heartrending and fascinating...the book has a scope and passionate intelligence that give it intrigue as well as heft.

Christine Whitehouse Time The book for a generation...Solomon interweaves a personal narrative with scientific, philosophical, historical, political, and cultural insights...The result is an elegantly written, meticulously researched book that is empathetic and enlightening, scholarly and useful...Solomon apologizes that "no book can span the reach of human suffering." This one comes close.

Détails sur le produit

  • Broché: 576 pages
  • Editeur : Scribner; Édition : Reprint (2 avril 2002)
  • Langue : Anglais
  • ISBN-10: 0684854678
  • ISBN-13: 978-0684854670
  • Dimensions du produit: 23,5 x 15,3 x 3,6 cm
  • Moyenne des commentaires client : 4.3 étoiles sur 5  Voir tous les commentaires (6 commentaires client)
  • Classement des meilleures ventes d'Amazon: 30.464 en Livres anglais et étrangers (Voir les 100 premiers en Livres anglais et étrangers)
  • Table des matières complète
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Première phrase
Depression is the flaw in love. Lire la première page
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Concordance
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Couverture | Copyright | Table des matières | Extrait | Index | Quatrième de couverture
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4.3 étoiles sur 5
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4.0 étoiles sur 5 Literate, Ironic and Uneven 27 juillet 2001
Format:Relié
Andrew Solomon clearly put his beautiful heart and soul into writing a personal and cultural cutting edge tome that will live as a cult classic amidst the few indispensable biographical books on depression. It's not to be missed.
Yet this is a difficult book to review. However authentic, informative and impeccable Andrew clearly worked so hard to be, there are self-absorbed problems with melodrama here (as he admits and "does not rue"). More important, he makes few distinctions between depression as its own entity and depression as an integral part of common and more complex personality disorders. This confuses and weakens the impact of an otherwise extraordinary book. In his own and others' stories, he often describes behavior and reasoning characteristic of Borderline Personality Disorder (such as recurring violent rages, self-mutilation, multiple unstable relationships, "moral turpitude," confusion of sexual identity and more) as indicative of depression. This lack of precision does not serve. With the force of Andrew's persuasive charisma, caution and informed reading are in order. (See Stop Walking on Eggshells by Randi Kreger and Paul Mason for priceless information on BPD.)
He names depression as ultimately "the biggest killer on earth" while a chapter on "Prevention" is curiously missing. (See the exceptional A General Theory of Love by UCSF psychiatrists Thomas Lewis, Fari Amini and Richard Lannon for profound thoughts on prevention.) (The chapter titles are Depression, Breakdowns, Treatments, Alternatives [tales of traveling the globe trying them all], Populations, Addiction, Suicide, History, Poverty, Politics, Evolution and Hope. The index is good and the bibliography is great.)
Andrew Solomon can be none other than an enneagram personality type 4. See Personality Types by Don Riso on the enneagram if you're interested.
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4.0 étoiles sur 5 sadness 5 septembre 2013
Format:Format Kindle|Achat vérifié
i was told to read this book from a friend suffering from depressions, to understand him better. i understand him better now but he chose not to live anymore before I finished the book. it was helpful though. thank u Solomon. he really insisted that I should read it so you must have explained things very accurately.
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5.0 étoiles sur 5 A "must-read" for compassionate Americans 27 juillet 2001
Format:Relié
Solomon has written an outstanding authoritative and compelling guide to understanding the many kinds of depression that plague us, their treatments, and their development in various ethnic , age and gender groups. His descriptions of "the experience," having been there several times, communicate directly to the reader. It's a good bet that most of us have had or do have a friend or relative struggling with this crippling process. That's why it is a "must read."
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