This powerful collection of reflections on depression includes some well-known authors, such as Ann Beatie, Susanna Kaysen, and William Styron, but for the most part the less well-known writers outshine the big names. Possibly that is because editor Nell Casey had more influence over the less prestigious writers, and encouraged them to crystallize their ideas. Nearly all of these pieces are new, while a few have been printed previously in magazines, and just two are extracts from previously published books. All the authors have been in close contact with depression, either personally or though helping a family member deal with a crisis. The experience of these writers gives their contributions authority and depth, and their ability to reflect on this experience makes this collection both thoughtful and moving.

The longest piece is by Lauren Slater, author of Prozac Diary and Lying. In her other work she has frankly and obliquely described her turmoil and how Prozac helped her; here she writes about her experience when she was pregnant. (She has also written on this in the New York Times Sunday Magazine, and she plans to publish a memoir soon about this part of her life.) While pregnant, she decided to go off Prozac because of her concerns about the possible effects of the medication on the fetus growing inside her. Soon she felt her peace of mind destabilizing, but going back on her medication was not able to return her to equilibrium, and she became alarmingly depressed. She feared that she would need hospitalization, and she considered abortion.

The most poignant aspect of her account is the decision about having to weigh the risks to her future child from medication against the risks to herself. She ended up taking a huge daily dose of Prozac, with lithium and Klonopin, all of which can cause defects in fetuses. It’s easy to see how having to face that decision could increase one’s depression. In this piece she also gives a sense of the strength of her marriage to her husband Benjamin, how they make decisions together, and how they survived this part of their lives. Slater’s strength as a writer is her ability to convey the texture of her experience with small details, while maintaining a sense of humor and deep irony, and this is a wonderful work of writing.

Several of the chapters, as well as Slater’s, focus on the way depression enters into families. Along with an extract from William Styron’s Darkness Visible is a companion piece by his wife Rose Styron. Her chosen role in life is very much a "wife" and her writing is the least compelling in the book, full of trite phrases. It’s striking that even with her doting love and admiration for her husband, she makes it clear how difficult he was to live with for years as his depression grew.

Donald Hall was married to the poet Jane Kenyon, who suffered from manic depression most of her life; after her death from cancer in 1995, Hall himself became depressed. One of her most well known poems is "Having it Out with Melancholy," which Hall quotes and relates to her life. Another poet, A. Alvarez writes about his suicide attempt and the end of his marriage in an extract from The Savage God. Nell Casey and Maud Casey write separate accounts of Maud’s depression and hospitalization, and both discuss how it affected their relationships with their mother. Martha Manning, author of Undercurrents, writes about the women in her family, and the different ways they deal with the genetic inheritance of depression and how her own depression affected her daughter.

Other writers in this collection discuss the nature of depression and its status as a disease in modern culture. Susanna Kaysen, author of Girl, Interrupted, expresses her doubts about the adjective "clinical" in the phrase "clinical depression," and emphasizes the reasonableness and importance of depression. Joshua Wolf Shenk writes an extremely thoughtful piece, "A Melancholy of Mine Own," about the language we use in describing depression and how it is so often inadequate to capture our experience. David Karp, in a piece adapted from his book Speaking of Sadness, writes about how he lives with depression and how he is suspicious of the talk of "chemical imbalances" and the solutions offered by medication. Finally, one of my favorites in the book is "Writing the Wrongs of Identity" by Meri Nana-Ama Danquah, who describes herself as a black woman struggling with depression. She writes about her own experience with the illness and her how, when reading about depression, she found very little representation of black people in the memoir literature. She herself has written the memoir Willow Weep for Me.

Overall, this is the best available collection of recent writings on depression, and I strongly recommend it to anyone looking for a thoughtful discussion of the meaning of melancholy and medication, rooted in personal experience.

Categories: Depression, Memoirs

Tags: Depression (Unipolar), Suicide