AGAINST DEPRESSION

A heartfelt argument that depression is not, as many would have it, a source of heroic melancholy and artistic genius, but, rather, a pathological condition that should, if possible, be eradicated.

When Kramer (Clinical Psychiatry/Brown Univ.) made public appearances after publication of his best-selling Listening to Prozac (1993), audiences persistently challenged him with questions like, “What if Prozac had been available in van Gogh’s time?” The assumption that suffering from mental illness is a prerequisite to genius and that humanity would be the poorer if depression were conquered is anathema to Kramer. Instead, he asserts, it is “the most devastating disease known to humankind,” and to back up his claim he cites some astonishing statistics: $40 billion in lost productivity in the United States, for example, or 3 percent of GDP. In a wide-ranging essay that draws on his own life and on his years of treating patients, he explores the gap between common perceptions of depression and the scientific understanding of it. In the first of three parts here, “What It Is to Us,” he looks at the charm of depression and its erotic power, at the way people are drawn to such precursors of depression as moodiness, passivity and vulnerability. In “What It Is,” he reviews research in biological psychiatry and neuroscience that links depression to frank abnormalities in the nervous system, including problems in stress responses, repair of cells in critical brain regions, and small or malfunctioning hippocampus glands. Finally, in “What It Will Be,” Kramer envisions a world without depression and lists benefits of its eradication. Without depression to fear, he says, we would be free to be quirky and neurotic, to take risks more openly and to love more generously—and we’d still have art and artists. While not predicting that depression will be eliminated anytime soon, Kramer brings hope to those afflicted by it.

A clear, valuable exposition of the progress researchers are making in understanding an all-too-common disease.