I had never employed a research assistant until I started work on this book. I was wildly fortunate to find the gifted artist Stephen Bitterolf, who has taken hundreds of hours away from his canvases and has worked on The Noonday Demon as hard as I have. Whatever rigor I have achieved here would not have been possible without his rigor; and many of my ideas were formed by ideas of his. This book could not exist in anything like its current form without his contribution. Furthermore, he has shown himself to be a man of character; his wit, affection, and kindness have been a source of constant pleasure to me.
My father was sixty-seven when I had my first episode of depression. He is to be praised not only for his love and generosity, but also for the flexibility of mind and spirit that has consistently allowed him to understand and arrest my illness over these last six years. I have never known anyone who so beautifully integrates the imaginative vitality of youth with the considered wisdom of age. He has been, always, my unfailing mainstay and my great inspiration. I have dedicated this book to him with all my heart.
Index
Page numbers from 445 to 499 refer to notes.
A
AA (Alcoholics Anonymous), 228, 240, 241, 365
Abraham, Karl, 285, 323–24, 325
Abrams, Richard, 122
abyss imagery, 27–28
acedia, 293–94, 300
acetylcholine:
initial isolation of, 331
in sleep, 145
tricyclic inhibition of, 117–18
ACLU (American Civil Liberties Union), 379, 380
Across-Species Comparisons and Psychopathology (ASCAP) Society, 405
acupuncture, 148
ADA (Americans with Disabilities Act), 366, 370, 392, 491
addiction, 217–42
avoidance of, 224–25
to benzodiazepines, 119
brain function and, 222–23
depression as enabling factor in, 242
to heroin, 232
variability in cultural standards of, 226–27
see also alcoholism; substance abuse specific addictive substances
ADHD (attention deficit hyperactivity disorder), 175, 181–82, 186
adolescents:
depression of, 187–89, 461
substance abuse and, 221, 467
suicides of, 257–58, 264–65
adrenal glands:
excessive sugar intake and, 139
long-term cortisol elevation and, 59–60
adversity, value of, 434–35, 438–43
AFDC (Aid to Families with Dependent Children), 338
African Americans, 195–200, 351
Age of Reason, 308–9, 314
aggression:
self-destructive impulses vs., 424
serotonin levels and, 114, 253–54
stress released in, 253–54
treatment enforced as safety measure against, 380
agitated depression, 48, 123, 220, 229, 290
agricultural societies, 407
Agrippa, 296
AIDS/HIV, 71–73, 77, 203, 353–55, 362, 437
Aid to Families with Dependent Children (AFDC), 338
airline pilots, depression stigmatization and, 367
Ajax (mythological figure), 289
alcohol consumption:
anxiety relieved by, 226
cultural differences in normal levels of, 226–27
fetal neurological damage due to, 254
medication absorption and, 467
Alcoholics Anonymous (AA), 228, 240, 241, 365
alcoholism:
antidepressant treatment for depressives with, 220, 222, 466
of children of depressed parents, 181
depression symptoms caused by, 219, 227, 467
dual-diagnosis cases of, 219–21, 228, 238–42, 468
endorphin levels and, 223
genetic predisposition for, 65, 223, 450
of men vs. women, 175
physical debilitation due to, 228
rates of, 218
REM sleep patterns of, 220–21
serotonin levels and, 217, 228
suicidality and, 227, 255
treatment options for, 219–22, 228–29
withdrawal from, 228–29
see also substance abuse
alienation, late Victorian/early modernist sentiments of, 320–22, 329
allergies, 80, 139
alpha-2 antagonists, 116
altruism, 410–11
Alvarez, A., 208–9, 244, 263, 280
Alzheimer’s disease, 192–93, 232, 463
amantadine, 116
Ambien, 119, 234
Ambrosini, Paul, 460
American Civil Liberties Union (ACLU), 379, 380
Americans with Disabilities Act (ADA), 366, 370, 392, 491
amphetamines, 116, 222, 231
amygdala, 55, 60, 172
anaclitic depression, 183, 460
Anafranet, 118
Anafranil, 114
Anatomy of Melancholy, The (Burton), 301–4, 310, 323, 480
Anderson, Laura, 92–98, 106, 262, 438, 442
Andrews, Paul, 409–10
Angel of Bethesda, The (Mather), 313
anger:
evolutionary role of, 413–14
repression of, 197, 198
anhedonia, 19, 67, 445
animals:
dominance in, 113–14, 404–6
emotions of, 402–3, 412–14
hibernation of, 406
learned helplessness observed in, 348
self-destructive behaviors of, 256–57
serotonin studies conducted on, 113–14, 253, 254
short-term stress responses of, 407
animist ritual, Senegalese, 165–70
“Annabel Lee” (Poe), 359
anorexia nervosa, 313
Antabuse, 229, 469
Anthony, Saint, 16
antidepressant medications, 111–20
adverse reactions to, 80–81, 98
and alcoholics, 220, 222, 466
atypical, 114, 118, 193
basic principle of, 111
body temperature and, 113, 452
while breastfeeding, 83
broad uses of, 435
changing combinations of, 86, 87, 93–94, 118–20, 121
for children, 184–85, 460
classes of, 114
cortisol-reduction approach in, 58
cost of, 60, 353
cultural attitudes and, 195, 343
current research on, 120, 171–72
delays in responses to, 60, 112–13, 120, 189–90, 237, 333, 450
dependency concerns and, 235–36
depressed substance abusers treated with, 220, 222
developmental history of, 330–34
directions of research on, 120
disabling effects in high dosages of, 423
effectiveness of, 60, 86, 103–4, 120
elderly and, 189–90, 192, 193
employment and, 366–67
excessive use of, 26–27
HMO usage of, 90, 107, 384
illicit substance abuse vs., 217, 235–36
inconsistency of, 118–19
lawsuits based on noncompliance with, 380
long-term effects of, 80–81
as maintenance strategy, 79–80
mania induced by, 48, 118, 453
MAOIs, see monoamine oxidase inhibitors
mild depression relieved by, 399
mood stabilizers for bipolar patients on, 48, 106
over-the-counter drugs vs., 398–99
palliative use of, 435
personal volition combined with, 102
pharmaceutical industry promotion of, 394–97, 495
pregnancy and, 83, 93
psychoanalysts’ aversions to, 48, 50–51
receptor theories of, 112, 333
REM sleep altered by, 113, 146, 452
resistance felt toward, 60, 369
&nbs
p; responsiveness lowered after interruptions of, 57
reuptake mechanism blocked by, 332
rights of refusal of, 380, 393
selection criteria among, 114, 120
sexual side effects of, 91–92, 115–17, 157
shame of responsibility for illness relieved by, 330
short-term efficacy of, 103–4
side effects of, 78, 80, 83, 87, 91–92, 93–94, 114–18, 124, 153–54, 157, 161, 171, 421–22, 423, 425
for single neurotransmitters vs. multiple systems, 397
societal intolerance exacerbated by, 62–63
SSRIs, see selective serotonin reuptake inhibitors
stress-reduction strategies vs., 125
in suicide prevention, 115, 251–52
suicide risks associated with, 48, 80–81
TRH as, 56, 448
tricyclic, 114, 115, 117–18, 148, 171, 222, 331, 332
see also specific antidepressant medications
anxiety, 50, 175, 202, 303
alcohol used for relief from, 226
coffee intake linked to, 139
cognitive-behavioral therapy for, 111
depression accompanied by, 65–66, 229, 239–40, 323–24, 405
exercise and, 137–38
marijuana and, 229–30
modern society as cause of, 406–9
physical manifestations of, 65, 422
protective role of, 410
psychopharmacological treatment of, 51, 63, 78, 87, 111, 119, 129, 234, 422
serotonin and, 65, 119
suicide as response to, 275
anxiolytics, 222
Aquinas, Thomas, 62, 293, 450, 479
Areopagitica (Milton), 439
Aretaeus of Capidoccia, 290–91
aristocracy, melancholy as illness of, 299, 300, 311
Aristotle, 288, 289, 295, 299, 301, 316, 334
Arnold, Matthew, 321–22
Arnsten, Dorothy, 171
Artaud, Antonin, 78
Åsberg, Marie, 253
ASCAP (Across-Species Comparisons and Psychopathology) Society, 405
Asendin, 62, 114, 118
Ashcroft, George, 487
Astbury, Jill, 177, 178
asylum system, establishment of, 317–19, 320–21
asymmetrical brain, 415–19
As You Like It (Shakespeare), 299
Atay, Joanne, 494
Ativan, 118, 119, 422
attachment:
evolutionary role of, 411–14
role of grief in formation of, 412, 435
attention deficit hyperactivity disorder (ADHD), 175, 181–82, 186, 460
attention span, medication effects on, 88–89, 423, 425
atypical antidepressants, 114, 118, 193
atypical depression, 48, 114
Augustine, Saint, 292, 306, 478
autism, 175
autoreceptor agonists, 116
Axelrod, Julius, 332
Aztecs, hallucinogenic drugs used by, 291
B
Ball, H. Irene, 447–48
Ballenger, James, 65, 111, 119, 124, 406
Baltimore, Md., depression treatment study on indigent HIV/AIDS populations in, 340
Barbey, J. T., 495
barbiturates, 254
Barlaeus, Caspar, 304
Baron, Richard, 368
basil, 288
batterers, 178–79, 180
Baudelaire, Charles, 315
Bazelon Center, 381
Beck, Aaron, 107, 471
Beckett, Samuel, 285–86, 329–30
Beddoes, Thomas, 319
Bedlam, 309, 318, 481–82
behavioral control, 328–29
see also cognitive-behavioral therapy
Bell Jar, The (Plath), 66
Benshoof, Janet, 109, 237, 438
benzodiazepines, 119, 193, 234, 469–70
Berger, M., 145
beta-adrenergic receptors, 333
bethanechol, 116
Biathanatos (Donne), 247
Bible, 292–93, 478
Bicàtre, 309, 482
Bielik-Robson, Agata, 201
Bingen, Hildegard von, 294
bipolar illness, see manic-depressive (bipolar) disorder
bipolar two, 92
birds, nesting behavior of, 406, 413
Birtchnell, J., 405
bisexuals, 202, 207–8
Bisgaard, Poul, 210
black bile, melancholy as excess of, 286–87, 288, 290, 291–92, 298, 306
black people, depression experiences of, 195–200, 351
Blair-West, G. W., 447
Blake, William, 309
blood-brain barrier, 123
blood sugar levels, 136, 139
Bloom, Harold, 470
BMAP (Brain Molecule Anatomy Project), 171–72
body, mechanistic models of, 306–8
body net, 423
body temperature, 56, 452
Boerhaave, Hermann, 307, 308, 309, 481, 483
Book of Common Prayer, 302
Boorstin, Robert, 370, 371, 441
Bostwick, J. M., 447
Boswell, James, 309–10
bowel problems, 65
Bower, Bruce, 459
brain:
asymmetry of, 415–19
autopsies of, 319
blood circulation within, 307, 417, 418
“decade of the,” 369
in imaging technology, 254, 362, 417
magnetic stimulation of, 139, 418
medical model of, 320
nervous system supervised by, 289
psychosurgery on, 137, 163–65, 441
as seat of emotion/mental illness, 286, 413–14, 418, 419
triune model of, 414–15
brain chemistry, 20–22, 111–14
anxiety problems and, 65, 111
ECT effects on, 121, 123
emotional mind vs., 102, 111
neural electrical impulses vs., 330
suicidality and, 252–54
talking therapy effects on, 111
theories of antidepressant actions on, 331–33
see also neurotransmitters; specific neurotransmitters
brain function:
adaptability of, 56, 112–13, 307
Alzheimer’s disease and, 192–93
cellular adaptive capacity in, 56
evolution of, 413–19
flexibility of, 416
genetic research project on, 171–72
impact of depressive episodes on, 55, 56
substance abuse effects on, 217–18, 219–20, 222–23, 231, 233
Brain Molecule Anatomy Project (BMAP), 171–72
breakdowns, 17, 39–99
cumulative causation of, 48–49
defined, 48
eating difficulties in, 50, 54, 55
immobility experienced in, 52–53
physiological functions affected by, 55–56, 448
sleep patterns in, 51
breastfeeding:
antidepressant medications and, 83
childhood loss of, 325, 326
Brecht, Bertolt, 321
breech birth, 40
bromocriptine, 116
Brontë, Charlotte, 133–34
Brown, George, 62, 63, 65, 175, 347, 450, 458
Brown, John, 311
Brown, Thomas, 455
Buckingham County, Va., depression treatment studied in women of, 339–40
Bucknill, John Charles, 485–86
Bukowski, Charles, 250, 472
Bulgakov, Mikhail, 7
bupropion, 116, 118
Burke, Edmund, 311
burns, self-inflicted, 421, 422, 424
Burton, Robert, 301–4, 310, 323, 480
BuSpar (buspirone), 78, 86, 87, 116, 119, 235, 383, 422, 447
B vitamins, 138–39
C
caffeine, 224, 225, 230, 397
Callahan, Roger, 142, 454–55
Cambodia, depression
of trauma survivors in, 32–37
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