When I wrote about infirmity in Life is Hard, I did so with a caveat: I would treat only physical disability and somatic pain. I gave myself excuses: it would be rash to assume that psychological disability and psychic pain have much in common with their physical counterparts; and the book speaks to at least some forms of emotional distress in other chapters. But in truth, I was anxious that the subject is too hard.
I seem to have good—or plentiful—company. In a bracing post on the website of the American Philosophical Association, Brendan de Kenessey does the math:
The first time I was hospitalized for depression, it occurred to me to ask whether my fellow philosophers had anything to say about my condition. Walking down the long white halls to the inpatient ward’s lone, decade-old desktop computer, I searched Philpapers.org, a philosophy bibliography, for “depression.” Depression has its own category, with 179 entries—but if you filter out the entries that are not philosophy, not about depression, or not in peer-reviewed journals, you get 56. … For comparison, the category on conditionals (sentences of the form “if ______, then ______”) has 2,297 entries.
Philosophers are far more likely to suffer from depression than to write about it. … Assuming that depression strikes American philosophers at [typical] rates, [about] 600 philosophers—more than specialize in ancient philosophy—will experience a depressive episode this year alone.
I have written about myself—but I haven’t tried to write about depression. Why is that?
With physical pain, I found it helped to articulate the content of my experience, how chronic pain presents—or misrepresents—the body as damaged or under stress; how it disrupts one’s relation to everything else: not just the world beyond the body, but the body’s past and prospects. Once you give voice to chronic pain, you can listen with dispassion, and perhaps talk back.
Depression feels different to me. What is the content of depressed experience? It seems to colour the whole world—or to drain it of colour. De Kenessey writes about depression as a kind of disability, not a representational state: depression makes it impossible to appreciate what’s good.
You can still believe, in an intellectual way, that there are good things. You can say, “It’s good that infant mortality is declining.” You still want good things to happen to the ones you love. But you can’t experience the goodness of good things.
Perhaps depression, then, is a negative space: an absence of experience. But while I recognize this anhedonia, it leaves out—doesn’t it?—the active suffering of the depressed. Why is depression not a privation, like being bored, but a source of at times intolerable pain?
I read Donald Antrim’s recent memoir with these questions rattling through my mind. Antrim does not flinch from the obliterative power of his own depression or the challenge of conveying it in words. “When telling the story of my illness,” he writes, “I try not to speak about depression. I prefer to call it suicide.”
A depression is a concavity, a sloping downward and a return. Suicide, in my experience, is not that. I believe that suicide is a natural history, a disease process, not an act or a choice, a decision or a wish.
In a critical review of Antrim’s book, Daphne Merkin—who has written her own memoir of depression—objects to this “rhetorical gambit”:
suicide is sudden and immediate while depression is a long and often recurrent illness. There is no getting around it: the former is a decision, however impulsive and catastrophic; the latter is a passively endured condition…
A more sympathetic reader might acknowledge Antrim’s focus on one strain of suicide and one species of despair: his own. They might explore the image that sustains the first third of his book: the Friday in April when Antrim dangled from a fourth-floor fire escape, wondering if and when his fingers would let go.
But if active vs. passive is a false dilemma—since letting go when one cannot hold on is done but not decided on—so is Antrim’s opposition, sickness vs. choice. There are diseases of decision and desire.
“Suicide must not be imagined as enigmatic,” Antrim writes; “it isn’t poetry or philosophy.” But his account of it is enigmatic, a “natural history” that leaves its inner character obscure. His prose is matter-of-fact, schematic even, as he documents his treatment, relapse, and repair, cared for by a cast of friends who are little more than names. The most revealing moments in his book are ones of prosaic absurdity, not luminous introspection:
One day, the zipper on my winter coat jammed, and the metal zipper handle broke off, and I felt that my life was coming to an end.
What is the content of depressed experience? Antrim’s argument is not that the question has no answer, or that it can be answered without poetry or philosophy, but that they can distract us from the urgency of treatment. He gives an answer of his own, in brief:
If any one feeling has defined my life, it is the feeling, more an awareness than a thought, that only lonely rooms are safe.
But the answer plays no role in his recovery: we can treat depression, at least sometimes, without trying to make sense of it.
Antrim was treated with ECT and his book aims to destigmatize both his treatment and the psychiatric ward in which it happened. It is a measured plea for the medicalization of suicide:
We have the hospital. I was there. I wanted to live and not die. The hospital’s floors and white walls, and the bedrooms and bathrooms, were clean. The patients were not beaten, humiliated, or shoved aside. Medication was never forced. Solitude was possible, but no one was kept in isolation. A nurse was always close. I had my black canvas bag, with nothing in it that could harm me. There was soap on the bathroom sink ledge, and coffee with breakfast, and the comfort of other patients. We need our hospitals.
Amen to that.
My best excuse for leaving depression out of Life is Hard was that I didn’t know how to help. But perhaps there is a point in saying so. And others may have better thoughts. De Kenessey turns to philosophers who theorize value. But as his own case testifies, that is consistent with valuing medical care. His essay matters as much for its frank acknowledgement of hospitalization as it does for its philosophy.
We should resist a final false dilemma: depression as philosophical enigma vs. treatable disease. God knows, a malady can be both.
My niece, who is a physician, said that the movie Inside Out was neurobiologically accurate. Do you agree?
Your description of depression reminded me of that movie right away. I think the movie uses the metaphor of color as well.
You talk about Antrim and Merkin trying to approach the inner experience of depression and the connection with suicidal impulses. Simon Critchley's "Notes On Suicide" approaches from another direction: he alludes early on to his life seeming to dissolve, but then turns to the external patterns of suicide, not all of which (we presume) are driven by depressive states.
Here's a few notes on his book:
https://www.goodreads.com/review/show/1496990539