LITMIR.BIZ

Скачать книгу

We must suffer, and why shouldn’t we? Life is unfair, after all. No talent, no distinction; no charms, no love. Natural enough: how else could admiration and affection, and the consolations they entail, possibly be distributed? Even to save a depressed person’s life, you cannot admire or love him at will. In the trough of the illness, the sufferer’s wheeze, shuffle, torpor, unvaryingly anguished expression, frequent humiliating flubs, and exasperating indecision rapidly exhaust any but the most heroic devotion. Few of us can claim such devotion.

      Money is different, though. There is no natural way to apportion it. Some wealth, we all recognize, is unearned (quite a bit, if you go into the matter); and what is earned is not always deserved. No one can take credit for her own genetic endowment or early environment. Perfect markets do not and cannot exist. How we produce and distribute is a political question—economics is politics all the way down. Whether our current drastic inequality is fairer and more productive than our former moderate inequality depends entirely on what we’re aiming to produce—and become.

      People fall ill emotionally for any number of reasons, of course. As the poet Robert Lowell remarked, if we all had a little button on our forearm that we could press for a painless and instantaneous death, very few of us would reach old age. In some cases of severe depression, like mine, financial insecurity is central; in others, less so or not at all. There is always some way to help, and though nearly every way costs money, some would cost very little. Even a minimal government could afford them. Exercise, for example, is highly therapeutic for depression, but it is just what severely depressed people cannot force themselves to do. Young persons doing a year of national service could drag such people out for a vigorous walk each day, or do an hour of yoga with them. Or call them a few times a day to remind them to drink water—depressed persons nearly always dehydrate. Or drive them to a therapist—climbing the Himalayas is easier in some states of mind than getting out the front door is in others. The quantity of suffering diminished per dollar expended in these ways would be impressive.

      Or you could give them money. As I slid into one episode, tormented by money worries, I saw an article by Robert Reich in the American Prospect magazine. He proposed exempting the first $20,000 of income from the payroll tax, the most regressive of all taxes. This would save 130 million American households an average of $5,000 per year. You could pay for this fully, he pointed out, by retaining the estate tax, the most progressive of all taxes, which affects only 2 percent of American households. Five thousand dollars a year would save a lot of ordinary people a lot of grief, and incidentally fix the economy. It might even save some lives.

      Suicide, Albert Camus wrote, is the supreme philosophical problem. It is also, at least from the depressive’s point of view, a political problem. The official figure for suicides in the United States is 30,000 annually, as of 2003, generally thought to be an understatement. Call it 40,000. I’ve read that two-thirds of these are severely depressed—say 25,000. Ten to fifteen percent of severely depressed people, it seems to be agreed, will eventually kill themselves. So—very, very approximately—each year 250,000 of your fellow citizens, one in nine hundred American adults, will be at risk of death from the protracted, indescribable pain of severe depression.

      Reich’s article mentioned that half of the estate tax, or around $350 billion, is paid by only 3,300 families. That’s roughly one in 40,000 American households. If that money were simply handed over to the severely depressed, they would receive $1 million each. Bound to save some lives, though one should not underestimate the pain of lost Alpine ski vacations, designer clothes, and recreational drugs to the children of the superrich.

      Also around this time, the philosopher John Rawls died. Everything is grist for one’s obsessions, it’s true; but the connection with Rawls is not really so far-fetched. Standing behind Rawls’s famous veil of ignorance, you face a choice: You can accept one chance in 900 of being locked screaming in Room 101, together with one chance in 40,000 of avoiding all taxes on a huge estate. Or you can escape Room 101, and save many others from it, by giving up a negligible chance of enriching hypothetical heirs, not exorbitantly (that would still be permitted) but ultra-exorbitantly. Rawls would have thought the right choice obvious, and I suspect most Americans would agree with him, even if their elected representatives don’t.

      Admittedly, there are other, perhaps worthier, candidates for relief. Severe depression almost always ends, usually nonfatally. For many other people—a billion or so—illiteracy, malnutrition, diarrhea, infection, and other conditions far more easily preventable or curable than depression do not end. Even if these people’s nerves are not on fire, Rawls might have judged theirs the more pressing claim. I think I could accept that judgment, even if for me it meant another spell in Room 101.

      Why, you may be wondering, was this long whine ever written down? It’s not a memoir, not an argument—what is it, anyway? The first draft—very much shorter and even purpler—was a suicide note, to be left behind on the riverbank or rooftop or night table. Emotional blackmail in a good cause, I told myself, though perhaps it was only spite, the feeble revenge of the ill on the well. In any case, I dithered. Like many other acutely depressed people I was, fortunately, too exhausted and disorganized to plan a suicide, much less compose an eloquent rebuke to an uncaring world. And then, very slowly, the fire died down. My viscera gradually unknotted, my energy seeped back, speech became less effortful, the world regained three dimensions. Blessedly, miraculously, everyday unhappiness returned.

      Then why persist with the blackmail fantasy? Why risk bathos rather than keep a stoical and dignified silence? This was my third devastating depression, and probably not my last. I hope and intend to survive the coming ones, but already it seems urgent to try to salvage something from these ordeals. The conjunction of my pecuniary panic with a large-scale transfer of our national wealth to the already rich seemed to make an occasion. The vast popularity of depression memoirs and manuals in recent years suggests that there must be tens or hundreds of thousands of others whose sufferings, as intense as mine, would also have been lessened by crumbs of that wealth. And behind them, endless legions of the merely miserable. Perhaps they would want someone to say all this, however ineptly and futilely. If so, I won’t have come back from hell empty-handed.

      * The first chapter of How To Be Depressed was originally published in the literary magazine Agni in 2003.

       II. Documentia

      My mental health file whirs to life in 1969 in Cambridge, Massachusetts. I’d recently left Opus Dei, the Catholic religious order to which I’d committed my young soul, and a major depression had followed. The records printed below are out of the mouths of my many caretakers; they chronicle my treatment at various medical offices and psychiatric clinics in the Boston area from then until 2016.

      How did I come by them? As I headed into a depression a few years ago, a friend who was helping out thought it would be useful to see my records, so I asked for them. Why publish them now? Certainly not because I think these extracts from my treatment notes reveal an exceptionally interesting psyche, nor because I intend the slightest scandal to be visited on my therapists, employers, or insurance company. All proper names have been altered.

      Then why foist on you these sad memorials of my four decades of depression? These medical records and treatment notes do not display any special literary facility. In fact, they’re hardly written or composed at all—they’re a very distinct form of writing, almost a form of anti-writing. Over the last thirty or forty years, the process of documenting such encounters has changed drastically. It used to be much more free-form, wide open, reflective, and candid. You can still see some of that here, but for the most part, as medical liability has become more of a concern and the whole society has become more litigious, providers have become very much more self-protective. Now, instead of employing an individual voice to portray an individual subject, they limit themselves to handing you expeditiously on to the next provider, the notes a sort of bill of lading.

      Our distractible human intelligence needs as many ways of talking about depression as can be provided—that’s all my motivation in publishing them. Given the longevity and tenacity of this particular demon in this particular life—mine—it seemed important to me to try to squeeze some insight from the mass of words and array of prescription

Скачать книгу