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Exorcising the Depression Demon

By Michele Hatty

PROZAC HAS COME to define more than a generation of Americans, millions of whom suffer from depression badly enough to make the little green pills almost as common as aspirin. Consider the variety of "mood lifters" flooding the market, from Ativan to Zoloft. Even TV tough guy Tony Soprano sees a therapist.

For writer Andrew Solomon, 37, chronicling his own crippling decade-long depression has been cathartic. It spurred him to examine what's behind this modern state of mind in a new book, The Noonday Demon: An Atlas of Depression (Scribner, $ 28). He recently spoke with USA WEEKEND.

Why are we all so depressed?

Modern life has become steadily more stressful. We're trying to do more things at once; the pace of life has become steadily faster. There's more alienation. People are getting less and less sleep. High levels of stress are very closely tied to high levels of depression.

Studies say as many as 1 in 3 people suffers from depression. Why does it now seem inevitable that we'll need medication for it at some point?

Most of us of would have required medication 50 or 60 years ago if [it] had existed. Because it didn't, we made do.

You credit medication and therapy for your own recovery from three breakdowns.

The depression has not gone away. There is no cure. People say, "You seem fine now." Yes, because I take these medications. But if I stop, then I wouldn't seem fine. I would have another breakdown and seem very, very ill. If I had had a heart attack and had gone on heart medication, I couldn't go off [it]. You vneed to stay on the medication to stay fine.

Is that true of everyone?

You can try stopping the drugs, but if you feel worse, then you [should] start taking them again. That's the only way really to find out. Medications are helpful to most people who try them, but only 50% of people are responsive to the first medication they try. Most people will be responsive - it just might be the second one they try or the third that works.

But a pill won't solve all our problems. What will?

Balance. Balancing medications with psychotherapy and all of the other [aspects] of good health: exercise, rest. While you're taking the drugs, you should also be working on the talking therapy, trying to change the way you understand and see yourself retain some sense of self-knowledge and control over who you are.

Has the influence of pop culture helped to reduce the stigma of mental illness?

People demand a higher degree of psychological pleasure than they used to, and think: "I shouldn't just live with this. I should do something about it." That's a significant difference. [Still,] for every single person who tells you they've experienced depression or are taking antidepressants, there are 10 who don't want to discuss it openly. The better the treatments get, the more open people will be. [But] I think it will always be a little bit of "the family secret."