Review of Nell Casey (ed.)’s Unholy Ghost: writers on depression:

This powerful collection of reflections on depression includes some well-known authors,

such as Ann Beatie, Susanna Kaysen, and William Styron, but for the most part the less

well-known writers outshine the big names. Possibly that is because editor Nell Casey

had more influence over the less prestigious writers, and encouraged them to crystallize

their ideas. Nearly all of these pieces are new, while a few have been printed

previously in magazines, and just two are extracts from previously published books. All

the authors have been in close contact with depression, either personally or though

helping a family member deal with a crisis. The experience of these writers gives their

contributions authority and depth, and their ability to reflect on this experience makes

this collection both thoughtful and moving.

There’s a common misconception (which I encounter all the time in contending with the families, spouses, employers and friends of the depressed people I treat) that clinical depression is just like the ‘down’ times that the rest of us experience. Untold fractiousnessness and second-level suffering results from the message to the depressed patient that they should just “snap out of it” by “force of will” and “get on with their life”, and the like. For those tolerant of a literary approach, this book is the best antidote I’ve found (I used to recommend William Styron’s Darkness Visible, which is excerpted in this anthology.) to give the skeptic some perspective on the qualitatively distinct suffering of a person in the throes of a deep depression.

Consider this, poet Jane Kenyon’s “Having it Out with Melancholy”, especially the brutal, starkly riveting stanza 7 whose central image has burned its way indelibly into my consciousness since I first encountered this poem many years ago:

If many remedies are prescribed

for an illness, you may be certain

that the illness has no cure.

–A. P. CHEKHOV, The Cherry Orchard

1 FROM THE NURSERY

When I was born, you waited

behind a pile of linen in the nursery,

and when we were alone, you lay down

on top of me, pressing

the bile of desolation into every pore.

And from that day on

everything under the sun and moon

made me sad — even the yellow

wooden beads that slid and spun

along a spindle on my crib.

You taught me to exist without gratitude.

You ruined my manners toward God:

“We’re here simply to wait for death;

the pleasures of earth are overrated.”

I only appeared to belong to my mother,

to live among blocks and cotton undershirts

with snaps; among red tin lunch boxes

and report cards in ugly brown slipcases.

I was already yours — the anti-urge,

the mutilator of souls.

2 BOTTLES

Elavil, Ludiomil, Doxepin,

Norpramin, Prozac, Lithium, Xanax,

Wellbutrin, Parnate, Nardil, Zoloft.

The coated ones smell sweet or have

no smell; the powdery ones smell

like the chemistry lab at school

that made me hold my breath.

3 SUGGESTION FROM A FRIEND

You wouldn’t be so depressed

if you really believed in God.

4 OFTEN

Often I go to bed as soon after dinner

as seems adult

(I mean I try to wait for dark)

in order to push away

from the massive pain in sleep’s

frail wicker coracle.

5 ONCE THERE WAS LIGHT

Once, in my early thirties, I saw

that I was a speck of light in the great

river of light that undulates through time.

I was floating with the whole

human family. We were all colors — those

who are living now, those who have died,

those who are not yet born. For a few

moments I floated, completely calm,

and I no longer hated having to exist.

Like a crow who smells hot blood

you came flying to pull me out

of the glowing stream.

“I’ll hold you up. I never let my dear

ones drown!” After that, I wept for days.

6 IN AND OUT

The dog searches until he finds me

upstairs, lies down with a clatter

of elbows, puts his head on my foot.

Sometimes the sound of his breathing

saves my life — in and out, in

and out; a pause, a long sigh. . . .

7 PARDON

A piece of burned meat

wears my clothes, speaks

in my voice, dispatches obligations

haltingly, or not at all.

It is tired of trying

to be stouthearted, tired

beyond measure.

We move on to the monoamine

oxidase inhibitors. Day and night

I feel as if I had drunk six cups

of coffee, but the pain stops

abruptly. With the wonder

and bitterness of someone pardoned

for a crime she did not commit

I come back to marriage and friends,

to pink fringed hollyhocks; come back

to my desk, books, and chair.

8 CREDO

Pharmaceutical wonders are at work

but I believe only in this moment

of well-being. Unholy ghost,

you are certain to come again.

Coarse, mean, you’ll put your feet

on the coffee table, lean back,

and turn me into someone who can’t

take the trouble to speak; someone

who can’t sleep, or who does nothing

but sleep; can’t read, or call

for an appointment for help.

There is nothing I can do

against your coming.

When I awake, I am still with thee.

9 WOOD THRUSH

High on Nardil and June light

I wake at four,

waiting greedily for the first

note of the wood thrush. Easeful air

presses through the screen

with the wild, complex song

of the bird, and I am overcome

by ordinary contentment.

What hurt me so terribly

all my life until this moment?

Along these lines, you might be interested in The Literature, Arts, & Medicine Database, a multi-institutional project initiated in the summer of 1993 at the New York University School of

Medicine — an annotated bibliography of prose, poetry, film, video and art which is being developed as a dynamic,

accessible, comprehensive resource in Medical Humanities, for use in health/pre-health and liberal arts settings.