What do you say to people who ask if you’ll eventually stop taking medication?
I say to people that they don’t expect a diabetic to stop taking insulin, or someone with a heart condition to stop taking blood thinners. I have a chronic, lifetime disease and the only responsible thing for me to do is stick with my medications.
People wonder about medications’ long-term effects on the brain. I explain that while the medications’ effects appear to be reversible as soon as you stop taking them, the long-term effects of having repeated depressive episodes appear to be absolutely dire. There is lesioning of the hippocampus, and brain cells die. And this is in addition to the havoc that such repeated episodes cause in your daily life.
Imagine you have heart disease. You’re prescribed medication, you do better for a while, so you stop the meds. Then you have another heart attack, so you go back on the medication to get better. Twelve heart attacks later, what kind of shape are you in? It’s obviously crazy. If you have recurrent depression, you are not being “courageous” or “genuine” to go off your medication. You’re being foolish.
Can you explain the importance of balancing therapy and medication?
Different treatments work for different people, and I am open to the endless possibilities out there. But for most people, a combination of medication and therapy is the surest-fire way to handle depression.
The medication alleviates the worst symptoms and lets you function again. It makes life and the world bearable. But once you have emerged from the horror, you need to learn skills for managing the illness. You need to understand where it comes from. You need to make your peace with the idea that you cannot be fully yourself without the use of medications or other support structures.
And you need someone capable who can keep an eye on you. Ideally, you also need to understand the structure of your own personality and who you are; this gives you a feeling of peace and allows you to get through a difficult time with dignity.
By his mid-twenties, Solomon established himself as a multi-disciplinary wunderkind, earning international accolades for his work as a novelist, journalist and historian. After the death of his mother, the then 31 year old Solomon descended into a major depression, rendering him unable to work or even care for himself. He was helped by a combination of medications and talk therapy. This experience formed the bedrock for his National Book Award-winning “Noonday Demon: An Atlas of Depression”, a tour de force examining the disorder in personal, cultural, and scientific terms.