Against Depression by Peter D. Kramer is an astonishing volume. It is not your standard work on a mental disorder – in fact, the title is both misleading and exactly on point. Against Depression is not so much about explaining and treating depression as it is a polemic literally against depression. Kramer effortlessly skips across a wide variety of knowledge clusters to formulate his argument, as comfortable delving into artistic exegesis of paintings to literary analysis of any of a variety of authors – modern and past, and then again into the depths of history and the cutting edge of scientific discovery – especially in the arena of the biological and physiological nature of depression.
Kramer argues that (a) humanity has a bias against the curing of depression because (b) we are afraid that some positive traits/activity will be lost if the depressed are cured (e.g. moody, brooding literary and artistic works; a deep understanding of pain; alienation (against tyranny); hope for a better world) but that (c) the result of curing depression would be a fuller humanity, not a lesser one.
Kramer’s work is a piece of art. Kramer shows an almost infinite capability to string together diverse topics and observations to make cognizant arguments. He is as comfortable discussing literary and artistic analysis as philosophy, psychotherapy, and the latest cutting edge science relating to the biological and physiological nature of depression. There is the unfortunate fact that someone’s editor didn’t do the best job proof-reading in two or three chapters1The number of errors in these several chapters are almost stunning, especially in comparison to the rest of the volume. I am wondering if these chapters were inserted at the end and did not receive the same rigorous process as the rest of the book, though the chapters themselves are interspersed throughout the book, not appearing chronologically at the end.. Besides this, Kramer’s writing is much more a philosophical work than anything else and it carries a philosopher’s tone. It is not the easy reading one has come to expect from lay-illness volumes – not only in its vocabulary but in the concepts it communicates and the time and space Kramer dedicates to these concepts. Still, the volume is extremely well-done and the task which Kramer has undertaken is a massive one, which we will discuss a little later, and as such one can lend little criticism against a volume that undertakes such as an impossible task.
Do We Fear The Cure?
Kramer is able to convincingly argue that we do fear a cure for depression. We believe that depression is part of our humanity – while it may not be in every person we cannot imagine some people without it. We wonder if by curing their depression we are in fact simply muting a portion of their personality, forcing everyone into a standard definition of humanity with little room for differentiation. Kramer reports repeatedly receiving the question, “What if prozac had been available to…?” (Nietzsche, van Gogh, Poe, Woolf). In other words, would we not lose the intellectual and artistic drive that this depression caused?2Neither Kramer, nor I in my agreement with him, believe that treatment can be pursued without any consideration for its effect on the personality. In fact, Kramer acknowledges that treatment can affect the personality – but suggests that this is because we have blunt treatments, not the fine surgical ones we need. His polemic indicates a desire to carefully advance the treatment of depression with consideration for the larger dangers of affecting personality. At the same time, he (and I, following after in his shadow) would suggest that depression itself is a disease and that the treatment of a disease with the right tools is the right thing, without question.
But It Isn’t Honorable…
Kramer goes on to argue that we don’t give other diseases this distinction – we don’t suggest that individuals should keep their cancer or their heart disease. We don’t claim that there is something inherently valuable that adds to a person’s personality in the illness. Yes, there may be something that the individual learns, but this is not inherent in the illness itself. He suggests that we can ask the question if illness is every useful, but that this question cannot be posed to depression specifically, but must be posed across the board to all diseases. In other words, it is unfair to pick out one group of sufferers who we choose must suffer so that humanity can benefit from the lessons they learn, while all other sufferers are treated.
Kramer goes on to demonstrate from cutting edge research that depression does not advance a person’s abilities to think and create but rather dulls them and that the research indicates long-term, irreversible damage to the physiological structure of the brain is caused by depression.
A Better Future…
Kramer attempts to draw a picture of a future without depression and suggests that it would create a better humanity, not a shallower, more bland humanity. He suggests that the fullness of personality is restored in healing from depression, not caused by depression. That the characteristics we see in the depressed individual while sometimes admirable in and of themselves (e.g. unrest with the current life situation) are not valuable when they come from disease rather than a person’s own personality.
A fascinating philosophical read that at its deepest asks what it means to be fully human and what role depression plays in encouraging or discouraging humanity, as well as evaluating our historical literary and artistic preference for works created by and about depressive themes to those of more brightness – and whether this indicates an inherent greater value in these works or a taint to humanity that we desire such.