Speaker 1: Hi everyone. Our episode next week is a return episode
Speaker 1: from Johan Harri and it's a book called Lost Connections,
Speaker 1: Uncovering the real causes of depression and the unexpected solutions.
Speaker 1: And to get ready for that episode, I want to
Speaker 1: re release one of our very early episodes. It was
Speaker 1: episode number five, so it's going back a couple hundred episodes.
Speaker 1: It's with Andrew Solomon, who wrote a book called The
Speaker 1: Noonday Demon and Atlas of Depression and another book called
Speaker 1: Far from the Tree, and we had a wonderful conversation
Speaker 1: and we do talk about depression amongst some other things.
Speaker 1: This is one of my favorite conversations, again from a
Speaker 1: long time ago, but one of those that I think
Speaker 1: back on very fondly, so I hope you enjoy it.
Speaker 1: The music breaks our old guitar parts, which makes me
Speaker 1: think I need to get the guitar out more and
Speaker 1: the iPad out less. Let me know what you think,
Speaker 1: and next week we will have Johan are Lost Connections.
Speaker 1: The encounter with the things that are dark and that
Speaker 1: are terrible and that are difficult is just exactly the
Speaker 1: thing that gives when the energy to feed the wolf
Speaker 1: who represents goodness and kindness and virtue. Welcome to the
Speaker 1: one you feed Throughout time, great thinkers have recognized the
Speaker 1: importance of the thoughts we have. Quotes like garbage in,
Speaker 1: garbage out, or you are what you think ring true.
Speaker 1: And yet for many of us, our thoughts don't strengthen
Speaker 1: or empower us. We tend toward negativity, self pity, jealousy,
Speaker 1: or fear. We see what we don't have instead of
Speaker 1: what we do. We think things that hold us back
Speaker 1: and dampen our spirit. But it's not just about thinking.
Speaker 1: Our actions matter. It takes conscious, consistent, and creative effort
Speaker 1: to make a life worth living. This podcast is about
Speaker 1: how other people keep themselves moving in the right direction,
Speaker 1: how they feed their good wolf. Welcome to the show.
Speaker 1: Our guest today is author Andrew Solomon. Andrew is a
Speaker 1: regular contributor to the New Yorker Art Forum and the
Speaker 1: New York Times magazine. In addition, he is the author
Speaker 1: of several books, including The Irony Tower, Soviet Artists at
Speaker 1: a Time of Glass nost also The Noonday Demon, and
Speaker 1: a novel, A Stone Boat. He is the winner of
Speaker 1: the two thousand one National Book Award and a Pulitzer
Speaker 1: Prize finalist Andrew's newest book is Far from the Tree, Parents,
Speaker 1: Children and the Search for Identity. Hi, Andrew, welcome to
Speaker 1: the show. What a pleasure to be here. We're We're
Speaker 1: really glad to have you on. I've I'm a big
Speaker 1: fan of both of your books, so this is a real,
Speaker 1: real pleasure for us. So our podcast is based on
Speaker 1: the old parable where there's a grandfather who's talking with
Speaker 1: his grandson and he says, in life, there are two
Speaker 1: wolves inside of us that are always at battle. One
Speaker 1: is a good wolf, which represents things like kindness and
Speaker 1: love and joy, and the other is a bad wolf,
Speaker 1: which represents things like hate and greed and jealousy. And
Speaker 1: the grandson stops and he thinks, and he says, well, grandfather,
Speaker 1: which one wins? And the grandfather says, the one you feed.
Speaker 1: So I'd like to start off by asking you what
Speaker 1: that parable means to you in your life and in
Speaker 1: your work. I think that the attempt to lead a
Speaker 1: moral life is an urgent business forum for many of us,
Speaker 1: perhaps even for most of us, and that one is
Speaker 1: always trying to get away from exploitation. I think, especially
Speaker 1: as a writer, because there's a great deal of writing
Speaker 1: that he is exploited him. My aim is always to
Speaker 1: right work which is actually helpful to people, um to
Speaker 1: continue to be productive somehow of trying to improve and
Speaker 1: make the world better. It sounds a little pomp as
Speaker 1: an arrogant as the basis for writing. Partly I just
Speaker 1: right to describe things, but ultimately I think the goal
Speaker 1: is to do things that are moving. And as I've
Speaker 1: looked at the areas in which I work, including this
Speaker 1: area of psychology and psychiatry, I found over and over
Speaker 1: again that people are often working with a real view
Speaker 1: to somehow making a somehow making a better world. And
Speaker 1: I think that that attempt, in all of its urgency,
Speaker 1: is part of what gives human experience its meaning. Great.
Speaker 1: One of the themes that shows up in both books
Speaker 1: that I thought was really interesting, and it's something we
Speaker 1: talked about on this show a lot, and it was
Speaker 1: really about the core question of about what should we
Speaker 1: change in ourselves and what things should we accept in ourselves.
Speaker 1: In Far from the Tree, you have a lot of
Speaker 1: examples of families who took a more accepting approach to
Speaker 1: their kids disabilit at these versus other families who were,
Speaker 1: you know, uh, trying to change everything they could. I'm
Speaker 1: curious if you could expound a little bit more on
Speaker 1: that that theme. I think that I was looking at
Speaker 1: that particularly in terms of parenting, but everything I said
Speaker 1: about parenting is relevant also to one's attitude toward oneself.
Speaker 1: But I would say that one of the central activities
Speaker 1: of parenting is changing your children. You educate them, You
Speaker 1: teach them a sense of moral values, you try to
Speaker 1: teach them some manners, You try to give them all
Speaker 1: kinds of knowledge they didn't have. Not to change your
Speaker 1: children would be to neglect them terribly. But it's also
Speaker 1: part of the experience of being a parent that you
Speaker 1: have to accept your child for who he is or
Speaker 1: she is, and make him or her feel good about
Speaker 1: who they are or what their identity might be. And
Speaker 1: I think there are some things that obviously need to
Speaker 1: be changed, and there are some things that obviously need
Speaker 1: to be celebrate it, and there's a great deal that
Speaker 1: falls in a gray, foggy middle. And I think a
Speaker 1: lot of the time our experience comes down to that
Speaker 1: old serenity prayer about having the courage to change the
Speaker 1: things that you can um and the forbearance to accept
Speaker 1: the things you can't and the wisdom to know the difference.
Speaker 1: And I feel like that wisdom is one of the
Speaker 1: most urgent but elusive pieces of wisdom for people in
Speaker 1: their own formation of an identity and in their parents experience,
Speaker 1: and so often, especially in the families I looked at
Speaker 1: and far from the tree, who are dealing with children
Speaker 1: with various kinds of stigmatized identities. There is the quality
Speaker 1: that the child has, there is the sense that it
Speaker 1: is stigmatized and therefore carries a burden. There are treatments
Speaker 1: of one kind or another. Those treatments are themselves often
Speaker 1: very traumatic, are very difficult, and the balance between the
Speaker 1: treatment um and its costs and the condition and its
Speaker 1: costs needs constantly to be assessed and assessed and reassessed
Speaker 1: over and over again. That gray area is such a challenge,
Speaker 1: and the wisdom to know the right thing is is
Speaker 1: so difficult and so much a matter of understanding and
Speaker 1: knowing yourself. One of the things that you talked about
Speaker 1: that you said in the book, you're talking about the
Speaker 1: story of Lucy Greeley, who had multiple facial reconstruction surgeries,
Speaker 1: and you you you used her as an example to
Speaker 1: say she kept trying to constantly change herself. And you
Speaker 1: said that people who know their condition to be irreversible
Speaker 1: are often happier than people who believe it can be changed,
Speaker 1: that hope can be the cornerstone of misery. Can you
Speaker 1: talk a little bit more about that, people who know
Speaker 1: that their condition is irreversible are that are able to
Speaker 1: start the process of accommodating it. If you know that
Speaker 1: there's nothing that you can do about having a lost
Speaker 1: part of your leg, or having whatever the other debilitating
Speaker 1: condition is that you might have, you figure out how
Speaker 1: to live a good life with that condition. If you
Speaker 1: have a condition which is easily fixable, you easily fix it,
Speaker 1: and then you do a pretty good job of living
Speaker 1: once it's fixed. But a lot of people have conditions
Speaker 1: which might be fixable or might not be fixable, and
Speaker 1: that might be somewhat fixable but not fully fixable, where
Speaker 1: there's a lot of vagueness, And those people tend to
Speaker 1: live all the time with a sense that their condition
Speaker 1: requires them one way or another and to keep trying
Speaker 1: to fix it. And they keep trying, and often the
Speaker 1: fix doesn't happen at all, or it doesn't happen in
Speaker 1: a sufficient degree and so those people end up terribly frustrated.
Speaker 1: So I look, for example, at the experience of people
Speaker 1: with Down syndrome. You can't actually make the Down syndrome
Speaker 1: go away at this point. You can have strategies of
Speaker 1: early intervention that are helpful to people who wish to
Speaker 1: function well despite their Down syndrome, and responsible parents pursue
Speaker 1: those options. It's pretty clear with Down syndrome what the
Speaker 1: things are that people and what the things are that
Speaker 1: don't help people, and what the extent of the fix
Speaker 1: can be. But you get to autism and you discover
Speaker 1: that there are all kinds of usually rather Charlottean like
Speaker 1: people marketing all kinds of peculiar strategies that they claim
Speaker 1: if brought about a complete remission of autism. There are
Speaker 1: people who are falling into the hands of those practitioners.
Speaker 1: But there's also solid science which seems to suggest that
Speaker 1: certain interventions are helpful to certain people to certain degrees.
Speaker 1: And so the autism parent is left thinking is this real?
Speaker 1: Is this fake? Should I be pursuing as some sort
Speaker 1: of improvement? Should I not be? If I don't try
Speaker 1: to get my child therapies that will help him in mind,
Speaker 1: neglecting my child if I do get my child, these
Speaker 1: therapies are the therapies themselves so traumatic as to be
Speaker 1: more destructive than they warrant for the amount of improvement
Speaker 1: they'll bring about. And because autism is such a heterogeneous condition,
Speaker 1: how people will respond to a given treatment is very
Speaker 1: difficult to know ahead of time. And for every treatment
Speaker 1: that someone says has been a miracle, there's someone else
Speaker 1: saying that the pursuit of it was a tragedy. There's
Speaker 1: a great example in the book where you're talking about
Speaker 1: two women who have autistic children of a fairly similar
Speaker 1: functioning level, and one is a fairly wealthy woman and
Speaker 1: who is tired and frustrated and doesn't enjoy being with
Speaker 1: her you know, it is stressed out by her son
Speaker 1: because she's always trying to fix him. And then you
Speaker 1: you describe another woman who's of a much lower social
Speaker 1: economic status, who has no faith that she can fix him.
Speaker 1: You say, because she could never fix her own life.
Speaker 1: And she's a lot more she enjoys him and has
Speaker 1: a lot more a lot more time with him that
Speaker 1: that is pleasant, and she's less sort of run out
Speaker 1: by it. It was important to me never to suggest
Speaker 1: by any means that it's easier to deal with any
Speaker 1: of the conditions I was looking at if you're poor.
Speaker 1: Being poor makes everything more difficult than it is for
Speaker 1: people who have got greater means. Who are poor don't
Speaker 1: get the same rest but are They don't get the
Speaker 1: same assistance or support. They don't get the same opportunities.
Speaker 1: That being said, people who are more privileged tend to
Speaker 1: be more perfectionistic and often experience these children as imperfect
Speaker 1: and often throw themselves into trying to fix them. And
Speaker 1: often back to the theme that we were talking about
Speaker 1: a moment ago, what these children really require is not
Speaker 1: to be fixed, but to be accepted and even to
Speaker 1: be celebrated. And sometimes that's very difficult for people who
Speaker 1: keep thinking, but there's something wrong with my child, and
Speaker 1: I need to make it right. And it comes more
Speaker 1: readily to people who think my child is who my
Speaker 1: child is, and I just have to deal with what
Speaker 1: I've been given. What I liked a lot in the
Speaker 1: book is you're not. You don't really come down on
Speaker 1: either side of that debate. You're not. You're not suggesting
Speaker 1: anything one way or the other. You're just sort of
Speaker 1: exposing the different options and challenges out there. And one
Speaker 1: of the things that's so interesting about the book is
Speaker 1: it's a book about people who have different identities of
Speaker 1: of all sorts, but a lot of them are considered disability,
Speaker 1: whether it be fness, down syndrome, autism, and uh. But
Speaker 1: what comes through in the book over and over is
Speaker 1: the joy that some of those parents find in that.
Speaker 1: And you say that the main thing that drives whether
Speaker 1: the parents are joyful and how able they are to
Speaker 1: love their children is their ability to find meaning in
Speaker 1: what's happening. One of the mothers whom I interviewed said
Speaker 1: to me, people always give us these little sayings like
Speaker 1: God doesn't give you any more than you can handle.
Speaker 1: But children like ours are not preordained as a gift.
Speaker 1: There a gift because that's what we have chosen. And
Speaker 1: I believe that people make those choices all the time.
Speaker 1: I believe that people who have these children, who have
Speaker 1: these extraordinary identities are characteristics, really have to decide relatively
Speaker 1: early on, am I going to suffer with this and
Speaker 1: have a very difficult time with it? Or am I
Speaker 1: going to um an a organism? How say? This isn't
Speaker 1: what I would have chosen this is what I wanted.
Speaker 1: This isn't what I had in mind when I set
Speaker 1: out to have children, but it will allow me to
Speaker 1: grow and to learn, and to have in some sense
Speaker 1: of richer life than I would have had without it.
Speaker 1: And I was impressed at how often people really do
Speaker 1: make that decision and how often they conform to it.
Speaker 1: Which is not to say that their lives are necessarily easy,
Speaker 1: or that given everything to do over again, they would
Speaker 1: have chosen these experiences. But one story after the next
Speaker 1: really dwelt on the sense that dealing with disabled people
Speaker 1: had made people kinder and more tolerant, and more open
Speaker 1: and more generous in all kinds of profound ways. And
Speaker 1: I remember one mother who had a child with Down syndrome,
Speaker 1: and who had ended up spending most of her life
Speaker 1: working to improve educational opportunities for kids with d S,
Speaker 1: saying to me, Um, you know, for our son, I
Speaker 1: wish I could make it go away, because it's a
Speaker 1: difficult way to be in the world, and I would
Speaker 1: like to give him an easier life. But speaking for myself,
Speaker 1: while I would never have believed twenty six years ago
Speaker 1: when he was born, that I could come to such
Speaker 1: a point I have. For him, I would make it
Speaker 1: go away in an instant. But for me it's given
Speaker 1: me so much richer and so much more purposeful a
Speaker 1: life than i'd ever otherwise have had. That Speaking for myself,
Speaker 1: I wouldn't give it up for anything in the world.
Speaker 1: One of the challenges I have in doing this show
Speaker 1: is that I have to read a book a week
Speaker 1: for the guests that come on, which I love doing. However,
Speaker 1: it leaves me very little time to read other books.
Speaker 1: If you're like me, the list of books you want
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Speaker 1: one thing that I think is a real can be
Speaker 1: a real poison in our culture and in our minds
Speaker 1: is comparing ourselves to other things. And and in the
Speaker 1: book The Noonday Demon uh an Atlas of depression, where
Speaker 1: you you talk about your own depression and you study
Speaker 1: depression in a lot of different circumstances, you reference the
Speaker 1: harm that the emergence of supermodels, did you know, the
Speaker 1: cultural emergence of supermodels did to women's views of themselves,
Speaker 1: And then you talk about something uh similar version of that,
Speaker 1: a psychological supermodel that we all seem to think we
Speaker 1: need to aspire to. And I think I'd like to
Speaker 1: ask you to talk a little bit more about that
Speaker 1: in the context of depression, and also in the context
Speaker 1: of families who have a child who is different and
Speaker 1: their initial it's not meeting the standard that they had
Speaker 1: expected or hoped for. Well in depression, I think there's
Speaker 1: the problem that people believe that the appropriate way for
Speaker 1: them to live is in a state of sort of
Speaker 1: constant rapture um. You know, you look at the representations
Speaker 1: of happiness that occur in a great deal of daytime
Speaker 1: television and popular culture of various kinds, and there's a
Speaker 1: suggestion all the time that you should be happy. And
Speaker 1: I don't think people especially expected to be happy, or
Speaker 1: at least not to be happy that much of the time,
Speaker 1: even forty or fifty years ago. And I think this
Speaker 1: notion somehow in a celebrity culture, For all that we
Speaker 1: see celebrities going through complete meltdowns and falling to pieces,
Speaker 1: we still see a lot of them and somehow having
Speaker 1: these wonderful, perfect lives, and we feel like, if my
Speaker 1: life isn't wonderful and perfect, I've failed. Now. It's hard
Speaker 1: enough to deal with the fact that you're depressed or
Speaker 1: with the fact that you're struggling in any of a
Speaker 1: broad variety of other ways without having the sense that
Speaker 1: it's a humiliation not to be perfect and not to
Speaker 1: be completely and perfectly happy. And because people have seen
Speaker 1: these images of extreme happiness that keep being represented to us,
Speaker 1: people often blame themselves and have a sense of enormous
Speaker 1: failure in connection with their own depression. So they're both
Speaker 1: depressed and feel like failures for being depressed. And I
Speaker 1: think that's a very unfortunate and very painful layering that
Speaker 1: takes place in looking at how that applies to the
Speaker 1: families I was interviewing and far from the tree with
Speaker 1: all of their engagements with these unusual and extraordinary children.
Speaker 1: I think a lot of the time the parents had
Speaker 1: a vision for their own lives, which was for everything
Speaker 1: to go perfectly, and then they have a child who is,
Speaker 1: in the eyes of the world, damaged and not as
Speaker 1: good as a child was not affected by one of
Speaker 1: these conditions, and they find it shameful and they feel
Speaker 1: somehow responsible for it, and they feel embarrassed for it. Well,
Speaker 1: that gives them, the parents, a much less robust and
Speaker 1: positive life than they would have had otherwise. But additionally,
Speaker 1: it gives their children a much lower level of self esteem.
Speaker 1: And there's a constant struggle that I think goes on
Speaker 1: between these parents and these children, in which the parents
Speaker 1: are hopefully moving toward um out of the outrage they
Speaker 1: often feel at the time of diagnosis, through the bewilderment
Speaker 1: that usually follows the outrage, into the acceptance which is
Speaker 1: really necessary for them to lead an okay life, and
Speaker 1: onward to celebration. And the movement through those four stages,
Speaker 1: and they aren't completely linear. You can get to the
Speaker 1: point of celebration and then you have a setback in
Speaker 1: your outraged all over again. But the movement through those
Speaker 1: stages with acceptance and celebration as the end goal is
Speaker 1: a way of rising. I think to the occasion of saying,
Speaker 1: I will not insist on the supermodel vision of what
Speaker 1: my family should look like. I will not insist on
Speaker 1: the supermodel vision of what my own moods and characters
Speaker 1: should be like. I will rather live authentically in my
Speaker 1: own experience, find as much happiness as I am able
Speaker 1: to find, and be grateful for the happiness I found,
Speaker 1: and live in the compass of it. Excellent. So I'd
Speaker 1: like to switch now and talk a little bit more
Speaker 1: about the Noonday Demon, the book about depression, and I
Speaker 1: had talked to you before the show about reading a
Speaker 1: section of it. Could you go ahead and walk us
Speaker 1: through that or read that force? Some people seem to
Speaker 1: give in to their depression, others seem to battle it.
Speaker 1: Since depression is highly demotivating, it takes a certain survivor
Speaker 1: impulse to keep going through the depression, not to cave
Speaker 1: into it. A sense of humor is the best indicator
Speaker 1: that you will recover. It is often the best indicator
Speaker 1: that people will love you. Sustain that, and you have hope.
Speaker 1: Of course, it can be hard to sustain a sense
Speaker 1: of humor during an experience that is really not so funny,
Speaker 1: it is urgently necessary to do so. The most important
Speaker 1: thing to remember during a depression is this, You do
Speaker 1: not get the time back. It is not tacked on
Speaker 1: at the end of your life to make up for
Speaker 1: the disaster years. Whatever time is eaten by a depression
Speaker 1: is gone forever. The minutes that are taking by as
Speaker 1: you experience the illness are minutes you will never know again.
Speaker 1: No matter how bad you feel. You have to do
Speaker 1: everything you can to keep living, even if all you
Speaker 1: can do for the moment is to breathe, wait it out,
Speaker 1: and occupy the time of waiting as fully as you
Speaker 1: possibly can. That's my big piece of advice to depress people.
Speaker 1: Hold onto time. Don't wish your life away. Even the
Speaker 1: minutes when you feel you are going to explode, our
Speaker 1: minutes of your life, and you will never get those
Speaker 1: minutes again. Thank you. That's a really beautiful, beautiful section,
Speaker 1: and I think it goes back a little bit to
Speaker 1: the idea of to some extent, if we're always wishing
Speaker 1: we were somewhere else and severe severe depression is a
Speaker 1: is a different worry. But the mild depression is often,
Speaker 1: at least for me, accompanied by that desire that I
Speaker 1: was somewhere else, doing something else, someone else, And I'm
Speaker 1: missing the moments of my life that are in front
Speaker 1: of me, regardless of how they may appear, they are,
Speaker 1: they are my life. And I like the way you
Speaker 1: you put that a lot. Yes, I think you know,
Speaker 1: depression is inherently painful. It's not painful because of social prejudice.
Speaker 1: It's not painful because of your own attitude toward it.
Speaker 1: It is inherently painful. And most of us really don't
Speaker 1: like painful experiences and would like to avoid them. But
Speaker 1: I've met people who have said that they went through
Speaker 1: a period of years when they were dystheymbic, which is
Speaker 1: to say they had milder depression, or when they were
Speaker 1: in and out of depression. Andrew said, I just spent
Speaker 1: all of that time wishing that things were different, and
Speaker 1: now I realized I wasted a big part of my
Speaker 1: youth in that enterprise. And I sometimes say when I
Speaker 1: talked to people about the pursuit of treat people will say, well,
Speaker 1: you know, I really was considering getting some kind of treatment,
Speaker 1: but I think I'm going to be able to beat
Speaker 1: this on my own, and I'm just gonna stick it out,
Speaker 1: and if it's still not working out that well in
Speaker 1: six months, then maybe I'll talk to someone and I say,
Speaker 1: look in, um, in six months, you're going to be
Speaker 1: twenty nine and you'll never be twenty eight again, and
Speaker 1: you will have lost six months of being twenty eight
Speaker 1: to this project of duking it out on your own.
Speaker 1: So why do you try to avail yourself of whatever
Speaker 1: treatments there are to get as well as you're able
Speaker 1: to get, as quickly as you're able to get there,
Speaker 1: Because otherwise, the longer you put it off, aside from
Speaker 1: the treatment implications and it's possibly escalating. But the longer
Speaker 1: you put it off, the longer it's going to be
Speaker 1: that you've missed a chunk out of your life, and
Speaker 1: when you're feeling well again, you'll regret that you missed
Speaker 1: half of the year you were twenty eight, right. I
Speaker 1: was curious to ask you you you wrote The Noonday Demon.
Speaker 1: Has it been ten years since it was published? I
Speaker 1: came out in two thousand one, Okay, so it's been
Speaker 1: it's been longer than that. I was curious if you
Speaker 1: have any thoughts about how treatment for depression has improved
Speaker 1: and changed since you wrote the book. I've actually just
Speaker 1: finished writing an epilogue for the book that will be
Speaker 1: in a new edition of it to bring it up
Speaker 1: to date, partly to bring up to date my own
Speaker 1: experience and that of the people in the book, but
Speaker 1: also to look at treatment. There has not been dramatic
Speaker 1: advancement in the area of antidepressant medication. The big insights
Speaker 1: about neurotransmitters that drove the development of the popular antidepressants
Speaker 1: remain the primary insights for psychopharmacology. Where there has been
Speaker 1: a certain amount of progress is in the treatment of
Speaker 1: so called treatment resistant depression for people who fail all
Speaker 1: of what were previously our existing technologies. Ketamine, which was
Speaker 1: long sold on the streets as special K, is now
Speaker 1: increasingly being used, still on a very experimental basis, for
Speaker 1: people with acute, refractory, unrelenting depression. And they found that
Speaker 1: many people who have been suicidal for an extended period
Speaker 1: of time will after a single infusion of ketamine intravenously
Speaker 1: have that depression remit um. It often remits within a
Speaker 1: few hours um and so that's an extraordinary effect. Because
Speaker 1: the antidepressant medications we have take weeks and weeks to work. Unfortunately,
Speaker 1: ketamine is a substance of abuse and the effects that
Speaker 1: it has are effects that can have many unwanted downstream effects,
Speaker 1: so it's not really a practical line of treatment, and
Speaker 1: the improvement it induces usually lasts only a week to
Speaker 1: ten days, occasionally to two weeks, so it's not really
Speaker 1: a practical means of treatment. But the fact that it
Speaker 1: works sets up an understanding of other pathways than the
Speaker 1: ones we know for the treatment of depression and hopefully
Speaker 1: will be applicable, and there are a number of things
Speaker 1: that are in development now that would operate on the
Speaker 1: same pathways as ketamineum. The other I think really major
Speaker 1: advance is the advent of deep brain stimulation, which was
Speaker 1: pioneered by Helen Mayburg and Emery. It's a surgical process
Speaker 1: in which a little electrode like the ones that are
Speaker 1: used for the treatment of Parkinson's disease. It's actually implanted
Speaker 1: quite deep in the brain and connected to a battery
Speaker 1: pack which sends a constant electrical signal to the area,
Speaker 1: and it changes the activity of something called Broca's area
Speaker 1: twenty five in the brain, which had not previously been
Speaker 1: associated with depression or really much studied at all, but
Speaker 1: which may Burg, who's an imaging specialist, had designated as
Speaker 1: the locusts of a lot of disregulation and depressed patients.
Speaker 1: It's obviously an invasive brain surgery. It's done only for
Speaker 1: people who have extreme, extreme depression that's been unresponsive to
Speaker 1: psychotherapy and medication and electroshock or electro convulsive treatment and
Speaker 1: sell them and so forth. But but for the people
Speaker 1: in whom it's worked, it's been quite remarkable. Um. There
Speaker 1: is a wonderful description of Mayber working with a patient.
Speaker 1: The patients have to remain conscious while it's being done
Speaker 1: because their consciousness can help to help them to respond
Speaker 1: if something is going wrong in the way that it's
Speaker 1: being inserted. And she puts the device in and then
Speaker 1: she turns it on and she never tells them when
Speaker 1: she's turning it on. And she had one patient on
Speaker 1: the operating table. She turned on the device and he
Speaker 1: suddenly looked at her and said, what did you just do?
Speaker 1: And she said why, and he said, all my life
Speaker 1: I've been locked in a room with a thousand screaming
Speaker 1: children and they've just left the building. So it's extraordinary work. Again,
Speaker 1: it's not practical for a broad range of people, but
Speaker 1: I think there's a feeling that it may provide insights
Speaker 1: that will ultimately be applicable to a larger range of people.
Speaker 1: It does seem to be a lot more um you know,
Speaker 1: transcranial direct stimulation and other there ways that are emerging
Speaker 1: that appear to be less invasive than that, but follow
Speaker 1: some principles around stimulating neurons via electricity. That seems seemed
Speaker 1: to be a lot more studies around that. I was
Speaker 1: curious about how, and it's going to be in your epilogue,
Speaker 1: but how has your depression been since you published the book.
Speaker 1: The sense that my depression was so disabling that it
Speaker 1: was destroying my life is now well and truly behind me,
Speaker 1: but it requires constant management. I'm on permanent medication and
Speaker 1: in permanent therapy, and when life gets very stressful, I
Speaker 1: have up kicks and surges of it. Again. I tried
Speaker 1: to make some changes in my medication to get away
Speaker 1: from some side effects about eight or nine years ago
Speaker 1: with catastrophic effects and went into a release severe depression
Speaker 1: and had to cancel various plans that I had and
Speaker 1: was unable to function really for a little while, and
Speaker 1: then I managed to pull out of that. UM. I
Speaker 1: had something of a depression when I published Far from
Speaker 1: the Tree. I had worked on the for eleven years.
Speaker 1: I found the idea of letting it go out into
Speaker 1: the world sort of terrifying. UM. I was under an
Speaker 1: enorsement of stress. I then developed a physical problem with
Speaker 1: partial hearing loss UM sensory neural hearing loss. I have
Speaker 1: had some of my hearing and my left ear come back,
Speaker 1: but my hearing is permanently compromised. There. I found the
Speaker 1: mix of feeling like my hearing was going and feeling
Speaker 1: like I was in this terribly self exposing business of
Speaker 1: putting my book in the world really overwhelming, and I
Speaker 1: found myself getting incredibly anxious in the way that I
Speaker 1: had when I was depressed, and feeling over and over
Speaker 1: again as though I couldn't get through UM this day,
Speaker 1: I couldn't get through the next day, I couldn't get
Speaker 1: through the day after that. I think I have the
Speaker 1: advantage now of having leaved through a number of depressive episodes,
Speaker 1: and so even when I'm feeling my worst, there's some
Speaker 1: rational piece of me that knows you will feel better
Speaker 1: and it won't take that long and you just have
Speaker 1: to ride this out. But at last it for quite
Speaker 1: a while, and it was really very horrible. And in
Speaker 1: a sense, when you've been feeling all right for a
Speaker 1: long time, you forget how physical and how horrible it is.
Speaker 1: You forget that you lie there in that state of
Speaker 1: line panic, unable to sleep for days at a time,
Speaker 1: or doing nothing but sleep for days at a time.
Speaker 1: You forget the sense that you're completely helpless in the
Speaker 1: clutches of it. And I found which was interesting to me.
Speaker 1: Now that I'm through that episode, I can talk about
Speaker 1: it very cavalierly, but while it was going on, it
Speaker 1: felt shameful and it was very hard for me to
Speaker 1: speak about it. Yeah, there are a lot of good
Speaker 1: points in in what you said there. I think one
Speaker 1: of the things I've learned to do is treat recurrent
Speaker 1: symptoms of depression. And I haven't had it to the
Speaker 1: disabling sense that you describe, but as I've learned to
Speaker 1: sort of tell myself, I've got the emotional flu, it's
Speaker 1: a lot like having the flu. I'm like, Okay, this
Speaker 1: is just gonna go. It's something that comes I don't
Speaker 1: need to reevaluate the entire context of my life at
Speaker 1: this moment. I don't need to make a big deal
Speaker 1: out of it. I just need to hide it out
Speaker 1: and that's been really helpful for me over time. And
Speaker 1: one of the things that I like a lot there
Speaker 1: at the end that you said is is that it
Speaker 1: still is when we're in the midst of it. It
Speaker 1: is still very difficult and very shameful feeling. It's easier
Speaker 1: to talk about it outside of it. But thank you
Speaker 1: for the work you're doing in talking about it, because
Speaker 1: people not talking about it and hiding it is one
Speaker 1: of the worst ways to handle mental illness. For sure. Yes,
Speaker 1: it is definitely one of the worst ways to handle it.
Speaker 1: And I think, as I said earlier in the program,
Speaker 1: that that burden of secrecy adds to the burden of
Speaker 1: the disease, and that the burden of dealing with both
Speaker 1: of them at the same time is utterly overwhelming. I
Speaker 1: always think about the gay activist Harvey Milk, who, when
Speaker 1: he was asked by a younger gay man what he
Speaker 1: could do to help the call, Harvey Milk said, go
Speaker 1: out and tell someone. And I think there has been
Speaker 1: in general, a great deal more openness about mental illness,
Speaker 1: and that as more and more people speak about it
Speaker 1: more and more openly, the stigma associated with it gets less.
Speaker 1: As I said, lessening the stigma doesn't take away the
Speaker 1: pain of the condition, but not having to deal with
Speaker 1: the sense of inadequacy that often comes with having depression
Speaker 1: is definitely astride forward. Definitely. It's it's that Buddhist idea
Speaker 1: of there's going to be pain, but we layer all
Speaker 1: these layers of suffering on top of it. Those the
Speaker 1: suffering being I shouldn't be having this, there's something wrong
Speaker 1: with me for having this, and versus just the actual
Speaker 1: pain is plenty if you just leave it at that.
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Speaker 1: the interview. You say at one point we all have
Speaker 1: our darkness and the trick is making something exalted out
Speaker 1: of it. You also say it takes an active will
Speaker 1: to grow from loss. The disruption provides the opportunity for growth,
Speaker 1: not the growth itself. And then you also say, if
Speaker 1: you banish the dragons, you banish the heroes. Can you
Speaker 1: talk a little bit about that as a as a
Speaker 1: way to wrap the show up? Well, I think that people.
Speaker 1: I say, if you banish the dragons, you manage the heroes,
Speaker 1: and people become attached to the heroic strain in their
Speaker 1: own lives, at least that's more or less. I think
Speaker 1: what there's something is and I think there is the
Speaker 1: feeling that while none of us choose our specific adversities,
Speaker 1: that the experience of surviving whenever the adversities are that
Speaker 1: comes along, that come along give us a sense of
Speaker 1: rasil allience and give us a sense of power that
Speaker 1: living through happy and joyful experiences on its own can't bring.
Speaker 1: And there's a lot of intimacy with others and the
Speaker 1: experience of adversity and in managing to live through the
Speaker 1: experience of adversity. So there are many people who, for example,
Speaker 1: faced with having children with these differences and disabilities that
Speaker 1: I've written about, UM, really find that they become more
Speaker 1: attached to those children by virtue of the time they've
Speaker 1: been with them. There's a sociologist who once said that
Speaker 1: we not only care for our children because we love them,
Speaker 1: but also love them because we care for them, and
Speaker 1: that that process of taking care of our children is
Speaker 1: in fact immensely bonding. And our experience of difficulty altogether
Speaker 1: is where we come to know ourselves. A life that
Speaker 1: is only luxury and pleasure our tends to feel rather
Speaker 1: hollow and empty. UM. So as I say, you want
Speaker 1: to get away from often from the specific adversity you're conquering,
Speaker 1: but I certainly feel when I look at my own
Speaker 1: children and think about what I want for them, that
Speaker 1: in any single instance I would spare them from an
Speaker 1: adversity or a painful experience. I try all the time
Speaker 1: to give them the best life I could, and yet
Speaker 1: I feel if I were able to protect them entirely
Speaker 1: from adversity and if they never had a painful experience,
Speaker 1: I would not be doing a good job as a father,
Speaker 1: because part of the job as a parent is to
Speaker 1: teach them resilience, and they can only learn resilience through
Speaker 1: the experience of difficulty. So you constantly want, in your
Speaker 1: own life and in the lives of your children to
Speaker 1: protect them, but also to engage with those difficult moments
Speaker 1: and to find whatever meaning there is buried in them,
Speaker 1: and to grow from them. Great. Is there anything you'd
Speaker 1: like to add on the topic of the parable before
Speaker 1: we wrap up. I think it's a very powerful and
Speaker 1: very beautiful um parable. And I've talked a lot in
Speaker 1: this program about choices, a choice that we make about
Speaker 1: how to experience our own lives, and I think those
Speaker 1: choices are choices about which wolf you feed, and I
Speaker 1: think we have those choices all the time, and I
Speaker 1: think often in some strange sense, one wolf feeds the other,
Speaker 1: that the the encounter with the things that are dark
Speaker 1: and that are terrible and that are difficult is just
Speaker 1: exactly the thing that gives when the energy to feed
Speaker 1: the wolf who represents goodness and kindness and virtue excellent.
Speaker 1: That is a great way to end. Well, thank you
Speaker 1: very much Andrew for for being on the show. Congrats
Speaker 1: on your recent success with some of the awards that
Speaker 1: Far from the Tree has won. And uh I thank
Speaker 1: you for the books myself. They're they've been personally valuable
Speaker 1: to me, so thanks, thank you so much for a
Speaker 1: pleasure to be with you. Okay, bye bye iCal