05/06/2010 05:12 am ET Updated May 25, 2011

Mental Illness in the Papers

In my last blog post, "Mental Illness at the Movies," I discussed Charles Darwin's hallucinations in the film, Creation, and concluded that "the psychotic strand may in the end be an advantageous trait."

Several days later, in a piece in the New York Times Magazine, titled "Depression's Upside ," Jonah Lehrer broached a similar possibility: that depression, not psychosis per se, may be an adaptation favored by evolution. He cited several experts who have argued that depression can improve one's focus and enhance one's analytical skills.

The article was erudite and thought-provoking, and I agreed with much of it, including the central thesis. But it might have been helpful if Lehrer had pointed out that depression at its most severe state, far from improving one's focus, strips away one's ability to concentrate. I have firsthand experience in this regard.

As I wrote last time, when I was having my two psychotic breaks, in particular my first one in 1997, I had great difficulty reading. Reading of course requires a high degree of concentration, which I lacked at that time.

I will agree, however, that when depression is at a more manageable level, it can produce the paradoxical effect of improving one's focus while heightening the difficulty of ordinary tasks.

The other quibble I had with the piece was over the issue of memory. Lehrer wrote that "depressed subjects struggle to think about anything else ... The end result is poor performance on tests for memory ... "

While I recognize that I may not represent the norm here, my memory has never been impeded by my depression or my psychosis.

Harold Bloom has said that when he gives poems a lot of love, and when they have an inevitability to them, he remembers them.

I might extrapolate that memory itself is a function not only of cognitive power but also of love. It occurs to me that those of us, who can recite poetry as well as recall people, events and conversations from the distant past, do so because we care deeply. We may have more active neurons in the cortex, but we also have a lot of love in us.

There isn't much love in Louis Menand's New Yorker essay, "Head Case." In the course of reviewing two new books on mental illness, Menand has few positive things to say about the mentally ill, psychiatry or anti-depressant medication.

He opens the piece with a hypothetical that has become all too common in this recession, the firing of an individual. "After a week, you have a hard time getting out of bed in the morning. After two weeks, you have a hard time getting out of the house. You go see a doctor. The doctor hears your story and prescribes an antidepressant. Do you take it?"

In beginning this way, Menand is noting the absurdity of classifying anyone with such a "depression" as being mentally ill.

I agree with his underlying view, that we are over-diagnosed as a society.

But he could just as readily have opened with a case of severe depression, something that is not absurd at all. As I have written before, the depression that I have experienced has not come and gone based on an event like a job loss. I have battled depression my entire life. Depression, psychosis and suicide run in my family, as they do in other families, like the Hemingways and the Hartleys. Yet many of us have been able to manage our severe depression and to live with hope, points that Menand never makes.

This lack of hopefulness continues in the piece, when he writes, "There is little evidence to support the assumption that supplementing antidepressant medication with talk therapy improves outcomes."

While there may be no studies to indicate such an outcome, I can testify to the benefits of therapy and medication. And I am not the only one. Other members of my family have benefited from such a combination, though as I have indicated before, patients must also make an effort to get better.

If there was any doubt about the prevailing tone in the article, Menand writes near the end, "In the Hippocratic tradition, melancholics were advised to drink white wine, in order to counteract the black bile. (This remains an option.)"

This little parenthetical gives us all we need to know about the disdain Menand feels for the depressed and for psychiatry. Does he really believe that anyone's depression can be solved in such a facile fashion?

Menand would argue that he is just being ironic and provocative. Certainly, we need irony in the world, but snideness doesn't benefit anyone.

There is no doubt that there are many people whose depression is dubious, but there are also many of us who suffer from the most debilitating forms of this disorder, which does not come and go with the seasons. It is here with us forever, as is our humanity. And that is no joke.