The Noonday Demon (87 page)

193
For a discussion of and statistics related to depression and stroke, see Allan House et al., “Depression Associated with Stroke,”
Journal of Neuropsychiatry
8, no. 4 (1996).

193
For a review of the work on strokes in the left frontal lobe, see
Ibid.

193
The anecdote of the weepy man is in Grethe Andersen, “Treatment of Uncontrolled Crying after Stroke,”
Drugs & Aging
6, no. 2 (1995).

193
For the anecdote of the man who returned belatedly to work, see
Ibid.

194
The quotation from
Mad Travelers
is taken from the book’s introduction, pages 1–5.

195
The quotation from
Willow Weep for Me
is on pages 18–19.

200
The Singapore magazine is
Brave,
and the article is by Shawn Tan and appeared in the 1999 final edition.

202
The passages on gay depression draw heavily from the work of Richard C. Friedman and Jennifer Downey, especially from their “Internalized Homophobia and the Negative Therapeutic Reaction,”
Journal of the American Academy of Psychoanalysis
23, no. 1 (1995), and their “Internal Homophobia and Gender-Valued Self-Esteem in the Psychoanalysis of Gay Patients,”
Psychoanalytic Review
86, no. 3 (1999). This work will ultimately be combined and augmented and published as a book to be called
Psychoanalysis and Sexual Orientation: Sexual Science and Clinical Practice
. I consulted with Richard Friedman at some length and he provided some supplementary information in anticipation of that book, and my quotations in several instances bridge the two articles with language approved by Friedman and Downey.

202
The 1999 study of male twins is in R. Herrel et al., “Sexual Orientation and Suicidality: A Co-Twin Control Study in Adult Men,”
Archives of General Psychiatry
56 (1999). They used a registry that had been set up during the Vietnam War and compared those who were exclusively heterosexual to those who had had same-sex partners. In addition to the shocking rates of suicide attempts, the study indicated that while straight men had a 25.5 percent rate of suicidal ideation, among gay people the proportion was 55.3 percent.

202
The 2000 study of suicide attempts in men between the ages of seventeen and thirty-nine was conducted by Cochran and Mays, and actually considered 3,648 randomly selected cohorts. It was published as “Lifetime Prevalence of Suicide Symptoms and Affective Disorders among Men Reporting Same-Sex Sexual Partners: Results from NHANES III,”
American Journal of Public Health
90, no. 4 (2000). The same researchers using a different database of 9,908 cohorts considered panic disorders in people who had had sex only with members of the opposite sex and those who had had same-sex partners during the previous year. This work was published as “Relation between Psychiatric Syndromes and Behaviorally
Defined Sexual Orientation in a Sample of the U.S. Population,”
American Journal of Epidemiology
151, no. 5 (2000). Of those considered for the latter study, 2,479 had to be turned away because they (rather depressingly, I think) had had no sexual partners during the previous year.

202
The New Zealand longitudinal study, which asked cohorts to comment on their sexual orientation and their sexual relationships from age sixteen onward, and showed risk factors for many complaints, was published by D. M. Fergusson, et al., “Is Sexual Orientation Related to Mental Health Problems and Suicidality in Young People?”
Archives of General Psychiatry
56, no. 10 (1999).

202
The Dutch study conducted in 1999 had 5,998 cohorts, and in it both homosexual men and women were seen to have at least one
DSM-III-R
psychiatric diagnosis more frequently than heterosexuals. Gay men had increased rates of present and lifetime depression and anxiety; gay women had higher prevalence of major depression and alcohol drug dependence. See the study by T. G. Sandfort, et al., “Same-Sex Sexual Behavior and Psychiatric Disorders: Findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS),”
Archives of General Psychiatry
58, no. 1 (2001).

202
The study of youth in Minnesota included 36,254 students from seventh to twelfth grades and was published by G. Remafedi, et al., “The Relationship between Suicide Risk and Sexual Orientation: Results of a Population-Based Study,”
American Journal of Public Health
88, no. 1 (1998). It indicated no variation for suicidal ideation between lesbians and straight women, but showed that while straight men had a 4.2 percent rate of suicidal ideation, gay males came in at 28.1 percent.

202
The study showing that homosexual males were 6.5 times as likely to make a suicide attempt as heterosexual males had 3,365 cohorts, and is found in R. Garofalo, et al., “Sexual Orientation and Risk of Suicide Attempts among a Representative Sample of Youth,”
Archives of Pediatrics and Adolescent Medicine
153 (1999).

202
The study that showed that 7.3 percent of homosexuals had made four or more suicide attempts as opposed to 1 percent of heterosexuals included 1,563 cohorts. Homosexual/bisexual students in this study showed greater incidence of suicidal ideation than straight students; 12 percent of homosexuals had attempted suicide as opposed to 2.3 percent of heterosexuals, and 7.7 percent of homosexuals had made a suicide attempt requiring medical attention in the previous twelve months as opposed to 1.3 percent of heterosexual youth. See the study by A. H. Faulkner and K. Cranston, “Correlates of Same-Sex Sexual Behavior in a Random Sample of Massachusetts High School Students,”
American Journal of Public Health
88, no. 2 (1998). The study showed that gay students were at elevated risk of injury, disease, death from violence, substance abuse, and suicidal behavior.

202
The finding that 10 percent of suicides in San Diego County were committed by gay men is in C. L. Rich et al., “San Diego Suicide Study I: Young vs. Old Subjects,”
Archives of General Psychiatry
43, no. 6 (1986). This was an uncontrolled study. D. Shaffer, et al., attempted to reproduce these results in the New York City area in 1995 in the article “Sexual Orientation in Adolescents Who Commit Suicide,”
Suicide and Life Threatening Behaviors
25, supp. 4 (1995), and were not able to do so, but these researchers were working on youth suicide only and took information about sexual orientation from family members and peers who are in many instances unlikely to know and in other instances unwilling to admit even to themselves the details of their children’s sexual orientation.

202
The work on the socialization of gay men and children’s upbringing in homophobic environments and the early incorporation of homophobic attitudes is in A. K. Maylon, “Biphasic aspects of homosexual identity formation,”
Psychotherapy: Theory, Research and Practice
19 (1982).

204
The study showing that gay students were likely to have their property stolen or deliberately damaged is in R. Garofalo et al., “The Association between Health Risk Behaviors and Sexual Orientation among a School-Based Sample of Adolescents,”
Pediatrics
101 (1998). The authors found that the homosexuals in the group were also more likely to engage in multiple drug abuse, high-risk sexual behavior, and other high-risk behaviors.

204
The fact that suicide rates were particularly high among Jews in Berlin between the wars is published in
Charlotte Salomon: Life? Or Theatre?
on page 10, though it is given more ample exposition in text panels that were mounted as part of the exhibition of Salomon’s remarkable work at The Jewish Museum in early 2001. I thank Jennie Livingston for steering me toward this material, and for proposing the link between this Jewish suicidality in pre–Nazi Germany and gay suicidality in modern America.

205
The
New Yorker
questionnaire about parents’ preferring unhappy straight-identified children to happy gay-identified children is in Hendrik Hertzberg, “The Narcissus Survey,”
The New Yorker
, January 5, 1998.

208
Jean Malaurie’s
The Last Kings of Thule,
though much maligned in recent years, gives a particularly stirring and passionate account of traditional Inuit life in Greenland.

208
The suicide rate in Greenland was published in Tine Curtis and Peter Bjerregaard’s
Health Research in Greenland,
page 31.

213
The descriptions of polar hysteria, mountain wanderer syndrome, and kayak anxiety come from Inge Lynge, “Mental Disorders in Greenland,”
Man & Society
21 (1997). I must thank John Hart for providing the parallel to “running amok.”

213
Malaurie’s quote here is from
The Last Kings of Thule,
page 109.

217
That there are about twenty-five common substances of abuse was taken from the National Institute of Drug Abuse’s Web site at
www.nida.nih.gov/DrugsofAbuse
.

217
The three-stage mechanism of substances of abuse is described in David McDowell and Henry Spitz’s
Substance Abuse,
page 19.

217
Peter Whybrow provides a concise summary of the interactions between cocaine and dopamine in
A Mood Apart,
page 213. A more in-depth analysis is provided by Marc Galanter and Herbert Kleber’s
Textbook of Substance Abuse Treatment,
pages 21–31.

217
Work on morphine and dopamine may be found in Marc Galanter and Herbert Kleber’s
Textbook of Substance Abuse Treatment,
pages 11–19.

217
For work on alcohol’s effect on serotonin, see
Ibid.,
6–7, 130–31.

218
That levels of the neurotransmitter enkephalin are affected by many of the substances of abuse is indicated in Craig Lambert, “Deep Cravings,”
Harvard Magazine
102, no. 4 (2000).

218
The brain’s response to increased levels of dopamine is explicated in Nora Volkow, “Imaging studies on the role of dopamine in cocaine reinforcement and addiction in humans,”
Journal of Psychopharmacology
13, no. 4 (1999).

218
The dynamics of addictive substances leading to addiction is discussed at some
length in Nora Volkow et al., “Addiction, a Disease of Compulsion and Drive: Involvement of the Orbitofrontal Cortex,”
Cerebral Cortex
10 (2000).

218
The statistics on proportions of addiction to specific substances are taken from James Anthony et al., “Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: Basic findings from the National Comorbidity Survey,”
Experimental and Clinical Psychopharmacology
2, no. 3 (1994).

218
Work on substances of abuse and the blood-brain barrier may be found in David McDowell and Henry Spitz’s
Substance Abuse,
pages 22–24.

218
The number of years it takes to develop dependence on alcohol and cocaine is described in H. D. Abraham et al., “Order of onset of substance abuse and depression in a sample of depressed outpatients,”
Comprehensive Psychiatry
40, no. 1 (1999).

219
The work with PET scans showing limited recovery even at the three-month period has been done by Dr. Nora Volkow. See, for example, “Long-Term Frontal Brain Metabolic Changes in Cocaine Abusers,”
Synapse
11 (1992). That chronic drug use has persistent neurological consequences is illustrated in Alvaro Pascual-Leone et al., “Cerebral atrophy in habitual cocaine abusers: A planimetric CT study,”
Neurology
41 (1991), and Roy Mathew and William Wilson, “Substance Abuse and Cerebral Blood Flow,”
American Journal of Psychiatry
148, no. 3 (1991). For information regarding cognitive impairment, including deficits in memory, attention, and abstraction, see Alfredo Ardila et al., “Neuropsychological Deficits in Chronic Cocaine Abusers,”
International Journal of Neuroscience
57 (1991), and William Beatty et al., “Neuropsychological performance of recently abstinent alcoholics and cocaine abusers,”
Drug and Alcohol Dependence
37 (1995).

220
A thorough review of the multiple causes of lesions in alcoholics is provided by Michael Charness, “Brain Lesions in Alcoholics,”
Alcoholism: Clinical and Experimental Research
17, no. 1 (1993). For a more general and recent review of alcohol and brain damage, see Marcia Barinaga, “A New Clue to How Alcohol Damages Brains,”
Science,
February 11, 2000. That memory loss is a problem in this population is discussed in Andrey Ryabinin, “Role of Hippocampus in Alcohol-Induced Memory Impairment: Implications from Behavioral and Immediate Early Gene Studies,”
Psychopharmacology
139 (1998).