The Noonday Demon (94 page)

322
George H. Savage’s remarks may be found in his
Insanity and Allied Neuroses,
pages 130 and 151–152.

323
These remarks from Freud are from the “Extracts from the Fliess Papers,” in
The Standard Edition of the Complete Psychological Works of Sigmund Freud,
vol. 1, pages 204–6.

323
Karl Abraham’s 1911 essay is entitled “Notes on the Psycho-analytical Investigation and Treatment of Manic-Depressive Insanity and Allied Conditions,” in
Selected Papers of Karl Abraham.
These passages are from this essay, pages 137, 146, and 156, respectively.

324
The passages quoted from “Mourning and Melancholia” have been taken from
A General Selection from the Works of Sigmund Freud,
pages 125–27, 133, and 138–39.

324
The article alluded to her is “Managing Depression in Medical Outpatients,”
New England Journal of Medicine
343, no. 26 (2000).

325
On Abraham’s response to “Mourning and Melancholia,” see his later essay “Development of the Libido,” in
Selected Papers of Karl Abraham,
page 456.

326
For this material from Melanie Klein, see her essay “The Psychogenesis of Manic-Depressive States,” in
The Selected Melanie Klein,
page 145. Other psychoanalysts writing on the topic include the great Freudian revisionist Sandor Rado. He put together a profile of the kind of person who is subject to melancholy, who is “most happy when living in an atmosphere permeated with libido” but who also has a tendency to be unreasonably demanding of those he loves. Depression, according to Rado, is “a great despairing cry for love.” Depression therefore evokes once more that early demand for the mother’s breast, the fulfillment of which Rado rather charmingly called “the alimentary orgasm.” The depressed person, from infancy on, wants love of any kind—erotic love or maternal love or self-love are all reasonable fulfillments of his need. “The process of melancholia,” Rado wrote, “represents an attempt at reparation (cure) on a grand scale, carried out with an iron psychological consistency.” The quotations from Sandor Rado are from his essay “The Problem of Melancholia,” in
Psychoanalysis of Behavior,
pages 49–60.

326
Hassoun’s writing on depression is in his recently published book
The Cruelty of Depression.

327
Kraepelin makes for some dull reading. The passages quoted here are from Stanley Jackson’s
Melancholia and Depression,
pages 188–95. An excellent discussion of Kraepelin is also included in Myer Mendelson’s
Psychoanalytic Concepts of Depression.

328
The line from Sir William Osler is from his
Aequanimitas,
as quoted in Peter Adams’s
The Soul of Medicine,
page 67.

328
Adolf Meyer is a delight to read. I am indebted to Stanley Jackson’s
Melancholia and Depression
as well as Myer Mendelson’s
Psychoanalytic
Concepts of Depression,
and Jacques Quen and Eric Carlson’s
American Psychoanalysis,
for much of my discussion of Adolf Meyer. The passages are quoted, in the order they appear in the text, from Myer Mendelson’s
Psychoanalytic Concepts of Depression,
page 6; Jacques Quen and Eric Carlson’s
American Psychoanalysis,
page 24; Myer Mendelson’s
Psychoanalytic Concepts of Depression,
page 6; Adolf Meyer’s
Psychobiology,
page 172; Adolf Meyer’s
The Collected Papers of Adolf Meyer,
vol. 2, pages 598 and 599; Theodore Lidz’s “Adolf Meyer and American Psychiatry,” published in the
American Journal of Psychiatry
123 (1966): 326; and from Adolf Meyer’s
Psychobiology,
page 158.

328
On Mary Brooks Meyer, see Theodore Lidz’s “Adolf Meyer and the Development of American Psychiatry,” published in the
American Journal of Psychiatry
123 (1966): 328.

329
The quotation on the goal of medicine comes from Adolf Meyer’s late essay “The ‘Complaint’ as the Center of Genetic-Dynamic and Nosological Thinking in Psychiatry,”
New England Journal of Medicine
199 (1928).

329
The passages from Sartre come from his novel
Nausea,
pages 4, 95–96, 122, and 170.

329
The passagess byBeckett are taken, respectively, from
Malone Dies
and
The Unnamable,
and appear in the volume
Molloy, Malone Dies, The Unnamable,
on pages 256–57 and 333–34.

330
The story of the discovery of antidepressants is told over and over again. A nice version of it is in Peter Kramer’s
Listening to Prozac,
and a more technical one in Peter Whybrow’s
A Mood Apart.
I have relied on both of these, as well as on the detailed history that forms the backbone of David Healy’s
The Antidepressant Era.
I have also incorporated information from oral interviews.

331
The Kline/Lurie–Salzer/Kuhn debate is in David Healy’s
The Antidepressant Era,
pages 43–77.

331
The discovery of neurotransmitter theory and the early work on acetylcholine, as well as the discovery of serotonin and the link between substance and emotional function is from
Ibid.,
145–47.

331
The 1955 article referenced is A. Pletscher et al., “Serotonin Release as a Possible Mechanism of Reserpine Action,”
Science
122 (1955).

331
The work on lowering serotonin levels is in David Healy’s
The Antidepressant Era,
page 148.

332
The development of the MAOIs is in
Ibid.,
152–55.

332
Axelrod’s work on reuptake is in
Ibid.,
155–161.

332
Joseph Schildkraut’s original article is “The Catecholamine Hypothesis of Affective Disorders: A Review of Supporting Evidence,”
American Journal of Psychiatry
122 (1965): 509–22.

332
I am indebted to David Healy for his critique of Schildkraut.

333
The Scottish scientists who worked on receptor theory are George Ashcroft, Donald Eccleston, and team members, as is explicated in David Healy’s
The Antidepressant Era,
page 162.

333
The story of Carlsson and Wong and serotonin is in
Ibid.,
165–69.

334
The development of individual drugs is chronicled on the Web sites maintained by their manufacturers. For information on Prozac, see Lilly’s Web site at
www.prozac.com
; for information on Zoloft, see Pfizer’s Web site at
www.pfizer.com
; for information on drugs in development at Du Pont, see their Web site at
www.dupontmerck.com
; for information on Luvox, see Solvay’s Web site at
www.solvay.com
; for information on drugs in development at Parke-Davis, see their Web site at
www.parke-davis.com
; for information on reboxetine and Xanax, see Pharmacia/Upjohn’s Web site at
www2.pnu.com
; for information on Celexa, see the Web site of Forest Laboratories at
www.forestlabs.com
.

335
That the poor depressed tend to become more poor and depressed is indicated by a number of studies. Depression’s effect on the ability to earn a living is reviewed in Sandra Danziger et al., “Barriers to the Employment of Welfare Recipients,” published by the Poverty Research and Training Center of Ann Arbor, Michigan. This study indicates that among poorer populations, those with a diagnosis of major depression cannot in general work twenty hours or more a week. That they become increasingly depressed can be adduced by studies that show poor treatment records for poor and homeless populations, such as Bonnie Zima et al., “Mental Health Problems among Homeless Mothers,”
Archives of General Psychiatry
53 (1996), and Emily Hauenstein, “A Nursing Practice Paradigm for Depressed Rural Women: Theoretical Basis,”
Archives of Psychiatric Nursing
10, no. 5 (1996). For an excellent discussion on the relationships between poverty and mental health, see John Lynch et al., “Cumulative Impact of Sustained Economic Hardship on Physical, Cognitive, Psychological, and Social Functioning,”
New England Journal of Medicine
337 (1997).

336
On depression among women, see chapter 5.

336
On depression among artists, see Kay Jamison’s
Touched with Fire.

336
One example of depression among athletes may be found in Buster Olney, “Harnisch Says He Is Being Treated for Depression,”
New York Times,
April 26, 1997.

336
On depression among alcoholics, see chapter 6.

336
That the poor have a high rate of depression can be adduced from the statistic that welfare recipients have an incidence of depression three times that of nonwelfare recipients, put forth in K. Olsen and L. Pavetti, “Personal and Family Challenges to the Successful Transition from Welfare to Work,” published by the Urban Institute, 1996. Sandra Danziger et al.’s “Barriers to the Employment of Welfare Recipients,” published by the Poverty Research and Training Center of Ann Arbor, Michigan, indicates that depressed welfare recipients are more likely to be unable to hold jobs, thus completing the circle of poverty and depression. Robert DuRant et al.’s “Factors Associated with the Use of Violence among Urban Black Adolescents,”
American Journal of Public Health
84 (1994), indicates a connection between depression and violence. Ellen Bassuk et al.’s “Prevalence of Mental Health and Substance Use Disorders among Homeless and Low-Income Housed Mothers,”
American Journal of Psychiatry
155, no. 11 (1998), reviews a number of studies indicating elevated levels of substance abuse among the depressed.

337
The efficacy of most pharmacological and psychodynamic treatments appears to be fairly consistent across populations. Depression among the indigent should therefore have the same efficacy rates as for a more general population. The difficulty with this population, in the current system, is of getting the treatment to patients.

337
The statistic that 85–95 percent of people with serious mental illness are unemployed in the United States is taken from two studies by W. A. Anthony et al.: “Predicting the vocational capacity of the chronically mentally ill: Research and implications,”
American Psychologist
39 (1984), and “Supported employment for persons with psychiatric disabilities: An historical and conceptual perspective,”
Psychosocial Rehabilitation Journal
11, no. 2 (1982).

337
On the early puberty of children of depressed mothers, see Bruce Ellis and Judy Garber’s “Psychosocial antecedents of variation in girls’ pubertal timing: Maternal depression, stepfather presence, and marital and family stress,”
Child Development
71, no. 2 (2000).

337
Characteristic behavior of girls with early puberty is described in Lorah Dorn et al., “Biopsychological and cognitive differences in children with premature vs. on-time adrenarche,”
Archives of Pediatric Adolescent Medicine
153, no. 2 (1999). For a broad review of the literature on early puberty, promiscuity, and sexual activity, see Jay Belsky et al., “Childhood Experience, Interpersonal Development, and Reproductive Strategy: An Evolutionary Theory of Socialization,”
Child Development
62 (1991).

338
On medicaid programs and the mentally ill, see Lillian Cain, “Obtaining Social Welfare Benefits for Persons with Serious Mental Illness,”
Hospital and Community Psychiatry
44, no. 10 (1993); Ellen Hollingsworth, “Use of Medicaid for Mental Health Care by Clients of Community Support Programs,”
Community Mental Health Journal
30, no. 6 (1994); Catherine Melfi et al., “Access to Treatment for Depression in a Medicaid Population,”
Journal of Health Care for the Poor and Underserved
10, no. 2 (1999); and Donna McAlpine and David Mechanic, “Utilization of Specialty Mental Health Care among Persons with Severe Mental Illness: The Roles of Demographics, Need, Insurance, and Risk,”
Health Services Research
35, no. 1 (2000).

338
Examples of successful aggressive outreach programs may be found in Carol Bush et al., “Operation Outreach: Intensive Case Management for Severely Psychiatrically Disabled Adults,”
Hospital and Community Psychiatry
41, no. 6 (1990), and José Arana et al., “Continuous Care Teams in Intensive Outpatient Treatment of Chronic Mentally Ill Patients,”
Hospital and Community Psychiatry
42, no. 5 (1991). For information regarding outreach programs for homeless populations, see Gary Morse et al., “Experimental Comparison of the Effects of Three Treatment Programs for Homeless Mentally Ill People,”
Hospital and Community Psychiatry
43, no. 10 (1992).