Many of us experience depression as a mood of joylessness, disconnection and boredom, which eventually passes. But what Daphne Merkin describes here is more akin to a permanent state of despair. From early childhood she experienced crying jags, feelings of abandonment and emotional impoverishment. She was later institutionalized. Many questions emerge. Why did her parents have so many children, when they clearly had little time for them? Why were the children put into the care of such a sadistic nanny? And where does depression take root in the psyche? This memoir is insightful, intelligent and ruthlessly honest.
Passionate, shocking, and personal, this social history of mental illness from Bedlam to the Community Mental Health Act to NIMH by a Pulitzer-winning journalist is part narrative history and part memoir. Powers’s motivation in writing it was twofold. “Something happened to my sons and I want to know what and why,” he says, that “something” being schizophrenia. When he heard an aide to Scott Walker make the statement he took for his title, he had to speak out. The first shock is how little we know about what causes the brain to run amuck. “Definitive truth on any area of mental health is as elusive as a cure,” Powers says. What we do have are observations, such as the concurrent rise of mental illness with the growth of cities, anecdotal evidence linking stress, overcrowding, and noise to mental illness, and the onset of many symptoms in late adolescence. And there are statistics: some 90% of suicides are committed by those with a mental illness and two-thirds of American children with lifelong mental illness receive no treatment at all. Today, Powers notes, the mentally ill and the homeless—often the same—are demonized in ways “not seen since the dark ages.” He blames this on deinstitutionalization, which has really been re-institutionalization, as “jails have become the country’s largest de facto mental institutions,” and on the false hope (and hype) of psychotropic drugs, which seem to promise a cure but in fact barely control symptoms. Powers’s report on Big Pharma is scathing, as is his detailed analysis of decades of social policies that have mainly exacerbated the suffering and alienation of the mentally ill. What can help? He cites a promising Vermont model that focuses on self-sufficiency, rehabilitation, and community re-integration. But as his own family’s harrowing story shows, much, much needs to be done.
Let me state upfront that this is not a guide for tackling nicotine addiction. Or maybe it is, but if so, it’s more about suggesting processes of coping. For Gregor Hens, that process is putting pen to paper: to acknowledge all the sensual pleasures that smoking and the experiences that surround it have afforded him over the years and, in a sense, to relive those pleasures from writing's safe distance. It’s subtle and majestic at once, a beautiful little book that should appeal to current smokers, former smokers, and non-smokers alike.