Brought to you by the Depression Is Real Coalition, The Down & Up Show is dedicated to the reality of depression. Our hosts will talk with some of the world's top experts on depression, as well as people who have been impacted by this illness. The reality of depression is that it is a debilitating and potentially deadly medical condition that affects more than 15 million Americans every year. The other reality of depression is that there is hope.

Down & Up Show #28: Writers on Depression

The Down and Up Show on Depression is Real.org, a talk show dedicated entirely to the subject of depression and the reality that there is hope for people living with this disease. Now your host, Dr. Ellen Frank.

ELLEN FRANK INTRO:
Welcome to another episode of the Down and Up Show on Depression is Real.org. I'm your host back after summer vacation, Dr. Ellen Frank. Nell Casey is the editor of the bestselling essay collection ÒUnholy Ghost: Writers on DepressionÓ. Her writing has appeared in The New York Times, Slate, Salon and Elle among many other publications.

She is a Carter Center mental health journalism fellow and is on the general council for ÒStories of the MAFÓ a non-profit storytelling organization. ÒUnholy GhostÓ is a unique collection of essays about depression that includes many different perspectives and depicts a diverse portrait of the illness.

It's good to speak to you today, Nell.

NELL CASEY ANSWER:
Hi, thank you, it's good to talk to you.

ELLEN FRANK QUESTION:
What was the inspiration for this book?

NELL CASEY ANSWER:
Well it was actually a coincidence ofÉ of sorts, I had just come through seeing my sister through a fairly serious depression. She had been hospitalized for mania, she had bi-polar and thenÉ and then actually as she came out of the hospital, fell into a very difficult and deep depression for many months.

And I had been through this very harrowing experience seeing through and getting her back on her feet. And just as we were coming out of that, a woman named Kay Silverman who at the time was an editor at William Morrow called and asked if I would be interested in putting together a collection of essays on depression, without knowing that I had just come through this person experience.

SoÉ you know it was a strange confluence ofÉ their need and my experience andÉ I wasÉ

ELLEN FRANK QUESTION:
And very considerable motivation at that moment.

NELL CASEY ANSWER:
YesÉ and was IÉ thought it would be an incredible opportunity to write about it and to have my sister write about her own experience and to sort of understand depression better by editing this book. So it felt like, you know, fate, an incredible opportunity.

ELLEN FRANK QUESTION:
How did you choose the specific essays that you included?

NELL CASEY ANSWER:
WellÉ as I say my first thought when she asked me to do the book was that I actually would love to write an essay and have my sister write an essay and so I had this idea right off the bat to do partner pieces where, throughout the book, there would be two essays partnered and one would be the person having suffered from depression and one would be the person having see that person through.

SoÉ IÉ I knew I wanted to do that right away and I talked toÉ Rose Styron (ph.) who isÉ was married to William Styron and she was interested. And I knew that I could get a portion of ÒDarkness VisibleÓ William Styron's memoir in the book as well. And then as I went along, these other partner pieces came up.

I got in touch with Russell Banks who actually I had understood suffered from depression but as it turned out that was (unint.) because his fiction is so depression, but he in fact is someone who's suffered from depression and actually credits the fact that he can get it out in his work that he doesn't so much suffer from it in his life.

But he said well my wife who's a poet and wonderful writer has long struggled withÉ depressionÉ

ELLEN FRANK QUESTION:
So he actually became the partner?

NELL CASEY ANSWER:
And so he suggested his ownÉ suggested the very thing I had been hoping to have throughout the book so that was sort of how that grew. And then a lot of the writers were people I'd read before and knew that they'd suffered from depression and they'd explored in their work before, like Suzanne Kasson and Lauren Slater.

And so these were writers I wondered if they had new things to say about it and in fact they didÉ and Lauren Slater had just gone through a pregnancy where she'd been depressed and Suzanne Kasson hadÉ hadn't really very much since ÒGirl InterruptedÓ. But when I got in touch with her she was ready to write a short piece or actually basically raging against the new culture of talking about depression all the time.

SoÉ including being mad at herself for starting it. ButÉ soÉ you know it was a sort ofÉ as these collections go, you know, you just reach out to the writers you like and the writers you know have written about this subject before but might have more to say andÉ that wasÉ I just continued to goÉ

And it was, you know, of course I had to go out to people and say I don't know if you've suffered from depression but I love your writing and if you have would you be willing to write for the book? And many people were very responsive, I mean I think it's a subject that brings up people's sort of sense ofÉ

ELLEN FRANK QUESTION:
Affect.

NELL CASEY ANSWER:
I'm sorryÉ

ELLEN FRANK QUESTION:
People's affect, people's feelings.

NELL CASEY ANSWER:
Yes exactly and a kind of sense of responsibility came up around it, people really wanted to get word out, really wanted to help other peopleÉ really wanted to describe, especiallyÉ these are, you know, very articulate writers who really wanted to describe the mood and it's variousÉ and intense forms.

ELLEN FRANK QUESTION:
Well Styron says thatÉ that the word depressionÉ doesn't actually describe what he was feelingÉ as if the word didn't do justice to his feelings.

NELL CASEY ANSWER:
RightÉ and he calls it a wimpy wordÉ so yeahÉ noÉ heÉ he was probably you know the first to sort of famously say depression didn't capture the mood, that it was a sort of wimpy word, that it didn't at all have the same dramatic effect that the mood did. SoÉ and he wrote that in ÒDarkness VisibleÓ but there were people throughout the book who struggled to find aÉ

I mean Josh Shank who wrote a wonderful essay in the book and in it he strugglesÉ to try and find a way toÉ he feels depression sort ofÉ it's tooÉ there's no way that one word can encompass this mood that is so destructive and soÉ volatile and difficult. So heÉ and another person who sort of joined Styron's campaign against the word.

ELLEN FRANK QUESTION:
Tell us a little bit about the title of the book, ÒUnholy GhostÓ, how did you choose it?

NELL CASEY ANSWER:
The title is actually from a Jane Kenyon poem, so it's called ÒHaving it Out With MelancholyÓ and itÉ there'sÉ it's actually in the epigraph of the bookÉ and sheÉ I'm sure as everyone knows is a wonderful poet who suffered a great deal withÉ suffered from depression and wrote about it frequently.

And she refers to it as unholy ghost in the poemÉ and so we came across that, the editor and I, and thought it would be a wonderful title for the book. We actually, as hard as it to describe, that seemed like aÉ like it got us nearly there.

ELLEN FRANK QUESTION:
If it's possible to choose one or two, which would you say, beyond your own and your sister'sÉ excuse me, are the most compelling essays in the book?

NELL CASEY ANSWER:
I mean I feel protective of the editor not to choose favorites because I reallyÉ and actually looking the book over again just even this morning before we spoke, I feel like the essays just live on in there. They're so incredibly descriptive and so honest.

But I will say the ones that felt relatable to me in ways that I was surprised and grateful because it added actually a certain dimension to my own experience that I wouldn't have had if I hadn't read these pieces. Russell BanksÉ writes about, as I say, taking care of his wife or at least trying to understand his wife's depression.

And he writes a lot about the sort of contagiousness of the feeling, you know he, in order to understand, took on too much and began to feel her depression in a way too. And later describes this as confusing empathy and sympathy andÉ IÉ felt that a great deal, that I just threw myself into understanding, trying to understand my sister's struggle.

And as a result started to take on parts of the experience or sort of tried to put myself in it andÉ and it became very scary and it's not helpful, it's not helpful to you, it's not helpful to the person you're trying to help. So there's a funny sort of equation and balance of both opening yourself to it so you can, you know, understandÉ so you can feel with what they're going through but notÉ but also sort of limiting that so you can continue to help.

AndÉ there wereÉ I mean IÉ again it's hard for to sayÉ in terms of style orÉ writing, I mean I think they're all incredibly strongÉ but I also thought Lauren Slater's piece capturedÉ a very significant experience which was needing to take medication while pregnant. She suddenly slides into her depression as, you know, as recurring depression.

SheÉ it comes back while she's pregnant and she finds she has to go on Lithium and it, you know, at that stage there was much less research then there is now. And she had to goÉ you knowÉ take medication. Her baby is fine, you don't learn that in the essay and book, but I know that from knowing her personally.

But it was, you know, it's a veryÉ it was a veryÉ hard and risky thing to have to do, you know. And it poses the veryÉ sort of fragile and threatening question of how, you know, who do you take care of first, yourself or the child? SoÉ and then I have to say my own sister's essay, both as an editor but also personally, I justÉ she had been so absent during her depression.

She was so withdrawn or sort of absent from herself and then her essay is so incredibly strong and vivid and incredibly well-written. You know I have toÉ for me personally, that wasÉ it just (inaud.) way to read it.

ELLEN FRANK QUESTION:
Let's come back for a moment to the question of family supportÉ tell me a little something about the different roles family and friends seem to play in the lives of the writers who discussed their depression and what are the limits of their support?

NELL CASEY ANSWER:
Well thatÉ as I say, was something that I was sort of continuing to learn even as IÉ was editing the book. IÉ you know in Russell Bank's piece, in Rose Styron's piece, in Donald Hall's piece, actually Donald Hall, Jane Kenyon is no longer alive, but he was married to Jane Kenyon, the woman whose poem we excepted for the title.

So he writes from aÉ from a perspective of family caregiverÉ and they all write about sort of being swallowed up initially because they were so devastated to see someone they love go through this and then had to step back and find a way to be helpful, to understand their limit as someone, you know, you can't solve, you can't take the depression away.

On the other hand you can help and it doesn't always feel as if you're helping. One of the great things about my sister Maud's essay was that she was finally able to say that the support she had from her family and friends was incredibly helpful, numb as she felt, it was just that stubborn consistent people being there for her, you know when she finally kind of came through, had meant a great.

She couldn't articulate that or say that at the time, but it did, it does helpÉ and I actually have another collection of essays that are coming out really, truly (inaud.) about family care giving, but in it Andrew Solomon writes about being cared for by his father through his depression.

And he says the same thing where, you know, don't believe that you canÉ be a hero. I mean you can't take the illness away and in fact I think that becomes sort a feeling of pressure to the person who's suffering, if they feel that expectation. But do know that you're helping, I mean, when you're there you are helpingÉ regardless of their, you know, not seeming to be able acknowledge it or see it for feel it.

It isÉ it is in this slow, steady way, supporting them. But it'sÉ you know, it's a bigÉ it's a big question because it's difficultÉ it's a very difficult relationship, it's a lot to take on. And throughout ÒUnholy GhostÓ most of the relationships explored were marriages andÉ very hard on the marriage, you know, it's a difficult thing to see someone go through and to go through yourself.

ELLEN FRANK QUESTION:
What kind of feedback have you gotten about the book?

NELL CASEY ANSWER:
I feel like people have been very responsive andÉ I thinkÉ you know I think people feel grateful that were so many people willing to be this honest about the experience and put themselves out there in order to make others feel a little less alienated or secluded in the illness.

AndÉ and so the response has been very good, I mean people have beenÉ I think both grateful andÉ and helped. I mean I hope they've been (inaud.) by reading it. And it's also had the kind of double affect of beingÉ oddly the sort of sub-theme to this has been writers, so it's people who areÉ you know people are very interested in the kind of literacy perspective.

People write a lot about reading and you know Larry McMurchery (ph.) writes about hisÉ he couldn't read for a long time through his depression and how much that meant to him, that he couldn't read, that that felt like an incredibly devastating loss.

And a lot of people write about creativity and writing and what depression does to their writing andÉ so I think people reacted alsoÉ they were very interested in this kind of sub-theme of creativity andÉ and (inaud.) literary take on depression.

ELLEN FRANK QUESTION:
Nell Casey, thank you so much for talking with us today.

NELL CASEY ANSWER:
Thank you.

ELLEN FRANK QUESTION:
I think your book really provides insight into an illness that's still so misunderstood and I can tell you that we've ordered two copies for the library in my own clinic.

NELL CASEY ANSWER:
Oh fantastic.

ELLEN FRANK QUESTION:
That's because I think itÉ will bring something really special to the patients we treat here.

NELL CASEY ANSWER:
I hope so, thank you.

ELLEN FRANK QUESTION:
For the Depression is Real Coalition, I'm Dr. Ellen Frank, join us next time for another edition of the Down and Up Show on Depression is Real.org.

Thanks for listening to the Down and Up Show, for more information log onto www.depressionisreal.org. You can find us there (inaud.) I-tunes and remember, stay subscribed.