Excerpt from The Noonday Demon by Andrew Solomon, plus links to reviews, author biography & more

Fear of heights is the most common phobia in the world and must have served our ancestors well, since the ones who were not afraid probably found abysses and fell into them, so knocking their genetic material out of the race. If you stand on the edge of a cliff and look down, you feel dizzy. Your body does not work better than ever and allow you to move with immaculate precision back from the edge. You think you're going to fall, and if you look for long, you will fall. You're paralyzed. I remember going with friends to Victoria Falls, where great heights of rock drop down sheer to the Zambezi River. We were young and were sort of challenging one another by posing for photos as close to the edge as we dared to go. Each of us, upon going too close to the edge, felt sick and paralytic. I think depression is not usually going over the edge itself (which soon makes you die), but drawing too close to the edge, getting to that moment of fear when you have gone so far, when dizziness has deprived you so entirely of your capacity for balance. By Victoria Falls, we discovered that the unpassable thing was an invisible edge that lay well short of the place where the stone dropped away. Ten feet from the sheer drop, we all felt fine. Five feet from it, most of us quailed. At one point, a friend was taking a picture of me and wanted to get the bridge to Zambia into the shot. "Can you move an inch to the left?" she asked, and I obligingly took a step to the left -- a foot to the left. I smiled, a nice smile that's preserved there in the photo, and she said, "You're getting a little bit close to the edge. C'mon back." I had been perfectly comfortable standing there, and then I suddenly looked down and saw that I had passed my edge. The blood drained from my face. "You're fine," my friend said, and walked nearer to me and held out her hand. The sheer cliff was ten inches away and yet I had to drop to my knees and lay myself flat along the ground to pull myself a few feet until I was on safe ground again. I know that I have an adequate sense of balance and that I can quite easily stand on an eighteen-inch-wide platform; I can even do a bit of amateur tap dancing, and I can do it reliably without falling over. I could not stand so close to the Zambezi.

Depression relies heavily on a paralyzing sense of imminence. What you can do at an elevation of six inches you cannot do when the ground drops away to reveal a drop of a thousand feet. Terror of the fall grips you even if that terror is what might make you fall. What is happening to you in depression is horrible, but it seems to be very much wrapped up in what is about to happen to you. Among other things, you feel you are about to die. The dying would not be so bad, but the living at the brink of dying, the not-quite-over-the-geographical-edge condition, is horrible. In a major depression, the hands that reach out to you are just out of reach. You cannot make it down onto your hands and knees because you feel that as soon as you lean, even away from the edge, you will lose your balance and plunge down. Oh, some of the abyss imagery fits: the darkness, the uncertainty, the loss of control. But if you were actually falling endlessly down an abyss, there would be no question of control. You would be out of control entirely. Here there is that horrifying sense that control has left you just when you most need it and by rights should have it. A terrible imminence overtakes entirely the present moment. Depression has gone too far when, despite a wide margin of safety, you cannot balance anymore. In depression, all that is happening in the present is the anticipation of pain in the future, and the present qua present no longer exists at all.

Depression is a condition that is almost unimaginable to anyone who has not known it. A sequence of metaphors -- vines, trees, cliffs, etc. -- is the only way to talk about the experience. It's not an easy diagnosis because it depends on metaphors, and the metaphors one patient chooses are different from those selected by another patient. Not so much has changed since Antonio in The Merchant of Venice complained:

It wearies me, you say it wearies you;

Copyright © 2001 by Andrew Solomon