I did not experience depression until I solved, for the most part, all my problems. My mother had died three years earlier, and I was already getting used to this event; I had already published my first novel; I got along well with my family; I came out unscathed from a powerful two-year novel; I bought a beautiful new house; I was published in The New Yorker. And so, when life finally got better and there were no reasons for despair left, depression crept up on its cat paws and ruined everything, and I acutely felt that there was no excuse for it in my circumstances. To fall into depression after an injury or when life is a complete mess is completely natural, but to indulge in depression when you have finally recovered from the injury and your life is in perfect order is confusing and unbalancing. Of course, you are aware of the underlying reasons: the eternal crisis of existence, the forgotten experiences of early childhood, minor insults inflicted by those who are no longer there, the loss of friends through your own negligence, the realization of the truth that you are not Leo Tolstoy, the lack of perfect love in this world, impulses of greed and uncharitableness lying too close to the heart, and much more. But now, going through all this register, I realized that my depression is a state of my mind and it is incurable.

My life is not particularly difficult. Most people would be happy if they had my cards at the beginning of the game. I’ve had better times and worse times-by my own standards, but just the recessions of what happened to me can not be explained. If my life was more difficult, I would have a completely different understanding of my depression. But after all, I had a rather happy childhood, with both parents who gave me love, and with my younger brother, whom they also loved and with whom we got along quite well. It was a strong family, so strong that I did not even think about a divorce or a serious quarrel between my parents, who really loved each other, and although they sometimes argued about this and that, but the question of their absolute devotion to each other and to my brother and me never even stood. We have always had enough money for a very comfortable life. I wasn’t very popular in elementary school and in middle school, but in high school I had a circle of friends with whom I was quite good. I always studied well.

As a child, I was somewhat shy, I was afraid of being shamed in public — and who is not? In high school, I began to notice periods of unstable mood, in which, again, there is nothing unusual in adolescence. There was a period, in the eleventh grade, when I became convinced that the school building where the lessons were held (which had stood for almost a hundred years) would soon collapse, and I remember having to harden myself against this strange spiritual turmoil from day to day. I understood that this was nonsense, and I was glad when everything went away after about a month.

Then I went to college, where I was blissfully happy and met many people who remain my friends to this day. I studied and had fun with all my might, I learned a whole range of new emotions and new horizons of intelligence. Sometimes, when I was alone, I suddenly felt isolated, and it was not just loneliness, but fear. I had a lot of friends, and then I would go to one of them; usually this would distract me from my worries. This happened irregularly and did not cause any real harm. I went to England to graduate school for a master’s degree, and after graduating, I began my writing career quite smoothly. He lived in London for several years. I had a lot of friends and several love adventures. All this has been preserved in many ways, my life still pleases me, and I am grateful to fate for this.

When severe depression begins, there is a tendency to consider its roots. I want to know where it came from, whether it was always somewhere nearby or attacked you suddenly, like food poisoning. Since the first breakdown, I have been entering the troubles of the early period of my life into the register for months in a row, everything as it is. I was born with my buttocks forward, and some authors associate buttock childbirth with birth trauma. I had dyslexia, although my mother, having caught it early, began to teach me how to overcome it from the age of two, so it was never a serious obstacle for me. I started talking early, but my coordination was not good. When I asked my mother about my earliest injuries, she said that I had difficulty learning to walk, and although speech did not cause me any effort, my motor reactions and sense of balance developed slowly and imperfectly. I was told that I fell, and fell, and fell endlessly, and only after much persuasion did I agree to at least try to get back on my feet. My unsportsmanlike behavior, a consequence of all this, became the reason for my unpopularity in elementary school. Naturally, children do not forgive this, but the rejection from their peers was offensive to me; However, I’ve always had a few friends, and I’ve always liked adults, and they liked me.

I have many scattered, unstructured memories from my early childhood, and almost all of them are happy. Once, during a session with a psychoanalyst, I was informed that a certain poorly defined sequence of my early memories suggests that I was sexually harassed sometime in my childhood. In principle, of course, this is not excluded, but I have not been able to remember anything convincing on this topic, nor to find any evidence. If there was anything, it was probably something quite tender, because I was carefully monitored and any bruise or tear would have been immediately noticed. I remember one episode, when I was six years old, and I was in a summer camp, – I was suddenly seized with unreasoning fear. I see it all as it is now: above, on the terrace, there is a tennis court, on the right there is a dining room, we are sitting under a large oak tree and listening to stories. Suddenly I lose the ability to move. I know for sure that something terrible is going to happen to me, now or later, and that as long as I am alive, I will not be free. Life, which until then was perceived as a solid surface on which you can stand and move, suddenly became soft and yielding under your foot, and I began to fall through it. If you didn’t move, you could hold out, but if you moved a finger, and the danger loomed again. It seemed very important whether I would go left, or right, or straight, but which of the directions would save me, I did not know, at least at any given moment. Fortunately, the teacher arrived in time and told me to hurry, because I was late for the pool; the obsession passed, but I thought about it for a long time and hoped that it would never happen again.

I think that when this happens to children, there is nothing unusual about it. Existential melancholy in adults, for all its torment, is usually rewarded with a deepening of self-consciousness; and the first revelations about the fragility of a person, the first hints that you are mortal, pile on mercilessly and act destructively. I have observed similar conditions in my godchildren and in my nephew. It would be a stupid fantasy to say that in July 1969, at Camp Grand Lake, I realized that I would die someday; but I stumbled, for no apparent reason, on my general vulnerability, on the fact that my parents are not subject to the world and everything that happens in it, and that I will never be subject to it either. I have a weak memory, and after that incident in the camp, I began to be afraid of what was lost in time, and at night, lying in bed, I tried to remember everything that happened that day in order to preserve it — this is such an immaterial thirst for hoarding. I was especially fond of parental kisses at night, and I put a napkin under my head so that if they rolled off my face, I would have time to collect them, and hide them, and keep them forever.

Since the beginning of high school, I began to feel a vague sense of sexuality in myself, and this, I must say, was the most unsolvable emotional riddle in my life. To insulate myself from this, I talked a lot with friends, and this was my main strategy for protecting myself from this problem during all my college years. Then several years passed in uncertainty, there was a long series of relationships with men and women; this greatly complicated the relationship with my mother. From time to time, I fell into a state of intense anxiety without any specific reason — a strange mixture of melancholy and fear. This condition sometimes attacked me as a child, while I was riding on the school bus. Sometimes it came to me in college on a Friday evening, when the noisy fun outside the window violently violated the privacy of the darkness. Sometimes it happened while reading, and sometimes-during love joys. It always attacked me when I left the house, and to this day it is an indispensable attribute of any departure — even when I’m just going somewhere for the weekend, this state falls on me as soon as I lock the door behind me. Besides, it usually came when I got home. Sometimes my mother, or a friend, or even one of our dogs meets me on the threshold, and I am overcome by a deep sadness, and this sadness scares me. I coped with it by maniacally hanging out with people, and it almost always distracted me. I had to constantly whistle a cheerful melody to escape from this melancholy.

The summer after I graduated from college, I had a little nervous breakdown, but then I had no idea what it was. I was traveling around Europe — it was the summer I had always dreamed of, a summer of complete freedom, something like a graduation gift from my parents. I spent a wonderful month in Italy, then went to France, then visited a friend in Morocco. This country scared me. There was a feeling that I was given too much freedom, too many habitual restrictions were removed, and I was nervous all the time, as I once was before going on stage in a school play. I returned to Paris, saw a few more friends there, had a lot of fun and went to Vienna, where I always wanted to visit. I couldn’t sleep in Vienna. When I arrived and took a room in a hotel, I immediately went to meet old friends who also happened to be in Vienna. We had a wonderful evening the old-fashioned way, decided to go to Budapest together, and then I returned to my room and spent a sleepless night terrified that I had allegedly made some mistake, I didn’t know what. The next morning I was in such a nervous state that I didn’t even try to have breakfast in a dining room full of strangers; However, when I got out into the air, I felt better and decided to go see the paintings; I thought that I must have overexerted myself and overworked. My friends had dinner with someone else that night, and when they said this, it stung me to the heart, as if I had been informed of a murderous plot. We agreed to meet after dinner and have a drink together. I didn’t have dinner that day. I couldn’t bring myself to go to an unfamiliar restaurant and order food alone (although this had happened many times before); I couldn’t even start a conversation with anyone. When I finally met my friends, I was shaking. We went somewhere, and I drank a lot more than I had ever drunk, and for a while I felt calm. At night I did not close my eyes again — my head was splitting, my stomach ached, I was tormented by persistent thoughts about how not to miss the boat to Budapest. The next day passed somehow, and after the third sleepless night, I was so scared that I couldn’t get up all night to go to the toilet. I called my parents.

— I have to go home, ” I said. They were quite surprised — after all, before the trip, I haggled with them for every extra day and every extra city, trying to stretch my time abroad as long as possible.

— Is something wrong?” — they asked, and I could only say that I was not feeling well and in general all this was not as insanely interesting as I expected. Mom showed understanding:

“It’s hard to travel alone —” she said. — I thought you were going to meet some friends there, but it can still be terribly tiring.

“If you want to come back,” my father said, ” withdraw money from my account, buy a ticket and come back.

I bought a ticket, packed up and returned home the same day. My parents met me at the airport.

— What happened? They asked, but all I could say was that I couldn’t stay there any longer. I felt safe in their arms for the first time in many weeks. I was sobbing with relief. When we arrived at the house where I grew up, I was already in melancholy and felt like a complete idiot. I have ruined the summer of my dreams, my journey; I have returned to New York, where I have absolutely nothing to do. I never saw Budapest. I started calling my friends, and they were surprised that I had suddenly turned up. I didn’t try to explain what happened. I spent the rest of the summer at home with my parents: I was bored, annoyed and always frowning, although we were good together at times.

As the years passed, I more or less forgot about all this. After that summer, I went to England to study at the university. A new university, a new country — but I hardly panicked at all. I immediately entered a new life, quickly made new friends, studied with interest. I fell in love with England, and nothing seemed to frighten me anymore. The nervous young man who left home to study at college in America gave way to a strong, confident, sociable guy. When I gave a party, everyone wanted to go to it. With my closest friends (they are still among my closest friends) I sat up all night long in a feeling of deep and lively intimacy, which gave fantastic pleasure. Once a week, I called home, and my parents noted that my voice sounded happier than ever. When I was not at ease, I longed for company and always found it. For two years I was mostly happy, but I was only dissatisfied with the bad weather, the inability to make everyone love me at first sight, lack of sleep and the beginning of hair loss. The only depressive tendency that constantly haunted me was akin to nostalgia: unlike Edith Piaf, I regret everything simply because it has passed; even at the age of twelve, I mourned the past time. Even in the most exalted mood, I always seem to struggle with the present in a fruitless attempt to prevent it from becoming the past.

I remember the first years after twenty as relatively calm. I decided-just like that, under the mood — to go in search of adventures and began to simply ignore my painful anxiety, even when it was associated with frightening situations. A year and a half after graduating from graduate school, I started traveling to the Soviet Union, to Moscow, where I illegally lived in someone’s empty apartments with artists I met there. Once in Istanbul, someone tried to rob me, but I fought back, and he ran away without taking anything from me. I allowed myself to try all kinds of sex; I threw away almost all the previous restraint and erotic fears. I grew my hair long; I cut my hair bald. I performed with a rock band several times; I went to the opera. I developed a passion for gaining experience, and I got it as soon as I could, wherever I could afford to go. I fell in love and arranged cozy home hearths.

And in August 1989, when I was twenty-five, my mother was diagnosed with ovarian cancer and my perfect world began to collapse. If she hadn’t been ill, my life would have turned out completely differently; if this story had been even a little less tragic, I might have lived my life with a depressive tendency, but without an obvious breakdown. Perhaps I would have had a depressive episode later, during a midlife crisis; maybe everything would have happened as it really happened. If the first part of a certain emotional biography is made up of harbinger experiences, then the second part is made up of excitatory experiences. In most cases, the deepest depressions are anticipated by lighter ones that have passed unnoticed or just by themselves. Of course, many people who do not experience depression at all also experience experiences that can be defined in hindsight as anticipatory episodes, but if they did not lead to anything, they simply fall out of memory — after all, what they may have anticipated did not materialize.

I will not tell you in detail about how everything fell apart: for those who know this debilitating disease, everything is clear without me, and for those who do not know, it will probably remain inexplicable, as it turned out for me in my twenty-five years. Suffice it to say that everything was really terrible. In 1991, my mother died. She was fifty-eight. A paralyzing sadness gripped me. But despite the tears shed and the immense grief, despite the passing of the person on whom I had completely relied all my life, I did not do well for the first period after my mother’s death. I was sad, I was angry, but I wasn’t mad.

That summer, I started taking a course of psychoanalysis. I told the woman who was going to become my psychoanalyst that before I could start, she had to promise me that she would continue the analysis until we completed the course, no matter what happened — unless she became seriously ill. She was in her seventies. She agreed. She was a charming and wise woman who reminded me of my mother. Thanks to our daily meetings, I managed to restrain my grief.

At the beginning of 1992, I fell in love. She was brilliant, beautiful, generous, kind, and fantastically involved in everything that made up our lives; she was also an incredibly difficult person. We had a hectic but mostly happy romance. In the fall, she got pregnant and had an abortion, which gave me a premonition of loss. At the end of ‘ 93, we separated — by mutual consent and with mutual pain. I slid down another step.

In March 1994, the psychoanalyst told me that she was retiring because it had become difficult for her to travel to New York from Princeton, where she lived. I no longer felt so dependent on our joint work, and I was thinking of ending it; nevertheless, when she broke the news to me, I could not restrain myself, burst into tears and cried for an hour. I don’t usually cry very often; I haven’t cried like this since my mother died. I felt infinitely, fatally lonely, and abandoned, and deceived, and betrayed. We still had a few months left to complete our work while her pension was being processed (she didn’t know how much, it was more than a year).

In the same month, I complained to her about the loss of feelings, about the insensibility that affected all my relationships with people. I became disgusted with love, work, family, friends. I began to write less, and then I completely abandoned this activity. “I don’t know anything,” the artist Gerhard Richter once wrote. — I can’t do anything. I understand nothing. I don’t know anything. Nothing. And all this agony does not make me particularly unhappy.” So it was with me — I did not find any strong emotions in myself, except for a strange, nagging anxiety. I have always had a restless libido, which often got me into trouble; now it seems to have evaporated. I did not feel a “nice habit” of physical and emotional intimacy, I was not attracted to strangers on the street, or those I knew and loved; in erotic situations, my thoughts drifted to what I needed to buy and what work to finish. All this gave me the feeling that I was losing my Self, and it scared me. I consciously planned pleasures as part of my life schedule. Throughout the spring of 1994, I went to parties and tried to have fun, but I couldn’t; I saw friends and tried to maintain intimacy — nothing came out; I bought expensive things that I had previously dreamed of, and did not feel any joy from it; in an attempt to awaken my libido, I went to previously untested extremes, watched pornographic films and went so far as to use the services of prostitutes. This new experience did not particularly terrify me, but it did not bring me pleasure, or even relief. The psychoanalyst and I discussed the situation: I was depressed. We tried to get to the roots of the problem, and I kept pulling away from life, slowly but inexorably. I began to be annoyed by endless messages on the answering machine — and this became my habit: calls, even from friends, began to be perceived as an unbearable burden. I called back, and there were more and more calls. I became afraid to drive a car. In the dark, I couldn’t see the road, my eyes were drying up. I constantly thought that I was about to crash into a barrier or into another car. I used to drive on the motorway and suddenly I feel that I don’t know how to drive. In a daze, I pulled over to the side of the road, covered in cold sweat. I started spending weekends in the city so as not to drive a car. The psychoanalyst and I reviewed the history of my melancholy attacks. It occurred to me that my romance with a woman had ended because I was in the early stage of depression, but I understood that the breakup could, on the contrary, be one of its causes. Trying to untie this knot, I reviewed my life and tried to understand since when I have depression: since the breakup of the relationship; since the death of her mother; since the beginning of her illness two years ago; since the end of the previous novel; since puberty; since birth. Soon I could not think about any time or any event without seeing their symptomatology. And yet it was just a neurotic depression, more characterized by anxious melancholy than insanity. It seemed to be under my control: a stable version of a condition that I had already experienced, more or less familiar to many healthy people. Depression comes gradually, like growing up.

By June 1994, I was overcome by an inescapable boredom. My first novel was published in England and was favorably received, but it did me little good. I read the reviews indifferently and constantly felt tired. In July, when I returned to New York, I felt that I was oppressed by any gatherings and even just conversations. All this required more effort than it was worth. The subway was unbearable. The psychoanalyst, who had not yet retired, said that I had a slight depression. We discussed the reasons, as if naming an animal meant taming it already. “I have too many acquaintances and too many things to do —” I thought — ” I need to cut it all down.”

At the end of August, I had a kidney colic, a nuisance that had already visited me once. I called my doctor, and he promised to notify the hospital so that they would speed up the removal of the stone in the emergency department. However, when I arrived at the hospital, it turned out that no one had been notified about anything. With renal colic, the pain can be crushing, and as I sat waiting, it seemed to me that my spinal cord had been dipped in acid and now my nerves were being stripped to their living core. Several people in dressing gowns listened to me, I told them all about my pain, but no one did anything. And then something clicked in me. Standing in the emergency room of the New York University Hospital, I screamed. They gave me a morphine injection in my arm. The pain subsided. Soon she came back; for five days I was in and out of the hospital. Four times I was injected with a catheter; finally, I was put on the maximum permissible dose of morphine plus injections of demerol (Demerol) every few hours. I was told that my stones are poorly translucent and therefore I can not be a candidate for lithotripsy, which would instantly crush them. The operation, they told me, is possible, but painful and, in principle, dangerous. Until then, I didn’t want to disturb my father, who was on vacation in the state of Maine; now I decided to contact him, because he knew many people at the clinic since my mother was there for the last time, and could arrange everything. He didn’t really care. “Stones? It’s nothing, they’ll come out, I’m sure everything will be fine, I’ll see you when I get back.” Meanwhile, I was sleeping no more than three hours a day. I was working on a very serious task, an article about the policy towards the deaf, and I was talking to the editors in a kind of fog. I felt like I was losing control of my own life.

— If this pain doesn’t go away, “I told my friend,” I’ll kill myself.

I have never said such words before.

After leaving the hospital, I was constantly afraid. The pain, or maybe the painkillers, completely undermined my mind. I understood that the stones could start moving again and a relapse would occur. I was afraid to be alone. Together with a friend, I went to my apartment, packed some things and left. It was a week of nomadism — I migrated from one friend to another. They usually went to work during the day, and I stayed with them, avoiding the street and not going far from the phone. I was still taking painkillers for prevention and felt a little crazy. I was angry at my father-irrationally, capriciously, viciously angry. He apologized for his indifferent behavior, as I called it, and tried to explain that he only expressed relief that I did not have some deadly disease. He said that he had heard on the phone that I was holding up relatively staunchly. I fell into a tantrum, which I can’t explain now in any way. I refused to talk to him or even tell him where I was. From time to time, I called him and left messages on his answering machine; usually they began with the words “I hate you, damn you.” At night I was saved by sleeping pills. There was a slight relapse, and I went back to the hospital; nothing serious, but it scared me to death. Looking back, I can say that I really went crazy that week.

I went to Vermont for the weekend to attend a wedding with friends. There were beautiful days of late summer. I almost canceled the trip, but then I found out everything about the hospital closest to the wedding site and decided to take a chance. I arrived on Friday, having had time for dinner and a quadrille (I did not dance); I met a man with whom I was somewhat familiar in college ten years ago. We started talking; I was overwhelmed by emotions that I hadn’t experienced in years. I was beaming; I was in a kind of frenzy, literally “flew” from emotion to emotion and could not predict that nothing good would come of it.

After the Vermont wedding, an inevitable decline began. I was working worse and worse. I canceled a trip to England, where I was also going for a wedding, fearing that I would not be able to cope, although a year ago I regularly went to London without any problems. There was a feeling that no one could love me, that I would no longer have any novels. There are no sexual desires left at all. I began to eat irregularly, because I was rarely hungry. The psychoanalyst still said that it was depression, and I was already tired of this word, and of this nice lady too. I said that I didn’t think I was crazy, but I was afraid of going crazy and whether she thought that it would end with antidepressants, and she said that giving up drugs was a courageous act and that we could get out of this together. This was the last conversation on my initiative, and the feelings experienced at the same time turned out to be the last for a long time to come.

Severe depression has a number of defining signs, mostly associated with withdrawal into oneself, although agitated or atypical depression can be characterized not by a dreary-apathetic mood, but by an anxious-melancholic mood and it is usually quite easy to recognize; it upsets sleep, appetite and energy balance. It has a tendency to increase the painful attitude to rejection, and it can be accompanied by a loss of self-confidence and self-care. It probably depends on the functioning of the hypothalamus (which regulates sleep, appetite and energy) and the cortex (which translates empirical experience into philosophy and worldview). Depression, which is part of the structure of manic-depressive (or bipolar) disorder, is genetically predetermined to a much greater extent (about 80%) than ordinary depression (10-50 %). Although it lends itself to a wider range of treatments, it is not easy to control it, especially when you consider that antidepressants can lead to a manic state. The greatest danger of manic-depressive psychosis is that it often leads the patient into a so-called mixed state: when both manic and depressive symptoms exist at the same time, a person can be filled with negative feelings and believe that they elevate him. This is the most common condition that provokes suicide; it can also be caused by antidepressants used without mood stabilizers, which are a necessary part of the treatment of bipolar disorders. Depression can be melancholic or atypical, for example, agitated. During the first one, you don’t want to do anything; during the second one, you want to kill yourself. Failure is a direct path to insanity. To borrow a metaphor from physicists, it is an uncharacteristic behavior of matter determined by hidden variables. There is a cumulative effect here: whether we see it or not, but the factors leading to a depressive episode are collected over the years, usually throughout life. There is no life in which there is no material for despair, but some people move too close to the edge, while others manage to stay at a safe distance from the cliff, feeling sad at times. But as soon as you cross the line, all the rules change. Everything written in the native language is now written as if in Chinese; what was fast, is now slow; sleep is needed for clarity, whereas waking is a sequence of unrelated meaningless images. During depression, the sensory organs slowly fail. “There is a moment when you suddenly start to feel how the” chemistry “works in you,” my depressed friend Mark Weiss once said. — I start to breathe differently, and the breath becomes fetid. My urine stinks. My face in the mirror is falling apart. I know when it comes.”