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Saturday, Nov 28, 2009
But however unlikely a champion he may appear to be, Solomon deserves credit for devoting much of his book to the experiences of poor depressed people, such as Lolly Washington of Prince George's County, Md. Lolly bore her first child at 17, was raped shortly after that and bore the rapist's child as well, then married a physically abusive man under family pressure and had three more kids in two-and-a-half years.
Her major depression arrived soon after. Solomon quotes her own description of what it was like: "I'd had a job but I quit because I just couldn't do it. I didn't want to get out of bed and I felt like there was no reason to do anything. I'm already small and I was losing more and more weight. I wouldn't get up to eat or anything. I just didn't care. Sometimes I would sit and just cry, cry, cry. Over nothing. Just cry. I just wanted to be by myself. My mom helped with the kids, even after she got her leg amputated, which her best friend accidentally shot off around then. I had nothing to say to my own children. After they left the house, I would get in bed with the door locked. I feared when they came home, three o'clock, and it just came so fast. My husband was telling me I was stupid, I was dumb, I was ugly. My sister has a problem with crack cocaine, and she has six kids, and I had to deal with the two little ones, one of them was born sick from the drugs. I was tired. I was just so tired."
By chance, Lolly became part of a Georgetown University study of indigent depressed women: She'd gone to the hospital to get her tubes tied and was spotted by someone screening for study subjects. It took pestering and several visits at home to persuade her to enroll in the study, which entailed therapy and group-support sessions. Once she did, her depression lifted very quickly. Solomon reports that Lolly's is one of the many "Cinderella-like" stories he encountered among poor depressed women given basic mental-health care: Four months later, she'd left the abusive husband, found a new job and moved the kids to a new apartment. "If it wasn't for Dr. Miranda and that," Lolly says of her therapist, "I'd still be at home in bed, if I was alive at all."
Laura Miller interviews editor Nell Casey
The stories Solomon tells of depression among the poor are not all so open and shut. Mental-health care, whether it's getting and filling a prescription or showing up for weekly therapy appointments, requires the kind of regular routine that many poor people find impossible to sustain. Emily Haunstein, a therapist who works with rural indigent women in southern Virginia, describes a typical patient's situation to Solomon: "When she has to come to the clinic on Monday, she asks her cousin Sadie, who asks her brother to come and get her to bring her in, while her sister-in-law's sister takes care of the kids, except if she gets a job that week, in which case her aunt can cover if she's in town. Then the patient has to have someone else come and pick her up, because Sadie's brother goes to work just after he drops her off. Then if we meet on Thursday, there's a whole other cast of characters involved. Either way, they have to cancel about 75 percent of the time, leaving her to make last-minute arrangements."
Nevertheless, poor depressed women are better off than poor depressed men. Male depression in general is harder to spot, Solomon says, because men tend to deal with the feelings of depression "not by withdrawing into the silence of despondency, but by withdrawing into the noise of violence, substance abuse, or workaholism." Indigent men's depression shows up in ways that "put them in jail or the morgue more often than in depression treatment protocols" like the one that saved Lolly Washington.
