September 13, 2020

Mental & Emotional Health

A few things worth sharing: 09-13-2020

The Lost Years and Last Days of David Foster Wallace.

Read Time < 1 minute

Here are a couple of things I think are worth sharing:


The Lost Years and Last Days of David Foster Wallace (Rolling Stone, October 30th, 2008)

Yesterday marks the 12th anniversary of David Foster Wallace passing away. I don’t know how I missed this piece when it came out in October 2008, about 6 weeks after his death. It’s a beautiful story of his life, his struggles, and very sadly, his final year. It’s heartbreaking to read this because I suspect—or at least want to believe—much more could have been done to medically manage his depression after the failure of his first therapy. I have spoken about this exact case with several psychopharmacologists since then and all felt there were many other options available, even at the time. Maybe that’s true, maybe it’s not. We’ll never know. But when we consider how many people suffer from depression, even if not as debilitating as DFW’s, I wish we could spend one-tenth of what we spend on cancer on this condition.1This is not an exaggeration. Look at the 2020 NIH budget, for example: an estimated $7.1 billion is provided for research on cancer vs $600 million for depression.




Shipping Out: On the (nearly lethal) comforts of a luxury cruise (Harper’s, January 1996)

Pure genius. I’ve never really felt the urge to go on a cruise, and recent pandemics aside, not much has tweaked that desire lately. David Foster Wallace’s 1994 classic on the topic seems even more timely today.


– Peter

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  1. I don´t know if this is the right place to thank you for the piece about David Foster Wallace but…..thank you!
    Reminded me that all of us are fragile in one way or
    another…and that we might try to remember that in our
    dealings with people….not because we might run into another David Foster Wallace but just because it would be the kind thing to do. Have not yet read the piece about the vacation cruise but am now looking forward to it. Again, thank you.

  2. I’m too busy to find time for just about anything these days, but then you send a classic DFW gonzo journalism essay on cruise ships – that is 24 pages long – and I managed to find the time to giggle and wonder if I’ll ever be half as good a writer. Reminded me of Hunter S’s style of writing (particularly The Great Shark Hunt). So all this to say…thanks for unearthing this gem!

  3. I just finished Infinite Jest and The Pale King, both great novels, although the latter wasn’t finished, so you can’t really compare it to Infinite Jest.
    Like Thomas Pynchon, he was one of the few novelists that had a keen understanding of both ‘hard’ science, and literature.
    He recognized the biological nature of disorders such as depression, panic disorder, schizophrenia, OCD, and others.
    The MAO Inhibitor, Phenelzine, was the only antidepressant that was effective in his monstrous case of clinical depression, and allowed him sixteen years of respite from his illness to create his wonderful work.
    Unfortunately, MAO Inhibitors have deadly interactions with many substances, and DFW was taken off Phenelzine for medical reasons not specified in any of the articles I’ve found written on him.
    Apparently, his doctor found Phenelzine life threatening to DFW in some way, although this wasn’t described in any detail in anything I could find written on the subject.
    As a result he suffered a relapse, and even when he tried to use Phenelzine again, he found it no longer effective, and as a result committed suicide due to the severity of his illness.
    Whether this could have been prevented by using some type of combination therapy, eg. Tricyclics +SSRIs +SNRIs, or some other variant, is unknown to me.
    The impossibility of understanding his torment even today, is evidenced by various reactions to his death found on You Tube, by various friends, and fellow writers, who ascribe his suicide to outside events, e.g., too much pressure from the press, his lifestyle, etc…
    Since these things didn’t affect him when Phenelzine was effective for him, why should they have bothered him at the time of his suicide?
    This reflects the impossibility of another person who does not suffer from clinical depression to understand how something like suicide and depression can be caused by a biological agent.
    The ground-breaking work of Dr. Donald F. Klein, who revolutionized the field of biological psychiatry in the 1980s, after twenty years of being labeled as a quack, saved the lives of many mental illness sufferers, yet his death this year was barely noticed by anyone outside the medical field. His most accessible book to the layman on this subject would be “Mind, Mood and Medicine”.

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