“People with family histories of alcoholism tend to have lower levels of endorphins- the endogenous morphine that is responsible for many of our pleasure responses- than do people genetically disinclined to alcoholism. Alcohol will slightly raise the endorphin level of people without the genetic basis for alcoholism; it will dramatically raise the endorphin level of people with that genetic basis. Specialists spend a lot of time formulating exotic hypotheses to account for substance abuse. Most experts point out, strong motivations for avoiding drugs; but there are also strong motivations for taking them. People who claim not to understand why anyone would get addicted to drugs are usually people who haven't tried them or who are genetically fairly invulnerable to them.”

“Exercise is for people who can't handle drugs or alcohol.”

“The people who succeed despite depression do three things. First, they seek an understanding of what's happening. They they accept that this is a permanent situation. And then they have to transcend their experience and grow from it and put themselves out into the world of real people.”

“Since I am writing a book about depression, I am often asked in social situations to describe my own experiences, and I usually end by saying that I am on medication. “Still?” people ask. “But you seem fine!” To which I invariably reply that I seem fine because I am fine, and that I am fine in part because of medication. “So how long do you expect to go on taking this stuff?” people ask. When I say that I will be on medication indefinitely, people who have dealt calmly and sympathetically with the news of suicide attempts, catatonia, missed years of work, significant loss of body weight, and so on stare at me with alarm. “But it’s really bad to be on medicine that way,” they say. “Surely now you are strong enough to be able to phase out some of these drugs!” If you say to them that this is like phasing the carburetor out of your car or the buttresses out of Notre Dame, they laugh. “So maybe you’ll stay on a really low maintenance dose?” They ask. You explain that the level of medication you take was chosen because it normalizes the systems that can go haywire, and that a low dose of medication would be like removing half of your carburetor. You add that you have experienced almost no side effects from the medication you are taking, and that there is no evidence of negative effects of long-term medication. You say that you really don’t want to get sick again. But wellness is still, in this area, associated not with achieving control of your problem, but with discontinuation of medication. “Well, I sure hope you get off it sometime soon,” they say. ”

“Listen to the people who love you. Believe that they are worth living for even when you don't believe it. Seek out the memories depression takes away and project them into the future. Be brave; be strong; take your pills. Exercise because it's good for you even if every step weighs a thousand pounds. Eat when food itself disgusts you. Reason with yourself when you have lost your reason.”

“While people argue with one another about the specifics of Freud's work and blame him for the prejudices of his time, they overlook the fundamental truth of his writing, his grand humility: that we frequently do not know our own motivations in life and are prisoners to what we cannot understand. We can recognize only a small fragment of our own, and an even smaller fragment of anyone else's, impetus.”

“Parents’ early responses to and interactions with a child determine how that child comes to view himself. These parents are also profoundly changed by their experiences. If you have a child with a disability, you are forever the parent of a disabled child; it is one of the primary facts about you, fundamental to the way other people perceive and decipher you. Such parents tend to view aberrance as illness until habituation and love enable them to cope with their odd new reality—often by introducing the language of identity. Intimacy with difference fosters its accommodation.”