“Hang me upside-down and fuck me in both ears. You pulled yourself out of a clinical depression by being a freaking hero.”

“sarcasm and jokes were often the bottle in which clinical depressives sent out their most plangent screams for someone to care and help them.”

“That dead-eyed anhedonia is but a remora on the ventral flank of the true predator, the Great White Shark of pain. Authorities term this condition clinical depression or involutional depression or unipolar dysphoria. Instead of just an incapacity for feeling, a deadening of soul, the predator-grade depression Kate Gompert always feels as she Withdraws from secret marijuana is itself a feeling. It goes by many names — anguish, despair, torment, or q.v. Burton's melancholia or Yevtuschenko's more authoritative psychotic depression — but Kate Gompert, down in the trenches with the thing itself, knows it simply as It.It is a level of psychic pain wholly incompatible with human life as we know it. It is a sense of radical and thoroughgoing evil not just as a feature but as the essence of conscious existence. It is a sense of poisoning that pervades the self at the self's most elementary levels. It is a nausea of the cells and soul. It is an unnumb intuition in which the world is fully rich and animate and un-map-like and also thoroughly painful and malignant and antagonistic to the self, which depressed self It billows on and coagulates around and wraps in Its black folds and absorbs into Itself, so that an almost mystical unity is achieved with a world every constituent of which means painful harm to the self. Its emotional character, the feeling Gompert describes It as, is probably mostly indescribable except as a sort of double bind in which any/all of the alternatives we associate with human agency — sitting or standing, doing or resting, speaking or keeping silent, living or dying — are not just unpleasant but literally horrible.It is also lonely on a level that cannot be conveyed. There is no way Kate Gompert could ever even begin to make someone else understand what clinical depression feels like, not even another person who is herself clinically depressed, because a person in such a state is incapable of empathy with any other living thing. This anhedonic Inability To Identify is also an integral part of It. If a person in physical pain has a hard time attending to anything except that pain, a clinically depressed person cannot even perceive any other person or thing as independent of the universal pain that is digesting her cell by cell. Everything is part of the problem, and there is no solution. It is a hell for one.The authoritative term psychotic depression makes Kate Gompert feel especially lonely. Specifically the psychotic part. Think of it this way. Two people are screaming in pain. One of them is being tortured with electric current. The other is not. The screamer who's being tortured with electric current is not psychotic: her screams are circumstantially appropriate. The screaming person who's not being tortured, however, is psychotic, since the outside parties making the diagnoses can see no electrodes or measurable amperage. One of the least pleasant things about being psychotically depressed on a ward full of psychotically depressed patients is coming to see that none of them is really psychotic, that their screams are entirely appropriate to certain circumstances part of whose special charm is that they are undetectable by any outside party. Thus the loneliness: it's a closed circuit: the current is both applied and received from within.”

“This story ["The Depressed Person"] was the most painful thing I ever wrote. It's about narcissism, which is a part of depression. The character has traits of myself. I really lost friends while writing on that story, I became ugly and unhappy and just yelled at people. The cruel thing with depression is that it's such a self-centered illness - Dostoevsky shows that pretty good in his "Notes from Underground". The depression is painful, you're sapped/consumed by yourself; the worse the depression, the more you just think about yourself and the stranger and repellent you appear to others.”

“Writing fiction takes me out of time. I sit down and the clock will not exist for me for a few hours. That’s probably as close to immortal as we’ll ever get.”

“The entire ball game, in terms of both the exam and life, was what you gave attention to vs. what you willed yourself to not.”

“I can remember hearing one middle-aged man who sat nearby saying 'Simmer down, boyo' to another older man seated kitty-corner to me across the doorway to one of the hallways extending out from the waiting area, except when I looked up from the book both these men were staring straight ahead, expressionless, with no sign of anyone needing to 'simmer down' in any conceivable way.”