“The depressed person was in terrible and unceasing pain, and the impossibility of sharing or articulating this pain was itself a component of the pain and a contributing factor in its essential horror.”

“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.”

“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.”

“The severing of an established connection is exponentially more painful than the rejection of an attempted connection.”

“The individual's right to pursue his own vision of the best ration of pleasure to pain: utterly sacrosanct.”

“Let me put it this way: You cannot live in the world without being in pain, spiritual and physical pain. We have developed mechanisms to deal with these pains, to overcome them somehow. Therapy, religion and spirituality, relationships, material success. All this can work, but also become a problem itself. The pursuit of happiness has even been put into the American constitution a couple centuries ago. Today we're so rich, we own much more than we need, we have liberties unknown before, even though they are endangered in the current political climate in the US - and we forget how wonderful it nevertheless is, compared to most other political and economic systems. We have a saying that goes: Give a man enough rope and he hangs himself.”

“We all suffer alone in the real world. True empathy's impossible. But if a piece of fiction can alow us imaginatively to identify with a character's pain, we might then also more easily conceive of others identifying with their own. This is nourishing, redemptive; we become less alone inside. It might just be that simple.”