Winner of the PEN/Martha Albrand Award for the Art of the Memoir Jeffery Smith was living in Missoula, Montana, working as a psychiatric case manager when his own clinical depression began. Eventually, all his prescribed antidepressant medications proved ineffective. Unlike so many personal accounts,Where the Roots Reach for Watertells the story of what happened to Smithafterhe decided to give them up. Trying to learn how to make a life with his illness, Smith sets out to get at the essence of--using the old term for depression--melancholia. Deftly woven into his "personal history" is a "natural history" of this ancient illness. Drawing on centuries of art, writing and medical treatises, Smith finds ancient links between melancholia and spirituality, love and sex, music and philosophy, gardening, and, importantly, our relationship with landscapes.

Jeffery Smith was born in West Virginia and was raised just across the the Ohio River in the Allegheny foothills. He now lives with his wife, Lisa Werner, in Coshocton County, Ohio, where he is working on a book about the traditional music of the Appalachians.

"More than a struggle about one man's struggle with his dark side: It's also a fascinating and highly idiosyncratic exploration of the illness, its history, and its place in the larger world."--Diane White, The Boston Globe

"Jeffrey Smith has written a gripping personal memoir of melancholia . . . He throws wonderful curve balls at his topic, using creative devices and poetic writing to get at the depth and range of depression." --Cynthia Crossen, The Wall Street Journal

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Chapter One

I am walking home, I kept telling myself. I live on East Third Street, in Missoula, Montana, and I am walking home, and by the time I get there this will be gone.

Or so I kept telling myself. I walked past the convenience store at the corner of Main, and in the light traffic of a Sunday noon, without waiting for the signal to change I crossed to the other side of Orange Street. Truth be told, I didn't believe a word of my little recitation. I wanted to; but by then I knew my enemy—as I called it then—too well to think I could just walk away from it. Earlier that day, to celebrate the coming of summer I'd been to a Sunday gathering with some friends on the west side of town. There in Barbara's yard we sat outside in the sun beneath a large maple tree. All about us the yard was festive with wildflowers: columbine, evening primrose, blue flax. Behind us her raised-bed garden was rich already with herbs and lettuce and greens. Over my shoulder with the breeze came the intimate smell of damp earth, a smell that could usually root any silliness right out of me.

But on that day I was unmoved. It was as if all these sights and smells had gone off into some murky distance where none of them would reach me. It was strange, but all too familiar, the way I could see these things but register none of the feeling they typically occasioned. I knew what this meant: it was back. For days before that brunch, there had been little hints and signs, but I'd brushed them off. And that was my inclination yet: it's just a passing mood, I told myself. I breathed in deep, to try to settle my mind. I wanted to believe if I would only focus more intently on the landscape, the gnawing clutter that was moving into my mind would disappear. So I leaned my head back and took in the horizon. Sapphire sky vaulted overhead. All around us the snow-peaked mountain ranges that frame Missoula—the Missions to the east, the Bitterroots to the west. But still I was unmoved.

I leaned forward again, returning to this circle of friends. Barbara and I were lovers, and we worked together as case managers at the community mental health center. Rita was also a mental health worker, and with her husband, Chris, I shared an Appalachian boyhood and a love of books. Tommy and Beth and their sons Evan and Campbell had previously lived in Asheville, North Carolina, and so had I. In Asheville I had scarcely known them, but in Missoula we had become close friends. The talk touched on baseball, music, wildlife, gardening, books, life in the southern mountains, religion—things I typically enjoyed talking about, or listening to smart and thoughtful people such as these talk about—and I could not speak; and I could not listen.

At one point Tommy turned in my direction. He seemed to be talking to me. Tommy was a kind, perceptive man, and it occurred to me that he must have noticed my trouble, and was trying to draw me into the conversation. I saw his lips moving, but his words were lost on me. I nodded my head, shrugged my shoulders, and turned away. Some other voice held my ear, and my mind was a tangle, a welter of confusion and overwhelm. I could only sit there dumbly. Beth picked her fiddle up off her lap and plucked and bowed it. I didn't care. I couldn't hear her either.

So my familiar was stalking me again. I felt its breath on my neck hairs. I could smell it. The spoor was everywhere around me. It was back, and it was nearly the longest day of the year; at our northern latitude the light would blanch the sky until past ten that evening. The idea of abiding that light for ten more hours exhausted me. Maybe, I thought, maybe my familiar won't follow me home; maybe I can stand up and walk away from it. So I quietly took my leave and shanked my way homeward.

I continued walking south on Orange Street and crossed the bridge, keeping my eyes on the pavement at my feet. I am walking home, I reminded myself, and once safely across the bridge I ducked under the handrail and sidestepped down the bank to walk along the Clark Fork River. By then I was halfway home. There on the floodplain I tried to sole my feet to the earth's roundness, tried to keep my hold on this quarter of its curve. Instead I felt leaden and fit only to plummet. I leaned back against a cottonwood tree on the riverbank. Shining clear light fell in sheets down the sky. In the breeze the lime-colored cottonwood leaves were all atremble; they shimmered the light in every direction, like some radiant version of glory revealed. I noticed, but I did not see: in my eyes all that sparkle and sinew had gone to blunt and shear, a blare of light.

There was no mistaking it now. I knew well enough: it is arrived. I scuffed the toe of my boot into the dirt. I dropped my head to study on the ground, jammed my fists into my pockets, and once again started for home. No external event of weather or circumstance could account for its coming. All I knew was that it came that day rising, as it always did, not falling as if from elsewhere but rising as if it came from within, as inexorable as it was unbidden. I slogged on home and in my dark and damp basement room I crawled into bed.

Like light it rises: light so unyielding it will suck all shadow from the earth and wick all moistness clean out of you. However it happens it seems your vital fluid has seeped out some invisible rent in your flesh. Then you become a vassal: the curb-chain clasps about your ankle; the weight gathers you, the thin membrane holding you aloft gives way. You cinch your shawl about your shoulders, and let fall.

You let fall, or you prevail upon pills to arrest your falling. I knew what was ahead of me—for most of the previous eighteen months I'd been mired in one depressive episode or another—and I didn't want any part of it. Along the way I had acquired the diagnosis "Severe Depression, Recurrent." Eventually that was amended with the phrase "treatment-resistant," since in that time I had been tried on six different antidepressants. Some of them had not worked at all; others had worked fast and bright, yanking me up almost immediately, and then a week or a month later each one stopped working altogether, and no increased dosages would restore their magic. It was exactly as if I had gone immune to them.

But the November before that gathering at Barbara's, my psychiatrist had prescribed Zoloft, one of the "selective serotonin reuptake inhibitors." It began working within a week, I had a glorious reprieve, and my state of mind held for two months, then four and then five and then six. Before the Zoloft began working I was struggling to keep up with a full load of graduate-level courses at the University of Montana, and I was involved, for maybe ten hours a week, with the editing of two literary magazines. Then in December, after the Zoloft kicked in, I accepted a full-time job doing case management at the community mental health center. Behind the Zoloft I had no qualms about adding a job to my workload. I was busier than I'd ever been, but somehow I kept up with it all: got my schoolwork done on time and my magazine work done on deadline; at my new job, I put in my quota of billable hours and then some. I became hale and jocose, outgoing, endlessly social. I scarcely ever sat home of an evening and read. In April I started into the relationship with Barbara, my first attempt at intimacy in two years.

For those seven months the Zoloft delivered just what I wanted: I was, I thought, fixed. Normal. But now it too seemed to be failing. I must be some fool, I thought, ever to believe that my familiar was gone for good. Now it seemed he'd been waiting patiently all along, knowing his time would come around again. I wanted that son of a bitch out of my life, and for good. On Monday I called my psychiatrist, who instructed me to double my Zoloft dosage.

This was how it always happened: the dreams went first, then sleep itself. It might have been ten days later, or two weeks—I think we were into July, anyhow, and once again I was awake every morning at four, after finally falling asleep just a couple hours before. I was unable to return to sleep, but neither could I will myself out of bed. I couldn't summon the concentration to read, so I would lie abed for three more hours, staring at the ceiling until it was time to go to work. I was exhausted; but I could not get the sleep to remedy it. When it was time to ready myself for work the stairway to the kitchen and bathroom seemed too steep to climb, and then my arms felt too heavy to lift and wash myself in the shower. So I just stood in there under the water.

The higher dose of Zoloft had done no good. I ought to have known: all those pretty little sky-blue pills wouldn't ward this off once and for all. It was too good; I had been too happy. It seems remarkable, when the antidepressants reverse these seemingly inevitable and unrelenting episodes; it's common, in fact, for depressives to refer to their effects as a "miracle." Well, it seemed I'd had my miracle, and now it was gone. And now each day passed as if turned on some noisome crank, something slow and tortuous, to be endured but not engaged. Come what may and I did not care. Every moment of it was just one more thing I had to withstand before I could retire to my dim, damp basement apartment and crawl into bed.

Outside, the coordinates were all askew. On the Fourth of July I got three blocks away from the house and could not for the life of me figure how to get to the grocery store. Down the street I saw my neighbor approaching on the sidewalk, made like I didn't, and crossed the street. How could I explain that I was lost, in my own neighborhood? I had to check the street signs to discover where I was and direct myself to the store.

"Eat well and get some exercise," my friends would tell me. Sensible advice, but there were some problems: first, any such enterprise requires at least a modicum of hope. To pull on sweatpants and sneakers and get out the door you first have to believe that your circumstance might be improved; and I could not convince myself of that. The pills had failed, so why would anything else work? Then, second, there was finding the energy to exercise, when I could hardly get myself up and down the stairs.

Third, it was never a good idea to leave the house. In the world without I was a liability, blighted and incompetent. Depression is a state of utter being: I could do nothing. Life had to be reduced to its most basic level: for example, precooked food was essential. When I finally made it home from the store, I opened a can of soup and poured it into a saucepan. Pueblo, the gray tabby who had moved off the street and into my room the summer before, sat on her chair there in the kitchen and watched. I dropped a pat of butter into the cast-iron skillet. I cut some cheddar cheese for a sandwich. When the butter melted I put the sandwich in the skillet to grill. Then I couldn't remember whether or not I'd added any water to the soup. I stood there hovering over the stove and still I could not recall. The looks of the slop in the saucepan told me nothing. I dragged a spoon through it and a taste of it didn't help much either. Finally I walked over to the sink, filled a coffee mug with water, and poured it into the soup. And then acrid clouds of smoke billowed up from the skillet. The smoke alarm started bleating. Pueblo leapt off her chair and scrambled down the basement steps to our rooms. I climbed onto her chair and undid the battery in the smoke alarm. By then the soup was boiling over. So I cut off the burners, and sat down to my dinner: watery lentil soup and a blackened cheese sandwich.

(Continues...)