Solomon's book, exploring his own near-fatal depression, is superb. He's become a passionate, outspoken advocate for those who, severely crippled by depression, cannot speak for themselves.

His Op-Ed essay in today's New York Times is superb. Some excerpts:

Under mounting pressure, the Food and Drug Administration last week announced changes in the labeling of 10 antidepressants to reflect apprehension that they may increase suicidal feelings.

But if the labeling scares depressed people away from medications that would help them, then such labeling is also dangerous.

It is probably the case that antidepressants both cause and prevent deaths. But it is also clearly the case that they prevent more deaths than they cause. The danger is that in seeking to prevent antidepressant-related suicide, we will increase depression-related suicide.

We tend to be unaware of the mortal nature of depression. Some 700,000 American adults attempt suicide every year; someone succeeds in committing suicide in the United States every 17 minutes. Four percent to 10 percent of people who suffer from major depression commit suicide. Untreated depression is lethal.

Depression is isolating, and part of the treatment should deal with the fearsome aloneness. Taking medication involves changing who patients are, and they need help to reassemble their own understanding of themselves.

The fundamental mechanism of antidepressant suicide is not that medication aggravates depression, but that antidepressants rouse people who are in a state of glazed lethargy.

The opposite of depression is not happiness, but vitality. In the depths of depression people may well lack the wherewithal to get out of bed or brush their teeth; everything seems difficult.

Antidepressants are activating. There is a delicate balance between the processes by which they give energy and those by which they ameliorate despair, and sometimes the energizing comes first. When that happens, patients get the verve required for decisive action without getting the feeling that they can beat their problems.

The result can be suicide. That is, a patient can go abruptly from wishing he were dead, to wanting to kill himself, to killing himself.

Anything that is strong enough to bring someone back from the brink of suicide is strong enough to push him there.

There is a world of difference between simply believing that life has no value, and knowing that feeling that way may be a side effect of medication.

Part of what motivates suicide is the belief that things will never get better; if patients are aware that sensations are temporary, and from a specific and easily identified source, they can grapple with them.

As a society, we are overmedicated and undermedicated. Many people with severe depression go untreated, and have barren, miserable lives because of it, while others commit suicide. Only 15% of people with major depression get appropriate treatment.

Both problems are authentic, but undermedication is far more dangerous.