Leonard Cohen’s Depression, Its (Failed) Medical Treatment, & Its Resolution

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Leonard Cohen’s Antidepressant Medications Joke & His Not At All Funny Depression

Those who have attended a Leonard Cohen Concert during the 2008-2009 Tour, checked out videos of those concerts, or read Heck Of A Guy posts referring to Cohen’s just a kid with a crazy dream … cheerfulness kept breaking through monologue may recall the portion of Cohen’s stage spiel that goes something like this:

I was 60 years old [when last on tour] — just a kid with a crazy dream. Since then I’ve taken a lot of Prozac, Paxil, Wellbutrin, Effexor, Ritalin, Focalin, … I’ve also studied deeply in the philosophies and religions, but cheerfulness kept breaking through.

The opening moments of this video from the Nokia Theater (Los Angeles) show on April 10, 2009 is representative:

Feature stories about Leonard Cohen in newspapers and blogs published during the World Tour have almost routinely covered his Zen Buddhist experience and his Jewish background; consequently, most audience members readily grasp the references to religions and philosophies.1

The significance of the list of antidepressant medications, however, may be less apparent because that part of Cohen’s history seems, with notable exceptions,  less frequently mentioned in those recent articles.

Clearly, someone should do something. But who and how?

That’s right – this calls for a  Heck Of A Guy public service announcement.

Leonard Cohen, Depression, Medications, and Noncompliance

By the 1950s, Cohen, then in his late teens, was experiencing signs and symptoms of depression,2 a disorder from  which his mother  also suffered.3

Cohen describes his despondency in A Happy Man by Mireille Silcott:4

“My depression, so bleak and anguished, was just crucial, and I couldn’t shake it; it wouldn’t go away,” he says, looking back at that time from his suite in the Vogue. “I didn’t know what it was. I was ashamed of it, because it would be there even when things were good, and I would be saying to myself, ‘Really, what have you got to complain about?’ But for people who suffer from acute clinical depression, it is quite irrelevant what the circumstances of your life are.”

He provides more details in a 1997 radio interview:5

Well, for me personally, depression has been an issue with me for the whole of my life and I’ve tried, like everybody else, various ways of dealing with that depression. You know, drugs, women, art, religion… you try everything … . Well, you know, there’s depression and depression. What I mean by depression in my own case is that depression isn’t just the blues. It’s not just like I’ve a hangover for the weekend… the girl didn’t show up or something like that, it isn’t that. I’m trying to describe clinically like an acute depression. It’s not really depression, it’s a kind of mental violence which stops you from functioning properly from one moment to the next. You lose something somewhere and suddenly you’re gripped by a kind of angst of the heart and of the spirit.”

Like many who have suffered from severe depression, Cohen has been critical of the too common error of re-labeling transient unhappiness as clinical depression:

The term clinical depression finds its way into too many conversations these days. One has a sense that a catastrophe has occurred in the psychic landscape.6

Cohen discusses his depression in this 1997 CTV interview with Valerie Pringle:7

I should note that one reason for my interest in Cohen’s medical treatment for his depression and his reaction to that therapy is my professional interest in treatment adherence, especially for psychiatric disorders.  I posted Leonard Cohen and Noncompliance With Antidepressants on AlignMap, my professional blog, two years ago.

In this interview,8 he discusses, with his characteristic candor and dark humor, his course of treatment and his decision to unilaterally discontinue these medications:

[Leonard Cohen] “… I was taking things like Prozac for depression, but none of those antidepressants worked.”

[Interviewer] “Which have you tried?”

[Leonard Cohen] “Oh, let’s see. I was involved in early medication, like Desipramine. And the MAOs [monoamine oxidase inhibitors], and the new generation — Paxil, Zoloft, and Wellbutrin. I even tried experimental anti-seizure drugs, ones that had some small successes in treating depression. I was told they all give you a ‘bottom,’ a floor beneath which you are not expected to plunge.”

[Interviewer] “And?”

[Leonard Cohen] “I plunged. And all were disagreeable, in subtly different ways.”

[Interviewer] “How?”

[Leonard Cohen] “Well, on Prozac, I thought I had attained some kind of higher plateau because my interest in women had dissolved.” He laughs. “Then I realized it was just a side effect. That stuff crushes your libido.”

[Leonard Cohen] “… So one day, a few years ago, I was in a car, on my way to the airport. I was really, really low, on many medications, and pulled over, I reached behind to my valise, took out the pills, and threw out all the drugs I had. I said, ‘These things really don’t even begin to confront my predicament.” I figured, If I am going to go down I would rather go down with my eyes wide open.”

Leonard Cohen On Psychotherapy

One notes that psychotherapy is not part of the joke.  As Cohen told Stina Lundberg in a 2001 interview:

I don’t trust them [psychological explanations]. As I say in that song: “I know that I’m forgiven, but I don’t know how I know; I don’t trust my inner feelings, inner feelings come and go.” I think that psychological explanations can be valuable and that psychotherapy can be valuable for some people, but the fundamental question of how and why people are as they are is something that we can’t penetrate in this part of the plan, that we simply cannot grasp, and the feelings that arise – we don’t determine what we’re going to see next, we don’t determine what we’re going to hear next, taste next, feel next or think next, we don’t determine, yet we have the sense that we’re running the show. So if anything is relaxed in my mind it’s the sense of control, or the quest for meaning. And my experience is that there is no fixed self. There’s no-one whom I can locate as the real me, and dissolving the search for the real me is relaxation, is the content of peace. But these recognitions are temporary and fleeting, then we go back to thinking that we really know who we are.

And he told another interviewer in 2001:

For one reason or another, I didn’t have any confidence in the therapeutic model. Therapy seems to affirm the idea unconditionally of a self that has to be worked on and repaired. And my inclination was that it was holding that notion to begin with that was the problem — that there was this self that needed some kind of radical adjustment. It didn’t appeal to me for some odd reason.9

Asked if he had tried psychotherapy, Cohen told another interviewer,

I preferred to use drugs. I preferred the conventional distractions of wine, women and song. And religion. But it’s all the same.10

For the record,

Cohen did go to a therapist once, actually — out of desperation. He was so depressed that he called a friend and asked if she could arrange for him to see her therapist straightaway. Then he drove to St. John’s Health Center in Santa Monica “at about five miles an hour,” barely able to negotiate the traffic. When he got there, the therapist asked him to describe his feelings. After Cohen had finished, she said, “How can you stand it?”11

Leonard Cohen’s Depression Ends

Cohen’s depression lifted spontaneously in the 1999. This description of the dissipation of his clinical syndrome from  a 2001 Observer interview with Nick Paton Walsh12  is compelling – and congruent with reports I’ve received from many patients whose depressions have subsided, as the Walsh puts it, “for no apparent reason:”

But two years ago [1999], for no apparent reason, the veil of depression lifted. For the first time in his life, Cohen sighed, looked out on the world and felt at peace with it.

‘There was just a certain sweetness to daily life that began asserting itself. I remember sitting in the corner of my kitchen, which has a window overlooking the street. I saw the sunlight that shines on the chrome fenders of the cars, and thought, “Gee, that’s pretty.”

‘I said to myself, “Wow, this must be like everybody feels.” Life became not easier but simpler. The backdrop of self-analysis I had lived with disappeared. It’s like that joke: “When you’re hitting your head against a brick wall, it feels good when it stops”.’

It was a remarkably late epiphany. Cohen had spent the past 50 years ploughing his way through drugs, drink, countless women and several religions in an attempt to find release from this ‘backdrop’ of self-doubt. But the cure was more simple – he learned to ignore himself.

‘When you stop thinking about yourself all the time, a certain sense of repose overtakes you. It happened to me by imperceptible degrees and I could not really believe it; I could not really claim it for some time. I thought there must be something wrong. It’s like taking a drink of cold water when you are thirsty. Every tastebud on your tongue, every molecule in your body says thank you.’

50 Years Of Depression – 10 Years Of Common Unhappiness13

So, that’s the story – Leonard Cohen endured  a devastating clinical depression that persisted 40-50 years, that proved resistant to a wide variety of appropriate medications, and that spontaneously remitted 10 years ago.

I suppose, on considering that history, that he’s earned the right to tell that I’ve taken a lot of Prozac, Paxil, Wellbutrin, Ritalin, … joke as often as he likes.

Credit Due Department: The image atop this post is from www.e-magineart.com and is used under Creative Commons license.

Note:This material was originally posted Apr 30, 2009 at 1HeckOfAGuy.com, the earlier incarnation of Cohencentric.
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  1. Re the source of Cohen’s “I’ve studied all the philosophies … ” crack, The original line was actually uttered by one Edward Edwards, who directed it to his friend, Samuel Johnson: “You are a philosopher, Dr. Johnson. I have tried too in my time to be a philosopher; but, I don’t know how, cheerfulness was always breaking in.” Recorded by James Boswell in The Life of Samuel Johnson, LL.D []
  2. Other sources argue, less convincingly, that Cohen’s depression was in evidence since age nine, apparently confusing a possible contributing cause of depression, the death of Cohen’s father that year, with the onset of the disorder itself. []
  3. Nadel, Ira Bruce.  Various Positions: A Life of Leonard Cohen. University of Texas Press, 2007. p 48 []
  4. A Happy Man by Mireille Silcott Saturday Night, Canada. September 15, 2001 []
  5. Synergie With Jean-Luc Esse And Leonard Cohen, France- Inter, October 6, 1997.  Translated From French By Nick Halliwell, UK []
  6. International Herald Tribune. Paris, 4 November 1968 []
  7. I cannot resist adding the editorial comment that Pringle’s attempt to perpetuate the myth that the elimination of an artist’s depression will also eliminate his creativity is just embarrassing []
  8. A Happy Man by Mireille Silcott, Saturday Night, Canada. September 15, 2001 []
  9. Angst & Aquavit by Brendan Bernhard. LA Weekly: September 26, 2001 []
  10. From Look Who’s Back at 67: Gentle Leonard Cohen by Frank DiGiacomo. New York Observer: Oct 15, 2001. []
  11. Angst & Aquavit by Brendan Bernhard. LA Weekly: September 26, 2001 []
  12. I Never Discuss My Mistresses Or My Tailors by Nick Paton Walsh. The Observer, October 14, 2001 []
  13. OK, I slipped in a psychiatric reference; Freud saw  the replacement of “neurotic suffering” by “common unhappiness” as the sign of a successful psychoanalytic treatment []