Heller McAlpin reviews books regularly for NPR.org, the Los Angeles Times, the San Francisco Chronicle and the Barnes & Noble Review.

Daphne Merkin’s “This Close to Happy” is a triumph on many levels, including the very fact of its completion. Merkin, a former New Yorker film critic and an essayist who gained a certain notoriety for a piece she wrote 20 years ago about her sexual predilections, was first hospitalized for depression at age 8. Following the publication in 2001 of an essay in the New Yorker about her subsequent psychiatric hospitalizations, she was commissioned to expand on the subject in a book about the dark cloud and miserable tug toward self-annihilation that has overshadowed her life, but its progress was delayed repeatedly by the very experience she was writing about.

The book’s publication at long last is heartening. “This Close to Happy” is as insightful and beautifully written as it is brave. Merkin clearly understands the risks of going public with such intimate, dark material and refuses the unrealistic comfort of an unequivocally redemptive ending. She also beats readers to potential criticisms, “from self-absorption to self-pity, with stops along the way for excessive candor and unsightly narcissism.”

Merkin is one of six children of financier Hermann Merkin and Ursula Breuer Merkin, Orthodox Jews who left Germany to escape Nazi persecution and made a fortune in investment banking and transatlantic shipping. Although her parents’ philanthropies include the Merkin Concert Hall in New York City, Daphne Merkin quickly debunks the image of a privileged childhood. She writes, “I recognize that there is always the risk in a story like this one of alienating the reader, of coming off like a poor little rich girl, mewling piteously against a backdrop of plenitude.”

"This Close to Happy: A Reckoning with Depression," by Daphne Merkin (Farrar Straus Giroux)

Yes, she grew up with her five siblings in a Park Avenue duplex with a nanny, cook, chauffeur and laundress. But charity definitely did not begin at home. Merkin paints a nightmarish picture of “strange withholdings — impoverishments, even — that can occur within a landscape of perceived privilege.” First and foremost was a lack of parental affection and attention, but also of ample food and clothes. Compounding these deprivations was the children’s vicious, overworked nanny, “who could kick and punch as well as beat us” and who was often the sole caretaker during Merkin’s parents’ frequent travels.

Merkin escaped from “this joyless landscape” into reading, which “brought me as close as I ever came to a sense of pleasure,” she writes. But books weren’t enough. “By the age of eight I was such a traumatized specimen, such an anxious, constipated mess . . . that even my relatively impermeable mother couldn’t overlook the evidence.” Her parents checked her into Columbia Presbyterian’s Babies’ Hospital for several weeks of psychological evaluation, her first time away from home.

Merkin, whose previous books include the novel “Enchantment” and the essay collection “Dreaming of Hitler,” puts her decades-long battle with suicidal depression in a wider context. Women, she notes, are twice as likely to suffer from this condition as men, although men are four times as likely to kill themselves. She rues the stigma attached to depression “in a society that is embarrassed by interiority” and wistfully recalls “the great, vexed Victorians, like John Ruskin, Thomas Carlyle, and Matthew Arnold.” Not surprisingly, the longtime literary critic’s book is filled with references to Virginia Woolf, Gerard Manley Hopkins and other touchstones.

In her struggle to solve the riddle of her affliction, Merkin returns repeatedly to debates over root causes and treatment options: nature vs. nurture, talk therapy vs. medication. Although she accepts a combination, she attributes her chronic “inner blackness” primarily to her “emotionally traumatic childhood” and her warped, “dire psychological entanglement” with her mother. After more than three decades on a staggering, “sophisticated amalgam of serotonin- and dopamine-tweaking agents,” she can’t help wondering, “Was I medicating a bad childhood or a chemical irregularity?”

Still, Merkin credits her survival in part to these medications and the thousands of hours and dollars she has spent on therapy. She yearns for “a colonic for the psyche” yet balks at the oft-recommended electroshock therapy, for fear of losing even the unhappy memories that define her. Psychiatric hospitals — described in grim detail — keep her safe from self-harm at her lowest ebbs yet fail to provide the nurture or redress she craves.

After more than 50 years of self-examination in therapists’ offices, Merkin is an old hand at intimate revelations, ranging from suicidal fantasies and worries about burdening her daughter to breast reduction surgery and shoplifting at Sephora. Some still have the capacity to shock, such as the fact that she showed her mother bite marks from sadomasochistic sex. (Even this desperate bid for maternal concern failed, Merkin reports: “ ‘I hope you enjoyed it,’ she replied dryly.”)

Less sympathetic readers may carp at Merkin’s ability to afford the luxuries of expensive, seemingly unlimited treatment options, cosmetic surgeries and summer rentals in the Hamptons. (Merkin readily acknowledges that her hardships pale in comparison with what people go through in Syria or Haiti.) But anyone who has experienced or witnessed the pain of clinical depression up close can’t help but be moved by her struggle. “This Close to Happy” earns a place among the canon of books on depression, including Andrew Solomon’s “The Noonday Demon,” William Styron’s “Darkness Visible” and Susanna Kaysen’s “Girl, Interrupted” — books that offer comfort to fellow depressives and elucidation for those lucky enough to have dodged its scourge.

this close to happy
A Reckoning with Depression

By Daphne Merkin

Farrar Straus Giroux. 285 pages. $26