A Syncopated Rhythm: Elizabeth Swados’ My Depression: A Picture Book

by Dr. Velebita Koričančić, Mexico City

In Elizabeth Swados’ My Depression: A Picture Book (2005), depression appears as a cloud and a black hole. Yet the book’s true force lies in how these images keep time. Swados gives depression a rhythm: it starts and stops, returns and interrupts, accelerates and stalls. By “syncopated” in this review’s title, I mean an uneven beat that throws ordinary life off tempo. Depression, in Swados’s hands, is timed.

Prior readings of My Depression have focused on metaphor. Elisabeth El Refaie’s chapter on Swados’s work as “trapped in spacetime” in Visual Metaphor and Embodiment in Graphic Illness Narratives (2019) interprets the clock-prison image as a figure stuck in time. She frames Swados’ rough lines and handwriting as part of the book’s depressive weight. My concern is close, but with a twist: instead of treating Swados’ images primarily as metaphors, I read them as beats, pauses, stalls, and returns. I am interested in how this picture book paces depression. Swados syncopates it.

The book establishes this tempo in medias res. It opens with a declaration: the author states that she has a good life, makes a living, writes music, and is surrounded by books, plays, friends, colleagues, students, and dogs. Then the rhythm cuts in. “It all gets cancelled out” when she falls into depression. Work collapses. Art collapses. So do friendships and ordinary skills. This pattern recurs throughout the book: everyday scenes repeatedly begin, only to break down. The world is briefly assembled; then it falls apart again. When the opening gives way to “NO ENTRY” graphic signs, Swados draws depression as obstructed space, but the obstruction also works rhythmically. Life moves forward, then crashes into a wall. Depression arrives “off and on,” and the cloud returns.

This uneven timing shapes the reading pace. Crowded pages filled with hostile speech bubbles accelerate the experience. They accuse, press, and multiply. They turn depressive thought into noise: too much speech, too much self. By contrast, nearly empty pages, including the one that reads “The small crimes build…,” slow the movement almost to a stop. The book switches visually between congestion and suspension, between verbal pressure and blank pause. Depression feels like a body dragging itself through time, then being abruptly halted. Stuck. Overwhelmed. Swados refuses tonal regularity. Although the theme is despair, the book does not settle into a single emotional register. Comedy and hopelessness sit uneasily together. Relief comes crookedly, if it comes at all. The beat is unstable because depression itself arrives unevenly.

As the book beats depressive time onto the page, its rhythm resonates with accounts of depression as an altered relation to emotion, body, self, time, and the social world, such as “The Lived Experience of Depression: A Bottom-Up Review Co-Written by Experts by Experience and Academics” (Wiley Online Library, 2023). Swados translates this altered relation into visual timing. Work, friendship, creativity, the body, and time do not unfold smoothly. They start. Stop. Crowd. Stall. Return. The reader is asked to keep time with that interrupted flow.

Treatment follows this rhythmic pattern. Swados first turns toward professional help, then toward medication as a chemical intervention, including side effects and Prozac’s shifts in perception. The treatment sequence becomes most vivid when Prozac changes the page’s score. Swados draws four stacked musical staves, each carrying a line of notes and short handwritten captions: “On Prozac anything anyone said / day or night, night or day / becomes a song from a made-up musical comedy.” Medication becomes audible, but oddly disembodied. The treated self disappears, and ordinary speech is transfigured into bars and musical notes. With Prozac, the book’s syncopation changes key. Help arrives, but it demands its own rhythm.

For a graphic medicine reading, Swados’s My Depression can be understood through Kevin Wolf’s (2022) account of visual forms that communicate medical experience and create empathic connection. Its specific contribution is temporal: it makes depressive time formally felt. It turns recurring depressive episodes into visual rhythm. If graphic medicine asks how illness can be shown, Swados answers through timing. Depression interrupts life, and Swados makes that interruption visible through pacing, crowding, blankness, and recurrence. What clinical language often tidies up (how daily life breaks, how symptoms revisit, and how despair sometimes carries comic undertones) is drawn here as rhythm. To read My Depression as syncopated is to experience depression as an uneven beat. That beat throws off time.

References

El Refaie, Elisabeth. “Trapped in Spacetime: Metaphor in Graphic Illness Narratives about Depression.” In Visual Metaphor and Embodiment in Graphic Illness Narratives, 154–183. New York: Oxford University Press, 2019. https://doi.org/10.1093/oso/9780190678173.003.0006

Fusar-Poli, Paolo, Andrés Estradé, Giovanni Stanghellini, Claudia M. Esposito, René Rosfort, Matteo Mancini, Paul Norman, Jennifer Cullen, Mary Adesina, Gemma B. Jimenez, Carolina da Cunha Lewin, E. A. Drah, Marie Julien, Manraj Lamba, E. M. Mutura, B. Prawira, A. Sugianto, J. Teressa, L. A. White, S. Damiani, C. Vasconcelos, I. Bonoldi, P. Politi, E. Vieta, J. Radden, T. Fuchs, M. Ratcliffe, and M. Maj. “The Lived Experience of Depression: A Bottom-Up Review Co-Written by Experts by Experience and Academics.” World Psychiatry 22, n° 3 (2023): 352–365. https://doi.org/10.1002/wps.21111

Swados, Elizabeth. My Depression: A Picture Book. New York: Hyperion, 2005.

Wolf, Kevin. “Graphic Medicine’s Golden Age?” Visual Studies 37, n° 5 (2022): 420–439. https://doi.org/10.1080/1472586X.2022.2119009

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A SHORT BIO:

Dr. Velebita Koričančić (ORCID ID: https://orcid.org/0000-0003-2941-1471) is a Croatian professor-researcher, born in Zagreb and based in Mexico City. She holds a Master’s degree in Latin American Studies, cum laude, from the University of Salamanca, Spain, and a PhD in Comparative Literature, with honors, from the National Autonomous University of Mexico (UNAM). She is an Assistant Professor at Anahuac Mexico University’s School of Communication and an Adjunct Professor in the Department of Latin American Studies at UNAM’s School of Philosophy and Letters. She is also a Candidate-level member of Mexico’s National System of Researchers and a literary translator.