Chapter 13: The Things We Do to Quiet the Monsters

⚠️ Spoiler Warning: This guide contains detailed spoilers for the entire novel. Proceed only if you've finished reading or are comfortable knowing the plot.

Summary

Jenny begins by distinguishing between not being suicidal and being at risk of suicide. She describes the insidious nature of depression, which lies to the sufferer. She has been in a deep depression for months, trying various treatments. She decides to undergo repetitive transcranial magnetic stimulation (TMS) after years of her psychiatrist's suggestion. She fights with insurance to get coverage, eventually succeeding. She keeps a diary of her TMS sessions. Day 1: The mapping process ("finding where my thumb lives") and the painful sensation of the magnetic pulses. Day 4: She gets used to the discomfort. Day 7: She feels a bounce back, even wanting to listen to music. Day 14: She cries in the parking lot, feeling relief. Day 20: She reports feeling stronger, doing more activities with her daughter. She agrees to a family trip to Europe. Day 27: Victor asks what will happen if she gets better and doesn't need him, showing the strain on their relationship. Day 31: She embroiders during sessions. Day 33: She feels guilt about taking time for self-care, but realizes it's necessary. Day 36: Last day; she rates her improvement: depression from 10-25% to 60-75%, anxiety much improved, sleep better, concentration slightly improved, OCD/ICD not much. One month later: She is off daily Xanax, still on antidepressants, feeling better but not perfect. Two months later: She describes "working the program" – a set of self-care steps. Six months later: Depression has returned in short episodes, she considers booster TMS. She reflects on having seen Europe and the importance of hope.

Key Events

Jenny distinguishes between not suicidal and at risk of suicide, framing the internal battle.
She decides to try TMS after years of resistance and research.
She fights with insurance for coverage, eventually succeeding.
Day 1: TMS mapping and first painful session.
Day 7: First signs of improvement; she listens to music and feels like leaving the house.
Day 14: She cries in the car, feeling emotions return.
Day 20: She has a full day out with her daughter and agrees to a Europe trip.
Day 27: Victor expresses fear of being unnecessary if she recovers.
Day 31: She embroiders during sessions, noting a more optimistic outlook.
Day 33: She grapples with guilt over self-care.
Day 36: Final session; she summarizes her results.
One month later: She stops daily Xanax but stays on antidepressants.
Two months later: She creates a "program" of self-care steps, including exercise.
Six months later: Depression returns briefly; she considers booster treatments but is grateful for the borrowed time.

Character Development

Jenny Lawson: She transforms from a state of hopelessness and numbness to a cautious but real hope. She begins to believe in the possibility of recovery, even if incomplete. She learns to accept self-care as necessary, not selfish. She also confronts the guilt of getting better.
Victor: Initially appears as a supportive husband, but Day 27 reveals his vulnerability. He fears that if Jenny gets better, she might not need him, indicating the strain their caregiving dynamic has placed on their relationship. Jenny reassures him and they work on transitioning roles.
Hailey: Jenny's daughter becomes a barometer of her recovery; Hailey is amazed by her mother's ability to do normal activities. The trip to Europe is a shared milestone.
Doctors and Nurses: They are portrayed as professional and patient, guiding Jenny through TMS. The doctor's compliment that she "doesn't let her pain go to waste" becomes a shield for her.

Themes, Symbols, and Motifs

The Monster: Mental illness is repeatedly described as a "monster" that lives inside Jenny, stealing her essence. The title "The Things We Do to Quiet the Monsters" refers to TMS and other coping mechanisms.
The Magnet/Drilling: TMS is described as a woodpecker drilling into the skull, but later as "happiness drilled into my head." It becomes a symbol of the painful but necessary work of recovery.
Hope vs. Fear: The chapter oscillates between hope (the improvement, the plan to see Europe) and fear (the possibility of relapse, the guilt of getting better).
Self-Care as Duty: Jenny reframes taking time for oneself not as a luxury but as a duty, comparing it to caring for a pet.
The Program: Borrowing from AA, Jenny creates a personal program with steps like exercise, avoiding negativity, forgiving oneself, and watching Doctor Who. This symbolizes the ongoing structure needed to maintain mental health.

Why This Chapter Matters

This chapter provides an intimate, diary-style account of undergoing TMS, a relatively novel treatment for treatment-resistant depression and anxiety. It demystifies the procedure and honestly reports both its successes and limitations. Beyond the medical, it explores the emotional complexities of recovery: the guilt of self-care, the shifting dynamics in relationships, and the fear of relapse. It also highlights the systemic barriers to mental health care, particularly insurance struggles, and calls for better support. The chapter ends on a note of realistic hope: improvement is possible, but recovery is ongoing work.

Study Questions and Answers

1. How does Jenny differentiate between being "not suicidal" and "at risk of suicide"? What does this distinction reveal about her mental state?

Jenny says she says out loud that she is not suicidal and believes it, but she knows she is at risk of suicide as written in her doctor's notes. This reveals that she understands the objective danger of her condition even when her subjective feeling doesn't match. It shows the gap between how she wants to see herself and the clinical reality, and the constant vigilance required.

2. What role does guilt play in Jenny's recovery, and how does she address it?

Jenny feels guilty for taking time for TMS sessions, exercise, and sleep instead of being productive. She recognizes that this feeling is irrational but acknowledges that knowing and feeling are different. She addresses it by reminding herself that self-care is a duty, not a luxury, and that taking care of herself benefits everyone around her.

3. Describe the change in Jenny and Victor's relationship dynamics during the chapter. What new challenge arises when Jenny starts to improve?

When Jenny starts to improve, Victor reveals a fear: "What happens if you get better … and don't need me anymore?" This shows that Victor has been a caregiver for so long that the prospect of Jenny no longer needing that role threatens his sense of purpose. Jenny and her doctor discuss this as a common issue in relationships where one person has been dependent. They work on transitioning to a healthier dynamic.