Darkness Visible: A Memoir of Madness

by William Styron

Depression is a disorder of mood, so mysteriously painful and elusive in the way it becomes known to the self—to the mediating intellect—as to verge close to being beyond description. It thus remains nearly incomprehensible to those who have not experienced it in its extreme mode, although the gloom, “the blues” which people go through occasionally and associate with the general hassle of everyday existence are of such prevalence that they do give many individuals a hint of the illness in its catastrophic form.

The most honest authorities face up squarely to the fact that serious depression is not readily treatable.

But my behavior was really the result of the illness, which had progressed far enough to produce some of its most famous and sinister hallmarks: confusion, failure of mental focus and lapse of memory.

believe in the reality of the accidents we subconsciously perpetrate on ourselves, and so how easy it was for this loss to be not loss but a form of repudiation, offshoot of that self-loathing (depression’s premier badge) by which I was persuaded that I could not be worthy of the prize, that I was in fact not worthy of any of the recognition that had come my way in the past few years.

One of the century’s most famous intellectual pronouncements comes at the beginning of The Myth of Sisyphus: “There is but one truly serious philosophical problem, and that is suicide. Judging whether life is or is not worth living amounts to answering the fundamental question of philosophy.”

This memory of my relative indifference is important because such indifference demonstrates powerfully the outsider’s inability to grasp the essence of the illness.

It’s quite natural that the people closest to suicide victims so frequently and feverishly hasten to disclaim the truth; the sense of implication, of personal guilt—the idea that one might have prevented the act if one had taken certain precautions, had somehow behaved differently—is perhaps inevitable. Even so, the sufferer—whether he has actually killed himself or attempted to do so, or merely expressed threats—is often, through denial on the part of others, unjustly made to appear a wrongdoer.

Randall Jarrell almost certainly killed himself. He did so not because he was a coward, nor out of any moral feebleness, but because he was afflicted with a depression that was so devastating that he could no longer endure the pain of it.

the pain of severe depression is quite unimaginable to those who have not suffered it, and it kills in many instances because its anguish can no longer be borne.

The prevention of many suicides will continue to be hindered until there is a general awareness of the nature of this pain. Through the healing process of time—and through medical intervention or hospitalization in many cases—most people survive depression, which may be its only blessing; but to the tragic legion who are compelled to destroy themselves there should be no more reproof attached than to the victims of terminal cancer.

Depression afflicts millions directly, and millions more who are relatives or friends of victims. It has been estimated that as many as one in ten Americans will suffer from the illness. As assertively democratic as a Norman Rockwell poster, it strikes indiscriminately at all ages, races, creeds and classes, though women are at considerably higher risk than men. The occupational list (dressmakers, barge captains, sushi chefs, cabinet members) of its patients is too long and tedious to give here; it is enough to say that very few people escape being a potential victim of the disease, at least in its milder form. Despite depression’s eclectic reach, it has been demonstrated with fair convincingness that artistic types (especially poets) are particularly vulnerable to the disorder—which, in its graver, clinical manifestation takes upward of twenty percent of its victims by way of suicide.

Depression, most people know, used to be termed “melancholia,” a word which appears in English as early as the year 1303 and crops up more than once in Chaucer, who in his usage seemed to be aware of its pathological nuances. “Melancholia” would still appear to be a far more apt and evocative word for the blacker forms of the disorder, but it was usurped by a noun with a bland tonality and lacking any magisterial presence, used indifferently to describe an economic decline or a rut in the ground, a true wimp of a word for such a major illness.

I shall never learn what “caused” my depression, as no one will ever learn about their own. To be able to do so will likely forever prove to be an impossibility, so complex are the intermingled factors of abnormal chemistry, behavior and genetics. Plainly, multiple components are involved—perhaps three or four, most probably more, in fathomless permutations. That is why the greatest fallacy about suicide lies in the belief that there is a single immediate answer—or perhaps combined answers—as to why the deed was done.

To discover why some people plunge into the downward spiral of depression, one must search beyond the manifest crisis—and then still fail to come up with anything beyond wise conjecture.

But never let it be doubted that depression, in its extreme form, is madness. The madness results from an aberrant biochemical process. It has been established with reasonable certainty (after strong resistance from many psychiatrists, and not all that long ago) that such madness is chemically induced amid the neurotransmitters of the brain, probably as the result of systemic stress, which for unknown reasons causes a depletion of the chemicals norepinephrine and serotonin, and the increase of a hormone, cortisol. With all of this upheaval in the brain tissues, the alternate drenching and deprivation, it is no wonder that the mind begins to feel aggrieved, stricken, and the muddied thought processes register the distress of an organ in convulsion.

What I had begun to discover is that, mysteriously and in ways that are totally remote from normal experience, the gray drizzle of horror induced by depression takes on the quality of physical pain. But it is not an immediately identifiable pain, like that of a broken limb. It may be more accurate to say that despair, owing to some evil trick played upon the sick brain by the inhabiting psyche, comes to resemble the diabolical discomfort of being imprisoned in a fiercely overheated room.

These thoughts may seem outlandishly macabre—a strained joke—but they are genuine. They are doubtless especially repugnant to healthy Americans, with their faith in self-improvement. Yet in truth such hideous fantasies, which cause well people to shudder, are to the deeply depressed mind what lascivious daydreams are to persons of robust sexuality.

Loss in all of its manifestations is the touchstone of depression—in the progress of the disease and, most likely, in its origin.

In depression this faith in deliverance, in ultimate restoration, is absent. The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come—not in a day, an hour, a month, or a minute. If there is mild relief, one knows that it is only temporary; more pain will follow. It is hopelessness even more than pain that crushes the soul. So the decision-making of daily life involves not, as in normal affairs, shifting from one annoying situation to another less annoying—or from discomfort to relative comfort, or from boredom to activity—but moving from pain to pain. One does not abandon, even briefly, one’s bed of nails, but is attached to it wherever one goes.

Time hangs heavy in the hospital, and the best I can say for Group Therapy is that it was a way to occupy the hours.

More or less the same can be said for Art Therapy, which is organized infantilism.

BY FAR THE GREAT MAJORITY OF THE PEOPLE WHO go through even the severest depression survive it, and live ever afterward at least as happily as their unafflicted counterparts. Save for the awfulness of certain memories it leaves, acute depression inflicts few permanent wounds.