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.

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

Unlike, let us say, diabetes, where immediate measures taken to rearrange the body’s adaptation to glucose can dramatically reverse a dangerous process and bring it under control, depression in its major stages possesses no quickly available remedy: failure of alleviation is one of the most distressing factors of the disorder as it reveals itself to the victim, and one that helps situate it squarely in the category of grave diseases.

Recently I had been deeply bothered that I was not deserving of the prize.

Low esteem

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.

Loss of self esteem

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.”

Suicide is a distinct danger

This certitude astonished me and filled me with a new fright, for while thoughts of death had long been common during my siege, blowing through my mind like icy gusts of wind, they were the formless shapes of doom that I suppose are dreamed of by people in the grip of any severe affliction.

Risk of suicide

sure understanding that tomorrow, when the pain descended once more, or the tomorrow after that—certainly on some not-too-distant tomorrow—I would be forced to judge that life was not worth living and thereby answer, for myself at least, the fundamental question of philosophy.

Is it inevitable ?

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.

Hypothesis

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.

AGREED

dreadful and raging disease.

Language

horrible intensity of the disease when out of control.

Language

veritable howling tempest in the brain,

Language

Like a great many American writers, whose sometimes lethal addiction to alcohol has become so legendary as to provide in itself a stream of studies and books, I used alcohol as the magical conduit to fantasy and euphoria, and to the enhancement of the imagination.

SUD

I felt a kind of numbness, an enervation, but more particularly an odd fragility—as if my body had actually become frail, hypersensitive and somehow disjointed and clumsy, lacking normal coordination.

ADLs

rhythmic daily erosion of my mood—anxiety, agitation, unfocused dread.

Agitation

suffocating gloom.

Language

But I felt an immense and aching solitude.

Language

could no longer concentrate during those afternoon hours, which for years had been my working time, and the act of writing itself, becoming more and more difficult and exhausting, stalled, then finally ceased.

Can not work

But never let it be doubted that depression, in its extreme form, is madness.

Psychosis

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.

Science

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.

Language

storm of murk.

Language

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. And because no breeze stirs this caldron, because there is no escape from this smothering confinement, it is entirely natural that the victim begins to think ceaselessly of oblivion.

Suicide

The loss of self-esteem is a celebrated symptom, and my own sense of self had all but disappeared, along with any self-reliance.

Self esteem

This loss can quickly degenerate into dependence, and from dependence into infantile dread. One dreads the loss of all things, all people close and dear. There is an acute fear of abandonment. Being alone in the house, even for a moment, caused me exquisite panic and trepidation.

Uselessness

the one of me, age four and a half, tagging through a market after my long-suffering wife;

Uselessness

forcing me into bed. There I would lie for as long as six hours, stuporous and virtually paralyzed,

No functionality work

(I could no longer drive)

Functionality

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.

Language

but in garbage there was an annihilation of self appropriate, as always, to melancholia’s fecund self-humiliation.

Esteem

I went about stolidly preparing for extinction, I couldn’t shake off a sense of melodrama—a melodrama in which I, the victim-to-be of self-murder, was both the solitary actor and lone member of the audience.

Suicide

I had fallen into. I woke up my wife and soon telephone calls were made. The next day I was admitted to the hospital.

How?

For me the real healers were seclusion and time.

Medicine

Not everyone might respond the way I did; depression, one must constantly insist, presents so many variations and has so many subtle facets—depends, in short, so much on the individual’s totality of causation and response—that one person’s panacea might be another’s trap.

Phenomenology

Mysterious in its coming, mysterious in its going, the affliction runs its course, and one finds peace.

Phenomenology

The psychiatric literature on depression is enormous, with theory after theory concerning the disease’s etiology proliferating as richly as theories about the death of the dinosaurs or the origin of black holes. The very number of hypotheses is testimony to the malady’s all but impenetrable mystery.

Etiology

evolution of depression and its later flowering into madness?

Poetic

Thus depression, when it finally came to me, was in fact no stranger, not even a visitor totally unannounced; it had been tapping at my door for decades.

Etiology ? phenomenology

The genetic roots of depression seem now to be beyond controversy. But I’m persuaded that an even more significant factor was the death of my mother when I was thirteen; this disorder and early sorrow—the death or disappearance of a parent, especially a mother, before or during puberty—appears repeatedly in the literature on depression as a trauma sometimes likely to create nearly irreparable emotional havoc. The danger is especially apparent if the young person is affected by what has been termed “incomplete mourning”—has, in effect, been unable to achieve the catharsis of grief, and so carries within himself through later years an insufferable burden of which rage and guilt, and not only dammed-up sorrow, are a part, and become the potential seeds of self-destruction.

Dad genetics mom event

So if this theory of incomplete mourning has validity, and I think it does, and if it is also true that in the nethermost depths of one’s suicidal behavior one is still subconsciously dealing with immense loss while trying to surmount all the effects of its devastation, then my own avoidance of death may have been belated homage to my mother.

Events