Darkness Visible

Styron explains that he had, for years, written regularly in a notebook; it was not a diary but held some erratic and private contents. He always imagined that in his old age, if moving into a nursing home became unavoidable, he would destroy it. As his depression deepened and suicidal urges became more serious, Styron recognized that if he decided to commit suicide, he would also have to destroy the notebook. The notebook became a symbol of the decision to live or die.

One day, Styron found himself at that crossroads. At an afternoon appointment, Dr. Gold told Styron that he was prescribing a new antidepressant. It would take four to six weeks to begin working, and in the meantime, Styron had to follow a strict diet because the drug caused an increased risk of stroke.

Dr. Gold also warned that the drug had the potential to cause impotence, which led Styron to wonder if the doctor fully understood what his quality of life was like or “if he seriously thought that this juiceless and ravaged semi-invalid with the shuffle and the ancient wheeze woke up each morning from his Halcion sleep eager for carnal fun” (60). The appointment discouraged Styron, who was already facing an evening with dinner guests, about which he felt numbingly indifferent.

Styron muses about the nature of pain. Humans feel a variety of pain on a daily basis, but one can withstand a tremendous amount of pain if one perceives a conceivable end to it. Humans therefore learn to bear pain as if it is temporary. With depression, the pain feels impossible to heal, as if it will never end, and “it is hopelessness even more than pain that crushes the soul” (62). Styron compares living with depression to living as the “walking wounded” following a military casualty. For depression, there is no visible intervention, no hospital machines or sickroom. The sufferer must continue living and moving about his day, presenting a face to the world as though nothing is wrong.

Despite the torturous difficulty of pretending to be well, Styron agreed to participate in the dinner party his wife had planned. He managed to make it through dinner, sitting mutely among friends who knew about his depression and extended him the courtesy of ignoring his behavior.

Amid the after-dinner conversation, Styron was struck with a sudden “despair beyond despair” (63). He politely excused himself and left the room. Styron found his notebook and disposed of it by wrapping it in paper towels, stuffing it in a cereal box, and shoving it into a garbage can outside, knowing that it would be picked up the following day. He experienced an out-of-body feeling, as though he were apathetically observing himself. For a few days after throwing out the notebook, Styron continued watching himself, as if he were both the actor and the audience in a melodrama that would ultimately be about his suicide.

Styron hadn’t decided how he would kill himself, but he began to put his affairs in order. He started to compose a meticulous suicide note but found all of his attempts inadequate and finally ripped up the drafts, “resolving to go out in silence” (66). Late one night, Styron was alone in the living room watching a movie. His wife was asleep, and he was sure that he couldn’t endure one more day. Suddenly, a piece of music in the film reached him, reminding him of the joy he had experienced in life—in that house, with his family. Realizing what his suicide would do to those memories and to his loved ones, he went to his wife and woke her up. Styron was hospitalized the following day. 

Dr. Gold facilitated Styron’s admission into the hospital—ironic, since Dr. Gold had previously discouraged Styron from seeking hospitalization due to the stigma. Styron recognizes now that this was terrible advice, as the hospital, while not particularly pleasant, is just a safe place to receive the next level of treatment. Styron wonders if another doctor would have been as concerned about stigma. He concludes that doctors who treat mental illness typically can’t fathom the pain experienced by their patients, and they assume that medication will eventually be the answer. Styron felt he should have been hospitalized weeks before, away from the opportunity for self-harm: “The real healers were seclusion and time” (69). 

Upon admission, Styron’s depression was so severe that hospital staff considered electroconvulsive therapy (ECT) as a possible treatment. Styron notes that his immediate desire to avoid ECT demonstrated “the pacifying effect that the hospital can create” and showed that he wasn’t entirely determined to destroy himself (70). Styron also discovered that his prescription for Halcion as a sleep aid was three times the usual dose, and that after switching to a new medication, his suicidal urges quickly waned. In fact, Halcion has since been linked to suicidal tendencies, and Styron considers the culpability of doctors who prescribe drugs like Halcion and Ativan without fully understanding the danger. He acknowledges that Halcion only exacerbated his depression; it didn’t create it.

Styron asserts that a seven-week hospital stay may not be the right treatment for everyone, but it was certainly the right treatment for him. The hospital was as bleak as any hospital, despite being one of the best in the country, but it was a sanctuary. The fact that depression made him passive turned out to be a positive thing, since Styron easily submitted to treatment. The routine comforted him, although he despised group therapy, possibly because he saw the therapist in charge as “an odiously smug young shrink […] who in attempting to get [patients] to cough up the seeds of [their] misery was alternately condescending and bullying” (73). Styron found art therapy similarly condescending. He participated unwillingly and angrily at first, but discovered that as his mental health improved, he actually enjoyed it. As his treatment came to an end, Styron felt alive again. He had the first dream he had experienced in several months.

The majority of people who suffer from depression do not die from it, even though many relapse even after recovery. When these recurrences happen, the patient is more likely to have the tools to handle it as well as the knowledge that the suffering will end. While living with severe depression, most sufferers “are, for whatever reason, in a state of unrealistic hopelessness, torn by exaggerated ills and fatal threats that bear no resemblance to actuality” (76). When other people in the depressed person’s life remind them of their worth, it can help the person to survive. While Styron was falling into the depths of depression, he had a friend with manic depression who had been hospitalized. As he was recovering, he told Styron repeatedly that “suicide was ‘unacceptable’” (77). He also showed Styron that the hospital wasn’t something to fear.

While Styron was in the hospital, he considered why he had been afflicted with such terrible depression. Psychiatric researchers have theories, but no answers. Styron wondered if his alcohol intolerance had actually been the trigger; perhaps it was aging, or the fact that he wasn’t satisfied with his work. He considered factors from his childhood, like events he had forgotten or repressed. After leaving the hospital, Styron realized that the depression had always been there. He saw themes of suicide repeated in his novels and in characters who were clearly suffering from depression. Styron eventually realized that his father had endured a similar path of depression and hospitalization.

Although genetics certainly played a part, Styron believes that the event that affected him the most was his mother’s death when he was only 13. According to Styron’s research, losing a parent at such a young age can lead to “incomplete mourning,” in which the young person never works through all of their grief and has unresolved feelings of anger, sadness, and guilt as they age. Styron references a book, Self-Destruction in the Promised Land, by Howard I. Kushner, which investigates Abraham Lincoln’s likely depression in connection to losing his mother at a young age. Styron realizes that the song that cut through his depression and pushed him to get help was one that his mother used to sing. 

Styron describes a scene in the film Through a Glass Darkly that attempts to depict the experience of “profound psychotic depression” through a horrifying hallucination of an enormous spider (81). Styron notes that this representation isn’t far from the truth of the experience, and that artists have always tried to truly represent the pain of mental illness. Styron says once again that the experience of severe depression defies description. The experience is an amalgamation of all of the evils of mankind—war, violence, chaos, and irrationality: “If our lives had no other configuration but this, we should want, and perhaps deserve, to perish; if depression had no termination, then suicide would, indeed, be the only remedy” (84). But people do recover, and for those who do, “their return from the abyss is not unlike the ascent of the poet, trudging upward and upward out of hell’s black depths and at last emerging into what he saw as ‘the shining world’” (84).