Dead Man Walking
Sophie’s Choice (1976) by William Styron is perhaps my favorite book. The author’s way with words, including foreign tongues, his wit, including many sexual suggestions, and ultimately the profound moral dilemmas he invokes make the book intensely indelible. Yet another memory one may recall are Styron’s strange and frequent references to esoteric medical conditions; his autobiographical protagonist travels nowhere without his dog-eared Merck Manual of Diagnosis and Therapy. Similarly, Styron’s first novel, Lie Down in Darkness (1951), tells the story of a star-crossed Southern family whose failures drive the sensitive daughter to insanity and suicide. It is thus somewhat predictable that in 1985, Styron would be hospitalized for acute clinical depression—and that this Pulitzer Prize-winning novelist would chronicle his struggle three years later in his seventh book.
Darkness Visible: A Memoir of Madness began as a lecture at a symposium on affective disorders at Johns Hopkins University in May 1989. Greatly expanded, the text became a 15,000-word essay published in the December issue of Vanity Fair. In 1990, the essay hit bookstores as a monograph. The title comes from John Milton’s description of hell in Paradise Lost, and it’s worth noting that Styron uses the word “madness” not to mean anger, but in its proper sense of insanity.
The story begins in October 1985 in Paris, where Styron travels with his wife to receive the Prix Mondial Cino del Duca, a prestigious prize of $25,000 given annually to an artist or scientist whose work embodies the principles of humanism. The past few months, during which he turned 60 and quit alcohol cold turkey, have increasingly left him floundering helplessly. His nights pass sleeplessly, while malaise and restlessness consume his days. He believes the trip abroad should occasion celebration and upend his dejection, and when it has the reverse effect, he recognizes something is wrong.
He consults a psychiatrist, a so-called Dr. Gold, who prescribes him high doses of the controversial tranquilizer Halcion (triazolam) for his insomnia. But this, too, only exacerbates his edginess and misery. Finally, in early December, Styron rewrites his will and prepares a suicide note. A few days later, as he had planned when the unmistakable urge finally struck, he destroys his notebook-diary. After his wife goes to bed, he sits in his living room watching a nondescript film, biding his time. Suddenly, a passage from Brahms’s Alto Rhapsody pierces his brown study, and in a flood he recalls all that life has to offer. He wakes up his wife, and admits himself to a hospital the next day, where he spends seven distasteful but convalescent weeks.
How do things get this bad? In keeping with a diagnosis of major depression, Styron shows at least four symptoms, in addition to loss of interest in usual activities, for at least two weeks. Physiologically and behaviorally, his voice wanes and his libido vanishes. Emotionally, he loses his ambition and suffers from anhedonia. Cognitively, he experiences hopelessness and ideates about suicide.
Freudians, or proponents of psychodynamics, would explain such agony by way of Styron’s traumatic childhood; after a long, painful siege with cancer, his mother died when he was 13. Styron agrees, by way of Tony Kushner’s Destruction in the Promised Land: A Psychocultural Biology of American Suicide (1989), which holds that incomplete mourning contributes to depression and suicide. Styron does not cite any other psychodynamic notions, like anger turned inward, dependency or self-punishment.
Biological theories would attribute Styron’s depression to genetics or abnormalities in the brain. And, in fact, the author’s father battled the disease throughout his life and was hospitalized during his son’s boyhood. Further, although Styron does not mention any chemical imbalances, his abrupt withdrawal from his old friend of booze might have impacted his neurotransmitters, the biochemicals that transmit nerve impulses across a synapse. Ditto for his addiction to Halcion, in dosages three times the normal quantity—a particularly suicidal combination for someone Styron’s age.
Cognitive theorists argue that depressives distort certain stressful situations in negative ways. Although Styron does not evince this pattern, the circles in which he travels include many artists who also fell victim, sometimes fatally, to depression. Indeed, one writes what one knows, and, as previously noted, themes of gloom run throughout Styron’s oeuvre. The result is an almost obsessive concern with morbidity, suffering and the vulnerability of the flesh.
Nor does it help that Dr. Gold, an adherent of the biological and hence drug-based school, turns out to be incompetent and negligent, a symbol of the dehumanizing approach to medicine that treats the disease rather than the person. First, he misprescribes Halcion. When Styron complains of fantasies of self-destruction and suggests checking into a hospital, Gold discourages him. Then, at a critical juncture, Gold prescribes another antidepressant—which takes several weeks to kick in. Group therapy in the hospital (Styron does not discuss individual treatment after Gold) is no better. Drawing pictures and molding clay, this man of letters feels, infantilizes him.
Accordingly, it is neither pharmacology nor psychotherapy—the classic pillars of mood-disorder treatment—which Styron credits as his savior. Rather, it is the simple seclusion of a sanatorium, wherein one spends all day, every day, focused on recovery, as well as the loving patience of his wife Rose.
Depression is as old as man, but only in the past decade or so, especially with the advent of Prozac, has it become a topic of mainstream conversation. We now recognize it is a disease, so it is easy to forget that not too long ago people considered depression a mystery or even self-inflicted. To this end, Darkness Visible is a gem of homespun honesty that destigmitizes what was once known as “the blues,” which brings knowledge thereof to an audience the textbook for my Abnormal Psychology class simply cannot do.
Indeed, if understanding breeds acceptance, then Styron’s memoir renders a great public service: articulating the ineffable. For only an artist can convey the sense that suffering melancholy is like being buried alive, or, in Styron’s words, “despair beyond despair” (63). Darkness Visible confirms the role of the writer in articulating the darkest secrets of the human psyche.
One secret, however, the book does not address is whether depression can be useful as a means to gain insight and spur creativity. On one hand, we can point to the great works of such depres-sives as Hemingway, Silvia Plath and Virginia Woolf. Surely descending to the depths of despair played some role in their genius? On the other hand, such romanticization is easy because it is not one’s own. Second, while depression may intensify one’s mind, an artist must first possess talent and passion. Third, while it is true that creativity often follows depression (Toni Morrison and The Bluest Eye, Philip Roth and American Pastoral), it is usually an escape from, not an entrance to it.[1] Fourth, and above all, as the psychiatrist Peter Kramer recently observed, “Facing a man in great pain, headed for self-mutilation and death, who would withhold a potentially helpful treatment?”[2]
Ultimately, then, Darkness Visible makes me appreciate that depression today, like myriad ailments, is quite preventable. And although I am healthy and vigorous, should I become otherwise, I will remember this book as a testament to the ability of the human spirit to triumph in the face of severe adversity.
Footnotes
1. Paul Gordon, “You Don’t Have to Be Suicidal to Be an Artist, and It Doesn’t Help,” Independent (London), February 28, 1999.
2. Peter D. Kramer, “There’s Nothing Deep About Depression,” New York Times Magazine, April 17, 2005.
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