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Clif Cleaveland, MD
20 November 2006
Noted writer William Styron died on November 1st. His membership
in the Fellowship of Southern Writers brought him to Chattanooga
years ago for the biennial meetings of that group. Though Styron is
best remembered for such novels as Lie Down in Darkness,
the Pulitzer Prize winning The Confessions of Nat Turner,
and Sophie's Choice, he contributed a remarkable essay to
the literature of emotional distress in Darkness Visible: A
Memoir of Madness. This work provides unique and painful
insights into depression, one of the commonest of psychological
ills. Consider the work a front-line report of the battle of one
person against overwhelming despair.
In 1985 Styron, at age 60, abruptly ended a forty-year pattern
of daily alcohol use. He denied a goal of attaining drunkenness.
Rather he described using alcohol to free his imagination for his
daily writing routine. Alcohol became suddenly disagreeable, and he
stopped imbibing in the spring of that year. He maintained a daily
dependence upon a prescription drug for sleep. Gradually, he lost
his zest for life and his ability to write. By the time that he
traveled to Paris in October of that year to accept a literary
award, he was barely able to function. As each day progressed he
sank further into despair. He dreaded late afternoons and evenings.
He found little comfort in social gatherings with friends. His
voice weakened and crackled. He felt suddenly quite old. Sleep was
impossible without the aid of medication which he took in triple
He began weekly sessions with a psychiatrist who prescribed
antidepressant medications. His condition worsened. Styron rails
against the blandness of the term "depression" to describe his
illness. He believed that "brain-storm" might be more appropriate
for the condition that he experienced. He was engaged in a fight
for his life. As he broke from the previous patterns of his writing
life, he contemplated suicide. He tuned out family and friends. He
carefully disposed of his journal. He considered the options for
ending his life. One evening, however, he pulled back. He awakened
his wife to report his immediate need for hospitalization.
Seven weeks would pass before his release. Intensive out-patient
care, medication, and subsequent hospitalizations would be needed
over succeeding years. He resumed his writing life. Darkness
Visible began as a lecture at Johns Hopkins Hospital before
expansion first into an essay for a popular magazine and then into
its present short-book form.
All of us experience depression to various degrees at different
times. A broken relationship, a complex illness, a set-back in a
job-each may trigger a spell of gloom, even of hopelessness. Most
of the time we pick ourselves up, dust ourselves off, and proceed
on our course, bruised, older, and hopefully, wiser. Loved ones may
sense that we are down and help lift us from our difficult
Styron writes of a more severe circumstance when personal
strength and resilience fail, when we may find ourselves in a
relentless, downward spiral. Depression becomes a monster which
must be clearly recognized as a destructive force against which the
individual has little chance. His narrative shows how we can fight
back. Pride must be put aside in enlisting the help of our loved
ones and skilled professionals.
Readers who have not personally battled significant depression
will realize their potential roles in extending help to friends,
family members, and colleagues who may be suffering from unstinting
despair. In re-reading Darkness Visible, I wondered why
someone in his devoted circle did not insist, even demand, that
Styron allow assistance in his distress. Did they feel that this
would be too intrusive? Did they not know what to say or to do?
There are times when we must be our brothers' and our sisters'
keepers. If someone we know well is slipping into despondency, we
must seek an opening and simply say, "You seem to be hurting. How
may I help?" This simple inquiry may save a life. For someone
experiencing depression, Styron's book will tell them that they are
not alone and that a productive, and rich life lies within reach.
Acknowledgement of depression is the key.