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A Tough Look at Depression

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 doses.

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 times.

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.