The book that changed the way we talk about depression

Nowadays, it's not hard to find first-person narratives about depression. Podcasts about mental health are numerous. So, too, are stand-up comedy specials that deal frankly with mental illness, like recent stellar examples from Gary Gulman, Maria Bamford, Chris Gethard, and Neal Brennan. If you're a reader like me, you could spend years making your way through the canon of depression memoirs.

This was decidedly not the case in December of 1989, when one of the country's most celebrated novelists described his experiences with the illness in the pages of Vanity Fair. In a nearly 15,000-word essay, William Styron, the then-64-year-old author of The Confessions of Nat Turner and Sophie's Choice, took readers inside his mind during the throes of a recent depressive spell. It was a place, he said, of "dreadful, pouncing seizures of anxiety" and a "gray drizzle of horror," where "faith in deliverance, in ultimate restoration, [was] absent." A longtime drinker, Styron had tumbled into the abyss after developing a sudden intolerance for alcohol during the summer of 1985. Once the illness was upon him, he suffered intensely, to the point of contemplating suicide. He was admitted to a psychiatric ward of a Connecticut hospital, where he stayed for several weeks, and his anguish eventually lifted. He ended the account with a message of hope. "One need not sound the false or inspirational note to stress the truth that depression is not the soul's annihilation," he wrote. "Men and women who have recovered from the disease — and they are countless — bear witness to what is probably its only saving grace: it is conquerable."

The Vanity Fair piece won a National Magazine Award, and a slightly expanded version was published as a bestselling paperback in 1990. In response, mail poured in to the magazine, and, later, to Styron personally. (According to his biographer, he kept these letters in a bureau in his work room.) Looking back, it's hard to overstate the cultural impact of the essay. The Atlantic's Peter Fulham has said, "Styron's book was, in almost every way, a first, and for that reason, his memory is solidified not just as a great American writer but as a pioneering advocate for mental health." Andrew Solomon, the author of The Noonday Demon: An Atlas of Depression, has said the book "liberated an enormous number of people to speak about their experience to themselves, to one another, to doctors who might be able to help them." Some medical schools began assigning Darkness Visible to students.

Subscribe to The Week

Escape your echo chamber. Get the facts behind the news, plus analysis from multiple perspectives.

SUBSCRIBE & SAVE

Sign up for The Week's Free Newsletters

From our morning news briefing to a weekly Good News Newsletter, get the best of The Week delivered directly to your inbox.

From our morning news briefing to a weekly Good News Newsletter, get the best of The Week delivered directly to your inbox.

Sign up

The book permanently changed the conversation about mental health in the United States, and it also changed the life of its author. "Having written for 40 years on the subject of man's inhumanity to man, he was now the preeminent portraitist of the self-inflicted savagery that was his particular type of mental illness," Styron's daughter, Alexandra, wrote in The New Yorker in 2007. For years after the publication of Darkness, Styron gave lectures and interviews on the subject of depression and mental health. When he died, in 2006, Slate described him as the "Bard of Depression." Last year, a podcast exploring Styron's mental health struggles described him as "the most famously depressed man in America."

***

I discovered Darkness Visible in the summer of 2006, just a few months before Styron died. I was 21, and I had recently returned from a cold, dark, grey semester abroad in Scotland, where I had experienced my first sustained spell of depression. Back at home in Rhode Island, during the sunny summer months, I searched for reading materials that could explain the painful, terrifying events that had just taken place inside my mind. In Styron's book, I found a vivid and accessible introductory text.

According to the National Institutes of Mental Health, 17 million adults in the United States, or 7.1 percent of all U.S. adults, had at least one major depressive episode in 2017. In Darkness, Styron addresses the widespread nature of the illness. "As assertively democratic as a Norman Rockwell poster, it strikes indiscriminately at all ages, races, creeds, and classes, though women are at considerably higher risk than men," he writes. "The occupational list (dressmakers, barge captains, sushi chefs, cabinet members) is too long and tedious to give here; it is enough to say that very few people escape being a potential victim of the disease, at least in its milder form."

For such a slim volume, Darkness is remarkably thorough. At one point Styron offers a roll call of some of the artists and writers who have lost their lives to suicide, including Vincent Van Gogh, Virginia Woolf, Sylvia Plath, Mark Rothko, Jack London, Diane Arbus, and Ernest Hemingway. Elsewhere, he explores the causes of his depression, including the death of his mother when he was 13. He also rants against the inadequacy of the label "depression," a "true wimp of a word" that, for decades, "has slithered innocuous through the language like a slug, leaving little trace of its intrinsic malevolence and preventing, by its very insipidity, a general awareness of the horrible intensity of the disease when out of control." And, throughout, he offers fierce rebuke against the stigmatization of mental illness, particularly suicide. "To the tragic legion who are compelled to destroy themselves there should be no more reproof attached than to the victims of terminal cancer," he writes.

But it is Styron's descriptions of the experience of depression that are most powerful. Depression has a way of giving its victims a sense that they are separated from the rest of the world by an uncrossable gulf. And the prize-winning novelist's words are a bridge across that chasm. Self loathing, he writes, is the condition's "premier badge." Loss is another touchstone of the illness; over the course of the narrative he tracks the loss of his voice, his libido, his energy, his ability to sleep and enjoy food, and, ultimately, his hope.

For most other illnesses of this intensity, he notes, a patient would be bed-bound or even sedated and hooked up to life-supporting machinery. The sufferer of depression has no such option, though, "and therefore finds himself, like a walking casualty of war, thrust into the most intolerable social and family situations. There he must, despite the anguish devouring his brain, present a face approximating the one that is associated with ordinary events and companionship."

For me, the book not only deepened my knowledge of an ailment that would periodically return to haunt me in the coming years, it was also my introduction to the therapeutic power of reading during times of mental struggle. Darkness gave me comfort in knowing that I wasn't alone, and also a small sense of power gained by the feeling that if I could understand what had happened to me, I'd be somewhat more prepared, more fortified in the future. Reading was also a way to pass time during those interminable depressed days, and to enjoy another person's company, even while remaining isolated. Some of the book's sentences were like anchors to cling to during particularly distressing moments. Even if you don't quite believe it, there's a subtle assurance to be found in reading, "Most people in the grip of depression at its ghastliest are, for whatever reason, in a state of unrealistic hopelessness, torn by exaggerated ills and fatal threats that bear no resemblance to actuality."

Years later, after nearly a decade as a journalist, I started writing my own pieces on mental health. Thanks to Styron and his successors, this was a far less revolutionary act than it would have been decades prior. And yet I still received — and continue to receive — deeply-felt responses that give me some sense of what Styron was talking about when he wrote, "It is the only time in my life I have felt it worthwhile to have invaded my own privacy, and to make that privacy public."

***

The world of mental health has changed significantly in the 30 years since Darkness was first published. Antidepressant use has risen dramatically since 1989, and they are now among the most commonly used therapeutic drugs. Celebrities, from athletes to actors to authors, feel much more comfortable sharing stories of mental struggle. (This recently-released montage of comedians talking about mental health is particularly good.) Social media networks have helped fuel the rise of websites like The Mighty, where users can read thousands of first-person narratives about depression and other illnesses, and share their own. My library of favorite texts, built up over various periods of distress, now includes Melissa Broder's So Sad Today, Matt Haig's Reasons to Stay Alive, the anthology Same Time Next Week: True Stories of Working Through Mental Illness, and the novelist Donald Antrim's commencement speech in which he describes his recovery from a debilitating depressive spell.

Discussion of depression has gone mainstream. And yet the problem of depression remains; according to some data, it's even getting worse. Suicides in the United States are at their highest rates in decades. We, as a society, are far from conquering what Styron described as a "howling tempest in the brain."

I had a relapse of my own depression, this fall. For weeks, I was reacquainted with that "despair beyond despair." This time, one of the most alarming symptoms was the near-complete loss of my ability to write. Depression, it turns out, attacks or undermines nearly every one of the skills necessary for writing: motivation, concentration, confidence, the ability to think analytically and make decisions, an underlying sense of self-worth. As these losses mounted and my list of missed deadlines grew longer, I inched closer to the flawed, but, in the midst of my depression, compelling, conclusion that I'd lost whatever ability I once possessed, and it would be better off if I just quit. The loss of this core personal and professional identity was a uniquely painful kind of torture.

With time (and therapy and exercise and support from loved ones and a new prescription for the antidepressant sertraline) the fog in my head lifted and my mind slowly became my own again. And, while I was on that upward swing, I reread Darkness Visible for the first time in years. This time, it struck me as less of a "Depression 101" lecture than a visit with an old friend. And given my writing-related woes, it had attained a new layer of meaning: it was a story of a writer who temporarily lost his ability to write and then regained it.

After all, when describing his symptoms, Styron had described how "I 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." Elsewhere he describes himself "As one who has suffered from the malady in extremis yet returned to tell the tale." This time around, I saw the book's very existence — its clarity, its eloquence — as compelling evidence of one of its key messages: "By far the majority of the people who go through even the severest depression survive it, and live ever afterward at least as happily as their unafflicted counterparts."

Want more essential commentary and analysis like this delivered straight to your inbox? Sign up for The Week's "Today's best articles" newsletter here.