![]() First edition cover (1990) | |
Author | William Styron |
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Language | English |
Subject | Depression |
Genre | Memoir |
Publisher | Random House |
Publication date | 1990 |
Publication place | United States |
Media type | Print (hardcover) |
Pages | 84 |
ISBN | 0-394-58888-6 |
616.85'27'0092 | |
LC Class | RC537.S88 |
Darkness Visible: A Memoir of Madness is a memoir by American writer William Styron about his descent into depression and the triumph of recovery. It is among the last books published by Styron and is among his most celebrated.
First published in December 1989 in Vanity Fair , the book grew out of a lecture that Styron originally delivered at a symposium on affective disorders at the Department of Psychiatry of the Johns Hopkins School of Medicine. [1]
Through the employment of anecdotes, speculation, and reportage, Styron reflects on the causes and effects of depression, drawing links between his own illness and that of other writers and public figures.
In October 1985, American author William Styron travels to Paris to receive the Prix mondial Cino Del Duca, a prestigious literary award. During the trip, Styron's mental state begins to degenerate rapidly as the depressive symptoms that he has been experiencing for several months worsened. He tentatively concludes that his depression was brought about by his sudden withdrawal from years of alcoholism and exacerbated by his overdependence on Halcion, a prescription drug that he took to treat insomnia. Styron also briefly mentions his own father's battle with depression and his mother's premature death from breast cancer, both of which he believes could have also contributed to his deteriorated state of mind.
As his depression becomes more severe, Styron seeks multiple treatment methods, including psychotherapy, consulting with a psychiatrist, and countless antidepressants, but to no avail. Initially, Styron is able to function better in the morning than in the afternoon and evening, but he soon struggles to even get out of bed. He eventually loses the ability to perform basic tasks such as driving and often contemplates suicide.
One night, after a particularly intense bout of suicidal ideation that culminates in him actively preparing to take his own life, Styron hears a passage from Brahms' Alto Rhapsody, to which he has a fiercely emotional response. He is suddenly repulsed at the idea of suicide and is compelled to eliminate his depression once and for all. The following day, Styron checks himself into a hospital, which he had previously avoided on the advice of his psychiatrist, who harbors a strong opposition to institutional treatment. It is ultimately at the hospital that Styron finally emerges from his depression and eventually makes a full recovery.
The most prevalent theme in Darkness Visible is how every individual afflicted by clinical depression ultimately has his or her own unique experience with the mental disorder. Styron repeatedly emphasizes how each person encounters different sets of physical and psychological symptoms, which can include persistent sadness, fatigue, insomnia, pain, self-harm, futility, lack of concentration, loss of pleasure in things and activities that were once enjoyed, and suicide ideation. He also discusses how every patient possesses a unique response to various treatments and how the success of a method on one individual does not guarantee its effectiveness on another. For example, Styron acknowledges that although psychotherapy and antidepressants did not successfully treat him, they are highly effectual in healing numerous others. He also expresses frustration at the stigma and ignorance surrounding depression, and frequently states that people cannot truly understand how devastating and destructive depression is until they experience it themselves.
Additionally, Styron stresses the importance of perseverance and taking initiative in seeking help and treatment for not only depression, but for any mental illness. The longer one keeps his or her ailment a secret out of either shame, fear, or apathy, the lower his or her chances of recovery will be, and the more likely he or she will succumb to the condition's symptoms, especially suicide.
Throughout the memoir, Styron discusses the effects of depression on the lives of several notable people, who range from accomplished authors such as Romain Gary (a close friend of Styron's), Randall Jarrell, Albert Camus, and Primo Levi (a chemist and Holocaust survivor) to prominent political figures such as U.S. President Abraham Lincoln and activist Abbie Hoffman. Styron also mentions Jean Seberg, an American actress who experienced severe depression herself and who was also Romain Gary's second wife. Many of these individuals eventually committed suicide. Through the connections he draws between his own experience with depression and that of the public figures he analyzes, Styron deduces that people with creative tendencies are ultimately more vulnerable to the disorder.
Styron also suggests alcohol withdrawal and benzodiazepine use as possible causes of his depression.
Upon learning of the significant amount of criticism and ignorance directed towards the suicide of Primo Levi, Styron wrote an op-ed for The New York Times in December 1988, maintaining that Levi ended his life not because of a lack of morality, but because of a real, dangerous illness that threatened the health and lives of many people. [2] The op-ed garnered positive reception and compelled many readers to openly speak about their experiences with depression, ultimately inspiring Styron to begin documenting his own ordeal.
In May 1989, William Styron delivered a lecture about his experience with depression at a symposium for affective disorders at the Johns Hopkins School of Medicine. [3] Several months later, he adapted the lecture into an essay and published it in the December 1989 issue of Vanity Fair. [4] The following year, Random House published Styron's essay as a full-length memoir titled Darkness Visible, which included additional material that had been excluded from the original work due to limited space in Vanity Fair. For instance, Styron's account of his fateful trip to Paris in October 1985 was not included in the essay, but it was incorporated into Darkness Visible.
The title of the memoir originates from John Milton's description of Hell in Paradise Lost: [5]
Upon its release, Darkness Visible received praise from critics and readers for eloquently yet frankly bringing awareness to clinical depression, a condition that was obscure yet prevalent among many people and highly stigmatized. In his review for The Washington Post , Anthony Storr lauded Darkness Visible as "a beautifully written, deeply moving, courageously honest account of an illness which is eminently treatable, but which often goes unrecognized." [7] The Chicago Sun-Times conveyed similar praise in its description of Darkness Visible as "a chilling yet hopeful report from a mental wilderness into which one in ten Americans disappear...enlightening...fascinating." In its critique, The New York Times hailed Darkness Visible as "compelling...harrowing...a vivid portrait of a debilitating disorder...it offers the solace of shared experience." James Kaplan of Entertainment Weekly gave the memoir an A− and praised it for being a "moving and authoritative account." [8] Kaplan also noted that although "Styron does much to dignify depression...[and] bring it out of the realm of unmentionable shame," he "failed to see...how the disease had been central to his whole existence." [8]
Meanwhile, some critics were dissatisfied with the short length of Darkness Visible. People described the memoir as "either woefully incomplete or, at almost 100 pages, more than you would want to know about Styron's history of melancholia." [9] People also criticized Styron for having "the same difficulty doctors do in defining depression and its causes." [9] Kirkus Reviews expressed a similar sentiment in its review of Darkness Visible, which stated that the memoir should have been written "with more intense intimacy and searing detail." [10] However, Kirkus Reviews still offered commendation by calling the memoir "gripping" and declaring, "...we feel that Styron has shown us...as much of his black pit as he can bear to show." [10]
Darkness Visible is renowned for drawing attention to the treatment of clinical depression. According to Peter Fulham of The Atlantic , Styron was effectively able to portray depression, which was typically difficult to describe, and its devastating impacts on not only his own life, but on those of others also afflicted by the disorder. [11] By doing so, he was able to eliminate a substantial amount of stigma surrounding depression, which encouraged individuals with the illness to share their experiences and seek help. Through his memoir, Styron ultimately served as a liaison between people with and without depression and as a leading advocate for mental health overall.
Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that each last from days to weeks. If the elevated mood is severe or associated with psychosis, it is called mania; if it is less severe and does not significantly affect functioning, it is called hypomania. During mania, an individual behaves or feels abnormally energetic, happy or irritable, and they often make impulsive decisions with little regard for the consequences. There is usually also a reduced need for sleep during manic phases. During periods of depression, the individual may experience crying and have a negative outlook on life and poor eye contact with others. The risk of suicide is high; over a period of 20 years, 6% of those with bipolar disorder died by suicide, while 30–40% engaged in self-harm. Other mental health issues, such as anxiety disorders and substance use disorders, are commonly associated with bipolar disorder.
Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Introduced by a group of US clinicians in the mid-1970s, the term was adopted by the American Psychiatric Association for this symptom cluster under mood disorders in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), and has become widely used since.
Kay Redfield Jamison is an American clinical psychologist and writer. Her work has centered on bipolar disorder, which she has had since her early adulthood. She holds the post of the Dalio Professor in Mood Disorders and Psychiatry at Johns Hopkins University School of Medicine and is an Honorary Professor of English at the University of St Andrews.
William Clark Styron Jr. was an American novelist and essayist who won major literary awards for his work.
Suicide is the second leading cause of death for people in the United States from the ages of 9 to 56.
Depression is a mental state of low mood and aversion to activity. It affects more than 280 million people of all ages. Depression affects a person's thoughts, behavior, feelings, and sense of well-being. Depressed people often experience loss of motivation or interest in, or reduced pleasure or joy from, experiences that would normally bring them pleasure or joy.
Works of fiction dealing with mental illness include:
Suicide intervention is a direct effort to prevent a person or persons from attempting to take their own life or lives intentionally.
Suicidal ideation, or suicidal thoughts, is the thought process of having ideas, or ruminations about the possibility of completing suicide. It is not a diagnosis but is a symptom of some mental disorders, use of certain psychoactive drugs, and can also occur in response to adverse life events without the presence of a mental disorder.
A major depressive episode (MDE) is a period characterized by symptoms of major depressive disorder. Those affected primarily exhibit a depressive mood for at least two weeks or more, and a loss of interest or pleasure in everyday activities. Other symptoms can include feelings of emptiness, hopelessness, anxiety, worthlessness, guilt, irritability, changes in appetite, difficulties in concentration, difficulties remembering details, making decisions, and thoughts of suicide. Insomnia or hypersomnia and aches, pains, or digestive problems that are resistant to treatment may also be present.
Mental disorders are classified as a psychological condition marked primarily by sufficient disorganization of personality, mind, and emotions to seriously impair the normal psychological and often social functioning of the individual. Individuals diagnosed with certain mental disorders can be unable to function normally in society. Mental disorders may consist of several affective, behavioral, cognitive and perceptual components. The acknowledgement and understanding of mental health conditions has changed over time and across cultures. There are still variations in the definition, classification, and treatment of mental disorders.
Suicide risk assessment is a process of estimating the likelihood for a person to attempt or die by suicide. The goal of a thorough risk assessment is to learn about the circumstances of an individual person with regard to suicide, including warning signs, risk factors, and protective factors. Risk for suicide is re-evaluated throughout the course of care to assess the patient's response to personal situational changes and clinical interventions. Accurate and defensible risk assessment requires a clinician to integrate a clinical judgment with the latest evidence-based practice, although accurate prediction of low base rate events, such as suicide, is inherently difficult and prone to false positives.
A suicide crisis, suicidal crisis or potential suicide is a situation in which a person is attempting to kill themselves or is seriously contemplating or planning to do so. It is considered by public safety authorities, medical practice, and emergency services to be a medical emergency, requiring immediate suicide intervention and emergency medical treatment. Suicidal presentations occur when an individual faces an emotional, physical, or social problem they feel they cannot overcome and considers suicide to be a solution. Clinicians usually attempt to re-frame suicidal crises, point out that suicide is not a solution and help the individual identify and solve or tolerate the problems.
Bipolar II disorder (BP-II) is a mood disorder on the bipolar spectrum, characterized by at least one episode of hypomania and at least one episode of major depression. Diagnosis for BP-II requires that the individual must never have experienced a full manic episode. Otherwise, one manic episode meets the criteria for bipolar I disorder (BP-I).
Post-schizophrenic depression is a "depressive episode arising in the aftermath of a schizophrenic illness where some low-level schizophrenic symptoms may still be present." Someone that has post-schizophrenic depression experiences both symptoms of depression and can also continue showing mild symptoms of schizophrenia. Unfortunately, depression is a common symptom found in patients with schizophrenia and can fly under the radar for years before others become aware of its presence in a patient. However, very little research has been done on the subject, meaning there are few answers to how it should be systematically diagnosed, treated, or what course the illness will take. Some scientists would entirely deny the existence of post-schizophrenic depression, insisting it is a phase in schizophrenia as a whole. As of late, post-schizophrenic depression has become officially recognized as a syndrome and is considered a sub-type of schizophrenia.
Major depressive disorder, often simply referred to as depression, is a mental disorder characterized by prolonged unhappiness or irritability. It is accompanied by a constellation of somatic and cognitive signs and symptoms such as fatigue, apathy, sleep problems, loss of appetite, loss of engagement, low self-regard/worthlessness, difficulty concentrating or indecisiveness, or recurrent thoughts of death or suicide.
Mental illnesses, also known as psychiatric disorders, are often inaccurately portrayed in the media. Films, television programs, books, magazines, and news programs often stereotype the mentally ill as being violent, unpredictable, or dangerous, unlike the great majority of those who experience mental illness. As media is often the primary way people are exposed to mental illnesses, when portrayals are inaccurate, they further perpetuate stereotypes, stigma, and discriminatory behavior. When the public stigmatizes the mentally ill, people with mental illnesses become less likely to seek treatment or support for fear of being judged or rejected by the public. However, with proper support, not only are most of those with psychiatric disorders able to function adequately in society, but many are able to work successfully and make substantial contributions to society.
Mental health in the United Kingdom involves state, private and community sector intervention in mental health issues. One of the first countries to build asylums, the United Kingdom was also one of the first countries to turn away from them as the primary mode of treatment for the mentally ill. The 1960s onwards saw a shift towards Care in the Community, which is a form of deinstitutionalisation. The majority of mental health care is now provided by the National Health Service (NHS), assisted by the private and the voluntary sectors.
In colleges and universities in the United States, suicide is one of the most common causes of death among students. Each year, approximately 24,000 college students attempt suicide while 1,100 students succeed in their attempt, making suicide the second-leading cause of death among U.S. college students. Roughly 12% of college students report the occurrence of suicide ideation during their first four years in college, with 2.6% percent reporting persistent suicide ideation. 65% of college students reported that they knew someone who has either attempted or died by suicide, showing that the majority of students on college campuses are exposed to suicide or suicidal attempts.