Trying not to die

Depression needs no introduction, but as for Donald Antrim, a true writer’s writer, some background may be in order. Antrim, now in his early sixties, has been a New Yorker contributor, a Columbia University writing professor, and a MacArthur fellow. An accomplished short story writer, he has also written three inventively surrealist or antirealist novels in the Barthelme or Saunders vein; Jonathan Franzen called one of them, The Hundred Brothers, “possibly the strangest novel ever published by an American.” Antrim’s 2006 memoir The Afterlife offers a grim but oddly exhilarating chronicle of his relationship with his alcoholic, unstable, ever-machinating mother, Louanne Self. It serves as a prequel or companion volume to One Friday in April, which could just as well have been called The Aftermath.

If The Afterlife helps us to grasp how and why Antrim ended up a depressed person, to whatever extent such a question admits an answer, One Friday has a somewhat more modest, practical, service-oriented ambition. It seeks to describe, in minutely physical terms, what it feels like to be terminally depressed. It is a convention of this genre, inaugurated for a wide public three decades ago by William Styron’s Darkness Visible, to emphasize that the psychological anguish of depression is unimaginable until experienced firsthand. Antrim’s innovation is to speak in terms of symptoms. One Friday is, among other things, a grueling index of sensations and complaints, from the seemingly trivial to the all but unbearable. These things, at least, can be imagined.

“I couldn’t hold my head up,” Antrim writes. “I could not form a smile. I could not tolerate touch. Merely standing was excruciating.” This is just the beginning. Yet Antrim, uncomfortable with the halo of victimhood, is careful to illustrate the depressed person’s effect on others. When we first encounter him, he is on his apartment’s fire escape, toying with various ways of falling to his death. He’s been calling friends all morning, and some of them are en route. He wonders if onlookers have guessed what he’s about to do, which is to say that he’s prepared to do it for an audience. He knows this is a strike against him: “Who would find me? Who would have to look back on that scene?” In his classic study The Savage God, the critic Al Alvarez admits to being “tremendously impressed” by one of his teachers who, to avoid leaving a “terrible mess” for his survivors, “put his head in a sack and cut his throat.” Antrim seems to understand that such judgments are inescapable.

Antrim doesn’t jump. He doesn’t fall. His friends arrive, and with their loving help, he embarks on a via dolorosa of treatment. He is institutionalized. He recites a litany of fears and wonders whether his darkest thoughts are “intrusive … or simply the only thoughts that I had.” He likens his symptoms to a waking experience of rigor mortis. Weight loss turns his apparel to “clown clothes.” At times, “it feels like my arms are falling out of the sockets.” Sunlight feels “like sand thrown in my eyes.” His nails harden into talons. His skin goes gray. He develops eczema. Dry mouth. Dysphagia. Jaw pain. Sleep disturbances. Lack of coordination. A constant perception of buzzing or vibration. Antrim’s life is reduced, over his months on a psych ward, to the alarming fine print on a prescription bottle.

These symptoms, and the nauseous physicality with which Antrim describes them, are a reminder that depression is not exclusively or primarily an emotional experience. But Antrim deftly evokes his psychological agony, too. We witness his frantic impulse to unburden himself to a doctor, as if to a priest. We experience Antrim’s shame after hospital staff mistake one of his episodes of panic for a violent outburst. In this bleak environment of unbreakable glass and suicide-proof doorknobs, euphemisms like “constant observation” (suicide watch) and “quiet room” (mattress on the floor, for sleeping or sobbing) take on a sinister quality. But this isn’t One Flew Over the Cuckoo’s Nest, and Antrim is grateful for every minute in the hospital.

It doesn’t respect Antrim’s book to treat it, in deference to its subject matter, as a sacred, infallible text. It is a tremendous public good, of course, but does it succeed as literature? For the most part, yes. In its brevity, clarity, and intimately conversational tone, it certainly lives up to its model, Styron’s Darkness Visible. It goes beyond that sober and elegant book by capturing a suffering person’s wild-eyed confusion. Antrim speaks to us directly but confidentially, like a Conrad narrator or the Ancient Mariner. He speaks simply and eloquently. This is the voice that ought to explain depression, from the inside out, to anyone willing to listen.

Antrim can be theatrical. He furnishes two pages of synonyms for depression. He wallows in gratingly macho talk about an itch he can only scratch with a bullet. He strains occasionally after novelty of effect or insight. Most regrettably, he announces that he will refer to depression as suicide throughout the book:

I do not think of suicide as the act, the death, the fall from a height or the trigger pulled. I see it as a long illness, an illness with origins in trauma and isolation, in deprivation of touch, in violence and neglect, in the loss of home and belonging. It is a disease of the body and the brain, if you make that distinction, but its etiology, its beginning, whether in early or later life, in the family or beyond, is social in nature. I see suicide as a social disease. I will refer to suicide, not depression.

This paragraph is a disaster, and it’s far too important to excuse as a rhetorical flourish gone wrong. Antrim’s personal conception of “suicide” is difficult to distinguish from anyone else’s conception of “depression.” Switching the terms muddies more than it illuminates: “I will refer to death, not cancer.” Why? How are we to refer to the act itself, the death, now that “suicide” refers broadly to the illness? Those, however, are editorial cavils. More importantly, Antrim’s definitional hocus-pocus is misleading. Depression is not in all cases “social in nature.” It can strike people who don’t, to their conscious knowledge, have a care in the world. Nor does every depression end in or even flirt with suicide. Depression without suicide is still depression.

On balance, Antrim has done a noble thing with this accessible, beautifully written, heartbreaking, and, sure, unflinching book. One Friday presents a powerful example of how friends should come through in a mental health emergency. It demystifies the electroconvulsive therapy, widely feared and misunderstood, that ends up saving Antrim’s life. “Maybe you’ve spent some time trying every day not to die,” Antrim writes, “out on your own somewhere. Maybe that effort became, or has become, your work in life.” This book, all the more humane for its defects, is for you.

Stefan Beck is a writer living in Hudson, New York.