DEPRESSION, FOR ALL THAT HAS BEEN WRITTEN ABOUT IT, remains in many ways a voiceless illness. If depression were an actor in a play, it would be one without words, its presence a reminder that psychic darkness isn’t invisible so much as carelessly—or, as it may be, willfully—overlooked. Since time immemorial, clinical depression—the kind that sometimes ends in suicide—has not been given its due as a legitimate ailment, with claims on our attention and concern every bit as much as cancer. Like many psychiatric conditions, including schizophrenia, the ratio between biological determinants and psychodynamic ones has never been firmly established, but depression is still often viewed as a failure of will, a spineless inability to stand up to life. Perhaps that has something to do with the fact that depression, unlike psychosis, exists on a continuum with the feelings of sadness and melancholy that ordinary, undepressed people are plagued by—and that it takes place in the privacy of the mind rather than presenting itself through easily identifiable symptoms.
In any case, despite depression’s ubiquity (suicide is the tenth-highest cause of death in the United States) and the greater light that has been shed on the subject in recent years, it continues to be mostly a source of embarrassment, even shame, for those who suffer from it. It skulks in the shadows, afraid or unable to show its face. If it could speak in the language of common experience instead of an anguished, tentative patois of negativity, it would say: “Look at me. Stop pushing me away. I am soundless but real. I could be your brother, or your great-aunt, or your best friend from college.”
The latest addition to the literature of depression is Donald Antrim’s fuzzy sliver of a memoir, One Friday in April: A Story of Suicide and Survival. Sections of the book ran in the New Yorker, where Antrim has also published other work, and he has a small but enamored readership. Antrim’s writing has always been spare and indirect, but it is exponentially more so here—close to affectless, as if he were coming at his emotions from a great distance. At its best his prose has a distilled quality, and at its worst it can seem lazy, given to generic descriptions (“The sun was out, and the sky was blue”); repetitive adjectives (the word “cold” is used so often that I stopped counting); and declarations that are meant to be succinct but sound a little worn-out (“I felt like I hurt everywhere, but also nowhere”).
One Friday begins on a Friday in April 2006, when the forty-seven-year-old Antrim, having just had a spat with his girlfriend, is clinging to the fire escape of his four-story apartment building in Brooklyn, considering jumping to his death. (Although one wonders if falling from this height might have resulted in serious injury rather than death.) “I didn’t know why I had to fall from the roof,” he writes, “why that was mine to do.” He goes on to tell us that depression is a “misleading term,” that he prefers to call his depression “suicide” because he sees it “as a long illness, an illness with origins in trauma and isolation” rather than “the death, the fall from a height or the trigger pulled.” Although Antrim offers this explanation as an original take on an enigmatic condition, I found it befuddling rather than clarifying: suicide is sudden and immediate while depression is a long and often recurrent illness. There is no getting around it: the former is a decision, however impulsive and catastrophic; the latter is a passively endured condition, the result of our chemistry and psychological vulnerabilities. Antrim’s distinction strikes me as more of a rhetorical gambit than an insightful contribution to the understanding of either depression or suicide. Later in the memoir, he offers rapid-fire summaries of psychiatric works by John Bowlby, Erik Erikson, and D. W. Winnicott, which reduce the complexity of their theories to the equivalent of a sound-bite: “All these authors,” he concludes, “describe the crucial role of touch, and of the family setting as a place of safety and security.” His book would have been better served if he had taken us through some of the twists and turns in what are seminal contributions to psychoanalytic theory.
In his earlier memoir about his growing-up years, The Afterlife, which I admired, the prose is more fluid and the under-writing serves to give the story a greater poignancy than it otherwise might have. He describes The Afterlife in One Friday in April as “an accounting of the death of my family.” We learn about their constant moves, “up and down the southern Atlantic seaboard”; his parents’ violent marriage (“I remember the crying, and the thuds on the floor in the next room”); his alcoholic, volatile, chain-smoking mother and the father he didn’t like, a professor who specialized in T. S. Eliot; and his younger sister Terry, who sat on the landing with him in the middle of the night, “afraid to look.” His childhood sounds miserable: he was “sleep-deprived” and “always sick,” with asthma, irritable bowel, headaches, and, beginning when he was ten, “awful and incapacitating back spasms.” Later in the book he returns to highlight the emotional deprivation that marked his childhood: “There were no hugs in our family; no hello or goodbye kisses on the cheek.” All this is narrated in Antrim’s stylized unsparing prose, which allows him to detail the inflictions and afflictions that beset him without sounding self-pitying or as if he expects sympathy from the reader—which, implicitly, he does. (This is as good a moment as any to note that self-pity is the bête noire of all confessional writing, although I’ve never been quite sure why, given that we all have moments of pitying ourselves, whether or not we have reason to.)
Early on in One Friday, we learn that people have been telling Antrim for months that he “wasn’t well, that I needed to get better.” “What did they mean, better?” he asks forlornly. “When had I been better—when had that been?” He has seen a series of psychiatrists, one of whom he stayed with for fifteen years; attended Al-Anon meetings; and unsuccessfully tried the usual array of antidepressants. On the surface, his life looks good enough; he has had girlfriends who cared about him, and at the time we meet him on his roof, The Afterlife (prior to which he has written three novels) is slated to be published. But none of this assuages his feeling of “abjection, the condition of those who have been neglected, harmed, cast out.”
Antrim’s friends, referred to only by first names—“Regan,” “Nicky,” “Janice” (later come “Dave,” “Geneve,” “Paul,” “Jane” . . . on and on, a singularly undifferentiated bunch)—persuade him to check into a psychiatric hospital. Three days later, after telling his assigned doctor about his mother’s “horrible life” and “about losses and errors of my own,” he is discharged. (He mentions in an aside that the doctor “listened for frequency compression” in his voice, which sounds like something he’s read about in some text or other. Certainly in my own hospitalizations for depression, one on the very unit Antrim describes, I’ve never come across this phrase.) Just over a month later, on the advice of Dr. T, a colleague of a friend of his from college, he caves in and goes to the psychiatric emergency room of the Columbia Presbyterian medical center. The following morning he is admitted to the New York State Psychiatric Institute, having made “the choice to submit to life as a patient.”
Unlike the ER, which Antrim has found “scary and difficult,” the ward is “open and light.” He relates the details of living on a psychiatric unit that will be familiar to anyone who has read anything at all on this subject: the forbidden “sharps” (objects like razors and nail clippers); the constant observation of patients who have made a suicide attempt; the twice-daily walks in the “fresh air” (in this case a yard “circled with tall chain-link fencing”); the three-times-a-week therapy; the drug trials; the quiet room; the pay phone. Once in a while he zooms in with a medical factoid—“the medial prefrontal cortex is crucial to proprioception, bonding with others, and our safety in the world”—or pops in images that seem like they’ve been borrowed from Sociology 101: “The hospital can be seen as a therapeutic city, and psychiatric patients as problematic through-traffic; in sickness we take the ward as a gulag.” At other times he relays a scrap of information that seems so well established as to verge on the platitudinous: “Alcoholics Anonymous helped produce the concept of alcoholism as a disease, not a sin or a sign of weakness, and this understanding has led to better health care and reduced stigma.” One wonders why Antrim has decided to include these tidbits of readily available research: Were they once part of a different, more expansive, and less elliptical book?
The centerpiece of One Friday is Antrim’s undergoing ECT, also known as electroconvulsive or shock therapy. This is where the book finds its thrust, reading less like a series of arbitrary observations and more like an actual narrative with a perceptible arc. Not coincidentally, it is also where we meet David Foster Wallace, who calls Antrim after he has been in the hospital for two months, having found out about his situation from a mutual friend. The procedure has been suggested to Antrim by an ECT specialist who, somewhat incongruously, is wearing “a Chanel suit.” She counsels Antrim to agree to the treatment (“We need your consent”), despite Antrim’s vision of what it will be like: “I was terrified of ECT. I imagined the electric chair; and I knew, or thought I knew, what shock would do to me. It would destroy my ability to write, or even to think clearly. It would take away my memories and my personality. I would be unable to function.” Enter Wallace, who, like a trusty guru with celebrity credentials, advises Antrim to take the leap. “I want you to do it,” he says, explaining that ECT has saved his life (although in fact Wallace eventually committed suicide). “‘I want you to try ECT,’ he told me. He said it again and again, because he knew that I was ruminating, and that I would not be able to believe him for long, just a few minutes.”
After five weeks of ECT and almost four months in the hospital Antrim returns home. He deftly captures the anomalous character of passing from the enclosed universe of the hospital to the outside world, how no one but you and your closest are aware of what you’ve been through: “Had you seen me walking up the stoop, opening the front door, you might have thought that I was coming home from a job in the city or an errand in the neighborhood.” He revisits his notion of suicide as “an eternal state, like the eternity of death,” and starts wearing reading glasses because his medication has blurred his vision. As time goes on, he thinks of ECT “as clean power, good electricity added to a wet, saline medium in which electrical signaling has become chaotic and mistimed.” He continues to ask questions of the sort that are peppered throughout the book, wide-open questions (“What story can you tell? How does it begin? What can you see? What can you touch and feel?”) that seem to emerge from his experience of teaching writing.
The questions gradually, almost indiscernably, close in on the issue—Antrim’s issue—of (his) talent and its price. “What torment drives the artist?” he asks. “What makes a writer? What is genius? Might fame be linked with suicide?” Such speculations, I think, are aimed at the readers who have willingly taken Antrim’s cryptic journey with him and are prepared to grant him special status as a chum of David Foster Wallace—as a gifted writer, even one as laconic and seemingly self-effacing as he is. In a way, Antrim is in a bind: he wants to be seen as a depressed suicidal everyman but also as a special case. Neither he nor we can forget that he is an acquaintance of Wallace. In that sense, the memoir is trying to have it both ways, presenting itself on the one hand as an insider report for his devoted following and on the other as a self-help book for a broad readership.
At the book’s close, after returning to the idea that suicide is “a long illness,” the roots of which go back to abuse and trauma, Antrim suddenly declares: “Suicide seems simply to happen, for reasons that we believe cannot be known.” Whether one does or doesn’t subscribe to Antrim’s confusing notions about suicide versus depression, the question still remains: Can an experience of such numbing desolation ever be conveyed, even by the strongest writers? For those of us who have attempted to do so, I think that one of the ways to impart the psychological cost of depression on those who suffer from it and the people who are witness to it is to enfold the illness within the life that takes place around it, however messy or disheartening. I wish, for all his allusions to his suffering, that we’d heard more about Antrim’s day-to-day-ness—that quotidian existence in which our darkness lies side by side with our more functioning selves, the parts of us that maintain friendships, teach, read, cook, and even love. After all, even the most downhearted people have occasional seasons of equanimity, impermanent though they may be.
We leave Antrim married and living with his Serbian wife, Marija, who is a classical pianist. They spend Christmas and part of the summer in Belgrade and the rest of the year in the same Brooklyn apartment where he “hung from the fire escape” fifteen years earlier. Although he still suffers from anxiety and insomnia, he can “feel the vibrations” of his wife’s playing—“Chopin, or Janáček, or Bach”—and is altogether far, far away from that harrowing Friday in April.
Daphne Merkin is a novelist, memoirist, and literary critic. Her most recent books are a memoir about depression, This Side of Happy (2017), and a novel, 22 Minutes of Unconditional Love (2020, both Farrar, Straus and Giroux).