It was in Paris in October, 1985, that Styron first realized his continuing struggle to regain his mental equilibrium might lead to his death. He had been fighting against a growing loss of self-esteem for some months over the previous summer, and during that October trip to receive the Prix Mondial Cino del Duca, which should have been a joyful occasion, his feelings of worthlessness deepened. He had at first ascribed his anxiety and restlessness to alcohol withdrawal, for he had abruptly given up whiskey and all other intoxicants the previous June. As his moods worsened, he started to read as much as he could on the disease of depression, about which little was known at that time. When his distress intensified before he had left for the Paris trip with his wife, Rose, he had made an appointment to see a psychiatrist as soon as he returned to his home in Connecticut.

As he meditates on his own wretched mental state, Styron is reminded of the death of the existentialist writer Albert Camus and the prominence of suicide and despondency in his work. This segues into a long discussion of the suicides of the activist Abbie Hoffman and writer Primo Levi and the suspected suicide of poet Randall Jarrell. Although depression afflicts an eclectic group and anyone might be a potential victim, there is some evidence to suggest that artistic types, especially poets, are unusually prone to the disease.

After returning home from Paris, Styron met with his doctor “Gold,” who treated him with platitudes and large doses of drugs. He became increasingly obsessed with his own death and considered many possible methods of suicide. He disguised and then disposed of a private manuscript, rewrote his will, and attempted to write a letter of farewell but found it too difficult. Late one night, knowing he could not get through another day, he listened to the Brahms Alto Rhapsody, whose beauty opened his heart to all the joys that he had known in his home. The next day, he admitted himself to the hospital, in spite of the fact that his doctor had not advised it. He found the hospital a benign and stabilizing place compared to his home, with its numerous random associations, and within a few days his fantasies of self-destruction all but disappeared. Styron spent seven weeks in the hospital, and he handles his experience with such dexterity that he manages to find humor in the classes offered there, such as art therapy. More than once, he emphasizes that the disease usually runs its course, and recovery is usually possible. In his own case, he believes that the real healers were seclusion and time. This short book ends with Styron’s analysis of the possible root causes of his own depression and a lovely literary illusion to Dante’s Inferno. The memoir is marked by painful honesty and a remarkable lack of self-pity, considering the acute suffering that it recounts.