[In the following review, the critic discusses William Styron's Darkness Visible, noting that in the memoir the author offers many self-diagnoses.]

William Styron's essay meanders through his experience of depression in a somewhat crotchety style, one which pulls the facts along like loose seaweed emerging through the surf. It is a wandering and poignant memoir that catalogues his thinking on depression.

So much has been written about this disorder. The 1980s (and now the 1990s) are the "ages" of depression, as the 1950s were the age of anxiety and the 1960s and 1970s were those of narcissism and borderline personality (Kohut, Kernberg, and Masterson). So I read Darkness Visible expecting a major footnote in the history of this disorder from the pen of an artist, not a clinician. To my surprise, the essay tends to relate the history of Styron's depression with an odd clinical detachment. He details his ambivalence toward pharmacological psychiatry, taking a more powerful stab at the etiology of depression than at allowing the reader into his experience of the madness it fosters.

The memoir begins with a clinical differentiation of the author's particular type of depression in psychiatric discourse: "At a later stage my entire mind would be dominated by anarchic disconnection … there was now something that resembled bifurcation of mood." In this early going Styron does a creditable job of detailing the particular symptomatology of his variety of depression. In the process he assembles an impressive community of literary colleagues with the same disorder—Albert Camus, Romain Gary, Abbie Hoffman, Randall Jarrell, Hart Crane, Cesare Pavese, Ernest Hemingway, Anne Sexton, and others.

Styron dates the onset of his depressive mood from the beginning of his intolerance for alcohol, a substance he had abused. For forty years alcohol had been "the magical conduit to fantasy and euphoria," "the enhancement of the imagination," "the invaluable senior partner." The deprivation arising from his sudden intolerance of alcohol made him feel "emotionally naked, vulnerable as [he] had never been before." Building on this mixture of biochemistry and folk wisdom, Styron folds his own quasi-medical analysis into the official cant: "Such madness is chemically induced amid the neurotransmitters of the brain, probably as the result of systemic stress, which for unknown reasons causes a depletion of the chemicals norepinephrine and serotonin, and the increase of a hormone, cortisol."

Once launched on the biochemistry of the disorder, Styron calls his psychiatrist, Dr. Gold, to [task] for not knowing his Physicians Desk Reference well enough to be aware of the pitfalls of Halcion and to prescribe the proper drug. From about midpoint to the conclusion Darkness Visible tends to weave in and out of biochemical and psychoanalytic models of explanation. So, while Styron feels that "psychiatry must be given due credit for its continuing struggle to treat depression pharmacologically," he praises cognitive therapy in the early stages, and he also acknowledges the psychoanalytics of objective relations when he claims "that devastating loss in childhood [his mother died when he was thirteen] figured as a probable genesis of my disorder." Alcohol, uninformed drug prescription, failed psychiatric therapy, loss and abandonment, turning sixty, vague dissatisfaction with work, and genetics (his father had it) are all singled out. He discovers the early warnings of his depression in his fiction: "Suicide had been a persistent theme in my books."