In December 1985, prominent novelist William Styron, in the depths of severe depression, found himself at a crossroads. Prepared to commit suicide, Styron opted instead to seek treatment. After seven weeks in a psychiatric ward, Styron reentered the world with a renewed sense of self and a will to live. When Primo Levi, a prominent Italian scientist, writer, and Holocaust survivor, killed himself in 1987, Styron responded to the widespread criticism of Levi’s suicide with an op-ed in The New York Times about the nature of depression, based on his own firsthand experience.

Styron asserted that suicide is not immoral or selfish, but the result of an untreated or poorly treated mental illness. He received an outpouring of responses from readers who had also experienced depression, and who felt seen for the first time. This response led to a lecture on the subject in 1989 at the Johns Hopkins School of Medicine. Later that year, Styron published an article in Vanity Fair about his experiences, and in 1990, he expanded that article into Darkness Visible, a book-length memoir about his personal experiences suffering from depression and returning from the brink.

In October 1985, Styron traveled to Paris to receive the prestigious Prix Mondial Cino del Duca. As he passed by a hotel he’d stayed in 35 years earlier, he realized he believed he’d never return to Paris—because he assumed he was going to commit suicide. He’d been struggling with insomnia and with depression symptoms that seemed mild in the morning but grew intense by afternoon and evening. Following the awards ceremony, he backed out of a planned luncheon for the following day; he’d unintentionally agreed to meet with his publisher at the same time. Seeing how offended the committee member was, he rescheduled with his publisher and attended the luncheon after all. Then, during the dinner with his publisher, he briefly lost the check for the award—$25,000—but felt less worried about losing the money than he was about whether he deserved the award in the first place. The mental fog and twisted thinking of depression made concentration difficult and led to a distorted perception of events.

Styron wanted to return to the U.S. right away to receive medication for his condition. Looking back, he considers his friend, Romain Gary, who committed suicide following the suicide of his ex-wife. He also thinks of a favorite author, Albert Camus, who died in a car accident in a vehicle driven by a known reckless driver. Camus frequently wrote about suicide and wondered in writing whether life was worth living; Styron wonders if Camus’s decision to get in that vehicle was a passive attempt at taking his own life.

Styron also contemplates the suicide of activist Abbie Hoffman and his family’s attempt to get the coroner to rule the death an accident. Styron speaks of the stigma felt by those whom suicide leaves behind and how they often attempt to deny what happened, as though it revealed a shameful flaw in the deceased’s character rather than being the result of a devastating mental illness.

Styron attributes the onset of his own symptoms, which began when he was 60, to his inability to continue consuming alcohol, a substance that had made it easier for him not to allow difficult feelings into his awareness. He began to be overcome with somatic symptoms, even though doctors gave him a clean bill of physical health. When he returned home, he began trying a range of antidepressants in addition to medications like Halcion. A notebook he kept as a random collection of his thoughts came to symbolize his struggle to survive. At one point, he disposed of the notebook, and he realized he’d made the decision to end his life.

At a critical juncture, Styron told his wife that he felt suicidal, and he entered a psychiatric hospital. Upon reflection, he believes that seven-week stay in the hospital, with its routine and seclusion, helped him more than any medication ever could have. Two years later, he learned of Primo Levi’s suicide and penned his groundbreaking editorial for The New York Times. Styron says multiple times that the experience of severe depression is indescribable, but he persists in trying to communicate the utter hopelessness and torment of the disease. He realizes that depression is incurable, and that he may experience additional episodes, but he’s optimistic that the next time, he will know that the suffering has an ending, and he will possess more tools for working his way back into the light.