From Medicine to Metaphor: Exploring Depression Through Literary Accounts
Almost all of us know someone, whether it’s a friend or family member, who has suffered from depression. Sometimes we hear public personalities discuss their experiences, affirming depression is a common struggle and that behind every persona exists a real, living, breathing human being.
Yet opening up about depression with others can be difficult, eliciting feelings of shame or fear of being misunderstood. This can place a wall between the individual battling depression, and those closest to them, making it harder to reach out for help.
Tragically, many with depression suffer in silence, left to grapple alone with a burden that’s been tucked away in the quiet spaces of inner life.
An incomplete picture of depression
Today depression is largely viewed as a neurobiological illness best described in disease-state terms. We use language such as disorder, episodes, remission, recovery, and relapse. Standardized tools help us rate depression from mild to severe, quantify its duration and intensity, and identify subtypes and modifiers. We talk about it in stark medical terminology.
But what does it feel like to be in the throes of a severe bout of depression? Like a musical composition, we can read its score, describe the key, identify the time signature and meter, and talk about its rhythm. But none of that would tell us what it’s like to listen to Beethoven’s Fifth Symphony.
Similarly, our clinical descriptions are at times insufficient to capture the experience of someone struggling with depression.
What does depression feel like?
Where our clinical picture falls short, literature and art can offer further insight. Some of the richest descriptions of mental health are found in the humanities, among poets and playwrights, who have turned to analogies and metaphors to offer understanding. Max Picard wrote, “It is only in the language of the poets that the real word, the word connected with silence, still sometimes appears.” Poetry can help convey the inexpressible.
It’s my hope that exploring first-hand depictions of depression will provide a different perspective on an invisible illness that impacts so many. Please be advised that sensitive and sometimes distressing descriptions of depression are discussed.
A bare stage
Alejandra Pizarnik was an Argentinian lyric poet who explored melancholy, solitude, and tragedy in her work. Pizarnik wrote of depression,
Nothing happens in it. No one intrudes. It is a bare stage…
A bare stage doesn’t require any scenery or backdrop, it’s empty. This description beautifully captures the loss of pleasure that accompanies depression — the inner life of someone in the throes of the disease, once bright and animated, has been stripped of its color. Scenery that was vibrant is replaced with hollowness.
Individuals with depression often express concern about feeling emotionally flat. This is less an experience of sadness, and closer to affective numbness or blunting, which can result in a sense of detachment from others and the world.
She also describes this disconnection as a lack of harmony, stating, “Melancholia is, I believe, a musical problem: a dissonance, a change in rhythm.”
House on fire
The mental pain of severe depression can be all-encompassing. One of the most powerful images that conjures this feeling is Tennessee Williams’ burning building. In his play The Milk Train Doesn’t Stop Here Anymore, he writes,
We all live in a house on fire, no fire department to call; no way out, just the upstairs window to look out of while the fire burns the house down with us trapped, locked in it.
The use of the language trapped and locked in are what makes this metaphor truly haunting, capturing a sense of desperation.
Writer David Foster Wallace, who suffered from deep depression for most of his adult life prior to his tragic suicide, extends this metaphor by asking us to imagine someone stuck in the same burning building faced with the decision whether to jump. The person who jumps does so not because death suddenly looks enticing, or they no longer have a fear of falling. Rather, they’re convinced the alternative is worse. Wallace writes, “You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling”.
A bell jar
Perhaps one of the most famous descriptions of the suffocating nature of depression is from Sylvia Plath’s Bell Jar. In the semi-autobiographical novel, an undergraduate student is awarded a summer internship for a magazine in New York City, only to find herself becoming increasingly mentally unstable as she grapples with her identity and social mores. The protagonist’s decline into mental illness parallels Plath’s own experiences, a life of enormous literary talent punctured by clinical depression.
She compares depression to being stuck under a bell jar, struggling to breathe. Bell jars keep lab samples hermetically sealed away from the world, an image that again evokes how immersive depression can be. Plath wrote,
I sank back in the gray, plush seat and closed my eyes. The air of the bell jar wadded around me and I couldn’t stir.
In another passage, she likens the condition to the eye of a storm, stating, “I felt very still and empty, the way the eye of a tornado must feel, moving dully along…”. Like Pizarnik’s bare stage analogy, this uses the concept of a vacuum to represent the emotional flattening accompanying depression.
Lost in the woods
Sadness and grief are temporal. We understand that with time we will recover. Dealing with depression is more akin to getting lost in the woods — at first, you believe you’ll be able to find the path again. But then the woods become more and more disorienting. And eventually, there’s no end in sight. Every direction looks the same. Author Elizabeth Gilbert wrote,
When you’re lost in those woods, it sometimes takes you a while to realize that you are lost. For the longest time, you can convince yourself that you’ve just wandered off the path, that you’ll find your way back to the trailhead any moment now. Then night falls again and again, and you still have no idea where you are, and it’s time to admit that you have bewildered yourself so far off the path that you don’t even know from which direction the sun rises anymore.
What makes the burden of depression so heavy is the impossibility to someone afflicted of envisioning an end.
A howling tempest
In his work Darkness Visible: A Memoir of Madness, author William Styron details his descent into depression, near suicide, and recovery. The title derives from Milton’s description of hell in Paradise Lost.
Styron’s memoir represents one of the most detailed first-hand accounts of what it’s like to be gradually engulfed by the condition, which he likened to a “howling tempest”. He wrote,
Slippage into futility is first gradual, then utter. Thought, which is as pervasively affected by depression as mood, is morbid, confused, and stuporous. It is also vacillating, ruminative, indecisive, and self-castigating. The body is bone-weary; there is no will; nothing is that is not an effort, and nothing at all seems worth it.
Styron also argued the term depression had too bland of a connotation, stripping the condition of its true malevolence and preventing broader awareness of the intensity when out of control. In his words, “The pain of severe depression is quite unimaginable to those who have not suffered it, and it kills in many instances because its anguish can no longer be borne”.
The limits of language
Frequent attempts to conceal the mental pain of depression increase its burden. It takes a degree of mental gymnastics for someone with clinical depression to construct a version of themselves for others that appears “okay”. Carrying that burden alone can feel like Atlas holding up the weight of the world on his shoulders.
Moving from secrecy to sharing — to no longer hide this pain — is the entryway into therapy. To do this, we first need to identify just what we’re feeling and give it a name; we must be able to put in into words. This isn’t an easy task. Poetic language, through its use of imagery and metaphors, perhaps offer a peak into these “unspeakable silences.” They make the inner life of someone with the condition more accessible.
But words are at times insufficient to adequately capture the exact nature of the suffering involved in depression. Language is fragile, it can point at or suggest, but doesn’t always directly correspond to the things it’s meant to describe. Pizarnik, for example, believed language was a slippery and imprecise reflection of the world, instead frequently revisiting the notion of silence. Or as T.S. Eliot wrote, “Words, after speech, reach into the silence… Words strain, crack and sometimes break, under the burden…” There are pieces of our experience that are simply lost in translation.
I am reminded of the novel The Hours, which depicts Virginia Woolf’s fight with what today may be characterized as bipolar depression. She shares with her husband, “If I were thinking clearly, Leonard, I would tell you that I wrestle alone in the dark, in the deep dark, and that only I can know. Only I can understand my condition”.
Narrative descriptions in recovery
Literary narratives of depression highlight the value of first-hand accounts in shining a light into the condition. We should listen to them. They offer a rich vocabulary that can assist in mapping the contours of clinical depression.
First-hand accounts drawn from literature and art can also evoke the essence of what depression “feels like”, by way of powerful images and metaphors, bringing to life an inner turmoil that often cannot be put into words. Poetic language carries with it depth of emotion and soul, helping bridge the gap between what can be said and what can only be experienced.
As Alejandra Pizarnik stated, “each word says what it says — and beyond that, something more and something else”. This provides a glimpse inside the mind of those suffering from depression and allows us to gain critical insight into a condition that is so often misunderstood.
Most significantly, what literary narratives offer is hope. If we can better understand the mental life of someone struggling with the depths of depression, it can improve our ability to manage and treat it.
Today we have more tools than ever before to effectively treat mental health disorders. Never forget that depression is conquerable. Even if you’ve reached “despair beyond despair”, keep going.
If you or someone you know is in crisis, please contact the Suicide Prevention Lifeline at 1–800–273-TALK (8255).
