In the years that I have been writing this column, I have on three or four occasions done an article on suicide. Each of those columns prompted a flood of grateful letters. The gratitude came from the fact that those columns suggested that, in most cases, suicide claims its victims in the same way as does a heart attack, a stroke, cancer, or an accident. There is no freedom not to die. Suicide victims are, like victims of sickness and accidents, not responsible for their own deaths and suicide should not be a matter of secrecy, shame, moral judgment, and second-guessing.

Canadian poet Margaret Atwood once wrote certain things need to be “said and said until they don’t need to be said anymore.”  With this in mind and given the painful misunderstandings that habitually surround suicide, I was all set last week to write another column on suicide which would reiterate the fact that suicidal depression, like certain other physical diseases, was a terminal illness and not a free choice that connotes moral and psychological delinquency, when a new book by William Styron, the author of ‘Sophie’s Choice’ and several other classic novels, fell into my hands. Entitled ‘Darkness Visible’, A Memoir of Madness (Random House, N.Y., 1990), the book chronicles Styron’s own descent into suicidal madness and his helplessness as he spirals into that hell.

Since Styron writes more clearly than I, and is sharing firsthand the experience of suicidal depression, allow me to quote him extensively:

“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 prevention of many suicides will continue to be hindered until there is a general awareness of the nature of this pain. … to the tragic legion who are compelled to destroy themselves there should be no more reproof attached than to the victims of terminal cancer. …

What I had begun to discover is that, mysteriously and in ways that are totally remote from normal experience, the gray drizzle of horror induced by depression takes on the quality of physical pain. But it is not an immediately identifiable pain, like that of a broken limb. It may be more accurate to say that despair, owing to some evil trick played upon the sick brain by the inhabiting psyche, comes to resemble the diabolical discomfort of being imprisoned in a fiercely overheated room. And because no breeze stirs this caldron, because there is no escape from the smothering confinement, it is entirely natural that the victim begins to think ceaselessly of oblivion.”

And Styron describes graphically how the depressed person thinks such thoughts of oblivion: “many of the artifacts of my house had become potential devices for my own destruction: the attic rafters (and an outside maple or two)  a means to hang myself, the garage a place to inhale carbon monoxide, the bathtub a vessel to receive the flow of my opened arteries. The kitchen knives in their drawers had but one purpose for me. Death by heart attack seemed particularly inviting, absolving me as it would of active responsibility, and I had toyed with the idea of self-induced pneumonia, a long, frigid, shirt sleeved hike though the rainy woods.”

After reading virtually all the literature, medical and psychological, on the issue, Styron suggests the suicidal depression is, in the end, caused by chemical imbalance, despite the fact that other factors (lifestyle, childhood, moral values, memory) play in. Modern sensitivities, he contends, make us reluctant to use old-fashioned words like madhouse, asylum, insanity, melancholia, lunatic, or madness, but “never let it be doubted that depression, in its extreme form, is madness. The madness results from an aberrant biochemical process. It has been established with reasonable certainty (after strong resistance from many psychiatrists, and not all that long ago) that such madness is chemically induced amid the neurotransmitters of the brain, probably as a result of systemic stress, which for unknown reasons causes a depletion of the chemicals norepinephrine and serotonin, and the increase of a hormone, cortisol.”

Styron was one of the lucky ones. With his suicide already planned, he “drew on some last gleam of sanity” and, in that, realized that “could not commit this desecration on” himself and his loved ones. He woke his sleeping wife and she drove him to a hospital. In its “safety” and given “seclusion and time” he healed. He lives today, healthily, and he tells the insiders’ story.

That insiders’ story is doubly valuable. Not only should it helps us to understand suicide more deeply and thus exorcise it of its shameful stigma, but, once its anatomy is better known, we should be able to better help others (and ourselves) in its prevention.

Beyond that, a proper understanding of suicide should help us all walk more humbly and compassionately in grace and community, resisting the bias of the strong and unreflective who make the unfair judgment that people who are sick want to be that way and who are blind to the fact of their own psyche’s exquisite fragility and perishability.