« Depression is a disorder of mood, so mysteriously painful and elusive in the way it becomes known to the self -- to the mediating intellect-- as to verge close to being beyond description. It thus remains nearly incomprehensible to those who have not experienced it in its extreme mode. […]
I felt loss at every hand. The loss of self-esteem is a celebrated symptom, and my own sense of self had all but disappeared, along with any self-reliance. This loss can quickly degenerate into dependence, and from dependence into infantile dread. One dreads the loss of all things, all people close and dear. […]
In depression this faith in deliverance, in ultimate restoration, is absent. The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come—not in a day, an hour, a month, or a minute. If there is mild relief, one knows that it is only temporary; more pain will follow. It is hopelessness even more than pain that crushes the soul. So the decision-making of daily life involves not, as in normal affairs, shifting from one annoying situation to another less annoying—or from discomfort to relative comfort, or from boredom to activity—but moving from pain to pain. […] In virtually any other serious sickness, a patient who felt similar devastation would be lying flat in bed, possibly sedated and hooked up to the tubes and wires of life-support systems, but at the very least in a posture of repose and in an isolated setting. […] However, the sufferer from depression has no such option and therefore finds himself […] thrust into the most intolerable social and family situations. There he must, despite the anguish devouring his brain, present a face approximating the one that is associated with ordinary events and companionship. He must try to utter small talk, and be responsive to questions, and knowingly nod and frown and, God help him, even smile. But it is a fierce trial attempting to speak a few simple words. […]
A disruption of the circadian cycle—the metabolic and glandular rhythms that are central to our workaday life—seems to be involved in many, if not most, cases of depression; this is why brutal insomnia so often occurs and is most likely why each day’s pattern of distress exhibits fairly predictable alternating periods of intensity and relief.
[…] By the time we arrived at the museum, […] my brain had begun to endure its familiar siege: panic and dislocation, and a sense that my thought processes were being engulfed by a toxic and unnameable tide that obliterated any enjoyable response to the living world. […] For myself, the pain is most closely connected to drowning or suffocation—but even these images are off the mark. William James, who battled depression for many years, gave up the search for an adequate portrayal, implying its near-impossibility when he wrote […]: “It is a positive and active anguish, a sort of psychical neuralgia wholly unknown to normal life.”
[…] I can think of no more apposite word for this state of being, a condition of helpless stupor in which cognition was replaced by that “positive and active anguish.” And one of the most unendurable aspects of such an interlude was the inability to sleep. It had been my custom of a near-lifetime […] to settle myself into a soothing nap in the late afternoon, but the disruption of normal sleep patterns is a notoriously devastating feature of depression; to the injurious sleeplessness with which I had been afflicted each night was added the insult of this afternoon insomnia, diminutive by comparison but all the more horrendous because it struck during the hours of the most intense misery. It had become clear that I would never be granted even a few minutes’ relief from my full-time exhaustion. »
— William Styron, Darkness Visible