depression in its major stages possesses no quickly available remedy: failure of alleviation is one of the most distressing factors of the disorder as it reveals itself to the victim, and one that helps situate it squarely in the category of grave diseases.

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.

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.

At any rate, during the few hours when the depressive state itself eased off long enough to permit the luxury of concentration, I had recently filled this vacuum with fairly extensive reading and I had absorbed many fascinating and troubling facts

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.