Why did the eminent Italian writer Primo Levi die in the shocking way he did?
In the depths of a clinical depression, Mr. Levi, an Auschwitz survivor who had written eloquently of his ordeal under the Nazis, jumped down a stairwell in Turin in 1987.
The question appeared to haunt—indeed, nearly dominate—a recent symposium held at New York University and dedicated to Mr. Levi and his work, according to an article in The New York Times.1 Some participants reacted with simple incredulity.
Alfred Kazin, a distinguished literary critic, was quoted as saying: “It is difficult for me to credit a will to blackness and self-destruction in a writer so happy and full of new projects.”
A friend, rejecting the idea that the writer had planned to kill himself, saw the death as the result of a “sudden uncontrollable impulse”—as if rational deliberation might have somehow colored the act with wrongdoing. In this and other statements, there was at least a tinge of disapproval, an unspoken feeling that through some puzzling failure of moral strength Mr. Levi had failed his staunchest admirers.
Apparently not expressed at the symposium, though quoted in the article, was the harshest example of such a viewpoint: a suggestion in The New Yorker that “the efficacy of all his words had somehow been cancelled by his death.”2 This idea leaves the implication that the force and fervor of a writer's work is rendered invalid if, instead of expiring of natural causes, he takes his life.
What remains most deeply troubling about the account is the apparent inability of the symposium participants to come to terms with a reality that seems glaringly obvious. It is that Mr. Levi's death could not be dissociated from the major depression with which he was afflicted, and that indeed his suicide proceeded directly from that illness.
To those of us who have suffered severe depression—myself included—this general unawareness of how relentlessly the disease can generate an urge to self-destruction seems widespread; the problem badly needs illumination.
Suicide remains a tragic and dreadful act, but its prevention will continue to be hindered, and the age-old stigma against it will remain, unless we can begin to understand that the vast majority of those who do away with themselves—and of those who attempt to do so—do not do it because of any frailty, and rarely out of impulse, but because they are in the grip of an illness that causes almost unimaginable pain. It is important to try to grasp the nature of this pain.
In the winter of 1985–86, I committed myself to a mental hospital because the pain of the depression from which I had suffered for more than five months had become intolerable. I never attempted suicide, but the possibility had become more real and the desire more greedy as each wintry day passed and the illness became more smotheringly intense.
What had begun that summer as an off-and-on malaise and a vague, spooky restlessness had gained gradual momentum until my nights were without sleep and my days were pervaded by a gray drizzle of unrelenting horror. This horror is virtually indescribable, since it bears no relation to normal experience.
In depression, a kind of biochemical meltdown, it is the brain as well as the mind that becomes ill—as ill as any other besieged organ. The sick brain plays evil tricks on its inhabiting spirit. Slowly overwhelmed by the struggle, the intellect blurs into stupidity. All capacity for pleasure disappears, and despair maintains a merciless daily drumming. The smallest commonplace of domestic life, so amiable to the healthy mind, lacerates like a blade.
Thus, mysteriously, in ways difficult to accept by those who have never suffered it, depression comes to resemble physical anguish. Such anguish can become every bit as excruciating as the pain of a fractured limb, migraine, or heart attack.
Most physical distress yields to some analgesia—not so depression. Psychotherapy is of little use to the profoundly depressed, and antidepressants are, to put it generously, unreliable. Even the soothing balm of sleep usually disappears. And so, because there is no respite at all, it is entirely natural that the victim begins to think ceaselessly of oblivion.
In the popular mind, suicide is usually the work of a coward or sometimes, paradoxically, a deed of great courage, but it is neither; the torment that precipitates the act makes it often one of blind necessity.
The origins of depression remain a puzzle, despite significant advances in research. Many factors seem to be involved. Aside from the basic chemical disturbance in the brain and behavioral and genetic influences, psychological reasons must be added to the equation. Mr. Levi may have been bedeviled by buried conflicts unrelated to Auschwitz.
Or, indeed, his ordeal at Auschwitz may have imposed on his soul an insupportable burden; other writers wounded by the Holocaust (Paul Celan and Tadeusz Borowski come to mind) decided upon suicide as a way out of the blackness of memory. But the overwhelming majority of camp survivors have chosen to live, and what is of ultimate importance to the victim of depression is not the cause but the treatment and the cure.
What is saddening about Primo Levi's death is the suspicion that his way of dying was not inevitable and that with proper care he might have been rescued from the abyss.
Depression's saving grace (perhaps its only one) is that the illness seems to be self-limiting: Time is the real healer and with or without treatment the sufferer usually gets well.
Even so, presumptuous as it may be to speculate from such a distance, I find it difficult not to believe that if Mr. Levi had been under capable hospital attention, sequestered from the unbearable daily world in a setting where he would have been safe from his self-destructive urge, and where time would have permitted the storm raging in his brain to calm itself and die away, he would be among us now.
But, in any event, one thing appears certain: He succumbed to a disease that proved to be malignant, and not a shred of moral blame should be attached to the manner of his passing.
[New York Times, op-ed, December 19, 1988.]
After the essay on Primo Levi was published in The New York Times I received an enormous number of letters, almost all of them from people who had experienced depression, directly or as a result of being associated with victims of depression, and who felt I had given voice to a subject too-long buried. The essay prompted an invitation from the department of psychiatry of the Johns Hopkins School of Medicine for me to speak at a symposium on mood disorders; this speech was eventually expanded into a long article in Vanity Fair, and eventually into a book, Darkness Visible.—W.S. (1993)