My more specific purpose in consulting Dr. Gold was to obtain help through pharmacology-though this too was, alas, a chimera for a bottomed out victim such as I had become.

He asked me if I was suicidal, and I reluctantly told him yes. I did not particularize–since there seemed no need to–did not tell him that in truth 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 from 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 through the rainy woods. Nor had I overlooked an ostensible accident, a la Randall Jarrell, by walking in front of a truck on the highway nearby. These thoughts may seem outlandishly macabre–a strained joke–but they are genuine. They are doubtless especially repugnant to healthy Americans, with their faith in self improvement. Yet in truth such hideous fantasies, which cause well people to shudder, are to the deeply depressed mind what lascivious daydreams are to persons of robust sexuality.

William Styron, Darkness Visible: a Memoir of Madness, New York, 1990, p. 53