In Darkness Visible, Styron expounds on depression and suicide. He examines two questions: where did this disease come from, and why me? He wonders why his depression became especially bad, and why some people survive and others don’t. Although Styron never reaches a conclusion, he does speculate about how both events in his childhood and alcohol withdrawal might have caused the onset of his symptoms.

Styron challenges the stigma surrounding depression and suicide by taking on the questions that arise when someone commits suicide. When loved ones ask why the person did it, there is rarely a simple answer. Nevertheless, Styron realizes that silence is killing people. Fear of the stigma, for example, led his doctor to delay hospitalizing him. Stigma made it impossible for the loved ones of Abbie Hoffman and Randall Jarrell to accept that the two men killed themselves. When Styron began thinking seriously about committing suicide, the stigma led him to imagine ways that he could die ambiguously, by making himself ill or staging a car accident. The same stigma made it difficult to ask for help.

Styron’s main argument is that society must change the way it thinks about mental illness in order to save lives.