Throughout my reading of Donald Antrim’s new book-length essay, One Friday in April: A Story of Suicide and Survival, I had been trying to ignore my own suicidal ideation, and to bracket off my own depression (sickness). This bracketing was meant as a safeguard, an insulation—but why did I think this was possible? All it did was lead to a start-stop kind of engagement. As a reader and critic, I try to find ways in which a book can encourage me to see anew the world around me—to take in my lived experiences from a new perspective. Antrim’s book calls for this approach. One Friday in April is at once an emotional and intellectual exploration of what it is to survive suicide: Antrim pulls himself from the literal brink of death. I’m not one who needs to describe art as “relatable,” I don’t think art has to be relatable (in any way) for it to be important or viable. But anyone who suffers, or knows someone suffering, with mental illness will notice plenty of familiar scenes.
The Friday in question saw Antrim climb to the roof of his Brooklyn apartment building and teeter on the edge of jumping: “The sun was setting, and the sky over New Jersey was orange, and I was in my socks, shivering. I was afraid for my life. I didn’t know why I had to fall from the roof, why that was mine to do.” Antrim’s sickness continued for more than a decade after coming in from that roof. Rounds of hospitalization and electroconvulsive therapy. Relapse and recovery. “From the roof, the world seemed to scream.” This is perfect and awful. It tells you all you need to know about the terrible kind of noisy the city was and how Antrim perceived it.
It’s hard to write about a book about depression and suicide without referencing William Styron’s Darkness Visible. Just seeing Antrim’s title is enough to start to put the two works in conversation. Antrim brings up Styron in the opening pages, quick to get it out of the way. Both he and Styron see the word “depression” as inadequate to describe this particular sickness. Styron called it “mysteriously painful and elusive […] nearly incomprehensible to those who have not experienced it.” Antrim refers to his sickness as suicide: “a natural history, a disease process, not an act or a choice, a decision or a wish.” For Antrim, suicide is not the act, but rather a long illness. “I see suicide as a social disease. I will refer to suicide, not depression.”
Suicide is the tenth overall leading causes of death among all people in the United States. Depending on age group, it’s a consistent top five. In 2019, per the NIMH, suicide rates among men were almost four times that of women. It’s worth noting that both Styron and Antrim are white males of a certain socio-economic status (SES). This is not to blame them, or make them feel guilty, and it by no means (I can’t stress this enough) makes less urgent their depressions and suicidal ideations. But it is important to note in terms of what it is to navigate the healthcare industry in the United States and the questions a book like One Friday can raise.
According to an article published in the Journal of Primary Care & Community Health, the perception that doctors have of patients with low socioeconomic status affect clinical decisions. The article shows evidence that, compared to other patients, physicians see lower SES patients as less intelligent, less independent, and less responsible. It’s not a stretch to see how these perceptions could impact a doctor’s decisions in terms of care—delaying testing, referral for specialty care, and what medicine is prescribed. Couple this with the already financial strains, lack of quality insurance coverage, and care is further restricted.
This is to say nothing about mental health. 55% of US counties don’t have a practicing psychiatrist. And even if they did, how many insurance programs cover mental health treatment—and to what extent? In 2019, only 10.9% of adults with mental health issues had coverage. Books like Darkness Visible and One Friday (there are many others) have at their core protagonists who inhabit, perhaps, the upper ends of the middle class, regardless of their self-perceived status at time of writing. That is to say, they could access and afford the care they needed. So many others can’t and therefore go untreated.
This is not to take anything away from Antrim’s brave and vulnerable book. One Friday in April didn’t set out to explore or answer how different socioeconomic groups navigate mental health issues. But it’s a hard thing not to think about. It’s also hard not to wonder how Antrim dealt with the stigma surrounding his mental illness. When it is addressed, it is addressed in brief and, for the most part, dismissed. Even if the stigma has lessened, it hasn’t lessened for everyone at the same rates. Non-hispanic whites received treatment at a rate of over 50%, while non-hispanic Black and African Americans and Hispanic and latinos received treatment at a rate of around 33%. These numbers don’t tell a complete story, but they do give us insight to who is seeking treatment and from there we can start to ask why.
Near the last third of One Friday, Antrim writes “I never wanted to die. Have you wanted to die? Do you now? At what stage in sickness do these desires come? Are they even desires?” What a fascinating question. How many times have I thought about ending my life? What I thought about was the aftermath: who would find me, what would they feel, what would they think, who would clean up? The thoughts weren’t about the act itself. Any of us that are sick want the sickness to end, but Antrim’s question—do any of us really want to die? That’s not really the way we want the sickness to end.
The Romanian philosopher Emil Cioran wrote “Why don’t I commit suicide? Because I am as sick of death as I am of life.” Cioran acknowledges that life is meaningless, but argues death is just as meaningless itself. Antrim’s final note in One Friday seems to have a bit in common with Cioran’s thinking. Antrim ends his book with more of a bit of encouragement rather than hope. He doesn’t tell us everything is going to be okay if we just wake up and decide to be happy. He points out that, at the moment he is writing, he is doing fine. But just outside and above him is the roof he peered over, the fire escape he clung to thinking about letting go. Things might get bad again. The fact that we can contemplate suicide, that we can stare at and examine the darkness of our inherent empty existence—maybe this reminds us of our ungainly humanness. And maybe that contemplation is enough for us to examine what we want to change.
NON-FICTION
One Friday in April: A Story of Suicide and Survival
By Donald Antrim
W. W. Norton & Company
Published October 12, 2021
