Percy Knauth had been a successful reporter, writer and editor with the Chicago Tribune, New York Times, TIME, LIFE, SPORTS ILLUSTRATED and Time-Life Books for 33 years when, at the age of 56, he decided to end his own life. There were no pressing money problems, no personal crises to be faced. What led Knauth, now 60, to contemplate suicide was a severe bout with depression—an illness that afflicts some 20 million Americans. Fortunately, he managed, through a combination of psychotherapy and antidepressant drugs (which he still takes), to overcome his disease before it destroyed him. Knauth, who tells his moving story in the newly published A Season in Hell, is also this year’s chairman of the million-member National Association for Mental Health. He recently discussed his battle for survival—and its relevance for others—with Barbara Kerr for PEOPLE.
When did you decide to kill yourself?
In April of 1971, while I was lying in a little attic room above West 67th Street in New York City. The means were at hand: enough pills to put me to sleep forever. Beside me, my wife, Behri, stirred, then reached out her hand. She felt my shoulders shaking and suddenly came wide awake. I lifted my head and she saw my face. Without a word, she took my head into her arms. My tears flowed until it seemed as if my soul was pouring out through my eyes. I was suffering from a disease. Like one in 10 Americans, my illness was depression.
What actually triggered your 18-month siege with suicidal depression?
Nine months before, my wife and our children anchored our small boat just off Napatree Point and picnicked on the beach. When it came time to leave, the children ran into the water and swam out to the boat. As I was swimming myself, a piece of seaweed brushed my leg and I snatched myself away in alarm. When I reached the boat, I was suddenly flooded by an icy fear. I couldn’t make it over the side and into the boat. After several desperate, panicky tries, I finally pulled my body over the gunwale, gasping. In the process, I had pulled a muscle in my left leg. I felt as though I had aged 30 years.
And this was enough to start your “descent into hell,” as you call it?
Yes. I was 56. I had never in my life felt old before. The night of the incident in the boat I tossed and turned and had wild dreams. The next morning the pain was worse. Unless I kept my mind on it and regularly straightened out my left leg before I put my weight on it, the leg collapsed. Once I forgot as I was going down the cellar stairs with an armful of bottles. I sat down on the stairs abruptly, dropping a couple of bottles, which shattered on the concrete floor. It suddenly hit me for the first time that I was getting old. That day I started a weird game of numbers in my head: in only 14 years I would be 70—if I lived that long—and 14 years were nothing at all!
Isn’t age an almost universal depressant?
It is not the fact, but how it hits you. A few weeks later, when I went to see the doctor, he asked me how I felt. I wept again. He remarked worriedly that I had a clinical case of involuted depression, prescribed pills and a psychoanalyst, neither of which did me much good. During the next eight months neither the analyst nor anyone else understood how desperate I felt. I bottled it all up inside.
Isn’t the average person depressed from time to time?
You’re programmed for depression by the events of your life. A divorce, the loss of a loved one or a job can make you vulnerable. Normal people may have trouble for a few weeks, six months at the outside; eventually they cope. But there is a deeper depression, less subject to the healing hand of time.
What is “involuted depression”?
It’s an illness that feeds on itself like a snake swallowing its tail. You start losing sleep and thereby lose psychic energy. Each day you wake up more and more tired and less able to resist whatever is eating away at you. Once it gets going it drags you quite rapidly into a downward spiral. In the next two weeks I went through several more stages—bewilderment, resentment, rage and despair.
What are the physical symptoms?
Headaches, breathing difficulties, loss of sleep, loss of appetite, loss of sexual desire and potency. It depends on what the vulnerable areas are. With me, shock, fear, bad news go instantly to the gut.
And the emotional symptoms?
Overall there is a generalized feeling of melancholy, punctuated by acute attacks of anxiety that deepen into fear and often into panic. There’s a growing helplessness—you feel guilty about things you couldn’t possibly have affected, like the Vietnam war or the drug problem. Hopelessness degenerates into worthlessness. Worthlessness leads to a total loss of self-esteem. Then you begin to get suicidal.
What kept you from suicide?
It wasn’t my family. In my distorted view, I saw them as better off without me. Actually, my job was more of a deterrent. I had the almost impossible assignment of preparing a 20-volume encyclopedia about animals in seven months. It became an obsession. I was more afraid of not completing those books than I was of dying. That job kept me, however wobbly, more or less on the rails. It’s extremely important for depressed people to try and keep some kind of routine—even if it is just making the bed in the morning.
Can depression be easily diagnosed?
Most internists are not trained or equipped to diagnose it. However, a new diagnostic tool—a relatively simple depression-rating scale—is now available to the general practitioner. It consists of about 50 true-or-false and yes-or-no questions that deal with the symptoms of depression. This way, doctors can assess quite accurately the nature and severity of a depression.
What is the best treatment for depression?
Every depression has a biochemical and a psychological factor. Nobody knows which comes first. Most likely it is the psychological factor that induces a biochemical result. The most successful treatment now consists of a whole new line of antidepressant drugs—Elavil, Etrafon and Trilafon are the best-known. But drugs alone won’t do the job. Proper treatment requires drugs plus psychotherapy. And the psychiatrist ought to intervene directly, almost like a surgeon—that is, give direct, immediate help. Otherwise the patient might do something desperate. A psychoanalyst usually maintains a passive role and does not intervene.
For you, what was the solution?
I went to the Depression Research Unit connected with the Connecticut Mental Health Center in New Haven, and was told that the dosage of the antidepressant drug I had been taking without much success, Elavil, was too small. My dosage was raised from 50 milligrams to 400 milligrams a day, and I began to feel better within a week. The drug has to build to a certain level in your system before it takes effect, so the initial dosage must be quite high. Yet most doctors are afraid to prescribe high dosages because of side effects, like dizziness, drowsiness, sexual impotence and occasional nausea. It is not yet possible to say, “You have such-and-such kind of depression, and this is the right drug for it.”
Is there a link between depression and alcoholism?
Depression is the major underlying factor in many cases. It’s easy to diagnose an alcoholic: he drinks too damn much. You dry him out and he drinks again. But if you can get at the depression behind his cycle, he can be cured of his alcoholism.
As this year’s chairman of the National Mental Health Association, what do you do?
I go out and speak at local and regional meetings and appear on television and radio shows. I find that there is still a sad lack of understanding about mental illness, especially depression. Many people—and that includes doctors—are unwilling to admit that depression is not just something in your head but exists in a clinical way. Millions of cases go undiagnosed and untreated.
What kind of response are you getting?
I get a highly emotional response. Some people come up just to thank me; others ask advice, and I feel inadequate because I am not a doctor. I suspect men may speak more frankly to me than they would to a doctor when they hear that I wept.
There is too much machismo around. In our culture, men say, “I can’t let my guard down. I can’t be weak.” Yet I’ve learned that there are times when every human being needs to weep.