Summary

As One Friday in April opens, we find Donald Antrim in an agitated state on the roof of his Brooklyn apartment building.  He paces, and alternately climbs down the fire escape, hangs from the railing, and lies on his stomach peering over the ledge.  Repeated outpatient courses of psychotropic medication and psychotherapy have done only so much for his deteriorating mental state, and the situation has come to a head. Disheveled and wild-looking, he manages to return home whereupon his friends take him to a psychiatric hospital.  

A MacArthur Fellow and author of several acclaimed novels, Antrim has previously published a memoir of his upbringing with his alcoholic mother.  In this new memoir, flashbacks of childhood neglect and chaos are juxtaposed with the present day as he takes the reader through the acute phase of his illness:  a lengthy hospitalization, a course of ECT, discharge from the hospital, rehospitalization, and eventual stabilization.   

The author considers his condition to be suicide, noting that “depression is a concavity, a sloping downward and a return.  Suicide, in my experience, is not that.  I believe that suicide is a natural history, a disease process, not an act or a choice, a decision or a wish…I will refer to suicide, not depression” (pp. 14-15).  

The book ends on a hopeful note. After several relationships that might be described as codependent, Antrim meets his current partner, whom he marries.  He sees the roof of his building through his window and remembers a certain Friday in April but is comforted by the sound of his wife playing Chopin and Bach on the piano.  

Commentary

This is an exceptionally brave book.  Antrim does not attempt to whitewash his situation in any way. Surely it is humiliating for someone so successful to acknowledge he has been utterly debilitated. He loses track of time. He gains weight and cannot fit into his clothes. His new book is released, but he is in no condition to help promote it.  At first, he objects to being called psychotic but eventually it comes as a relief to know he is understood.  One Friday in April will be inspirational to others who have suffered to see how an accomplished person is reduced to being allowed to use his razor only under strict supervision.  

At times Antrim touches on the link between mental illness and creativity.  If he had hoped the cathartic exercise of writing about his childhood would have stopped his illness he learns otherwise: “Writing had not stopped my dying. (p. 80)” At another point, his friends joke that his diagnosis “might enhance my literary reputation” (p. 115).  Finally, in one of the more poignant episodes in the book, Antrim gets a call from the novelist David Foster Wallace and is encouraged to undergo ECT.  He has an excellent response to that treatment, but later learns that Wallace has hanged himself.   

While a diagnosis of psychotic depression fits best with the range of symptoms the author manifests, his point about suicide as a distinct disorder is well taken.   In fact, the most recent edition of the DSM (Diagnostic and Statistical Manual) took the major step of including Suicidal Behavior Disorder as a “condition for further study.” This corroborates the author’s experience and means that SBD might be included in a later edition.  (see also https://www.frontiersin.org/articles/10.3389/fpsyt.2020.499980/full)  

Those who are looking for an exposé or critique of the mental health system will not find it here.  Antrim credits his psychiatrists and the hospital with helping him get through an unbearable time. One Friday in April is a book that will give reassurance to people who have endured suicidal thoughts that if they persist they will get better.      

Publisher

W.W. Norton & Company

Place Published

New York

Edition

2021

Page Count

141