A Nausea of the Cells and Soul: How David Foster Wallace Humanized Depression in Infinite Jest

Illustration by Steve Ponzo

The American collective has become more aware of mental illness over the last decade. Our understanding and our ability to draw empathy from that understanding, however, is still very much a limping enterprise.

Diseases and maladies of the mind do not convey sickness directly and human beings are not great at abstraction. When someone has the flu that person is visibly ill. He has a fever, maybe a cough, maybe he’s vomiting, he looks pale—he looks, in a word: sick. Traditionally and generically sick. See also adjectives: ill, unwell, queasy, infirm, peaked and blighted. We use these words to describe the aesthetic characteristics of the ill. They are vastly insufficient beyond the realms of physical malady.

Mental illness alters the way someone sees and experiences the world and thus, how they respond and act within that world.

It’s existence sickness.

People who live or work with the mentally ill know how taxing everyday interactions can become. Being wrapped in a state of perpetual sadness seems like a conscious determination because most of our behavior is centered around our free-thinking faculties and our decision-making. If you have not experienced what it’s like to be aggressively depressed, it’s difficult to fully empathize with depression on an abstract or human level.

This is why so many people respond to depression by saying remarkably tone-deaf lines like: “C-mon, just smile, the sun is shining!” or, “Stop it; what are you so sad about?”  Depression remorselessly eats away at the mind. Our thoughts, our movements, our breathing, everything that makes us human originates in the beautiful electric sponge in our skull. Our happiness, or lack thereof is a result of a certain number of neurons jumping -or not jumping- a certain number of synapses.

It’s that simple, and that complex.


Famed novelist David Foster Wallace’s struggle with depression and his eventual suicide have forever altered the lens through which his work is viewed. It’s unavoidable. A reader can’t help but see the pain on the page; the art and the man are forever intertwined. Wallace’s insight is brazenly vulnerable and deeply affecting without context, with it, it’s entirely heart-shattering.

He had an incredible talent for splintering down complex emotions into relatable and simplistic anecdotes and fragments. As a dedicated student of philosophy and a devout lover of the post-modern works of Thomas Pynchon (among others), Wallace developed a voice that crowbarred itself between the world of philosophy and contemporary fiction. He would use fiction in order to explore philosophical concepts and relationships. Throughout much of his magnum opus, Infinite Jest, Wallace examines the tumultuous relationship human beings have with popular entertainment, as well as our reliability on social structures and substances—and all of the internal battles that go along with lifting our comforting lids each morning. Wallace, on a macro level, is known for his fractured narratives, his exhausting footnotes and endnotes, his violently robust vocabulary, the bandana he so often had wrapped around his head—and his suicide.

But when you dive into his work, it becomes clear that the unhinged super-intelligence and the post-modern tactics are not as compelling as the visceral honesty and the heart-aching humanity his prose expressed. It wasn’t there all the time—far from it. But it creeps in like a thief in the night and pins you to the wall. When I first read Infinite Jest, several parts stood out, but none more than this small, two-page section about secondary character Kate Gompert:

“That dead-eyed anhedonia is but a remora on the ventral flank of the true predator, the Great White Shark of pain. Authorities term this condition clinical depression or involutional depression or unipolar dysphoria. Instead of just an incapacity for feeling, a deadening of soul, the predator-grade depression Kate Gompert always feels as she Withdraws from secret marijuana is itself a feeling. It goes by many names—anguish, despair, torment, or q.v. Burton’s melancholia or Yevtuschenko’s more authoritative psychotic depression—but Kate Gompert, down in the trenches with the thing itself, knows it simply as It.

It is a level of psychic pain wholly incompatible with human life as we know it. It is a sense of radical and thoroughgoing evil not just as a feature but as the essence of conscious existence. It is a sense of poisoning that pervades the self at the self’s most elementary levels. It is a nausea of the cells and soul. It is an unnumb intuition in which the world is fully rich and animate and un-map-like and also thoroughly painful and malignant and antagonistic to the self, which depressed self It billows on and coagulates around and wraps in Its black folds and absorbs into Itself, so that an almost mystical unity is achieved with a world every constituent of which means painful harm to the self. Its emotional character, the feeling Gompert describes It as, is probably mostly indescribable except as a sort of double bind in which any/all of the alternatives we associate with human agency—sitting or standing, doing or resting, speaking or keeping silent, living or dying—are not just unpleasant but literally horrible.

It is also lonely on a level that cannot be conveyed. There is no way Kate Gompert could ever even begin to make someone else understand what clinical depression feels like, not even another person who is herself clinically depressed, because a person in such a state is incapable of empathy with any other living thing. This anhedonic Inability To Identify is also an integral part of It. If a person in physical pain has a hard time attending to anything except that pain, a clinically depressed person cannot even perceive any other person or thing as independent of the universal pain that is digesting her cell by cell. Everything is part of the problem, and there is no solution. It is a hell for one.

The authoritative term psychotic depression makes Kate Gompert feel especially lonely. Specifically the psychotic part. Think of it this way. Two people are screaming in pain. One of them is being tortured with electric current. The other is not. The screamer who’s being tortured with electric current is not psychotic: her screams are circumstantially appropriate. The screaming person who’s not being tortured, however, is psychotic, since the outside parties making the diagnoses can see no electrodes or measurable amperage. One of the least pleasant things about being psychotically depressed on a ward full of psychotically depressed patients is coming to see that none of them is really psychotic, that their screams are entirely appropriate to certain circumstances part of whose special charm is that they are undetectable by any outside party. Thus the loneliness: it’s a closed circuit: the current is both applied and received from within.”

This is marrow-level empathy. Wallace is speaking from purgatory—emoting from a void between the sun and the floor; it’s a space he is able to recess back in to for a spell and still lift his head out for long enough to articulate as an outside source.

The use of the word “incompatible” here is illuminating. It paints the picture that life and clinical depression are two distinct, unconnected forces that cannot co-exist within the same framework, that depression is an interior pain that is innately at odds with exterior existence. He describes major depression as the spiritual anti-thesis to the heartbeat—a ruthless super-villain motivated solely by the destruction of the self. He calls it a “nausea of the cells and soul.” This description is vital in understanding the ubiquitous nature of mental illness. When the body is sick, the body holds the sickness. When the mind is sick, every cell that comprises one’s being and every spiritual morsel rattling around one’s head is sick.

It’s, “a closed circuit.” Wallace again…

“The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.”

Existence is our gift, we are told, it’s everything, it’s a miracle-spark. So to choose to end it, to choose to leave life and all its color is an unfathomable premise for most. The burning high rise analogy is perhaps the most poignant section of the entire novel.

One who jumps from a burning building does so to avoid the flames, not out of any will to end his/her life—“the fear of falling remains a constant.” Which is to say, death holds the same weight and force for those who commit suicide. Depression does not alter the level of fear. It only serves to make it seem more appealing by contrast. As a collective, we tend focus on the act of suicide itself without paying much attention to the circumstances that precipitate it. It’s the internal vs. external issue again; we can’t see the pain, so the pain holds less weight overall—there’s no tactility here, no corporeal representation. And this only compounds the loneliness and isolation one feels when dealing with an illness of this nature.

Wallace may be right. Perhaps it’s impossible to fully empathize with major depression and suicide without having been held within that cage previously. But reading his work drags you into the interior and holds you there for enough time to really feel it. He grabs your hand and walks with you deep into the flames, pointing out the details, only to suddenly drop you on the other side and head back into the fury as a party of one.


by Jesse Mechanic

 Illustration by: Steve Ponzo

Steve Ponzo is a NY based artist and illustrator: http://www.steveponzo.com

1 Comment

  • Casey Orr says:

    “This is marrow-level empathy”….what a beautiful written article, seriously. Your commentary and introspect adds to many of Wallace’s words, which honestly probably isn’t the easiest accomplishment. Thanks for sharing your insight, Jesse.

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