The excerpt from William Styron's "Darkness Visible: A Memoir of Madness" powerfully conveys the relentless nature of pain experienced by someone suffering from depression. The author describes how the suffering is compounded by the knowledge that relief is not on the horizon, making the experience even more unbearable. This chronic condition strips away hope, leaving one trapped in a cycle of despair. The fleeting moments of mild relief only serve as reminders that the pain will inevitably return, deepening the sense of hopelessness.

The decision-making process becomes a stark contrast to normal life; rather than navigating through varying degrees of comfort and discomfort, one merely shifts from one form of pain to another. The metaphor of being bound to a "bed of nails" reflects the inescapable nature of the experience, emphasizing that there is no respite from this torment. It highlights the profound impact of depression, where the absence of joy and relief leads to a crushing weight on the soul.