I had read Phil Katz's story before and I read it again today - it wasn't any less painful the second time around. I think if we were to debug it - there doesn't seem to be any one unmistakable conclusion, rather a combination. It would all depend on how severely one reacts to their emotional trauma. Some people are numbed, some are able to move on, some find healthy diversions in hobbies, people, achievements and some like Phil just plain fail to function well and have to resort to drugs and alcohol in order to run away from the living nightmare. I think at some point existence becomes rather more painful than death for some - that's the only way you're able to kill yourself without regard.
Humans are puzzling as a species - all the years of conditioning, the everyday conflicts and contradictions we have to face, the constant need for asserting our existence through external means, the need for relations, the child/parent and then spouse systems and all the things that can go wrong with them, all the other uncertainties - amazingly many live through this but some just can't escape the dread.
>I am as puzzled and frustrated by the above records, and by the rest of my psychiatric file, as any casual reader could be. So much earnest effort, so much expert knowledge, so little success. The world’s most common disease is still this opaque.
Having read half a dozen compelling depression memoirs—Styron, Jamison, Millett, Solomon, Kaysen, McMurtry—I was skeptical, when The Baffler proposed publishing extracts from my file, that there was much more to say. Maybe there isn’t, at least not in that register. But maybe it’s enough just to keep talking.
Reading this gives me immediate anxiety. I have times during the day where just seeing things and being alive is almost unreal, like I can't deal with, and the thought of doing this for N number of years more is overwhelming. As I'm getting older life is just even more surreal, I sometimes wonder if I have the mental fortitude to make it to old age. This isn't a cry for help, you just touched a nerve with that sentence.
One old saw has it that when a man is starving he forgets even the urgent promptings of a full bladder. A newer old saw claims that religion is the opiate of the masses (with its uncoined analog regarding fetishism & the ruling classes).
The quoted OP railed against wasted time and effort, but his views on the despiritualization of the modern man are not clear. A non contemporary would likely diagnose a 'spiritual crisis' for the existential angst of the uncommon non-aristocratic unbelieving modern man.
It is no wonder then that so many find a life of ultimately meaningless toil and distraction so dreadful, and akin to those words by OP.
Until I experienced the emotionless emotions/feelings I couldn't have imagined it. We take for granted that our brain functions properly, even depression and other ailments are comprehensible, it's the incomprehensible emotions that can't be lived through.