Emotional damage.

Addendum: It is brilliant! Because of the time span this book covers, it almost feels like an epic fantasy. It's definitely a long read, but I actually didn't feel bored at any point. It made me feel things - not sadness, tbh, but pain, guilt, hate and anger. The book slaps the abysses of humanity right in your face. "A Little Life" is at the same time both exaggerated and realistic.
I may read it again in the future to understand how all the clues are woven into the story. Despite loving this book very much, I won't be able to recommend it unreservedly to friends and family. At least not without the list of trigger warnings.