My notebook pages are blank again tonight, as they have been for the past 30 nights. I know what I am supposed to write, but I cannot bring myself to do it. The pen takes on an immense weight as I force it towards the college-ruled lines I prefer. When I pass from external reality to those internal landscapes where my inspiration dwells, my inner vision blurs. I cannot – or, will not – say what needs to be said.
The voices in my mind argue. One voice says, “What’s the point? It’s never going to help.” Another adds, “They’ll just think you’re whining.” A third screeches, “Hide it! You mustn’t tell anyone.” A fourth reminds me, “You’re not supposed to ruminate, you know.”
A lone voice holds out, and asks, “Yeah, but what about them?”
She’s asking about the ever-growing list of people I personally know whose lives have been affected by major depressive disorder (depression) and suicide. She’s asking about the 40,000 Americans who take their lives every year. She’s asking about losing one person to suicide every 40 seconds around the world.
I know she’s right. Someone must speak for them. They need storytellers to bring the full force of language to bear. They need poets to describe what depression actually feels like in the most vivid words possible. And, if not me – after being diagnosed with major depressive disorder by three different doctors in three different cities and after trying to kill myself twice – then who? Serious writers are committed to telling the truth, and the truth that depression is a horrible, torturous, nightmare of a disease is one of the few truths I know intimately.
I’ve known that I should be writing about depression for a long time, but I stall. There’s several reasons. First, I’m scared. The stigma is real. According to the National Mental Health Association, 43% of Americans still believe that depression is the result of a weak will or a deficit in a person’s character. Additionally, The Lancet recently published a study where 855 of 1082 (79%) people with a diagnosis of major depressive disorder in countries around the world reported they experienced discrimination. I’m afraid if I reveal what really happens in my mind, I will suffer professional consequences. I’m afraid my loved ones will be terrified, and consciously or not, distance themselves from me.
Fear of the stigma combines with a biological impulse to isolate myself. A depressed brain functions like a sick brain. Just like when experiencing the flu, the brain sends signals to the body to slow down and to withdraw from the presence of people. This adaptation helps to prevent the spread of contagious diseases, but for the mentally ill, this adaptation can prove lethal.
I experience this impulse for isolation as a vicious cycle. I feel a growing amount of intense pain, but convince myself I cannot tell anyone for fear they will desert me. When, inevitably, a loved one notices my pain, I feel guilty for burdening them with the knowledge of my pain. The pain grows. I isolate myself further to “protect” my loved ones from the burden of my pain. The isolation, of course, adds to the pain. Until I find some resolution for this cycle, it becomes ever more vicious.
The stigma and the impulse for isolation work together on a broad level to create a cultural silence. The last thing most of us with depression want to do is publicly display our experience – especially when we are caught in the middle of a depressive episode. Our dilemma is we’re horrified of telling the raw, vivid truth when our healing – on both the individual and cultural level – demands that we are completely honest about what depression feels like.
Our silence is killing us. It is true that there will be some, even some of our closed loved ones, who cannot handle hearing the truth about depression. To tell the truth, we might have to endure the dirty glances, the harsh words, and even the loss of so-called friends. But, what about them? What about those lost forever to the silence? What about the 40,000 Americans who will die this year because they could not find a way through depression? What about those still alive, fighting quietly against the demons with everything they’ve got? What about those who might be saved by wisdom shared? Our silence is killing them, too.
Now, I’ve never been one of those writers who clings blindly to the faith that simple story-telling is going to save anyone from anything besides, perhaps, common boredom. I am not calling on artists to simply “bear witness” to the struggles of mental illness. I am calling on artists to embrace their roles at the vanguard of language and to create a new vocabulary capable of articulating depression’s horrors. I am calling on artists to arm the depressed with words to adequately describe their pain, with confidence in the knowledge that mental illness is real, and with the reassurance they are not alone.
We cannot rely on the doctors to do it for us. Imagine using the language of the Diagnostic and Statistic Manual, Fifth Edition (DSM V) published by the American Psychiatric Association to understand what depression feels like. The DSM V describes symptoms of major depressive disorder as “depressed mood or irritable most of the day, decreased interest or pleasure in most activities, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, guilt/worthlessness, diminished ability to think or concentrate, suicidality.”
Imagine suffering with the disorder, struggling to understand what is going on in your mind, attempting to stave off the guilt and despair that accompanies the illness, while gathering the strength to ask for help, and the only words you can come up with are, “I’m experiencing psychomotor agitation and retardation.”
What follows are my attempts to be honest. I’ve written these takes from the edge, in the middle of a depressive episode.
This is what depression feels like, Take 1:
The day arrives, as it always will. August 18: the anniversary of my last suicide attempt. This August 18 marks three years since I gave in to the pain and chose death over a life with more suffering.
Now, I could tell you that I’ve been living happily ever after. I could tell you that attempting suicide twice, failing twice, and explaining to loved ones what I’ve done instilled in me an unshakeable joy that cured the illness. I could tell you that mental illness is a dark, almost forgotten, but certainly complete chapter of my life that time is busy burying in my past.
I could tell you a lot of things that would make you, and me, feel better. Maybe we’d feel better if I explained that depression is just an extended feeling of sadness. Maybe we could rest assured if I admitted that I possess a moral weakness. And, accepting this weakness, I have rectified my character defect, beat my mea culpas into my chest, sought forgiveness, and live redeemed in the grace of your favorite God. Maybe we could ignore depression – trusting the psychiatrists have it under control – if I wrote that anti-depressants have saved me because taking my pills everyday is all it takes to feel better.
But, I’m writing this while coping with news from another friend who messaged me from the psyche ward after another of his own suicide attempts. I’m writing this while wondering if I said the right things to my friend in India who is trying to help her suicidal friend in a country where a stigma surrounds mental illness in an even stronger way than stigma surrounds mental illness in the USA. I’m writing this while pondering a friend who lives with the reality that her parents both killed themselves. I’m writing this while I realize that I have three close friends who each have a brother who killed himself. I’m writing this while weeping for a friend who recently learned of his cousin hanging himself and leaving behind his wife and three children.
This is what depression feels like, Take 2:
Everything fucking hurts.
This is what depression feels like, Take 3:
When the night’s shadows begin climbing through the living room window, the distractions have run out, and the last remnants of peace flee, the void remains.
Whispers form at the edges of my consciousness. The whispers sew dissatisfaction, discomfort, and despair. They gossip about my fears, inadequacies, and insecurities. I try two things at first. I ignore them. Then, I reason with them. Ignoring them works for awhile, but they always come back, especially when I am tired or stressed. Reasoning works as long as I find solid thoughts to stand on. If I begin to doubt, the whispers gain volume, gain gravity, and weigh heavier in my mind.
I scramble to fight them off, but I tire and eventually collapse. That’s when they pounce and I sink deeper and deeper with doubts thumping against me. My head begins to hurt, my shoulders grow sore, my legs shake, wobble, and cramp.
All I want is inner silence. Sleep is a viable tactic, at first. I go to bed earlier and earlier. But, when I sleep, I dream. And, my dreams are poisoned. Nightmares hold me in replays of the worst times in my life. Night terrors force me awake as I spring up in bed screaming and shivering.
I’ve woken my partner countless times screaming in my sleep. So, tonight, I move to the couch. Though I am still, balled up on the couch, I search frantically through every corner of my mind for the litany of statements I’ve been taught to toss in front of the darkness as my last defense.
The litany is composed of things doctors, therapists, and loved ones have told me. Things like:
“Depression is a disease. It’s not your fault.”
“You have to expect a chronic illness to flare up again from time to time.”
“Depression is not you, Will. It’s something that happens to you.”
“You’re not a burden. We love you.”
Right now, I cannot recall the words, so I try to remember a time when I did not feel like this. Memory’s well opens before me. I know, from experience, the water is cold. Maybe the fear that accompanies my plunge attracts the worst. Or maybe its a standard though harsh rule of consciousness that says you cannot use memory to run from memory. Seeking for any memory opens you to all memory.
Either way, I am met, first, with the darkest images. I thrash through the images in the hopes that I can produce some warmth for myself. My personal history appears to me in those freezing waters like a funnel. I see my life descending, even from birth, to those chilling moments where I stand at a table – exhausted and numb – grinding anti-anxiety medication into a powder with a butter knife.
In my countless replays of these memories, I have ground my consciousness so forcefully over the events that the details are preserved in crystalline clarity. I remember the wry smile that forms on my lips as I open my wallet to find one single dollar bill. Literally, my last dollar. I remember the smell of lacquered wood through the paper as I press my nostril to one end of the rolled bill and press the other to the powder. I remember the mild, humorous surprise at the ease at which the actions came to me. Where did I learn to do this? I had never snorted anything before.
After I snorted the pills, I dumped the rest of the bottle into my hand and emptied them into my hand. I remember one pill stuck in the lines on my palm. I wondered what a palm reader would say about that. I remember the way the pills clacked against my teeth.
The scariest detail I remember, the memory that haunts me the most, is the strange sense of peace that washed over me as I calmly put on my pajamas, climbed into bed, pulled the blanket to my chin, and folded my hands on my chest. The pain, I knew, would soon be over. There was ecstasy in that knowledge. I wish I never felt that ecstasy. It can be so seductive sometimes, so welcoming, as it reaches towards me with a warm smile offering what it promises is the ultimate antidote for the pain.
I flee the memory and swim as hard as I can for the surface, but guilt catches me on the way up. There’s the now-ancient residue of guilt that surrounds my memories of attempting suicide. There’s the guilt that attaches to my inability to stamp the memory of that poisonous ecstasy out. There is also a newer, stronger guilt: The guilt that accompanies my realization that I am cycling again, that I have forgotten all that I have learned in therapy, all that I have promised myself about revisiting the past.
I wonder if I am an addict – addicted to despair, addicted to guilt. I remember that the word “addict” comes from the Latin “addicere.” The definition of “addicere” includes “to be bound to” or “to enslave.” I definitely feel enslaved, bound against my will to depression.
I am no longer still. I punch the couch and kick it with my heels like a child throwing a temper tantrum. I am angry, but more than anything I seek to convert the emotional pain my memories produce into a physical pain. Physical pain, at least, has an identifiable source. This emotional pain is rooted nowhere, but hurts everywhere.
I finally exhaust myself. I lie wet from sweat and tears. My mind settles down, but an empty, hungover feeling takes hold. It’s happened again like so many times before. I am scared it will never not happen again. I stare out the window to a starless night. The void remains.
I can’t share anymore right now. Writing these experiences on a page gives them a physical reality. In this way, the experiences can be confronted, but it also gives them a life they did not have before. What is said, cannot be unsaid. It’s impossible to say whether the memories will be defeated like this, but it will be impossible to defeat them without pulling them from my mind and pinning them to paper.
Gathering the courage to share these experiences publicly is the last effort. If you’re reading this you’ll know I won.
To find that courage, I’ll remind you and I’ll remind myself: I’ve heard doctors say that the proper cure requires the proper diagnosis. This is as true on the personal, medical level as it is for the social and cultural level. And, right now, as a culture we lack an adequate vocabulary to describe what depression actually looks and feels like. We cannot adequately describe the symptoms and therefore cannot make the proper diagnosis without honest accounts of depression. Our fear, our guilt, our silence are killing us. It’s time to speak.