When Shame Gets In The Way Of Asking For Help.

The Insidious Nature of Depression.

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The weight tied to my ankle pulled to the bottom suffocating I cannot breathe, I cannot do this, but I fought and I fought and I got that fucking weight off and I was above water and I made it to the side and I was out of breath but I emerged, triumphant. Then pulled back in, this weight heavier, I’m fine I got it I have enough breath I can do this. I make it and I emerge, triumphant, again. And then well, I’m a little out of breath but I got this. Then suddenly I’m so far under the water and I’m flailing and fighting and I really cannot breathe and this time I’m not sure I even see the light but okay the weight is off but wow I am tired and I do not think I can bear this but no I have to I have to keep fighting I mean I want to keep fighting but I just cannot bear this weight and it is so dark down here I am so exhausted so I float, listless. Sinking. It is so dark down here and so dark up there and when there is light it hurts my eyes and I just cannot get back up or to the side or keep breathing it is just so dark and unbearably heavy and I am sinking but my tiny quiet voice cries out someone, help me and my voice makes it to the surface and I open my eyes to tolerate the light.


I didn’t tell my therapist I stopped working out or no longer enjoyed cooking or couldn’t read my New Yorker or felt so tired my bones hurt or wondered if I had any friends or ruminated on all the mistakes I made in my life. I didn’t ask for help for all those little things because I did not realize all those little things were big things.

I didn’t tell anyone when I imagined blowing my brains out in the front seat of my car parked on an isolated road somewhere in the Angeles National Forest because I am a mom and moms don’t have those thoughts.

I pretended to be okay because I was so ashamed I was not. I didn’t ask for help until I was drowning and that is way too fucking late to ask for help.

Depression is a beast and an asshole and a tricky little liar. I didn’t realize how depressed I was in part because I didn’t want to and in part because its symptoms are sneaky. It arrives long before I cannot get out of bed and I cannot stop crying. I’ve been dysthymic -low level chronic depression- and anxious most of my life. I’ve spent countless hours in therapy and I am self-aware. I’ve been a clinical social worker, a parent of a kid with depression, an advocate for the mentally ill and for medication. I know depression and its evil twin anxiety are neither failure nor weakness. And still. I was too ashamed to ask for anti-depressant medication. To say, I don’t have enough tools in my toolbox and the weights tied to my feet are making it impossible for me to use the tools I have. I mean, when I found life unbearable I could have just imagined a week in Fiji. Instead, I thought about all the ways I could end my life.

I finally asked for help when my sadness overwhelmed my capacity to get out of bed, to eat, to stop my unprompted flow of tears. I started anti-depressant medication and it is working so I am out of bed and living and resting and drinking lots of water and remembering to eat, taking it one day at a time, trusting I will get though it. But this is why too many of us don’t make it. Knowing you need help is hard, asking for it harder, getting it often hardest of all. My cousin is a psychiatrist, so I could bypass the entire health care system, but if I hadn’t had that access?

If I hadn’t had that access I would have had to get an appointment with my primary care physician, get a referral to a psychiatrist, get an appointment, and waited for preauthorization for the medication he prescribed. That process is days if not weeks, and that’s with good health insurance. That is too long, too complicated and too dangerous. We must treat mental illness as we do any other illness. Sometimes it needs urgent care.

The only way we will change the way mental health is perceived and addressed is by sharing our stories and courageously crawling out from the shame we hide beneath. I had friends -and my daughter who has lived with depression for years- to talk me though the first darkest days, to tell me it will pass, to remind me to be gentle, to validate my experience, to make me laugh. They have been open about their illness so I knew I could turn to them. If they hadn’t been? I don’t know. But their openness helped me so maybe mine will help you.

I have depression, I am in a major depressive episode, and I am not ashamed. You will see me looking cute at the market and on a date with my husband and out with friends because depression does not look like you think it does. It lays you flat and sinks you down and lets you laugh and be beautiful and that is why it is so challenging to understand.

If someone you know is struggling, reach out and reach in, they may be too far below the surface to see your light. And if it is you, listless and sinking, cry out, someone will hear you.

And share your story. Together we will end the stigma and save ourselves.

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