I spent my junior and senior years of high school in boarding school, and when we got sick, the staff seemed more worried about weeding out fakers than ministering to the stricken. It wasn’t Lowood Institution, but our RAs’ first concern, upon hearing anyone declare herself too sick to go to class, was to ensure that the sufferer did not leave her room for the entire day. (Remember, guys, this was the year 2000: most of us didn’t even have a cell phone. Computers were bulky desktop machines in the computer lab. Facebook and Netflix did not exist.)
But we girls took care of each other.
I remember when the flu really knocked me on my ass that first year away from home. I was so feverish that the first lonely day passed in a haze. That evening, I was vaguely aware of a few of my friends, tiptoeing in and out of the room one after the other.
In the morning, I saw a stack of plastic take-out containers on my dresser. At least three or four different girls on my hall, after eating their own dinners, carried something back for me.
Sometimes it’s easy to know what to do when somebody’s in trouble, and easy to do it, but sometimes it’s hard, depending on what gets to you. I’ve cared for many family members, including one laid low in the hospital with an infection, a broken back, and a serious opiate intolerance. Staying calm and getting someone’s bedpan into place while they’re also splashing you with vomit is quite a feat (the fact that I haven’t actually thrown up since the year 2003 may tell you something about my aversion to puke).
Caring for other people, no matter how much you love them, can be a herculean task, even if it’s a temporary physical illness.
But have you tried coping with someone else’s mental illness?
I haven’t. Not really. That’s because I’m the one who has a mega mood disorder, wondering if there’s anyone out there who can cope with me. I loved the friends who brought me dinner when I had the flu in high school. But that’s not a scary thing to do. What is scary, I have deduced, is watching somebody slip into the clutches of a serious depressive episode.
A few years ago, glum statistics about the recurrence of depression were all the rage, but I recently saw a hopeful headline through the Facebook group Come Out of The Dark, a growing movement to de-stigmatize mental illness (I interviewed founding author Jonathan Rottenberg about depression here, here, and here): apparently, 50 percent of people who suffer one depressive episode never have another one.
Unfortunately, I’m in the other 50 percent. I’ve written a lot about depression over the past year, (including my motion to outlaw the phrase “that’s just the depression talking”). Until quite recently, despite a stay in a Johns Hopkins psych ward (listen to the radio story here), I believed that my depression was a rotten element of my life, but that it was your garden-variety mood disorder. I thought most of my therapist’s depressive clients must have symptoms of the same severity that I experience.
I was wrong. Shit’s getting scary.
Though I’m social, functional, and extremely productive at work, I almost always feel unhappy. But a couple times a year, things get really bad. At first, I can sense them sliding as surely as you can feel the rawness in your throat and the heaviness behind your eyebrows that means you’re getting a cold. I can’t seem to control this any more than I can control a rhinovirus teeming in my mucous membranes.
The first signs of a bad episode can hit several days before the crisis. They include a marked loss of interest in leaving the house and talking to others, and a growing sense that I need to isolate myself. My colleagues and probably my friends will notice nothing wrong because I pretend I feel fine while working. But my family may begin to call or e-mail to ask why I haven’t been in touch. My appetite shrinks, or I don’t have the energy to make meals. I can’t bear the silence when I turn my music off. I can’t sleep. I have trouble taking notes during interviews. I can’t plan the structure of an article before sitting down to it, and struggle through it graf by graf.
Like a person trying to head off a cold with vitamin C fizzers, I fight back. I sit by windows to soak in the sun. I get myself out of the house for some exercise. I bury myself in work or distract myself by reading or cooking or drawing or painting.
If I’m alone and mentally unoccupied for more than a few minutes, I begin to cry.
A writer’s life is measured in deadlines. I published 23 articles in January. About ten days ago, between the 19th and the 20th article, I felt something slip.
On Monday night, I couldn’t sleep until three or four AM.
On Tuesday night, I sat up very late on the couch holding a novel but thinking long and deep about the method and practicalities of my own death. I got into bed but couldn’t sleep until it was almost dawn.
On Wednesday morning I began to cry while I brushed my teeth.
I went to my desk and worked on an article about tax credits for graphene-powered diagnostics research until the pain in my back was so bad I couldn’t sit or stand. I lay down in bed at about 2pm with my laptop. Soaking, crushing sobs began to roll over me. I had a powerful urge to hurt myself and fought off the desperate sense that I should keep others away. I messaged a friend who had supported me in bad times before. My most torturous thoughts poured out. I apologized, but my friend told me not to. I asked if we could get together the next day, and my friend said yes. I felt a little better. An hour or two later, the friend revoked the invitation. I’m not your therapist, the person said. I’m still your friend. But I need a break.
Small words, and valid. But they broke something in me that was bigger than the friendship: the sense that I could get help if I truly needed it. The sense that my life was worth the ask.
“I don’t know what to do,” my then-husband said, over and over again, when he came home from work and found me sitting in bed a few hours later, drenched in tears, rocking and struggling for breath, my face in my hands.
At this age, if the Facebook feed is any indication, I should have kids of my own. Instead, my ex called my mother for help. An hour or two later I calmed down enough to talk to her on the phone. Later I gathered my courage, and texted another friend, who answered with kindness.
Here’s the flip side of the Come Out of the Dark campaign. It’s not just a matter of finding your own mettle to speak up. To come out of the dark, you need someone who can handle it when you stop pretending, and there’s nothing but incoherent crying, panicked, circular irrationalities, and the stark toxic reality of a potential suicide.
The truth is that very few people know what to do.
In those bad stretches, I don’t share my real state of mind with many people. I have found a degree of kindness and support, but sometimes, when I try to explain my worst feelings, I’ve been called selfish, crazy and oversensitive. People have suggested I don’t want to get better. They have withdrawn when I was suffering most.
On Wednesday night, I took a few sleeping pills and waited for unconsciousness. On Thursday morning, I kept waking up and dredging myself back to sleep because I couldn’t face the day. My stomach felt sick but I tried to eat a piece of leftover quiche. I managed about half of it.
I brought my laptop to the couch and stared at my e-mails for an hour or two, tears rolling down my face. I settled on Monday as the definite date for my suicide.
I got through the rest of the day by breaking it into hours and telling myself I had to live only one hour at a time. I reminded myself to breathe. I worked on my assignments, making calls as if nothing was wrong. I spoke to my therapist on the phone.
She said she’d call me every day to check on me.
“I’m sure your practice is full of people just like me,” I said. “You can’t be talking to them all every day. That’s no way to run a business, or your life.”
She replied I was the only one of her patients who is suicidal right now.
On Thursday night, the friend I’d texted called me to see how I was doing. We made plans to get together on Saturday.
On Friday, I came back to myself enough to notice the signs of my slide around the house. A big pile of dirty laundry. An uneaten loaf of my favorite bread. A mug I had filled with tissues while crying at my desk.
My therapist called.
God, I was thirsty. I gulped glass after glass of water but I was still thirsty. When was the last time I had had a glass of water? Tuesday?
On Saturday morning in the shower, I sang a few words of the Weezer song that came on my Pandora station. My voice was weak.
I had two eggs for breakfast.
My therapist called.
My friend drove for an hour to take a walk with me. I was so grateful I almost cried. I suddenly remembered that during a very bad episode from last spring, the same friend had driven three hours each way to visit me. My mind had gone so far underground at the time that I had forgotten the visit.
On Saturday night, after I turned out the light, an essay began to clang in my head. It kept me awake for hours. I realized I might live.
I fell asleep and dreamed I was zipping east in center city Philadelphia on the south side of Market Street on a skateboard, riding it with my left foot and kicking the ground with my right.
On Sunday morning, I decided that before I could write the essay, I had to finish a magazine feature that was due later in the week.
I wrote the feature.
I got hungry and ate some leftovers.
My therapist called.
I was just about to write something about “the week ahead,” but realized all I can do is re-adjust to the fact that next week exists for me.
I dread it. But I won’t prevent myself from living it.
That’s how the crisis winds down. Not in comfort, happiness, or relief. Just life, continued. Tears still come in brief, hot squalls, because I dread the next crisis. Since I’m still alive, I wrote six more articles (not including the magazine feature). Seven, including this piece. I’ll write another tomorrow. I did the laundry.
I got the flu again in my freshman year of college. I lay in my bed in the dorm overnight, baking and shivering. My temperature neared 104 degrees.
A school nurse visited my room for the next few days. She was worried about pneumonia, but she knew what to do, like the friends who brought me meals.
Now, another health practitioner insists on checking on me every day. I had assumed my state of mind was common among her patients. It’s not. And the people I love don’t know what to do.
It forces me to face the severity of my depression. The realness and risk of it. I’m shaken by an odd sort of grief, beyond the usual tumult and exhaustion of these cycles: I scare people. Even people who care about me. And even when someone does come through for me, my state of mind may temporarily be so altered that I don’t remember it. Great incentive to make an effort, huh folks?
So I don’t blame anyone for wanting distance from my problems, or saying painful things, any more than my relative could’ve blamed me for not being able to heal her broken back, that day in the hospital.
But if more people could see depression as a problem that is as serious, frightening, and tangible as pneumonia or broken bones, maybe facing a virulent death wish on my own wouldn’t be just as terrifying as trying to tell someone else about it. After trying to communicate the depth of my distress, I feel as helpless and ashamed as if I’ve thrown up all over the unfortunate person in my way.
For now, all I can do is wait, and work, keep on top of the laundry, stay in therapy, and hope I can make it through the next slide. Why tell the story? Partly because that’s how I process and survive. And partly because every time I write about depression, I hear from others in the same boat. And we all feel a little less alone, and make it for another day.
To read about the responses to this essay, click here.