I struggled with depression for seven years before I was put on medication. Part of this delay was because the first time I tried counseling, the nice lady at my college health center listened for a minute and then said, “Well, it sounds like you have a lot to be grateful for.” Part of it was because my family, like so many others, didn’t talk about mental health much. Part of it was because even though I knew I was sad, I didn’t know I was sick.
Mental illness has been stigmatized for centuries. Evil spirits, hysteria, witchcraft, divine retribution – you name it, mental illness is attributed to it. But in recent decades, our culture has consciously pushed many of these stigmas aside. Millennials And Generation Zers are clearly more open about their mental health than previous generations. We tend to understand that anyone can struggle emotionally. We don’t pathologize, we normalize. We don’t labelwe look at it holistically. We don’t call people ‘mentally ill’, we refer to their ‘mental health issues’, ‘challenges’ or ‘struggles’.
In almost every way this is a wonderful triumph of modernity, but in one very important way it doesn’t work for me.
My depression started in my second year of college, with prolonged periods of darkness, lethargy, and despair. However, these attacks, I told myself, could easily be explained indirectly. I am an intoxicating person who made intoxicating friends and had intoxicating conversations. I studied English, which meant constant analysis and revision – skills that became so common in the classroom that they began to infiltrate my daily life – and a healthy dose of Kafka, which can draw the sunniest person to the depths of despair. I went to a fancy college that often felt like an indulgence, creating feelings of guilt and confusion. After my visit to the campus counseling center, I also felt ashamed for not being grateful enough for my blessings. Put it all together and it was no surprise that I was sad.
My depression deepened in senior year, which seemed logical: seniors are often daunted by the future, afraid of the “real world,” or torn by relationships in college.
As my periods of darkness continued after college, part of me began to wonder if they had a name, but there were so many people—including friends—who Actually struggled with depression. I wasn’t sure if what I was experiencing qualified for that. I told myself I was just an intense person in my twenties trying to figure life out. My therapist seemed to agree. She used diagnostic words to describe temporary situations – “a time of depression, a moment of anxiety” – as if they were experiences that occurred in isolation and could be overcome by changing my mindset and using problem-solving skills.
In 2020, these ‘experiences’ hit me harder. I moved to Los Angeles in June, started teaching high school, and started attending graduate school online. In the midst of all these transitions, there were days when I couldn’t get off the couch and days when I cried for no reason. Still I said to myself: everyone was sad during lockdown, so of course I was too! But when my grief didn’t subside for months, I began to suspect that what I was feeling wasn’t something everyone was going through.
During the summer of 2021, at a particularly low time, I cried to my then-boyfriend, now husband. “What’s happening to me? What is this?”
“Are depressionHe said as he squeezed my hands gently. “You have depression.”
My sobbing stopped abruptly.
‘Why hasn’t anyone done that? tell me?”
As obvious as it seems looking back, at the time I still wasn’t convinced. The label felt unearned, like a gamble.
Later that summer, during a weekend with friends, I had another epiphany. As we were getting ready for dinner, a friend, M, said she forgot her Zoloft. Another friend, L, offered her a Zoloft from her own stash, but the dose was larger than M’s. Yet another friend offered M a dose her Zoloft, and M, relieved, took two.
I watched this interaction and thought: Wait, all these people are on medication? What about me?
I went home and made an appointment with a psychiatrist.
Between 2021 and 2024 I took my meds and worked with an amazing therapist. I started calling my “low” episodes depression, albeit cautiously and self-consciously. I learned to recognize what caused them—a slowing down of my body, a “greying” feeling in my brain—and to stave off them by taking a break from work, going for a walk, or taking a bath. My friend learned it too, and helped me get outside or put on a good book when I started to feel catatonic.
I left teaching and went back to my first love, writing, and got a little better. I made new friends, spent more time with family and got a little better. My boyfriend and I got engaged, then got married, moved, and started a new job. During this time, I have continued my self-care, therapy, and medication. The freedom and ability to do that was and is not lost on me. I had the flexibility and resources to take work breaks and spend time on hobbies. So many people suffering from depression don’t get what they deserve: the time and support to care for themselves, not to mention access to mental health care or the funding to guarantee it.
Last spring it became busier. I took care of myself less and worked more. I was too dedicated in my new job and was pitching my first novel to agents instead of writing it, so my creative time decreased. I knew it was going downhill, but I didn’t stop. When I felt my body weakening and my brain becoming foggy, I tried to rest and recover, but eventually it all caught up with me.
My family, friends, therapists, husband and I call it ‘what happened in June’, but in plain language I had an experience of suicidality. It came on suddenly and flowed quickly from my mouth like an old song to which I knew all the words: I didn’t want to live anymore.
The days that followed exist in my memory in an endless hallway, locked behind an unmarked door. For my husband they are vibrant and deep-seated, but for me they are weak and distant.
“That’s because you weren’t there,” he says, which is true. I had left my body.
We went to the hospital. My husband took time off from work. My mother flew in. Friends and family sent love and support. The following week I increased my medications and my therapy sessions. Once I was relatively stable, we analyzed what was causing the crisis – work stress, fatigue, isolation – and brainstormed ways to improve it. We structured my days around things that made me happy, or at least kept me from being sad. I worked in the garden. I sat in the sun. I joined a church and a walking club, started writing a new novel, bought a bicycle, saw my friends. I worked less. I called more loved ones. I took my mental health more seriously than ever before because this time I knew it was dangerous. And I got better.
It came back in mid-August, even with my tripled medication and lifestyle changes. One Tuesday morning, as I sat at my desk, I felt it descending – the greyness, the fog, the slowdown. It was as if someone had pressed ‘turn off’.
I was surprised – and frustrated. I was no longer a rambunctious student or a flailing twenty-something. I had worked so hard to unlearn the thought patterns that were letting me down and the lifestyle habits that were draining me. I had worked so hard to be happy.
And yet there I was – unable to get off the couch. Can’t feel happiness.
That day I had a session with one of my therapists. I told her how I felt, and the worries I had that no matter what I did, these days would keep coming – that there was something wrong with me.
“Well, let’s not pathologize it,” she said.
Two days later I met my other therapist. I told her that I still felt down and that I wanted to be normal.
“You Are normal,” she said.
That same day I met with my psychiatrist (I swear, I’m trying, So difficult).
“For someone with your mental health issues,” he said before discussing dosages.
That night I told my husband all that normalize — the not pathologizing – made me feel like my mental health was about my personality, not my brain. As if it were normal who I was – no disease, no disorder, just normal me.
“All I want,” I told him, “is for someone to tell me I am sick.”
I want to pathologize this. I want to call it a disease. I want to know that what is happening to me is not normal. Because if it’s normal? What if nothing is wrong? What I have then is a character flaw, and I will have to keep walking, gardening, and taking care of myself until I determine who I am.
But if I am sick – if I have a mental illness disease, no “problem” or a “challenge” or a “struggle” – then I don’t have to be angry with myself. I don’t need to correct my personality, criticize my emotional range, be a mastermind every day to avoid possible sadness. When my illness flares up, it’s not because I’ve lost the war with my demons, it’s because that’s how my brain works.
Isn’t this the point of destigmatization in the first place? To help people feel less shame, less guilt and less personal responsibility for the way their brains work? I understand that normalizing diverse experiences is an attempt to be supportive, but it is not supportive to gloss over or disguise the very real medical issues people face.
If anyone had taken my episodes seriously – medical — when I first experienced them, I could have gotten better at nineteen. If our culture addressed sadness, worry, and lethargy with more discernment and less fear of offence, we could separate the person from the diagnosis, treat the diagnosis, and let the person be.
I’m doing better now and I plan to keep improving. Part of what has helped is that I am becoming clearer about what is actually wrong with me.
During a recent session, I asked my therapist about my official diagnosis. She pulled out the DSM and we read the types of depression: dysthymia, substance-induced, persistent, etc.
‘But…’ I said, ‘what Are this? Syndromes? Circumstances? Experiences? What is depression?”
She closed the DSM and looked at me. She seemed hesitant, and I wondered – I still wonder – why we are so afraid to use the words.
Finally, she said the three words I’d been waiting for: “It’s a disease.”
Isabelle Stillman is a writer from St. Louis, Missouri, currently based in Long Beach, California. She is the editor of December, a literary magazine, and is currently questioning her first novel.
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