How to Treat Depression and Stop Thinking Like an Idiot

My awkward phase was basically my entire adolescence. When I started junior high, I wore boxy t-shirts and a pair of jeans to school every day. I had gained about twenty pounds of hips in middle school, but not much else was going on in the way of womanly developments, so I still looked like a little girl - with just really big thighs. I had long hair that had once been blonde, but was now some horrible color I was in denial about, and I always kept it back in a ponytail. I had glasses and zits and braces.

And I was obsessed with the idea of going crazy.

I used to talk to my friends about it all the time - though they usually dismissed me pretty quickly. Even the adults in my life (teachers, youth group leaders, parents) didn't seem to be at all interested in the conversation. But I had a question that I was fixated on, and nobody but me ever seemed to care what the answer was.

"People always say," I would start out, "that if you think you might be crazy, you aren't. They insist that insane people have no grasp of reality, and are therefore unaware of their own insanity. And that may be true." Then I would get really eager, leaning forward as I prepared to argue my case. "But what about during the transition? When a person starts off sane and then later becomes insane, there has to be some sort of transitional period during which they retain some sanity. There has to be some horrible period during which they do crazy things, but are aware of it. Where it's like they're watching themselves, unable to stop their behaviors because of the illness descending upon them, but cognizant enough to realize what they're doing."

This is frequently where I lost people, but I was pretty good at pressing forward even after my listener had lost interest. "Can you imagine?" I'd ask. "They would be so powerless! And scared, too, because they never know if they can trust what they perceive to be reality. They could never be sure if what they thought was happening was what was really happening. Wouldn't that be terrifying?" The horror of the idea would swell within me, and I'd become irritated with the dispassion displayed by my audience. So I'd go back to my question and insist, "Well, do you think that happens to people or not? Do you think someone can go crazy and be aware of it?"

Dear 14-Year-Old Self: The answer is yes. It is called depression.

I am not a doctor. And I'm pretty young, and therefore stupid inexperienced in many ways. But I come from a family where clinical depression runs wild and free on both sides, and I've experienced it at least a couple of times myself. And in my experience, a depressive episode feels like going crazy. It feels like losing yourself, as your old interests and hobbies and friends suddenly seem unimportant. As skills and talents you once had now seem inaccessible. As your very personality seems to fade away, lost in impenetrable darkness.

When I first became aware of my family's history of depression - maybe when I was 16 - my main concern was that my mother was going to go crazy. She had always been an inspiration to me, a brilliant woman with many talents and a personality that drew people toward her no matter where we went. But when she went into a depressive episode, she locked herself in her room. She spent days doing nothing at all. She couldn't stand to be around people. It was like she became someone else, like she had gone crazy and lost herself.

And she would come out of it. But sometimes it got really bad. She started to see a therapist around that time - and I, like most people who are uneducated about mental health, assumed that therapists were only for crazy people. I loved my mom, and I still admired her. So at first I tried to ignore that she was seeing a therapist, to pretend it wasn't happening.

A year or so later, though, my mom sat me and my siblings down for a serious conversation in which she confessed that she had been cutting herself. She pulled back the long sleeve of her shirt (somehow, none of us had noticed that she'd been wearing only long-sleeved shirts for months), and I was shocked to see the jagged scars on her wrists, some as thick as pencils. She told us that she hadn't actually been "cutting," but scratching, using her own long nails to make herself bleed, using the physical pain as a relief from the worse pain inside. She told us that she wasn't doing it anymore, and that she wasn't going to do it anymore, and that a lot of that was because of the work she'd done with her therapist. She tried very hard to educate us about mental health, the reality of mental illness, and the importance of taking it seriously and treating it like you would a physical illness.

I listened to her. And I tried to learn the lesson. But I only learned it in my head, just enough to apply it to other people. And that was good; it helped me to extend compassion and understanding instead of ignorant judgment. It made me nicer to other people. But in my heart of hearts, I didn't believe it. Because I'd already started, by then, to sense the void within myself; and though I denied it consciously, subconsciously I knew that I'd inherited whatever genetic flaw it is that makes you go crazy. And while I could forgive others for not being able to control their emotions and their thoughts, I believed that I was better than that. Stronger than that. Even as my mom talked about the importance and the benefits of therapy, of getting medication when you need it, I thought fiercely - I'm never going to go to therapy. And I won't let them lobotomize me with those drugs that are supposed to make me "normal." I am strong. I won't let it get that bad.

Pride is my cardinal sin. And if you hate the teenager-me a little bit, that's okay. I do, too. I was arrogant and closed-minded, and the truth is that in my heart I clearly was still being judgmental about people with mental illness. In my defense, I was 17. And I was very, very frightened.

Because 17 is the age I was when I had my first depressive episode. It was much less intense than this most recent one, but it lasted a lot longer - a slow burn as opposed to a instantaneous inferno. And once that had happened, I stopped worrying so much about my mom going crazy and started worrying about ME going crazy. To the point where watching TV episodes that dealt with insanity started to make me feel anxious. They had the eerie feeling of foreshadowing.

I recovered from that first episode and returned to my normal self - vivacious, intelligent, curious, dynamic, yet inexplicably boyfriendless - and I largely moved on with my life. I was ambitious; I wanted a lot out of life, and I worked hard to get it. I got a full-ride scholarship to college. I moved to St. Petersburg, Russia and taught English for four months as a volunteer teacher. I earned a Bachelor's Degree - something neither of my parents had done. I was successful.

But throughout that period of my life, there would be days when I felt as though there were a ticking time bomb inside of me. My whole life was a game of Russian Roulette, a stroll through the minefields, and I knew that at any moment something could set me off, and I would begin my spiral into insanity.

If you've read any of my previous blog posts, you know that that is exactly what happened. I got a job, and early into it I began to slide into a depressive episode. A massive one. I fought it with everything that I had, determined - as I had always been - that I could keep myself sane if I just fought hard enough. But in the end, having almost completely self-destructed, I finally had to give in. I went to the doctor and to the therapist with an air of defeat, of failure.

But I was an idiot. I was an idiot to think that I could cure myself just by trying hard not to feel sick.

How many people do you know who have fought off cancer by sheer determination?

That's why words like "crazy" and "insane" are problematic. They make us think of weakness, that for someone to lose control of their mind is an embarrassment and a shameful character flaw. BUT IT ISN'T. And that's what I've been learning these past two weeks.

We have control of our minds in the same way that we have control of our bodies - most of the time, we can tell them what to do; we can decide what they intake; we can manage their health. But sometimes you get hit by a car, and then your legs don't do what you tell them to anymore. Sometimes you are born to a woman with a drug addiction, and her chemicals end up inside of your body, poisoning you against your will. Sometimes your appendix ruptures for no apparent reason, and you have to be rushed to the hospital so the doctors can save your life.

We think we have control of our bodies, but that isn't always true. And when it isn't true, it's not because we did something bad or we're inherently weak. Sometimes it's because of our own choices, but sometimes it's because of the choices of others, or random happenstance, or unforeseen complications, or simple genetic vulnerability - you don't think less of a person who is allergic to peanuts!

The same principle applies to our minds. We have control of our minds sometimes, but not all the time. And when we don't, it's not because we did something bad or we're inherently weak. Sometimes you get hit by a terrible tragedy. Sometimes you are born into a family where you are beaten and unloved. Sometimes you start crying for no reason and you can't stop until they rush you to the hospital so the doctors can save your life.

I am not allergic to peanuts. My vulnerability is that I am prone to depressive episodes.

It is not something I chose. It is not something that I brought upon myself. It was written into my genetic code at birth. And most of the time it doesn't affect my life; but sometimes something happens, and I get really sick. And then I have to go to the doctor.

The doctor analyzes my symptoms and recognizes that I am experiencing an imbalance of chemicals that is causing nausea, fatigue, and an inability to focus. He gives me a diagnosis and writes me a prescription so that I can fight off the illness and become well again. Because that's why we invented medicine.

The pharmacists give me two bottles of pills, each with instructions written on them. I take them home and put them in my little pill box organizer - one box for every day of the week. Every morning, I roll over to my nightstand and pull out my water bottle and three pills for the day - a red one for depression, a blue one for anxiety, and a white one for my hay fever. (Because I do have some allergies.)

And every once in a while I go to a therapist. When I'm there, he talks to me so we can figure out how I was exposed to whatever it was that triggered this episode. We talk about ways to avoid potential "allergens" in the future. And he teaches me things that I can do in a moment of crisis - things like breathing and mental exercises - giving me the mental equivalent of an EpiPen.

And what kind of person would you expect to walk around without an EpiPen when they know they're allergic to peanuts?

I'm not sure if I've made any sense at all here. Wandering from junior high to a metaphor about EpiPens seems a little meandering, but I find that many of my journeys are less direct than I expect them to be. My main point is this:

I am feeling better. Amazingly better. And I'm even feeling better about feeling better, so all kinds of good things are going on. And as I've been recovering, I've been realizing what an idiot I was about mental health before this happened - not because I'm a stupid person, but just because I hadn't learned it yet. Well, now I'm learning it. So I'm also sharing it.

Mental illness is as real as physical illness. And it can be treated, just like physical illness can be treated. We need to let go of whatever stupid hang-ups we have over words like "crazy" and "insane," and we need to start encouraging people to go to the doctor when they need to. If it's your friend, or your family member, or an acquaintance, or YOU, don't over-complicate things.

When you get sick, go to the doctor.

And let it be as simple as that.