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A Conversation about Mental Illness and Stigma

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Having Depression is NOT a Choice – This is Why

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I saw this on Twitter and read it about a dozen times. I thought, “this is me, this is what it’s been like during too many major depressive episodes over the past 5 years.” I shared it on Facebook and realized that simply sharing it only reaches a very small group of people. This scares people. This is honest and open. This is scary. But the part that is missing are the answers. I want to share my answers, my experience, my reality. Personal experiences are the missing link in order to gain understanding about those suffering with what can be a debilitating illness.

1. How would it feel to wake up and not having the emotional strength to face people?
I’ll tell you how it feels. I have felt it on and off over the past 5 years. It is daunting, sometimes an insurmountable goal that you know you can’t reach. I would get myself going on certain days, like days I would see my therapist and the days I work. It is not easy. I have worked in retail for the past 2 1/2 years and people is what it’s about. My mask is sometimes put up and while it has slid off at times, I have always done my best. At times, I choose not to go to synagogue with my husband and our daughter. It’s sometimes been too scary to bring my daughter to a friend’s birthday party. It can be exhausting.

2. To think that time is passing by with no reason?
I felt that strongly today. I had a session with my therapist where I felt misunderstood. While she meant well, it felt as if she were trying to convince me to see things realistically in order to not beat up on myself. I felt my feelings were not being heard. After that, the rest of the day felt odd and I am not even sure how time has actually passed.

3. To feel so alone even when you are sitting in a room full of people?

This is why I have stayed away from people when I have been depressed. Feeling alone when you are alone is one thing, but feeling alone while in a room full of people, even close friends, does not always make a difference. It is a terrible feeling.

4. To have to put on a face and hide your feelings because in your mind you think no one would care anyway?

This is almost automatic for me when I am in a depressive episode, unfortunately. I think to myself that I don’t want to burden my friends any more than I already have. There have been times I have asked my past 2 therapists over these past years, why do people care about me? Their responses were the same: a list of my attributes, reasons why people like me, love me, care about me. Sometimes I believed them, but others I didn’t.

5. To lose friends because you can’t find the strength to go out and you can’t physically be ‘happy’?

Fortunately, I have not lost one friend due to my illness. I don’t know what the odds are of that, but I am aware that it is not necessarily usual. I have heard from others, very sad stories of dear friends who literally disappeared on them because of their mental illness. 

6. To cry yourself to sleep, hoping that tomorrow will be a better day, then when you do try you are exhausted from the night before, and it all starts again?

This may sadden many, but there have been many nights I have cried just as I fall asleep over the past 5 years at the times I have been depressed. I pray for a better day, that I will wake up a bit refreshed and feel better able to tackle whatever the new day brings. The fatigue that my depression causes is the enemy of this hope on some days. It has taunted and paralyzed me. This cycle is more than exhausting, in terms of physically feeling tired, it is emotionally draining as well. This combination can be depleting and debilitating.

7. You try to hide your feelings hoping no one would notice, and more.

This is also a challenge, yet something I can do well, at times. When I am anxious, I can talk a lot. People then believe I am feeling better or well, when what is really happening is that I am not feeling great but masking it with my anxiety. I am actually not always aware I am doing it until I feel my heart beating a bit faster than usual.

8. Now tell me why someone would choose that?

This is truly the million dollar question. Would any of you choose any of this, as well as all of the treatments I have endure(d): therapy 3x per week, medication trials, ECT (Electroconvulsive Therapy), TMS (Transcranial Magnetic Stimulation), ketamine infusions and psychiatric hospitalizations? Any aspect of my experience mentioned above? I can’t imagine so.

Depression is an illness, not a choice.

Saying it is a choice is the largest form of stigma I can think of. It’s cruel. I would move mountains and do anything possible to be rid of my depression, anxiety and OCD. I have tried and will continue to try. To say I would choose to have these illnesses is shortsighted and ludicrous.

I have said this before:

My mental illness is treatment resistant, but erasing stigma doesn’t have to be.

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The Sound of Silence

I wear one several times a week and I hear nothing. I walk miles each day wearing it, passing many people and I hear nothing but the vast noise in my own head: my OCD thoughts and never-ending emotional worry. I try to focus on listening to the music through my ear buds, my 90s favorites. As I walk, I receive some smiles, friendly “hellos,” but otherwise silence. It’s deafening. They walk past, children and adults, and clearly read the message on each one. If eye contact is made, they either look away quickly or look past me almost pretending they never read it at all.
I know my expectations are very high. I want to be stopped, told how great the message is that I am wearing, that it’s so important, but, again, there is only silence. I want so much for people to engage, say something, let me know they get it. I want to hear how glad they are I am promoting such a critical message and fighting the stigma of mental illness.
The reality that faces me, however, is a quiet one. People do not comment on others’ messages on their shirts. I know I have never stopped someone to comment and perhaps it would be weird to do so. My passion gets in my way, at times. I know this and I am not naïve about this. Right now, I am feeling pressure, which ebbs and flows over time and that I have written about in the past. I am feeling the pressure of needing to be louder about my experience with mental illness, with multiple diagnoses and multiple treatments. I feel desperate that people will never get it and this is only added to my worry about the never-ending stigma that is rampant in society. I am so sick of it, of hearing about it, of living it. I am sick of hearing about people who have become outcasts from their own family and friends after a hypomanic episode, a psychotic episode or a depressive episode. We need support from those who know us and love us. Recovery simply cannot work without these people who are vital to our living the best we can. I cannot imagine living my life without the support I receive from those who have always loved and cared about me, during the difficult times as well as the better times. 
So, I am angry. I am fighting. I don’t really care when someone says, “I am so OCD about…”I simply hope s/he knows or is willing to learn about the reality of someone who lives with the real OCD. I don’t care when someone says, “I am having a bad day and I’m sooo depressed.” Again, I hope s/he can learn what it is like for someone who is living in a major depressive episode. I do care when someone says, “My husband and I had a fight about the laundry and I just want to kill myself because I am so annoyed.” I care because that person had an argument, which we all have with our spouse, but doesn’t mean she truly wants to kill herself as a result of that argument. She is using it as normal everyday jargon and that upsets me. Again, I know I have those high expectations of people, but saying that in front of someone you know has struggled with mental illness and/or has been suicidal or even a complete stranger, immediately stigmatizes not only that person but the term itself. 
September is Suicide Prevention Month and it is imperative that we educate one another, share stories and experiences and support those who are struggling and have struggled. You never know what another is going through unless s/he tells you, but even then, we never share every single thing that we experience. No one does. 
When my 8 year old daughter is angry, I ask her to talk and communicate about it and that is what I am doing here. I want people to say something, smile, give a thumbs up…anything to let me know they get it. So comment when someone is wearing any shirt that supports any illness or cause. We wear it for a reason.
My depression is treatment resistant, but erasing stigma doesn’t have to be.