I was recently at a dinner with two friends, when we began discussing mental illness and mental health treatment.
All three of us have openly had periods of struggle with both depression and anxiety, but we all had very different takes on treatment, particularly in regards to antidepressants.
“I wouldn’t go on them,” said the first friend.
“I would go on them, but just until I feel better,” said the second.
My take was the opposite: I have been taking antidepressants on and off my entire life, and since deciding to take them consistently nearly three years ago, my life has turned around. I plan to be on them forever.
Conversations like this are not uncommon. When it comes to mental health issues, opinions are often polarized and strongly held.
I understand that antidepressants are not for everyone; many people are fortunate in not suffering from mental illness, and even many of those who do would prefer to have medication be their last resort.
For me, medication is a part of a more comprehensive treatment plan to avoid falling back into the throes of the major depression that I know always lingers beneath the surface of my delicately balanced equilibrium.
I remember what it feels like to be unwell.
For as far as my memory extends, I recall always feeling a haunting sadness, a darkness that seemed ever-present, as if it lived in my marrow.
Of course, there were times when the depression was more prevalent than others, but –- nonetheless ― it was always there.
I compare the onset of a particularly heavy spell of depression to a thick fog that moved through my veins and took refuge in my skeletal cavity; I felt weighed down and trapped, a hostage to my own mind.
I remember days, weeks and months where it felt like I was separated from life by a sheet of Plexiglas; I could see what was going on and (mostly) keep up with the world, but everything felt muffled and blurry. The worst depression is not sadness; it is numbness, a haunting apathy and hopelessness. When you fall to that place, it is nothing except empty darkness.
Though I could always feel it, my depression was not always easy to see from the outside. To a maniacal degree, I always pushed myself to excel.
I was high school valedictorian. I was class president. I had many friends. I graduated from Brown University. I held several jobs and showed up and did my work.
Perhaps, on paper, I don’t match the stereotypical image of what one may think it looks like to have a mental illness. Yet without a doubt; I know I am mentally ill.
Yes, that’s right: I am mentally ill.
I am not sad. I am not going through a phase that I will outgrow; I have major depressive disorder. No matter how happy I am, how many of my goals I achieve, I know I will always have depression. I do not mean that to be defeatist, I mean it to be pragmatic. My depression is manageable. If I take antidepressants, go to therapy, exercise and abstain from drugs and alcohol, then I am not only able to function, I am able to thrive.
“I am not sad. I am not going through a phase that I will outgrow; I have major depressive disorder.”
But on the flip side, if I do not pay attention to my mental health, if I do not do what I need to do, I am aware of where my emotional health can go. Again: It is a very dark place.
I know because I have been there. I spent so many years denying that I was depressed. I spent so many years resisting therapy and medication. I believed they were punitive, or unnecessary. I thought it was unfair that I had to go through such measures to create a stable emotional baseline, where most of my friends just naturally found themselves there.
That period of my life was turbulent. It can be defined by suicide attempts and drug and alcohol abuse; by eating disorders and emotionally paralyzing spells of depression; by dysfunctional relationships and general despair. I have had my life commandeered, and almost taken, by my mental illness.
I know so many others have, as well.
Though I am not afraid to admit that I am mentally ill, I understand why people are: Mental illness is still stigmatized. Nationally, we mostly speak about mental illness in the wake of mass shootings, or after suicides. Historically, when people suffered from mental illness, they were shipped off to devastating institutions. As a result, people might worry that they’d lose jobs, friendship or romantic relationships if they were honest about their mental health issues.
“Though I am not afraid to admit that I am mentally ill, I understand why people are: Mental illness is still stigmatized.”
Mental illness should not just be spoken about in these contexts. It should be spoken about all of the time.
Mental illness is common: According to the National Alliance on Mental Illness, “One in 5 adults experiences a mental health condition every year. One in 17 lives with a serious mental illness such as schizophrenia or bipolar disorder.”
One of the worst parts of mental illness is this idea of isolation and silent suffering, the belief that your feelings and behaviors are wrong, that they must be hidden and denied.
The only way we are going to make the mental health system better is if all we all start having honest dialogues about what we, or our loved ones, need to be healthy.
Therapy and medications are not punishments, and they are not luxuries either. For many people, they are necessary for survival ― and certainly necessary for having a high quality of life.
Mental illness should be treated like physical illness; there is nothing in it to be ashamed about. You should not have to share it if you are diagnosed, but you should not feel like you have to hide it either.
Everyone who suffers from it experiences diverse symptoms, and everyone will respond differently to varying treatment methods and approaches, as well.
One thing is for certain: Having a mental illness does not make you weak, and it does not make you a bad or dangerous person.
“Having a mental illness does not make you weak, and it does not make you a bad or dangerous person.”
It makes you a person with a unique set of challenges, but they involve obstacles that can be worked through, and ― if not completely overcome ― then at least controlled.
You can be happy, and you can be free, but it takes work, commitment and self-honesty.
As a society, it takes reform; we need increased access to affordable quality mental health care, and we need to change the way we perceive and approach mental illness and mental health treatment.
As we approach a presidential election, when we often talk about health care and reform of the health industry, in general, we need to make mental health care a prominent part of that conversation.
We have come too far to have people silently suffering. We have come too far to have people feel alone.
I hope that conversations like the one I had with my friends become more common; that – even if uncomfortable initially – mental illness becomes a conversation that can be had at a dinner table.
Change can only come once taboo is removed; progress can only be made once people feel comfortable being honest.
This essay is included in Seamus Kirst’s memoir, Shitfaced: Musings of a Former Drunk.
A version of this post originally appeared on the author’s blog,www.seamuskirst.com
If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.