Tuesday, September 10, 2013

Depression is not a dirty word.

Fair warning, this is a long, serious, and intensely personal post.

Did you know that today, September 10th, is World Suicide Prevention Day?

Per the International Association for Suicide Prevention: Suicide is one of the leading causes of death in the world, especially among young people. Nearly one million people worldwide die by suicide each year. This corresponds to one death by suicide every 40 seconds. The number of lives lost each year through suicide exceeds the number of deaths due to homicide and war combined. 

My life was affected by suicide from an early age. My fourth grade teacher at a private school in California's San Fernando Valley took her life during the school year. A close classmate from the public school I attended in 5th and 6th grade took her life in 7th grade after I had moved away. A boy I knew in middle school killed himself. A close friend in the 7th and 8th grade attempted suicide, and my mom took me to visit him at the hospital a few hours from our house. A high school boyfriend's mother repeatedly attempted suicide, and was confined to a mental health institution several times during our relationship. Just typing these few sentences brings new waves of grief and even anger over the loss and near loss of these precious people. I look at my 5th grade and 7th grade sons, and realize that by the time I was their age, I was already quite intimate with loss from suicide.

This year's theme for World Suicide Prevention Day is "Stigma: A Major Barrier to Suicide Prevention." An organization I support phrased it more simply, Challenging Stigma. In researching more about what that means, I read that because of the stigma surrounding mental illnesses, people who most need help will often not seek it. A significant number of the people who die by suicide suffer from mental illness, which includes depression. One quote on the IASP site was quite sobering, "Many health professionals who feel uncomfortable dealing with persons struggling with mental illnesses or suicidal ideation often hold negative, prejudicial attitudes about such patients. This can result in a failure to provide optimal care and support for persons in crisis." So the stigma of mental illness doesn't just come from the community, it's coming from people within the medical health professions. Pardon my saying so, but this is very depressing!

Per a quick search, a stigma is a mark of disgrace associated with a particular circumstance, quality, or person. And of course, the dictionary gives an example (which could not be more pertinent to the point of this post), example: the stigma of mental disorder. So how are stigmas dealt with? According to the IASP, they must be confronted and challenged so they won't continue to be a major barrier to the treatment of mental illness and the prevention of suicide.

In doing a quick check of Google stats on this blog, I have about 300 people throughout the world who stop by to read every day. (Whoa, really? Hello!). That isn't as huge a platform as many other blogs, but I'm using what I've got.

Allow me to get really personal and let's confront and challenge the stigma of one type of mental illness, depression.

In late 2005, our family moved from Hong Kong to Los Angeles. The project my husband had been working on had ended, and instead of pursuing more opportunities abroad, we decided to be good parents and settle in for the long run in one place so our children would have the kind of stability which comes from not moving around the world every 9-12 months. Michael started seeking out a job which wasn't directly related to live entertainment (because face it, entertainment doesn't scream family friendly) and I joined the PTA and volunteered to work in Nathan's kindergarten classroom once a month. We started looking at houses to buy, thinking that was a stable and responsible move, something stable and responsible people do. And then something weird happened.

I've suffered from insomnia my entire life. It takes me hours and hours to fall asleep, if I ever do. Even as a tiny kid, my parents would put me to bed a full hour before my little brother because it took me so much longer to fall asleep. So that's the norm for me. But during this time period after Hong Kong, I found I was sleeping all the time. And despite all this extra sleep, I could never get enough of it. I would wake up in the morning to get Nathan ready for school, drive him over, then come back to the house where I'd spread a blanket of toys on the floor for Benjamin to play with while I'd curl up behind him and fall asleep. I had an alarm set on my phone to remind me to go pick up Nathan, and almost every day I would remain sleeping until that alarm went off. I'd go get him and return home, then put Ben down for a nap. Half the time I would crawl into bed beside him because I was so tired, despite having slept the day away. After preparing dinner which I could barely bring myself to eat, I'd leave the boys' bedtime routine to Michael because I was yawning so hard. I'd excuse myself, get in my jammies, and suddenly it was morning again and I'd have to drag myself out of bed, fighting the overwhelming and persistent fatigue with all I had.

At first, I dismissed it as jet lag. And then reverse culture shock from being back in America (something I experienced greatly after living in Japan). After about six weeks I was still sleeping for about 18 hours of any 24 hour period. While I felt no sense of alarm, Michael was growing concerned. In the few hours of the day when I was actually awake, I noticed a strong sense of being emotionally numb and distant (which explains why I wasn't alarmed). When Benjamin would cry, I would look at him and feel no connection whatsoever. He could have been any kid, or even an inanimate object. When Nathan would get home and want to snuggle, he himself would wrap my arms around him and I'd look at them, puzzled, like they weren't a part of me. More like a photograph of a mother holding her son than something I was engaged in. 

In a dreamy manner, I mentioned to Michael how I didn't feel like I was actually there at all, that I was just a hologram. And that everything seemed remarkably drained of color. This really bothered him. Thinking there was some physical illness, Michael dragged me to the doctor for a full check up. Every panel and test was run and it all came back perfectly normal. Michael expressed his concerns, and the doctor asked if I wanted to hurt myself. I thought that was a silly question, for I didn't have the physical or mental energy to even think of harming myself. All I wanted was to fall asleep for a really, really long time. And maybe, if I was really honest, to stop existing. But not to do anything so concrete as die, and certainly not at my own hands.

I left with a diagnosis of depression, a prescription for antidepressants, and an appointment with a therapist. Because I was so numb and removed from myself, I felt no shame at sharing these facts with my family and friends. I wasn't aware that depression and mental illness can provoke extremely strong reactions in people, and many people hold on to hurtful opinions which they aren't afraid to share.  

My parents, I believe, were quite broken hearted that I was taking medication for depression. Part of this is generational. But we are also a strong family who pull ourselves up and move on in the face of adversity. Medicating symptoms away instead of just getting over it felt like an inexcusable weakness. Our family has dealt with everything from teen pregnancy to Hatfield & McCoy-type feuds with gun-toting neighbors and taken it all in stride, even sharing laughter. But me being formally diagnosed and treated for depression nearly unglued everything.

We belonged to a community of faith, and when I spread the word there, I was told by many people, quite unhelpfully, that it was my own fault. It was all in my head. I'd brought it on myself through something I'd done. Or hadn't done. People who would bring over a casserole if you had a hint of a physical ailment were quite condemning of a mental one.

Well meaning friends would tell me I just needed to exercise or eat better or take supplements or just get over myself. I was told if I wanted to get better I simply needed to act as if I was better and move on. I struggled to put my numbness and inability to do anything into words they could understand. The closest description of my predicament: if I was sitting down and knew all I had to do to be fully and forever cured was stand up, I still couldn't do it. The chains and locks of depression kept me tightly bound in that chair.

At the same time, other people in my life who had struggled with depression and mental illness came out and shared their stories. Some with tears of relief running down their faces, like an older man also in our community of faith who had hid his diagnosis for years. Some people, like my in laws, didn't understand what was wrong, but without judgment stepped up in a physical way by taking Nathan to school or making dinner when the pull of my bed or the couch was too strong to resist on yet another day. Other people showed curiosity and asked me lots of questions and really tried to see it from my point of view rather than immediately condemning me.

The medication helped. I started eating again, and packed on a significant and shocking amount of weight. But I saw that after so much numbness, the fact that I actually cared about the weight was a positive sign. The talk therapy actually helped me see that there had been other periods in my life where I had been suffering from depression, though in far milder states. I found out my larger, far extended family has a rarely-discussed history of mental illness, which completely explained my parents' broken-hearted attitude toward their daughter's depression. I am curious, creative, and artistic with a melancholy personality which gravitates toward the dramatic. Science has shown there is a correlation between depression and people who share those traits. There is no blame, no one at fault.

After a year of treatment, I had improved so much I actually felt like the antidepressants were holding me down. Together with my doctor, I tapered off the medicine. I have seen the occasional counselor in the years since. I have carefully learned the difference between a healthy sad reaction or a big life change, and one that requires intervention. I am very careful not to engage in self-destructive behavior and thought patterns, and I completely abstain from alcohol and anything else which artificially changes your mood. I exercise, express myself creatively, and take stock of my feelings regularly.

Following my little tumble down the rabbit hole of depression, Michael and I realized buying a house and staying in one place f o r e v e r is a perfectly stable and responsible thing to do for some people. It is not the right thing for everyone. Especially someone like me, who thrives on change and adventure. Every day I encourage people to follow their dreams. After experiencing the crazy yet exciting challenges of living and thriving in Japan and Hong Kong, the idea of purposely and intentionally choosing to never live abroad again and to settle into a life I clearly wasn't made for was too much for my mind to handle. It just shut down. Michael decided to continue pursuing his passion, opportunities in entertainment, and simply knowing we were following our dreams instead of trying to fit into a box not made for us made a huge difference in my mental state.

Though never mentioned here on the blog, depression is something I'm never shy about discussing in real life. I do care about what people think about me, but perhaps not enough to change my open and honest personality. The more I talk about it, the more people share about their own experiences, and together we fight the stigma of depression. The expat community is filled with people taking antidepressants and anti-anxiety medications. This kind of life can take a lot out of you. I had a recent extremely frightening experience here in Shanghai, and no less than three people quietly stepped forward to offer me a Xanax from their personal stash. They were all people who I look at and think they have their act completely together. It can happen to anyone.

My motivation for finally putting this out in cyberspace is someone very precious to me who struggles daily with a vicious form of depression and constant suicidal thoughts. This person has come up against an unspeakable amount of stigma in battling this issue. For two years I've watched this person and knew I needed to write this. The fire that finally got me to sit down and put the words out there are the many recent headlines involving high profile people taking their own lives. Being a wealthy and successful movie producer or the son of a world famous protestant minister does not put you out of the reach of depression or mental health issues.

In all cases, including my own, people feel terribly alone and isolated in their suffering, which can allow that depression to sink its claws in even deeper. I wanted to use this small platform to be able to say if you suffer from depression or other mental illness, you are not alone. And if you are someone who blessedly does not suffer from these things, please look around you and realize someone in your life probably does. And that your actions and words can have a profound effect on the outcome of their story.

If I could have put into words what I most wanted and needed to hear from the people in my life, and what I would say to someone else today who struggles with mental health issues and depression, it's this: I may not understand this, but I will stand by your side as you go through it. You are not alone. You cannot be replaced. Depression is not a dirty word.

I support a group called To Write Love on Her Arms. Their mission statement: To Write Love on Her Arms is a non-profit movement dedicated to presenting hope and finding help for people struggling with depression, addiction, self-injury, and suicide. TWLOHA exists to encourage, inform, inspire, and also to invest directly into treatment and recovery. They are some of the coolest people around, and if anyone can help destroy the stigma of mental illness, it's them. If you need help yourself, please see their list of resources here. You can find additional resources here.


  1. ((hugs)) I'm not sure if I ever knew you were depressed at the time. You would remember telling me, I'm sure. Glad you got through it and got help. Depression is icky!!!!!!

  2. Thank you for sharing this Heather. I hope your friend can find success in this struggle.

  3. Thank you Rachel. It was a rough time for sure. The reaction of those closest to me geographically somewhat hampered me sharing it further. I don't remember if we ever discussed it while I was going through it.

    Matt, I hope and pray for the very same.

  4. Heather, you should have warned me I would need Kleenex to make it through the reading of this. What you shared resonates with me on such a deep level, it moved me to tears. Having a mother and a brother who both suffer from mental illness and have each survived multiple suicide attempts, perhaps it only stands to reason that I would also wage my own battle with bipolar disorder & depression, at times teetering on the edge of suicide myself. Like you, I felt like if I was strong enough, or good enough, or tried hard enough, I could pull out of the grip of my mental illness sans medical intervention...but after I hit a breaking point a few years back which ended in an ambulance trip to the local ER followed by 8 days of admission into a mental facility, I finally understood and accepted my need for assistance. Even now, my struggle with mental disorders continues to plague me. Medication, counseling and the support of God and my family have gone a long way to encourage me to not give in or give up. I suppose my advice to others who are struggling with depression would be to not be afraid to ask for help when life gets too overwhelming. My suggestion to those who do not share in this battle, is to be uplifting to those who do. Sometimes all it takes is something as simple and easily shared as a smile or a kind word to change the course of the day, or even the life, of someone who is on the brink of disaster.

  5. Thank you for sharing this Heather. Just two days ago a few friends and I celebrated the birthday of my dear friend who committed suicide last year after a lifelong, mostly private battle with depression. Any steps toward changing the negative stigma towards those who suffer from depression are steps we all need to take.

    Again, thank you for sharing your very personal story. Thank you, thank you.

  6. Anxiety, OCD, bi-ploar.. all in my family and being more open about it now.. since we see it in each other! Thank you Heather for sharing so deeply and personally. You are NEVER alone! No one is perfect and all have our deep struggles and hidden 'demons' to combat. Thankfully we have our Lord whom we get our strength and HOPE! Hugs to you my dear friend across the waters...you are so close yet so far....

  7. Thank you for sharing so openly Something I have not had the courage to do yet as my battle is far too fresh to put out there. I love you and I admire you for sharing.


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