Depression and Its Stigma

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By Charlie Serotoff

I’ve been thinking about writing this for a while now, and have been trying to figure out how to communicate all of the anger and frustration in my head.

One of my friends ended his own life last week. It's been very upsetting and I've been angry and frustrated and I felt the need to post something to help people be more empathetic and help individuals with depression realize there can be hope.

I’m going to make an attempt to make you understand what depression is. What it feels like. Why it’s hard to address and talk about and what you can do to help.

Depression is extremely difficult to talk about it with friends or family. As some of you probably know, when you’re depressed, it can be unacceptable to feel that way to friends and family, because depression is a hard thing to understand. With the best of intentions, they want you to be happy. They don’t want you to be sad.

Our culture makes it uncomfortable for those around you to cope with the depressed or sad version of you. So, many people hide their depression. They’ll portray this happy smiling person who makes others laugh, and people love them for it. They love the false version of that person. The version they think is happy. While at the same time the depressed person is a million miles away. Often they’ll feel little to no connection to their peers, because the peers are not connected and tuned in to what’s really going on.

Being in New York City, the center of everything, with a good job and health insurance, it was still a nearly impossible task to get help when I was desperate for it.

Our fucking healthcare system sucks and people are dying because of it. There are so many systemic failures which I’ve seen can lead someone to commit suicide. There’s of course, the state of the mental healthcare system in the US, but also the shame associated with having a mental disorder, the unacceptable nature of being sad or being depressed in our culture and people in general being ill-equipped to deal with a depressed friend or loved one.

Many will say, and have said “I don’t understand why someone would commit suicide.” I’ll tell you how: For those suffering with depression and who have suicidal thoughts, it’s a terrifying and hopeless pit to be in, which is only exacerbated and made worse by people showering you with advice on how to break out of it.

What happens is you start to feel sad all of the time, sometimes because something triggers you, and sometimes for no rational reason. The trigger often sets off a chain reaction in your head for a thought process that you have developed over the course of your lifetime and all roads lead you to feeling worthless, and that there is no hope. You spiral down further and further until you’re in constant pain and hurting because everything you experience is tinted with a shade of misery. Nothing seems like it can be fun or enjoyable again.

It’s infuriating to think about or talk with friends because many times, everything in your life is fine, or good. You could have a good job, great friends, family, be physically healthy and you feel this overwhelming sense of sadness that you’ll never be happy again. In your head you know your life is good, and in your body you feel awful. This dissonance contributes to why talking about depression is so hard for many people.

You’re in lots of pain, until at one point you stop feeling everything altogether. It becomes less painful to feel nothing rather than constantly living in agony. What you feel is not really negativity or sadness anymore, it's more just this detached, meaningless fog where you can't feel anything about anything — even the things you love, even fun things — and you're lonely, but since you've lost your ability to connect with any of the people that would normally make you feel less lonely, you're stuck in the boring, lonely, meaningless void without anything to distract you from how boring, lonely, and meaningless it is.

You’re existing. You’re not living.

The progression from existing but not living to a decision to end one’s life becomes necessary, and logical. You already feel as if you’re dead. Everyday is full of suffering with each and every activity you do. You’re completely disconnected from anyone and anything you loved at one point. The transition from living and feeling like you’re dead, to physically dead doesn’t seem like a big step. It is just the next step.

For anyone out there who suffers from depression and has contemplated similar thoughts, it’s not even scary to imagine taking your own life. It just seems like its the only possible course of action as everything has become meaningless.

So this is how I felt and it’s how I realized how fucked our mental health system is. I have had depression for most of my life. Last June and July, I was at the lowest point in my life and I knew I needed help and I needed it quickly. The process it took to actually find a psychiatrist, who would listen to me and who was willing to help was arduous, and felt impossible. It took many months, thousands of dollars, and innumerable frustrating phone calls and emails to get to a place where seeing one would cost me $400 out of pocket each time I saw him. During this time, I was beyond pissed off. Being in New York City, the center of everything, with a good job and health insurance, it was still a nearly impossible task to get help when I was desperate for it. I eventually was able to find the right one for me, who was able to help, and only because I had a doctor in my own family who knew of him (thanks Mom).

It should not be this difficult for people to get help when they are seeking it. When their life literally depends on it. Health insurance companies are set up to cut benefits, make it prohibitively expensive to get the help we need, and many doctors, psychiatrists, psychotherapists, etc. still don’t even accept it. The ones who do are far and few and in between. Mental disorders, including depression, are chemical and without treatment by a professional, an individual is not going to get better.

In addition to making it easier for people with mental illness to get the healthcare they require, there’s also something everyone of us can do: we can each help to erase the negative social stigma related to having a mental health issue. When you break a bone, everyone asks what happened, and it’s almost a badge of honor. But when your mind is broken, and people ask how you are doing and you respond I’m awful, I’m depressed, I’m seeing a psychiatrist and therapist to help me. They get uncomfortable and run away. We have to stop doing this. It isolates our depressed friends and family more than they already are.

The takeaway from this is that it’s important we talk openly with one another about depression. It’s important that if a person is clinically depressed, we help them get help. Just like an infection won’t heal without antibiotics, depression won’t fix itself without the right professional help. If you know a person who has had long term depression, listen to them.

Get comfortable in hanging out in the area of sadness. Embrace them for who they are, not the happy version you want them to be. Connect to them. Love them and support them. I made it through and came out the other end ok, and ended up getting the help I needed so badly for so many years. Many people don’t. Help each other. Be there for each other. Talk about depression it openly.

You can save someone’s life by talking with them and getting comfortable in the uncomfortable.

[Editor's note: This piece was originally published as a Facebook post. Thank you Charlie for letting us amplify your thoughtful rumination.]

Charlie Serotoff is a native New Yorker who currently resides in Manhattan. He works at the internet, enjoyed playing Magic: The Gathering and doing Crossfit, and secretly has a dream to become a paleontologist one day.