It struck me as sadly ironic that on October 10, 2016—World Mental Health Day- a member of a closed Facebook group I belong to posted about the recent suicide of her teenage son’s best friend and the devastation his loss has left for his family, friends and community.

National statistics tell us that 16.1 million adults aged 18 or older in the United States will experience at least one episode of major depression in the next 12 months. 20% of American teenagers will suffer an episode of depression before they reach 18 and suicide is the third leading cause of death for young people between ages 15 to 24. I have worked professionally with depressed and suicidal teenagers. I have lost friends to suicide. I have been one of those 1 in 5 teenagers who felt hopeless and helpless and like the pain would never end.

My story is just that—mine, unique to me.  Each of my depressive episodes over my lifetime had its own precedents and its own thumbprint and I cannot speak for everyone who ever experienced depression or contemplated suicide when they were younger.  I can only try to shed a little light onto the types of thoughts and feelings that can feel opaque and inexplicable to the loved one of someone who has attempted or committed suicide.  I can only  own my own story.

I don’t think I had ever even heard the word “depression” the first time I slid down into that abyss. It was the late 1970s and polite company did not talk about those types of things. Or if they did, they used the broad term “nervous breakdown” to capture a whole host of unmentionables such as depression, anxiety and mania. Even if I had had the language to describe what was going on with me, I don’t think I would have called myself depressed.  Depressed meant sad, right?  I wasn’t sad. I certainly don’t think that any of the adults in my life would have believed or understood that someone that young could even be depressed.

I was 12 years old the first time I consciously thought about dying, but looking back, I think that I had probably been struggling with dysthymia, a chronic low-level state of depression, for almost two years. Of course, I wouldn’t have said that I was suicidal (another word not yet in my vocabulary), I just wasn’t so sure I wanted to live anymore.

By 12, my dysthymia had worn me down. It was like I was almost bone tired emotionally. My memories of this time are actually in black and white— it is as if all color had drained out of my surroundings, drained out of me. Sounds seemed distant, my own voice sounded like I was speaking from underwater and the people around me felt far away and abstract. I felt . . . nothing. I was empty. I was blank. I started contemplating walking into the creek than ran close to my house, submerging myself and simply not coming up again. It almost seemed like it would be peaceful. I don’t know if the creek was even deep enough to drown myself in (it was very rocky with a strong current), but just walking in seemed like an increasingly rational idea. Life was flat and colorless and there was no light, no color, no joy, and my 12 year old self was asking “what is the point?”

I felt so detached from everyone and everything around me that it never even crossed my mind that such a step could hurt the people around me. Depression is a very selfish illness— it draws all our thoughts and energy inward. I had become so insubstantial, so thin, so busy listening to the noise in my own head that that I don’t think I even realized that my family would notice or care if I disappeared. It never occurred to me to tell anyone how I was feeling (or not feeling). I suspect inertia as much as anything else kept me from walking into the water.

My second depression was very different. I was sixteen and I was no longer numb. I was feeling. . .everything. All at once. With great intensity. There was more desperation this time, more urgency. I don’t think that I actually wanted to die. My pain would sometimes became so acute, so sharp that my chest, my very heart, would actually hurt. I felt like I had always been in this amount of pain and that it was never going to end. No evidence to the contrary would have convinced me that there had been better times behind me and could be again.  I thought that I would feel this helpless and hopeless forever. One afternoon I tried to climb over a bridge in front of a couple of friends. They intervened, although I am not sure that they understood exactly what was going on, just that I was doing something uncharacteristically dangerous and weird for someone deathly afraid of heights.

In retrospect, the depression made me feel like I was being physically silenced by an invisible force. I could articulate mindless, unimportant things but when I tried to express my feelings, my pain, my fear, my deep loneliness and isolation (feelings that I had even when I wasn’t alone), it was like there suddenly wasn’t enough air, not enough moisture in my mouth, to make the words come out. I wanted to be visible. I wanted to feel understood. I had an instinctive awareness that I was teetering on the point of no return and could not get back to safer ground on my own. The ground was slippery with gravel and I could no longer regain my footing. I desperately wanted, needed, someone to see my SOS for what it was and reach across what now felt like an enormous chasm and give me their hand, throw me a lifeline. Provide an anchor point to ground myself to until I could do this again for myself.

None of my friends ever told an adult about my little bridge escapade. We closed ranks, we assumed that the adults in our lives simply wouldn’t understand, wouldn’t “get it.” At 16, we don’t feel like anyone can possibly understand our feelings. We want to feel like we belong, that we fit in, but we also simultaneously want to feel distinct and unique and special.  16 year olds need to separate from our parents and connect with our peers in new ways. It is a tough developmental stage. I am sure that at 16, I also struggled to picture my mother ever being my age, ever feeling the type of intense feelings I was feeling. She seemed so removed, so cold, so other.

By 16, I had already learned that my mother did not deal well with strong feelings (particularly mine) and she would start to vacuum or loudly wash dishes when I would try to confront her in a way that only a stubborn, angry 16 year old girl can do. I actually have memories of following her around the house, dogging her steps, trying to get her to look at me, to listen to me, to acknowledge my (at least in mind) righteous anger.

I was struggling with depression, I was struggling with my sexual identity, I was desperate to get out of my small New England home town, and I was tired, so tired, of being told to be “good” and “polite” and “quiet” and to “just suck it up” because “life isn’t fair.” I responded to this by acting out, becoming a wild child, getting involved with an alcoholic lesbian who was 4 years older than me while ironically still retaining the reputation as the “good” friend, the responsible, dependable straight “A” student that some of my friends were admonished to emulate. Somehow, despite everything I was doing to the contrary, I was oddly still invisible.

The countdown to college and real freedom started and the depression gradually eased again. There have been other depressions over the years, some accompanied by intense anxiety, some where I lost my appetite, couldn’t sleep, cried all the time and became withdrawn from family and friends. Days and weeks when it was hard to get out of bed and shower and put on clean clothes. But I did it. I am nothing if not a high-functioning depressive, as many driven perfectionists are. I would have told you in my teens and 20’s that I have never accepted the limitations of being merely human (this is still an issue for me, to a lesser extent.) I had the best grades of my college career while being profoundly depressed and I have functioned (almost) normally as the head of an intake unit of a busy community mental health center (except for the daily crying jags at my desk with my office door closed) when I was teetering on suicidal depression.

I stood many nights in front of my open 13^th floor apartment window while I was in grad school and contemplated walking out of it, like I was playing a twisted game of chicken with myself. I wouldn’t say to myself, “I will walk out this window.”  I would say to myself, “I can walk out this window.” Like having that option was somehow comforting. I had thoughts about stepping in front of a speeding Septa train (thinking about the poor traumatized conductor and passengers always stopped me) when I was coping with the double whammy of a traumatic miscarriage coupled with my mother’s diagnosis of terminal cancer.

I didn’t end up in therapy by choice the first time (an episode of exhaustion and dehydration got me hospitalized overnight at the Student Health Center and discharged with a mandatory therapy referral) but it was surprisingly helpful. My first therapist (mature and used to dealing with addiction issues) understood instinctively that I needed to hear that someone cared, that it mattered to her at least if I lived or died, and continued to tell me that until I finally started to believe it.  And as I gradually emerged out of that episode of depression, I realized that other people had cared all along, but that I hadn’t been able to see it, I hadn’t been able to feel it.  This is one of the ways that depression eats us alive.

Don’t get me wrong— it was not suddenly all rainbows and unicorns after I saw that first therapist. I have been several therapists-in-training’s worst nightmare over the years— a smart, insightful client (who was also trained as a therapist) who could run circles around them and refused to contract for safety because I knew I wouldn’t call them if I was in trouble between appointments and I chose not to be dishonest about that. I actually feel badly for those therapists-in-training and that poor young psychiatry fellow who had the misfortune of working with me. I have been that beginning therapist who cares so much and don’t want to make mistakes, particularly not with other people’s lives.  I have been that therapist who was not confident in my boundaries and who does not yet have the experience and wisdom to understand the professional use of self and that the most important thing any therapist can bring to a clinical relationship is themselves.

The best way I can articulate this is that when you have felt invisible for so long, when your pain is unseen and unacknowledged (“You look so good! You must be feeling so much better”), you start to test the people who say they care. Depression makes you feel so unlovable, so unworthy, so guilty about EVERYTHING that you are sometimes driven to push and push and push the people who care about you back, almost as if you are asking (yourself and) them, “Can you still love me now?”, “Can I still count on you?”, “Do you still have my back?” It is a paradox of depression that when you are most mired in it, you start to question the people who do try to reach out to you.  Depression is a voice in your head whispering constantly about how worthless you are, how everyone would be better off without you. You start to dismiss the people who want to care for you because you think to yourself, “I am completely worthless. I am completely unlovable. You say you care about me. Therefore, you must be crazy or have really bad judgement. Because how could anyone care about me?!”

The cruelest moments of depression have been the dark, endless, lonely nights when I can’t sleep.  My ex-husband used to refer to these times as the nights when the “wolves were howling” at my door. I have also called them the long, dark nights of the soul, when I would replay every stupid thing I had ever said in my whole life, and I would list off my faults and life regrets like Arya Stark reciting her “ kill” list on Game of Thrones and I would start to forget that the sun actually would come up again.

These nights are when the most powerful thing in the world was sometimes a loved one willing to sit with me until I could sleep or would be willing talk to me on the phone and be that lifeline until the sky started to lighten and the wolves started to retreat. I have experienced as a therapist, and as a human being who has walked with depression, that being present, bearing witness, being willing to hold someone’s pain, to cry with them and to really see them with all their rough edges and accept them as they are in all that vulnerability is an incredible gift to give. It can save lives.

There are two songs that really speak out beautifully to anyone struggling with depression, but I think these particularly resonate with the experience of depression in someone’s teens or early twenties.  I discovered the first song when I was in college and the words are still as meaningful. It always felt like someone older and wiser was directly  trying to remind me that it gets better when I couldn’t say it for myself.

Wait Until Morning by Deidre McCalla

In the still of a hollow night

I heard you cry

It was the sound of a heavy heart

A sad goodbye

You are about to make a move you’ll be sorry for

I can see the silence in your eyes

Chorus:

Wait until morning

It’s be better

I know that it’s hard now

It won’t last forever

Wait Until Morning

You’ve grown tired of holding on

To all the pain

It washed away every trace of life

‘Til just the shell remains

If there’s a tax on the lessons that you have learned

Well, you’re certain that you’ve overpaid

(Chorus)

There’s nothing I can tell you that will make it be all right

And there’s nothing in this whole wide world you must decide tonight

In the distance a passing train

Breaks the spell

As the lights on the freeway dance

Round like a carosel

And a bright star smiles down on this sleeping town

And I know it shines on you as well

(Chorus)

 

18 year old Shawn Mendes has written a beautiful song that I wish every teenager in pain could listen to. It would have deeply resonated with me when I was 16 and deeply resonates with me now as both someone who struggles with depression and a parent.  I feel that this is what every parent of a depressed and suicidal teenager wants to say and doesn’t know how to articulate.

Hold On by Shawn Mendes

Stop, take it in and I breathe for a minute
I think too much when I’m alone
I’ll never win when I keep all my thoughts inside
So I’ll pick up the phone

Chorus:

And my dad says Shawn stay with me
Everything will be alright
I know I haven’t seen you lately
But you’re always on my mind
I don’t know what you’re going through
But there’s so much life ahead of you
And it won’t slow down no matter what you do
So you just gotta hold on
All we can do is hold on

These days are flying by
Weeks feel like minutes
I can’t remember being small
I tried to figure it out
I can’t seem to find out how
I guess I don’t know much at all

And my dad says Shawn stay with me
Everything will be alright
I know I haven’t seen you lately
But you’re always on my mind
I don’t know what you’re going through
But there’s so much life ahead of you
And it won’t slow down no matter what you do
So you just gotta hold on
All we can do is hold on, yeah
All we can do is hold on
Yeah you just gotta hold on
Just, just hold on
Just hold on for me

My dad says Shawn stay with me
Everything will be alright

I don’t know what you’re going through
But there’s so much life ahead of you
And it won’t slow down, no matter what you do
So you just gotta hold on
All we can do is hold on, yeah
Yeah you just gotta hold on
Just hold on for me