A different kind of coming out.

Stories in the public eye about mental illness generally fit into three categories;

Category one) a person (usually a celebrity) coming out as having recovered after a lengthy battle with their illness (of course, still having the occasional bad day, but with an obvious, upbeat and optimistic view of their future, full of goals and dreams and wishes for themselves. They have solid support people, or plans in place, for any signs of relapse). They’re likely still mentally ill but are clearly glass-half-full. They’ll vociferously advocate through whatever channels they have available to them for others who are suffering to reach out for help – because [insert generic “help is available” and “recovery is possible” phrases here]. There are plenty of stories which come from the “I’ve come out on the other side” point of view, which to be honest, are not particularly helpful for some of us who are chronically depressed and/or suicidal, when we’re stuck in the “here and now sucks” hole.

Category two) stories of hope for recovery, where a person may have started setting bigger goals for themselves than getting out of bed in the morning, or showering. They may have plans for the future and a view that things will get better. People who look to a future where good things will happen. People who see that maybe there is a light at the end of the tunnel after all and they actively seek treatment options with the hope of improvement in life circumstances etc.

Category three) the story where it’s too late. A life has ended. It’s a tragedy. Nobody saw it coming. What could we have done to prevent this? How could we have been so blind to their pain? Where were the warning signs? What if we had paid more attention, or said something, or not said something, or behaved differently? The devastation in those left behind. A life ended too soon. They had so much to live for. They were too young.

My story is perhaps best described as a combination of the three. This story is my own kind of “coming out” after years of being tired, utterly exhausted, of hiding behind a mask, pretending that I’m fine when really I’ve wanted to die.

Stories of depression are never going to be positive while they are happening. In the media and even from mental health organisations, we are encouraged to ask people if they are okay, but we do not share the stories of the here and now, where frankly, life sucks and doesn’t look like it’s going to get any better. We only share the stories which facilitate recovery or inspire some kind of hope for the future. Media and resources provide fantastic albeit clinical information regarding mental illness, but we seldom stumble across any reading which truly articulates the reality of depression; of the emotions and the thought processes of the depressed mind. In my opinion, it seems the media and organisations alike feel it is necessary to foster only those conversations of hope or where recovery is happening – to prevent worsening depression or to avoid triggering situations or outcomes in those already affected, perhaps.

In reality, ignoring the concept of just how unattractive depression is while it is happening is leading only to a further lack of community understanding of an illness which, though invisible, is as real as a broken limb. It is leading not to encourage the conversations about mental illness before it is too late, but to the community shying away from the reality of those “here and now sucks” conversations. Ignoring the story until it becomes positive (or until it ends) is simply leading to the further stigmatisation of mental illness, and in turn is leading to more personal shame from those suffering a mental illness. People who are ashamed of their current reality will not reach out for help – and this is leading to at least six Australians committing suicide each day.

Welcome to my own “here and now”.

I’m not here to convince people that things will get better, or that there is that hypothetical light at the end of the tunnel – because that is something I am not yet convinced of myself. I’m just being real.

So maybe I’m the warning signs that nobody sees. I’ve heard more than once that everyone thought I was okay; that I was doing the best I’ve ever been doing. That people “didn’t think I was depressed anymore” and were genuinely shocked to learn of my current circumstances.
I’ve hidden from most people, friends and family alike, that I was having any issues at all. Though, as has been suggested to me, perhaps people had their suspicions. When I stopped going to work. When I got quieter and just a little more withdrawn. When I always mentioned that I was tired or wasn’t sleeping, sometimes for days at a time. When I constantly complained of physical pain (to substantiate any kind of mood or behaviour which may have shined any kind of light on my mental anguish). Even I didn’t recognise it at the time, but in hindsight, these were all signs of my downward spiral.

This is the part where I’m physically in a psychiatric facility and mentally stuck between living and dying; torn between wanting something more for myself or wanting nothing at all. There’s currently very little to no hope for the future.

And that’s okay. That is depression. Depression is real and does not discriminate. Depression must be felt; it’s a wave that could drown you or a wave you could ride – there is no in between. Depression won’t just disappear.

I’m here to share my current reality – not to bullshit my way through how hopeful I am for my future or prospects of hope for my own recovery, because realistically – what even is recovery? When you’ve lived with depression for so long, hope for better days, or even for less shitty days, is not there. And if it is, it’s damn quiet compared with the rest of the yelling going on in your head.

My point here is: this is now. What you read here will be what is happening now. It will be selfish and is aimed more at relieving my own anxieties, not about satiating everyone else and making sure they’re okay. It is aimed to stop the hiding, which has become tedious and exhausting for me. It will be honest and raw and probably scary and sad and hard for those who are close to me to read. And I am sorry that it will hurt them, but I am not sorry for sharing.

This is my own kind of “coming out”.

 

Three: acceptance and equality. I am who I am. Love is love.

This week, I am not the only one to be saddened and angered at the loss of Leelah Alcorn. Leelah identified as transgender, and her parents did not accept her as such; they would only refer to Leelah using the pronouns “he” or “his”. But Leelah was not a “he”. From the age of four, Leelah knew she was actually a “she”.

I can only imagine the depths of the depression that Leelah felt, and can empathise with the circumstances which lead to her suicide (although I would never claim to fully understand them).

When I first heard Leelah’s story, I was outraged. I was sad. I cried from anger, even though this was a girl I had never known. I felt so much despair at her story.

After her suicide, Leelah’s parents buried her in a suit, and her headstone reads her birth name, Joshua Alcorn. Her parents refused to accept their daughter for who she was, even after her death. Her death was a tragedy in itself and their refusal to accept Leelah after her death only makes the situation more tragic. Leelah’s parents did however move to have Tumblr remove Leelah’s blog and suicide note from the site, as they were named as subjects in her final words, and arguably blamed for her death. Tumblr obliged in deleting Leelah’s blog and suicide note; however, the Internet doesn’t work that way. Something everyone should learn about the Internet is that once something is put out there, it is there FOREVER. You might delete it, sure. But it’s there.

I am posting a copy of Leelah’s suicide note here because I am sad, angry and frustrated on behalf of this girl who will never live her life, when acceptance and equality, support and love, would have been so easy to give to this beautiful girl. Leelah wanted her death to mean something, and sharing her final thoughts is a very small action that I feel like I can make to contribute to Leelah’s final goal.

46% of people who identify as transgender attempt suicide every year. This has to change. This is not okay.

#pinkforLeelah was a social media movement this week where people painted the nail on their ring finger pink in support of Leelah, equality and LGBT rights. Keep the movement going.

For Leelah Alcorn. I hope that she may someday rest in peace.

“If you are reading this, it means that I have committed suicide and obviously failed to delete this post from my queue.

Please don’t be sad, it’s for the better. The life I would’ve lived isn’t worth living in… because I’m transgender. I could go into detail explaining why I feel that way, but this note is probably going to be lengthy enough as it is. To put it simply, I feel like a girl trapped in a boy’s body, and I’ve felt that way ever since I was 4. I never knew there was a word for that feeling, nor was it possible for a boy to become a girl, so I never told anyone and I just continued to do traditionally “boyish” things to try to fit in.

When I was 14, I learned what transgender meant and cried of happiness. After 10 years of confusion I finally understood who I was. I immediately told my mom, and she reacted extremely negatively, telling me that it was a phase, that I would never truly be a girl, that God doesn’t make mistakes, that I am wrong. If you are reading this, parents, please don’t tell this to your kids. Even if you are Christian or are against transgender people don’t ever say that to someone, especially your kid. That won’t do anything but make them hate them self. That’s exactly what it did to me.

My mom started taking me to a therapist, but would only take me to christian therapists, (who were all very biased) so I never actually got the therapy I needed to cure me of my depression. I only got more christians telling me that I was selfish and wrong and that I should look to God for help.

When I was 16 I realized that my parents would never come around, and that I would have to wait until I was 18 to start any sort of transitioning treatment, which absolutely broke my heart. The longer you wait, the harder it is to transition. I felt hopeless, that I was just going to look like a man in drag for the rest of my life. On my 16th birthday, when I didn’t receive consent from my parents to start transitioning, I cried myself to sleep.

I formed a sort of a “fuck you” attitude towards my parents and came out as gay at school, thinking that maybe if I eased into coming out as trans it would be less of a shock. Although the reaction from my friends was positive, my parents were pissed. They felt like I was attacking their image, and that I was an embarrassment to them. They wanted me to be their perfect little straight christian boy, and that’s obviously not what I wanted.

So they took me out of public school, took away my laptop and phone, and forbid me of getting on any sort of social media, completely isolating me from my friends. This was probably the part of my life when I was the most depressed, and I’m surprised I didn’t kill myself. I was completely alone for 5 months. No friends, no support, no love. Just my parent’s disappointment and the cruelty of loneliness.

At the end of the school year, my parents finally came around and gave me my phone and let me back on social media. I was excited, I finally had my friends back. They were extremely excited to see me and talk to me, but only at first. Eventually they realized they didn’t actually give a shit about me, and I felt even lonelier than I did before. The only friends I thought I had only liked me because they saw me five times a week.

After a summer of having almost no friends plus the weight of having to think about college, save money for moving out, keep my grades up, go to church each week and feel like shit because everyone there is against everything I live for, I have decided I’ve had enough. I’m never going to transition successfully, even when I move out. I’m never going to be happy with the way I look or sound. I’m never going to have enough friends to satisfy me. I’m never going to have enough love to satisfy me. I’m never going to find a man who loves me. I’m never going to be happy. Either I live the rest of my life as a lonely man who wishes he were a woman or I live my life as a lonelier woman who hates herself. There’s no winning. There’s no way out. I’m sad enough already, I don’t need my life to get any worse. People say “it gets better” but that isn’t true in my case. It gets worse. Each day I get worse.

That’s the gist of it, that’s why I feel like killing myself. Sorry if that’s not a good enough reason for you, it’s good enough for me. As for my will, I want 100% of the things that I legally own to be sold and the money (plus my money in the bank) to be given to trans civil rights movements and support groups, I don’t give a shit which one. The only way I will rest in peace is if one day transgender people aren’t treated the way I was, they’re treated like humans, with valid feelings and human rights. Gender needs to be taught about in schools, the earlier the better. My death needs to mean something. My death needs to be counted in the number of transgender people who commit suicide this year. I want someone to look at that number and say “that’s fucked up” and fix it. Fix society. Please.

Goodbye,

(Leelah) Josh Alcorn”

Two.

“Sometimes, the easy option is the best option.”

I was reading some of my old journals, and came across an entry that I wanted to dissect.

They say that, when you are experiencing depression, you should maintain some kind of lifestyle. To meet your basic needs, as this will help improve your mental state. Get out of bed. Shower. Eat well. Exercise. Drink water. See people. Sleep the right amount – not too much, not too little. Routine.

When you’re depressed, the little commonplace sorts of tasks can become the most difficult, strenuous, draining tasks in the world. In depression, so much more energy seems to be exerted to just go about daily life.

I’m going to go right ahead and label the “simple” things as the hard option.

And you know what? Most of the time, people with depression take the hard option. They get out of bed and go about their tasks because that is what they’ve been told they should do (and is in fact what stigma has led to society to expect for them to do – because depression is not a real illness and we should just “suck it up”). So many people with depression continue about their lives, keep going to work and keep up a façade that they’re all tightly held together.

If I had a broken leg, the hard option would be to just use my leg and keep walking, right? But I wouldn’t do that, because I’d make the break worse. The injury would take longer to heal, and most likely would not heal properly. My leg would certainly never be the same again.

Well, I’m going to say that it’s the same with depression. Yes, people with depression can physically continue with their lives.

But let’s pretend for a minute that depression is a bone in my body. Each day I keep going to work; keep seeing people, taking care of my everyday tasks. And each day, my “depression bone” breaks worse than before. It’s taking longer to heal. And it’s never going to be the same again.

The alternative?

Well, that would be the easy option.

Nowadays, “mental health days” are a term of speech, connoted with negative implications of laziness, of “faking sick” to get a day off, of being slack etc. In reality, “mental health days” are the easy option people with depression, on occasion, NEED. We need a day where no, we aren’t getting out of bed. Yes, we are watching crappy TV shows all day. No, we’re not showering. Yes, we’re eating junk. No, we’re not going for a walk. Hell, we’re not even going outside. If the food was in our bedroom, we wouldn’t leave. We need that day (or longer) where yes, we get to hide from the world and just simply let ourselves not be okay. We’re not held together. And maybe hiding under a blanket in the dark and popping a couple of valium is the answer in that moment, because there is such a high likelihood that any alternative will mean that there is no next moment.

Sometimes, the easy option can be the difference between a bandaid or stitches; doctor or hospital; hospital or morgue. The easy option is there so that we are allowed to offer ourselves limitations. To acknowledge our current state and give ourselves a rest, even if just for a day. And in taking that easy option, in turn, we are given one less break in our “depression bone”.

So yeah. Sometimes if I’m depressed, I am going to stay in bed all day. Because I have limitations as to how much reality I can face on that day; in that moment.

Maybe it’s weak.

It’s the easy option.

But sometimes, the easy option is there, keeping someone alive.

Sometimes, the easy option is the best option.

One.

This, I guess, is part I: A Catch Up.

There is no sugar coating it; this isn’t a happy story. I’m not so optimistic, but I’m told that there is a more than reasonable likelihood that the story will change; that my story will change. It won’t be happy all the time, of course; no one’s story is. But they tell me that life has ups as well as downs and it won’t always be this miserable kind of personal hell.

It’s at the point now though where I’m exhausted and it’s becoming hard for me to keep up with my own thoughts, let alone to manage relationships with my friends and family. I hate that I know that my truth causes pain, and worry, to the people close to me. So, I get stuck. Do I tell the truth and cause more pain? Is it easier for me to lie (though generally, lie through omission) to ensure everyone’s blissful ignorance? To keep up the appearance that I’m a-okay? To protect everyone from my reality? How many lies can I tell? How believable can the lies actually be? And how do I keep track of the different lies that I’ve told to different people? That part in particular is becoming difficult.

I’m at the end of my tether. I’m waging so many wars against myself, and by letting out the truth now, this is one war that I can stop. Or if not stop, I can perhaps form some kind of containment line. Maybe it will provide me some relief, to come out of hiding. Maybe it’ll make things harder.

It’s a risk for me to keep typing this piece and to consider posting it in a public forum.

Okay, let’s go full disclosure: I’m shit scared, and maybe that’s really what is behind my having not “come out” before now. I’m scared of people’s reactions, of personal consequences, of being judged, of being pitied, of the inevitable changes in other’s perceptions and their subsequent treatment of me, of sharing such personal thoughts, emotions and stories. Not to mention the fallout for my family; the questions and comments they’ll undoubtedly have to endure, along with the pressure of having my darkest thoughts out in the open.

But anyway, here it is:

I’m writing from the psych ward.

Diagnosis: major depressive disorder (clinical depression), anxiety, borderline personality disorder, and a touch of an eating disorder (non-specific).

How did I end up here? To quote Ernest Hemingway; gradually, then suddenly.

I’ll start with the suddenly: three major overdoses of painkillers within a month, two of which were in the space of five days and requiring emergency hospitalisations. Consultations with my psychiatrist after these occurrences lead to the decision of a crisis psychiatric hospital admission as a kind of containment during my clear period of distress (this was to be a one or two week stay; the short version of the long story is that it became a five week stay). To say I wasn’t excited about the prospect of an inpatient stay is an understatement.

So the gradually part? I’ve been diagnosed with depression for around ten years. I have been on and off medications for half of that time and have seen plenty of professionals – some more helpful than others. The most memorable were the ones who told me I was “just attention seeking” or the GP’s who saw me for two minutes, at most, before prescribing anti-depressants (and all the Valium an addict could want – not that I’m an addict, though these prescriptions seemed irresponsible at the time, even to me).

They never requested I go back for check-ups. And so I never did.

Over the years, I’ve wanted to die. I’ve tried to die. I’ve acted in ways which could have ended lethally, though at the time were not deliberately intended to do so.

As part of my illness (which I still on occasion struggle to accept as an illness) I’ve done things which to me are commonplace or a regular occurrence, though what most people would consider alarming and/or distressing – there’ve been dozens of minor to moderate overdoses over the years, more than I can count, and some more severe ones I’ve not bothered seeking medical attention for. I abused alcohol. I abused food. I now abuse myself by denying myself food, yet still exercising compulsively, and in an amount which I’m told is excessive. I’m considered by the psychiatric staff as a “self-harmer” – basically, a label for the self-inflicted wounds and scars that appear on my body, put there by my own hand with a razor at some point of distress, or inability to tolerate my feelings or situation. There’ve been cuts too graphic to describe which have not received any kind of medical attention, when any reasonable person could have seen that stitches were required at a minimum.

When I started writing this, I wasn’t really sure where this particular post was heading. But now that I’m this far, it seems that basically my aim for part I was to, in a sense, “come out”, and to answer my current most frequently asked questions: where are you? Why are you there?

I mentioned lies of omission. I’ve been somewhat honest with people when they asked me what was wrong or where I was. I’d tell people I was in hospital. I’d tell people I’d had issues with medication (which, realistically, is a truth – from side-effects to ineffectiveness, I’ve experienced everything in between – though this was never the cause of hospital admission). I’d tell people I had issues with my liver (again, not a lie – taking overdoses destroys liver function, and realistically, it’s only by chance that my liver function isn’t worse than it is).The point is, I could omit enough to tell people about my current circumstances without actually lying.

The one thing I couldn’t do is tell people the full truth.

So here.

I have depression. I’m suicidally depressed. I have frequent thoughts of harming myself. Sometimes I dissociate; detach from reality and find it hard to figure out what is real and what is not; what actually happened and what didn’t. I feel guilty constantly; that I’m letting people down, that I’m a burden on everyone around me, especially my immediate family. The biggest guilt factor comes from my blatant disregard for my own life, where there are so many people in the world, and even in my own life, with ‘real’ problems, who would do anything to be able to live. Or to see their loved one live just one more day.

It’s selfish of me to want to die when others so desperately want to live.

Popularity of mental health initiatives and causes is increasing, but that doesn’t necessarily translate to understanding or awareness of what mental health issues entail. I mean, what do you say in response to someone who answers with the above when you ask them “are you okay?”

Um. Shit. Okay. Er…

Generally, the answers are most unhelpful and along the lines of “stay positive; focus on the good things”, “you’re strong and you’ll fight”, “things will get better”, “you’ve got so much to look forward to”, “life isn’t that bad”. Worse still, “don’t be sad”, “you’ll get over it”. If only it were that easy. Whilst well intentioned, these responses are quite dismissive – they can come across as demeaning and certainly do not acknowledge the severity of the hold that depression can have over someone’s mind; over someone’s entire life.

I recently witnessed a parent telling her middle-aged child that there are worse things in the world than her child’s severe anxiety. “Look at all the terrorism in the world,” she says. “You’ve got it good; get over it. The doctors can only give you medications; you’ve got to start trying to help yourself and doing things for yourself to get better.” [Side note – I would argue that anybody who is voluntarily in a psychiatric facility (and all admissions to private psychiatric facilities are voluntary) is doing something to aid their own recovery – whether they believe it or not – because of the simple fact that they are in said facility in the first place. Maybe they’re improving or maybe they’re staying much the same – but they are in a hospital designed to help with either extreme].

My favourites were the comments along the lines of, “You’ve just got anxiety, and you just need to relax.”

Telling someone with anxiety to “just relax” is the same as telling someone with terminal cancer to “just grow healthy cells”; it is unhelpful, belittling and will do nothing to alleviate the situation.

In addition were the comments of comparison to other patients who “were trying so hard” or who “had it together” because they got out of bed this morning and did a crossword puzzle. Comparison, as they say, is the thief of joy, and it is naïve to compare one person’s point of mental illness recovery to another person’s point of mental illness recovery.

To explain mental illness in terms which may be helpful for those who find the above demeaning statements to be the right answer; mental illness is terrorism. Maybe that sounds extreme. But when you have that voice in your head yelling, criticising every single thing you do and every single thought you have, yelling that you should just get over yourself – hearing those same thoughts out loud from those around you proliferates those internal thoughts, making them more and more ingrained, making them seem more and more real, until they are all that you can believe – and they are then taken to the point where you are nothing but useless; you’ve ruined the lives of everyone around you, your whole life is ruined and life is not worth living. And you know that so many others have it so much worse than you, which makes your guilt factor so much more intensified. It’s the whole starving children in Africa thing. So why don’t you just pull your shit together? Why don’t you just suck it up, since others have it worse?

Unfortunately it’s not that easy. I mean, if you can’t get over something which you’re being told is “only” anxiety or “just” in your head, how can you function at all? How can you function if even your own brain is against you? And so you implode. And in comparison, it is a small scale impact, but it is still a kind of terrorism.Terrorism by your own mind.

If not totally dismissive or demeaning responses, we tend to get the other end of the spectrum; totally controlling. Should we call an ambulance now? Should we lock you up straight away? Does the psych ward take admissions at this time of night?

It’s hard to find a happy medium. Somewhere between being totally controlling and totally dismissive must be an answer. Something about accepting depression as it is happening. Allowing depression to just ‘be’ in this moment and not jumping straight into “fix it” mode. Sometimes, for me personally anyway, I just need someone to sit with me while I’m depressed and tell me that it’s okay that I’m not okay, without trying to fix me.

Human nature means we don’t want to see others suffer; it makes us want to end suffering. Even myself, on the days that I feel that it’s too late to save me from myself, I’d still do anything to help anyone try to make it through their own mental illness. With an illness like depression (as with a broken bone), our first reaction is to just fix it now; not so much to understand or accept the circumstances as they are happening. It is uncomfortable for us, to sit with depression, allowing it to be felt and riding it out – not jumping to either the dismissive extreme or the controlling extreme. Depression and depression recovery is a process and can be a lifetime illness for some. As with illnesses such as cancer; perhaps the aim, for the short term at least, is remission, and not cure?

My own current answer is in my professional support network, medication and a clinical trial for treatment of severe depression.

I have a mental health care plan involving several professionals; a GP (seen around monthly), a psychiatrist (fortnightly, or close to daily, depending on hospital admission status), a psychologist (weekly), a dietitian (a new addition to the mix, and no rigid scheduling as yet). There’s a list a mile long of psychiatric meds (and dosages) I’ve tried in just the last year. Anti-depressants, mood stabilisers, anti-psychotics.

Escitalopram. Fluvoxamine. Sertraline. Venlafaxine. Valdoxan. Imipramine. Topiramate. Quetiapine XR.

The current cocktail is a short list in comparison, though the most at one given time, and thus far seems to be doing something more than the list of duds above. Fluoxetine in the mornings, Lamotrigine morning and night, Quetiapine (short release) at night, plus diazepam and zopiclone as needed. This mix seems to have me in a state of some kind of stability, for most of the time.

In addition, I am currently receiving a treatment most people have never heard of, let alone experienced at the age of 24: Transcranial Magnetic Stimulation therapy (TMS) (the longer version of the initial one or two week hospital stay turning into a five week stay is my beginning a four week course of TMS after week one).

TMS is still in the clinical trial phase for treating depression in Australia, though has been used to treat major depression and other mental illnesses overseas for over fifteen years. My summary: TMS involves the patient sitting in a chair five days per week with a heavy magnet on their head, sending magnetic pulses into the parts of the brain thought to be causing the depression, in the hope of lessening said depression. It differs from Electroconvulsive Therapy (ECT) in that it is less invasive; the patient is conscious for the entirety of the treatment and the treatment does not cause seizures. As we are still in clinical trial in Australia, there are four randomly selected protocols which may be followed, which have differing lengths per day in the chair and differing strengths of magnetic pulses.

In the current studies, TMS is seeing around a 50% success rate, as compared with anti-depressants which have around a 30% effectiveness rate.

I’m on protocol A; this means I get twenty minutes per day in the chair. That wording makes it sound much harsher than it is – it’s actually quite a comfortable chair and I do get to just kick back and relax for my twenty minutes.

As I write this, I am back in the psychiatric hospital as an inpatient, having finished my initial four week course of TMS (with a fortnight’s break in Thailand), and now receiving a further two-week consolidation course. Do I think it’s working? No idea. I still have bad days. I still have really bad days. I still think about suicide and think of harming myself. Maybe I’m more stable? More even, perhaps? I guess being able to get out of bed in the morning is an improvement upon two months ago. Getting in activities during the day, like walking, working out, cleaning, seeing friends – all an improvement upon two months ago. I would say however that my mood is mostly still low, but not that extreme low that ends with handfuls of painkillers and trips to the ER – more of a tired kind of low. Maybe flat is a more appropriate word.

And I can’t always tell if new treatments are working or not. There have been times when my medications have been changed and I’ve thought I’d stayed the same or become worse, whereas others have noticed a slight to considerable improvement in my mood and state of mind.

So maybe I am not the best judge of whether or not this (or any) treatment is working.

Mostly, I just wonder when I became so fucked up. How can there be something so wrong with my fundamental or biological make up that has me see existence as pointless – I mean, aren’t we just living within society’s confines and doing what is socially acceptable to the majority until we die? Birth, education, work, reproduce, die.

How can I be so fucked up at my relatively young age? How can I be receiving the same kinds of psychiatric treatments as people two or three times my age? Why don’t I just get over myself? Hold myself together like I know I can, like I did for years, and go back to pretending everything is fine? I could get a job, and work a job, and pay my bills, and be a functioning adult. I could contribute to society.

If it weren’t for that voice that jumped in every now and then telling me that actually, no, I don’t want to get out of bed today – let alone live.

And now that I’ve let my family in on the secret, I can’t take it back. I can’t just decide to go back to pretending I’m okay because now, they’ll know better.

I know I have a good life and I am lucky. Many people have it much, much worse. All of my basic needs are met – I have food, I have water. I have a roof over my head and clothes on my back.

I am surrounded by love and support and I feel loved and supported. I have a wonderful family who have proved that they would do anything for me. I have close friends who, for some reason, still like me even after everything I have put them through. I’m physically fit and well. I am smart, intelligent. I’m funny. If I wanted to do something, I would put my mind to it and nothing would stop me from achieving it. I’ve never gone without because I’ve always been smart enough to work for what I wanted. I’ve been successful.

I’m reminded of this often.

My problem is that depression has it’s grips on me. It makes me unable to see anything apart from the terrible feelings inside of me. Depression knows no future. Depression is dark. Neverending darkness. Depression is finding it hard to sleep at night because you so desperately do not want to wake up in the morning. Depression is knowing that there is so much good in your life but feeling awful and wanting to die anyway.

We’re coming up now to my discharge from the current inpatient stay. I’ve been having a few days of feeling terribly depressed. One of my nurses suggested that perhaps I was anxious about going home – of not having the 24/7 staff support (or Valium on request for those freak-out moments). I blatantly disagreed with her suggestion – it was absolutely ridiculous to me that she thought I wasn’t ready to go home.

I’ve spent barely five days out of the last two months at home. I want my own bed. I want to be able to shave my damn legs and pluck my eyebrows when I want to. I want to be able to see my family and friends on my own terms. Even to pick my little sister up from school. To drive my car and to be able to do things when I want to, not within the time windows I’m constrained to by hospital policy along with my risk assessment. I want food that is edible. I want to see my pets every day.

Upon further reflection though, I’ve decided that my nurse was right about me being scared to go home – but not in the way that she thought. I am depressed because I’m going home, but not because I’m anxious or scared about leaving hospital.

I’m scared of the pressure.

If someone goes into hospital with, say, an infection, they’re put on IV antibiotics for a few days and sent home perfectly well and good again.

It’s different when someone goes into a psychiatric hospital. They go in, generally (or, in my case at least) for short-term intervention for what is going to be, in a lot of cases, a lifelong illness.

Yet, the societal expectation is still the same. You’ve been in hospital; now that you’re coming home, you must be better. It’s as though somehow being hospitalised was the magical fix to the depression or the mental illness. And while the hospitalisation may have helped to contain or stabilise the mental illness in the short term, coming out of hospital doesn’t mean that the illness has magically gone away.

The same should be said about medication; putting someone on an anti-depressant doesn’t mean that they no longer have depression. It simply means that they are reducing their symptoms to a point where they can function (and perhaps, live a fulfilling life?).

There are still going to be ups and downs. The aim of the hospitalisation is to increase the ups. But the reality is that the downs are still going to happen. There are still going to be bad days and maybe really bad days – maybe even further self-harming behaviour or suicide attempts.

The hard truth is that psychiatric hospital admission is containment, not cure. There is no IV that can be plugged into the mentally ill patient to cure their illness or their suicidality. That is the simple fact.

And honestly – that is making me feel stressed and making me feel pressured. I am hyperaware that I am still not okay, but coming up to my discharge date, I feel pressure that people will expect me to be okay or to be “normal” again.

So basically, that’s it. That’s how I am. That’s where I am right now. I’m scared, freaking out, about coming home to a place where maybe people are going to expect that now I’m all better. Patched up and out of the wars, so to speak.

I still have depression, I am still suicidal. I have been receiving some inpatient treatment and I am about to come home.

Overall, I’m doing okay. I’m up to planning a couple of months in advance rather than living minute to minute – though I would not call my “planning” solid plans. For right now though, I’m living in the moment. Sometimes the moment is good and sometimes it’s bad and sometimes I need a couple of Valium to make it to the next moment and that’s okay. Sometimes I can feel good and sometimes I can feel bad. That makes me human.

The feelings are real. The moments are real.

And this is me telling you that I’m done pretending that they’re not.