An Open Letter to My Friend Who Is Seeking Treatment for Suicidal Depression for the First Time

(CW: suicide, depression)

Dear friend:

First, I want you to know that you are not alone. If the words of a stranger mean anything to you at all, please know that I am so proud of you. You see your situation for what it is now, and you know a little more of who you are.

And who you are is a fucking slumbering warrior. I guarantee you that you are stronger than you know, stronger than you could ever imagine. I know this because you have fought a quiet battle you didn’t even know you were in for weeks or months or even years just because you were too strong and tough to lay down. You’ve been living in a haunted house for years and laughing yourself sick at ghosts instead of letting them drag you down to hell. Be proud of that.

But what are you going to do now?

For all of the progress we’ve seen in portrayals of struggling with mental illness, the accepted cultural narrative around surviving it is still a pure fantasy. It’s a fairy tale about a beautiful, tortured soul who succumbs to the darkness inside of them until a savior leads them to the light. A weeping best-friend type confronts them at precisely the right time, a mix of a dramatic and photogenic low where the afflicted is vulnerable enough to accept help. They race through a few sessions with a well-meaning hippie therapist, find the right mix of pills and positive thinking to quell their symptoms, and Recover. The story ends with them fully at peace and staring into the sunset, maybe holding the hand of an annoyingly precocious blonde child, and ruminating on the Thing They Have Escaped From Because They Are Good and Deserve It.

This is a lovely fairy tale, but it is not how mental illness actually works. Your life doesn’t shake to pieces and get rebuilt by kind hands with the reassurance it will never tumble again. The unmarketable truth of it is that most of us who are diagnosed with things like depression and anxiety never get better. There’s no blonde moppet waiting on a sunny hillside for our credits to roll. Mental illness is not some crucible of the soul, sent to challenge you and spit you out the other side a wiser, better person. A diagnosis is only the beginning of the road. You do not Get Through It. You do not Recover.

You jump on the merry go round of treatments and medications available and you hang on until the ride stops. If you’re lucky, you reach a plateau where you make peace with the fact that this might be as better as you’re going to get, It may sound grim, but that’s the best case scenario for many of us. Survivable, exhausting bullshit that never goes away.

This is why a lot of us kill ourselves, by the way, but that’s neither here nor there.

Did that mention of suicide jar you a little? Don’t worry, it jarred me too. It jars me every single time it happens in my brain. Every day, sometimes multiple times a day, no matter how “better” I get. The technical term is “suicidal ideation”, but the term I use for it is “Steve Urkel”. Because, just like a sitcom neighbor, my suicidal thoughts are an annoying, unbidden intrusion. For whatever reason, a piece of my brain wants me to suffer and it wants me to be dead. I can’t claim to understand it, and I don’t know how to make it go away, so I just have to live with it.

It is incredibly likely that am going to be stuck with Steve Urkel for the rest of my stupid life.

So I have to choose to live with him.

If I choose to live at all.

When depression wires your brain to kill you, being alive is not a passive thing. It is a choice you make every single day. And when you realize that being alive is a choice you are making as opposed to a default state, well, that is a difficult reality to come to grips with. But it is reality, and you can’t outrun or outdrink or it forever. Trust me. I’ve tried. It always waits for you to come back and do the work.

I am sorry to tell you this, because I know you were hoping to hear something different. Some inspiring story about how I Overcame Because I Deserved It. I don’t tell those kinds of stories, because they aren’t true.

And you need the truth. You need to get real about this thing, my friend, or is is absolutely going to kill you someday. Depression is a chronic condition, and the failure to treat it appropriately results in death. A slow death by booze or apathy or a quick jump off a bridge- not much difference in the outcome, really. You have to choose to live, and it is a choice you will make over and over again every time you do the work that you have to do to keep yourself alive and well.

It is a choice I make every day. It is the choice you need to make as well.

I know you’re looking for guidance. I want you to see stories where people like you get to live long, happy lives alongside their depression. Right now, those stories are not commonly told- we see the earthquakes, but not the aftermath. In absence of those stories, I’ll tell you everything I can, while we wait for the world to catch up with us.

I want to tell you it gets easier. It doesn’t. But you will get better. You will learn your patterns, you will learn your triggers, and you will learn how to manage it all. You will learn that even in your lowest moments, when it seems like the miasma of your misery will never abate, there is at least one more good day waiting for you somewhere. You will break through the clouds and see the sunshine again. That will make this bearable for you. And one day you will look back on a week, a month, a year and realize that for most of that time, you felt pretty good. And that will feel like a victory. Be patient with yourself. You will get there.

I want to ask you- what do you want to live for? I don’t mean something big and sweeping. Right now, think of the smaller things you can hold close to you. Is there a pet that you feed every day, a little creature who knows the sound of your footsteps and would miss them if they disappeared? Is there a restaurant that makes the best chicken and waffles you’ve ever had? Is there an amazing story burning inside you that only you can tell? Hell, is there a TV show you just really need to see the ending to? Hang on to those things. Celebrate them. Spoil that pet. Eat chicken and waffles every damn day. Make your art because it’s yours. Treat yourself to the season pass of that TV show and give yourself a couple hours a week to read fanfiction until your eyes bleed. As you learn to live with this, you can widen your scope. For now, keep it manageable and focus on filling your heart from many small places at once.

Do every stupid thing that makes you feel alive. That’s a song lyric, and it’s also good advice. Try a hundred things and become devoted to the ones that work. I lift weights and do yoga every week because I want to be alive. I use a mood tracker where I tap a cartoon face that looks like mine and it tells me once a week how many times those faces were happy or sad. This makes me feel like a child, but it works for me, so I do it. You can’t be self-conscious and you can’t be scared and you can’t let other people be the boss of you. You have to smile, bear teeth at the void, and throw yourself forward.

Be woo-woo. Be goth. Be unapologetically your own construct. If anyone doesn’t like it, they can go fuck themselves. If you don’t want to tell them that, call me. I will absolutely say “fuck” to anybody at any time, and I’d be happy to do it for you.

You are going to have to think about medication. We don’t really do a good job discussing this as a society, so you might assume all depressed people are medicated, but that isn’t true. Medication is a life-saving intervention for many people with depression, but it will not fix things for you on its own, and it might not work at all. Lots of us choose to be medicated, and lots of us don’t. There isn’t a right answer and anyone who gives you shit about the choice you make isn’t your friend. You will likely try a half-dozen medications before you find one that helps you, and they’ll all have their own side-effects that you may or may not find more intolerable than depression itself. Don’t hate yourself for needing it and don’t hate yourself if it doesn’t work. If it helps you, it might save your life, so it is worth the effort. Don’t skip doses. Use B12 and fish oil for withdrawal. It helps.

Stay in therapy. Go to the gym. Eat real food. Be kind to yourself. STAY IN THERAPY.

I know this all seems overwhelming, but I need you to remember that you are strong. You’re a survivor. Google it. Did you know that survivor’s personality is a real thing? That they tend to be more adaptable, better at handling change and transition? Did you know they tend to be more creative? They tend to be funnier than most other people? These are the skills you learned in the haunted house where you grew up, these are the things you did to keep the ghosts at bay. You can use them out here, too.

Eventually, when you get your feet under you and feel like you have a grip on things, you’re going to want to talk about it. I’m sorry to be the one to tell you this, but it’s going to be a mixed bag. Some of your friends are going to come through for you in amazing ways. Some of your friends are going to be assholes about it. People are going to try to get you to come to their yoga classes and take vitamins and embrace the power of positive thinking.

If those people aren’t depressed and they don’t have PhDs in clinical psychology, they don’t know how to help you. They’re saying “What’s wrong with you is scary, and I don’t want it to happen to me too. Fix yourself, please, because the black goo in your soul is getting on my tablecloth.” Be kind to them, but keep on your path, because it will carry you to other people- the people who know. And they will love you for who you are, and they are worth the walk and they are worth the wait.

If nothing else, I’m right there with you. Welcome to the family. Sorry it sucks.

I want to tell you that you will triumph over your depression, but the truth is that you don’t need to. You are already living your best life, and imaginary future-state non-depressed you isn’t real, so they don’t get to be the boss of you. There is no imaginary perfect you. There is only the you that you are right now, and that person is already incredibly strong and brave and generally amazing, so be that person to the best of your abilities and trust yourself to survive. Steve Urkel isn’t going to go away, but you will learn to recognize his voice. Like me, you will hear a little voice in your head say something like “boy, that was an awkward conversation, you should just kill yourself.”

And instead of agreeing with the voice, you will say “Shut the fuck up, Steve Urkel.”

And then you will go on a walk, and text a friend, and move a little bit further down the road. And that will feel like a victory too.

Survival means learning to love yourself without regret or apology. Imagine reaching into your own ribcage, fingers winding through the slats of your bones and the silk of your blood. Hold your heart. Feel it shudder in your hand like a bird- so delicate, so warm, so worthy of your protection. Hold that heart close, and send your love to it instead of waiting for it to stop beating. It deserves to be alive.

So do I.

So do you.