three people, one with his hands over his ears, one with her hands over her eyes, and one with his hands over his mouth

Mark is a tall, lanky, 20-something guy. He works hard. Occasionally, plays hard. Loves to fish. He’s on the quiet side, well-liked by his friends. He has had several relationships, but not yet found “the one.” He’s curious about learning, although he didn’t make straight A’s in school. He had to study. But when he gets something, he really gets it.

Now, his boss counts on him to get the job done, and done right.

He lost his best friend several years ago, who was hit by a drunk driver. That’s how I first met him. He was trying to cope with the death of his buddy, and needed help. He got through that, although it was tough.

Depression runs in his family. An uncle died by suicide. His family was traumatized by the near death of his sister, years ago. Everything changed in the family after that, very subtly. But it was never the same. His folks turned their attention to her, and were often critical of his efforts to please. He downplays all this, questioning whether it’s all that important to mention.

Mark has an ongoing struggle with depression. But you would never have known it. Then he took a risk, and came into therapy.

He’s beginning to recognize depression for what it is, and when it’s affecting his reasoning. He’s catching himself, as he realizes the negative messages he has absorbed. He’s connecting the dots between how he responds to authority, competition, women — and his early childhood experiences. He’s even beginning to open up about it, meeting a guy friend for coffee before work.

“We met around 6:30 at the Stop And Go. We talked about how both of us can get really depressed.”

I was happily — floored.

Two guys. Meeting for an early cup of java. Talking about depression.

These men don’t look depressed to anyone. They’re out there, working their jobs. Getting things accomplished. But they are still searching for the reason why they drink too much, or rarely feel content.

Andrew Solomon, who writes eloquently about depression explains, “The opposite of depression is not happiness, but vitality.


Solomon is describing classic depression. This is when the smallest of tasks becomes intolerably and irrationally difficult to accomplish. But there is a kind of depression that’s different. People who are out there functioning in life, often extremely well. Like Mark. No one, not even him, sees him as depressed.

Perfectly Hidden Depression is what I call it.

If classic depression is an absence of vitality, Perfectly Hidden Depression is an absence of self-acceptance. It is unacceptable to a person that they could be depressed. They want to deny the way they truly feel or think — their inner fatigue, the thoughts that they’re not good enough. Sometimes, even, that death will be welcome. He (or she) keeps secret the abuse that he suffered, or other traumas or loss he experienced. He knows it happened, but the impact of it isn’t recognized. The feelings are rigidly stored away in an almost inaccessible place in his mind, left to gather dust and be discounted.

So he hides. He hides behind a job well done or a family that looks perfect. He hides from the stigma that still exists. He exerts tremendous amounts of energy to look great to everyone who knows him, to be outwardly the epitome of success.

Kevin Breel talks about it eloquently in this Ted Talk.

This is not only a male problem. Plenty of women do the same thing.

People with classic depression are overwhelmed by the loss or difficulty of their lives. They can’t function, and are lost. People with Perfectly Hidden Depression are overwhelmed by the idea that anyone might find out that they aren’t all that they seem — that the back story of their lives might be discovered. They function far too well. They actively deny the importance of any pain. And carry on.

Therapy is different with these two problems. With classic depression, the goal is to help someone reconnect with their external world — to reengage with their families, their friends and their purpose, to stop the withdrawal and the implosion of their very being, and to ease the misery of thinking that can be filled with self-loathing and hopelessness.

With Perfectly Hidden Depression, the goal is to help someone engage with their inner self — to acknowledge and work through their denial of pain — to aid in a reconnection with how their early experiences affected them, and to reassign their worth, not to what they accomplish, but to their own value. To help them find a way to accept that whatever pain they have doesn’t have to be hidden, but can be explored.

Admitting pain doesn’t make you less of a human being. It makes you human.

If this is you, please risk getting help. Or admitting it to yourself.

It’s worth it. You are worth it.

You can read more of Dr. Margaret on her website or on YouTube.


I like to think of dysthymia as a shadow of depression that’s always creeping up from behind me, following my every step. Until suddenly, it’s right in front of me, and everything around me is covered in this shadow. After a few days, it disappears again. I know it’s still behind me because I can feel it. It can throw a shadow over happy moments or rather, moments when I’m supposed to be happy. Yet most people, including me for years, don’t notice the shadow until it gets too close.

Dysthymia is often unrecognized and thus, it is also underdiagnosed. For a long time, it caused me to wonder what was wrong with me. I was depressed, but not “quite depressed enough” to call it depression, I thought.

That’s why I try to tell friends and colleagues about my illness: To bring awareness. To show people depression comes in all shapes and sizes. To show that it doesn’t have to be this stereotypical thing like we see in the movies.

Yet, talking about it on a personal level, beyond the facts and symptoms, is hard. Whenever I tell someone about how I feel, I wonder if they really believe me. After all, I don’t have scars on my wrists to prove I have depression. My panic attacks are happening inside of me. No nausea, no throwing up, no trembling body. There’s only this panic raging through my veins. I never missed a day of school or work because I couldn’t get out of bed.

It still feels like I have to prove my illness is real, not only to people around me but also to myself. Dysthymia can be such a subtle feeling, a feeling I have known for so long, but sometimes I just doubt myself.

What if I am making this up? Maybe I’m overreacting? There are people out there who have it so much worse.

It’s frustrating and it’s scary. The better I cope with it, the more I doubt myself and the more I’m afraid the shadow might come back and cover everything in darkness, like it did last year. It’s like I’ve gotten so used to dysthymia being a part of my life over the past couple of years that I become anxious when it’s not around. I almost miss it.


One of my own friends had been struggling with depression without telling anyone, and she only felt comfortable enough talking about it after I did the same. It proves there is so much power in speaking up about my experiences, even though people might not always believe me.

Image via Thinkstock.

Dear __________,

I wrote this for you.

Today I am turning 18. Eighteen is meant to be a big milestone, but it means extra when you feel like the past four years of your life have been constantly shifting between not living and living hell. It has been exhausting.

For most of those four years, I woke up every morning with the feeling of dread. On most days, I didn’t want to get up. I didn’t feel like I was living; I was simply trying to survive, one day at a time.

I never imagined living past 18, for I hoped the world would have ended by then. I didn’t want to die; I just wanted all the pain to go away. It felt hopeless in the dark.

But here I am today, a freshman in college, singing “Happy Birthday” to myself.

I know you won’t take credit for this, but I wouldn’t have made it without you.

It must be hard to understand someone who doesn’t understand herself. Someone who is still trying to figure out what the words “depression” and “anxiety” mean.

It must be hard to love someone who is hurting. Someone who tries so desperately to tear apart her body because feeling pain is better than feeling numb.

It must be hard to care for someone who wanted to stay in the dark, even when she needed to be in the light.

But you tried anyway.

You made an effort to understand how I am feeling and how you can help me feel better. I absolutely hated talking about meetings with my therapist/psychiatrist, but I appreciate you for asking anyway.

You continued to put up with me, and my many irrational fears, with incredible amounts of patience.

You believed in me, even when I didn’t believe in myself. I didn’t give up on the hardest days because I remember you telling me you are proud of me and how far I have come; I didn’t want to leave you disappointed.

Thank you for pouring your love and care into me, both tender and tough, every day, but especially on the days I needed it the most. From you, I am learning to forgive myself and those who have hurt me, for you forgave me when I made mistakes and stepped across a line.


Thank you for giving me your time, whether it is spent sitting in silence, responding to my emails/texts, or drinking tea. You are always there, even when I cannot stop talking from being excited or am crying so hard that I can’t breathe.

Thank you for being my safe haven, for I never felt alone or unsafe in your presence. I don’t know if you realize the important role you played and are still playing in my recovery process, but I hope this at least gives you an idea.

You have stayed, even when I was so fixated on the people coming and going. Whether it has been four weeks or 14 years, I am still so thankful that you are a part of my life.


If you or someone you know needs help, visit our prevention resources page

If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255

Image via Thinkstock Images

“God has a lot of grace for you, Amanda. And sometimes that grace comes in the form of a pill…”

There are some words that are spoken over us, into us and through us, that take hold and affect our lives. For those of us who live with mental illness, a little grace is a precious offering. Ironically, Grace is my middle name. I am often reminded of the need for it in my relationship with myself.

I struggled and have struggled with the thought of taking medication. I was determined, not even six months ago, to get started. Then, for some reason, I told my assigned psychiatrist I was fine. I didn’t need it. I was all good. It was probably just my hormones, indigestion or something. So, she told me to check in next month, and I was on my way, prescription-less.

Well, I wasn’t OK. Somewhere, deep down, I knew that. You would never hear me say it aloud. No, no. I was just going to work harder at being “healthy,” and it would be fine.

I don’t like to be told something in my life can’t be improved with hard work and determination. So, naturally, when I was told there was an organic, chemical defect in the way my brain worked, my first thought was how I was going to change my eating habits, sleeping habits and exercising habits and that would be enough.

More tea, less coffee. No alcohol. No sugar. No dairy. Daily exercise and eight plus hours of sleep a night. Drink more water. Find a new job. Reduce my stress levels. Meditate more. That will fix it. No meds needed.

I had been doing all those things and more for awhile. It didn’t fix it. Sure, I improved a little the more intense the rules became. I also spent so much time trying to function on a basic level that I had no time for anything else. I still ended up in the passenger seat on a Sunday afternoon outside of a Trader Joe’s, utterly paralyzed by a deep depression and a tormenting anxiety. I still ended up sobbing over nothing. I still ended up with a real feeling of utter isolation and loneliness. I was still in real pain.


In short, the external did not matter. It was not life, my eating habits, how much I focused on being positive or strengthening my resolve. It was my brain. I needed help.

So, I sought my pastor. I actually requested to counsel with him for reasons unrelated to my mental health issues, but they came up eventually. He could read between the lines. He told me something I will never forget.

“God has a lot of grace for you, Amanda. And sometimes that grace comes in the form of a pill…”

So here I am, submitted to that grace. I called my psychiatrist and I told her I was wrong. I did need help. I called my doctor. Even though I am afraid, I am not ashamed. I don’t tell a man with a broken arm to bury his pain. Why am I different?

Invisible disease is still disease. My pastor was right. We’re lucky. We live in a time when medical help is available. I don’t have to struggle without an answer. There’s grace for me.

Image via Thinkstock.

I’m a Christian and I’m not happy, and I’m done feeling bad for it. I’m done feeling guilty. I’m done hiding it so I can continue to fit into the nice, neat and pleasant boxes people try to put me into.

I’ve found the problem with the Church is so often, if we don’t feel comfortable with something or we disagree with it, we avoid it like the plague. I’m tired of that. I grew up not knowing there was a reason I felt so empty at times, thinking I really was just lazy, stupid, awkward and too forgetful. I never thought maybe there was a reason for how I acted.

I was never told what depression was. I never heard the word until I did my own research. Now, I’m not saying Christians are the only ones who are guilty of avoiding this subject. This is not the case at all, but as followers of Christ, it’s our job according to Isaiah 61:1-4, “to bring good news to the oppressed, to bind up the brokenhearted, to proclaim liberty to the captives, and release to the prisoners.”

Who are the brokenhearted? Who are the captives? Many of them are the same people who we shun, who we “pray for” and do nothing else for or who we ask, “Why does she have to be so sad all the time?”

I’m one of them. I’ve lived most of my life a prisoner of depression and anxiety, trapped in my brain that said, “You’re worthless. You aren’t smart enough. You aren’t a good enough Christian. Why are you always so lazy? Why are you so bad at socializing? Why are you so bad at finding motivation to pray and read the Bible? It must be your fault you feel so far away from God.”

No one figured it out for me. I searched and searched until I realized there was an explanation and there are other people who understand exactly how I feel. I’ve had to build my own community of support by opening up. I’ve had to be more honest than I’ve seen hardly anyone else in my life be before.


There have been times in my life when reading anything in the Bible that wasn’t Psalms or Isaiah didn’t feel like a comfort. Rather, it felt like a smack in the face reminder of all the “happiness” Christians nowadays preach, the happiness I didn’t know how to feel. Jesus didn’t preach shallow “happiness.” He preached hope.

He specifically preached it to those people who were sick, dying, blind, lonely and hopeless. Since those are the people who need hope every single day to get them through. Sometimes, it’s hard to look at messages of joy when all you feel is emptiness. You don’t want verses full of praises and “inspiration.” You just want someone to say you’re going to get through this. You want someone to say you might not be OK, but you’re still loved and accepted.

That’s the kind of message we should be teaching.

And not only that, but we should be directly addressing the problems we ignore. We need to stop treating “suicide,” “self harm,” “eating disorder” and “addiction” as dirty words, but instead, we need to offer help to those who feel like this is their only option. We need to accept Christians can have a relationship with God and still be depressed. We need to quit telling people with anxiety to, “Stop being afraid. Jesus is with you.” Instead, we need to support them, ask them how we can help and listen when they answer us.

We need to stop shunning people with disabilities, sensory issues, learning disorders and chronic illnesses simply because they look and act different than what we may be used to. We need to stop blaming people with mental illnesses and disabilities for struggling. Because we’re here to help people. That’s our job. And to do this we need to acknowledge we’re all a little broken. And that’s OK.

Image via Thinkstock.

If you or someone you know needs help, visit our suicide prevention resources page.
If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255. You can reach the Crisis Text Line by texting “START” to 741-741.


At 34 years old, I’ve had countless jobs, and a lot of them are jobs people would be (and are) extremely content and happy to have gotten.

I have left each and every one of them.

I got the jobs because I am good at what I do. Customer service and sales are my forte and I’m not ashamed to admit it. What I am ashamed to admit is I have never held a job for much longer than two years.

I have never been able to see why I have been such a “job hopper.” Yet tonight, whilst reading some articles about depression and having one of my regular self-reflection moments, I realized something. Could my depression and anxiety have anything to do with it?

I had to write it down while I had the thought clearly in my mind. Looking back, I have begun every one of my jobs with extreme enthusiasm. I have excelled at anything I put my mind to, but after a period of on average six to 12 months I find myself getting worse at my job. I feel angry at myself because once I was brilliant, and now I am always making mistakes. Not only that, but I feel my superiors and sometimes my colleagues are “out to get me.” They don’t like me, don’t invite me to join them in social activities, seem to be critical of everything I do or worse make no comment whatsoever.

I get home and find myself unable to function, my personal hygiene goes out of the window and house work doesn’t even make the to-do list. I find solace in retail therapy and spend money that should be saved for bills on clothes and food on silly things I convince myself I need at the time. For example, I received a large inheritance in August 2015. By January I had spent pretty much all of it. Most of which, I still cannot identify where it went.

I have noticed a pattern in my job changes, and therein lies my epiphany. My depression sets in, and I begin to fail. I don’t concentrate on what I’m doing. I don’t include myself in activities. I try to assert myself at work and end up alienating the people around me. That’s when I start looking for another job. I feel discriminated against, that people are prejudiced against me and on the occasions when I’ve asked for help, I have felt it wasn’t forthcoming or that the company was just doing the “bare minimum” for me. In my last job, I even had at least three outbursts, one causing a director to have a quiet word of warning with me. I was there a total of nine months.


I saw a quote this evening that sums up these thoughts: “Depression lies.” It is so true. Had I not been depressed and just been overloaded, I could have asked for help and come back to my high-performing self. Instead, I let myself get further and further into the darkness, and finally end up finding another job, feeling like I’m “bettering” myself. In reality, I was avoiding the issues all together. I would then start in another role and begin the cycle again.

I am currently unemployed and signed off sick because of my depression and anxiety, which has happened only once before when I had a high-pressure job, which led me to a breakdown. I couldn’t even walk through the door of the office building without bursting into tears. I was eventually let go. Although, due to their management of the situation, I was able to turn that around and offer my resignation instead.

Now, even the thought of going back to work both excites and terrifies me. I want to work. I have always worked, but I know I can’t handle the pressure without a strong mental health plan at my workplace. But even then, will I go back into my bad habits?

My depression seems to have led me down a self-destructive path, which I only recognized 18 years after first starting to work. I am now left wondering, will I ever go back to work? Can I find a job or a career I can be satisfied in? I have begun a business with a friend of mine, and I worry if I am capable of running half a business. I want to succeed, but am I capable of it?

While I’m certain I need at least some time to get my head together, I have seen job adverts and thought, “Oh, I could do that!” Then, I get anxious I will try and fail again. I also feel depressed I can’t work at the moment and I feel useless, lazy and demotivated — a failure.

I find myself wishing employers would educate themselves regarding mental health and how to recognize the symptoms of a depressive phase or an anxiety attack. Until they do, how can I trust myself in any job? With a CV like mine, I will soon become unemployable due to my lack of sustainable employment. Maybe I already am. We’ll have to wait and see.

Image via Thinkstock.

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