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When Your Depression Feels Too ‘High Functioning’ to Deserve Help

Editor's Note

If you struggle with self-harm or experience suicidal thoughts, the following post could be potentially triggering. You can contact the Crisis Text Line by texting “START” to 741741. For a list of ways to cope with self-harm urges, visit this resource.

Yes, I hold a full-time job.

Yes, I graduated college.

Yes, I pay my bills.

Yes, I have good friends and support.

But yes, I also have depression.

And yes, I think about suicide every single day. I have for years.

No, you can’t see any scars, but yes, I have them. There’s a reason I wear long sleeves.

I’ve been “managing” my depression and suicidal thoughts for over a decade now. I’m in therapy, I’m on medication — “doing the work,” or whatever you want to call it. But I haven’t been OK in a long time.

I’ve always respected the heck out of people who take time away from work or school to focus on their mental health or receive treatment. When I talk to people who are able to make that decision for themselves, my first thought is, “Wow. That’s amazing! Power to you, I’m so proud of you.”

And my second thought is, “I could never do that.”

Not because I think I’m “better” than them, God no. It’s not that I don’t need a break or need more intensive treatment — I don’t think it’s “normal” to think about killing yourself to the extent I do every day. I don’t think going days without washing my hair or changing my clothes is healthy by any means. It’s probably not a great sign I’m isolating more. Crying myself to sleep because all I want is to die isn’t ideal. But, I’m managing, right? The lines on my arm might beg to disagree…

But how could I walk away from my job to put my mental health first? What about insurance? What about paying rent? What would I do about my parents? How can I just leave a job? What if it’s not waiting for me when I come back? What will people think? No one will ever look at me the same. What if I waste all this money on a program that ends up hurting me more than helping me? Wouldn’t be the first time. What if I’m overreacting and I’m actually fine?

Who am I kidding, thinking I can take a few weeks off and do a partial hospitalization program (PHP)? I’ve been working this long while dealing with my depression, suicidal thoughts, post-traumatic stress disorder (PTSD), and an eating disorder. Isn’t that proof I don’t need this? Or don’t deserve this?

OK, let’s pause and rewind a second, because no, these aren’t hypothetical questions.

I hit a low on New Year’s that led me to ask a friend to take me to the hospital (that’s a story for another time). While I didn’t end up choosing to stay inpatient, the plan was to do a PHP or intensive outpatient program (IOP) after. I had reached my limit. There was no more coping. I couldn’t do it anymore. The thought of going back to work and continuing at the rate I was going was impossible to entertain. I was done. And if I had access to something I could have used to die, there’s a decent chance I would’ve taken it.

But, let’s be real: This is the American health care system we’re talking about. I didn’t leave the hospital that day and start a program the next. It’s been almost three weeks trying to set this up, and it’ll be at least one more before I finally start the program. I’m grateful I have access to care at all, don’t get me wrong, but going three weeks after hitting a low like that waiting for treatment has been hard.

And yet, I’ve been working. I talked to my HR department about taking time off to do the program, and the assumption was I would just work until then. I don’t think either of us thought it would be this long. Working the last few weeks has felt like absolute hell on top of everything else going on in my life right now, though. And while my boss knows the gist of the situation, he doesn’t seem to register the fact that between when I told him I was taking leave for more intensive medical treatment, to the time that treatment starts — I didn’t automatically get better. I’m not operating at 100% right now. And while everyone else in the company (who knows) has been understanding, it’s tough when the boss you work with every day doesn’t seem to be. (OK, my work rant is over, sorry.)

The point is, though PHP is for people who are struggling to function and need more support, I’ve also been working. Does that mean I don’t need the treatment? Does it mean I don’t deserve to do it? Am I “crazy” for doing this? I’ve certainly felt it at times.

But, I don’t think ability or inability to work is a great qualifier for needing support or not. I certainly wouldn’t ever question anyone else who decided they needed more intensive treatment but was working in-between. Because you never know what else is going on. Just because someone seems like they’re “high functioning” despite their mental illness, doesn’t mean they are. Functioning is incredibly subjective, and while our society may equate working to functioning, I call BS.

Everyone deserves to receive the care they need. If you’re hurting, you’re hurting. That’s it. You don’t need to justify or explain it. You’re worthy of help simply because you’re human. And I write this just as much as a reminder to myself as I do to all of you. So, if you’re thinking about asking for help but feel unsure if what you’re experiencing is “bad enough,” take the step. I’m taking it right here with you.

Photo by Toni Frost on Unsplash

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