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To the Emergency Room Nurse Who Questioned My Depression

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“I’m only going to write in your chart that you have anxiety, not depression.”

“That’s a bad label for a 23-year-old to have.”

“It will run your life if you don’t get off those meds.”

“What could you possibly be depressed about?”

To the male nurse at Phoenixville Hospital who said these things with a laugh to me in the emergency room. It was one random Wednesday in the middle of the night. I couldn’t sleep because I was feeling sick, so I figured I might as well go get taken care of thanks to my low co-pay in an effort to avoid using a sick day. I was feeling like crap, was running on two hours of sleep, so I just simply didn’t react. I actually think I politely laughed at your attempt to make a joke at my disorders.

Then I stared blankly once your words settled in after a minute or two.

I should explain.

My depression stems from perfection. I’ve been struggling with perfection for as long as I can remember. Perfection was the very thing that was ruining me.

The easiest example to use for me to explain my struggles with perfection is school.

All throughout my life, I put the biggest pressures on myself. Bigger pressure than anyone else in my life ever put on me, even my mom and dad. My parents knew I was good at school and they never had to worry about my grades being good. My grades were always good, but never good enough for me. So I would study and study and study, to the point where I would over-exhaust myself and end up doing worse than I probably would have to begin with.

I grew up being told I was smart from a really young age and somewhat felt like I had to live up to that. And because of that, I felt like getting good grades, being the top of my class and getting into good schools were the only ways to prove that. I know now that I was so misguided in this belief.

I went to public high school and only felt challenged in subjects I wasn’t naturally good at, like math and science. I was accepted to an amazing college where everyone around me came from private school backgrounds with AP test scores out the wazoo. The pressure was on and I knew immediately that I wouldn’t be the best, I wouldn’t be top of my class; the odds were stacked against me and I was destined to fail. This, of course, was what was in my head.

This pressure to be perfect is so distracting that it can be debilitating. Overworking and stressing myself out caused my immune system to shut down and my mind to run overtime. I didn’t just want to do well, I wanted to do amazing, and yet I had parents who would repeat the phrase “Cs get degrees, Samantha!” at every chance they got to remind me. It was all me.

This is what it’s like to be a perfectionist. This is what it’s like to want something so badly that it hurts you. This is part of high-functioning depression.

To the male nurse at Phoenixville Hospital: People like you see the word depression and immediately think of a sulking, black-wearing person, even in the year of 2017 when mental illness plagues 1 in 5 adult Americans. This is precisely why we have to change the conversation around mental illness because it can so easily go unnoticed. And that’s what happens to people like me. And that’s why people like you, Mr. Nurse, need to be educated.

I got through college and did exceptionally well for myself. I was happy with my college experience and all of the friends I made along the way. I had planned to move to Washington, D.C. to get an internship. If anything, my master plan was getting an amazing job in a new city at a swanky PR firm and get a cute little studio apartment of my own. Instead of DC, I got an awesome job at home. And was going to move home with my awesome parents, rent free. Everything was great and I was on the right path. But after college, and after the excitement of graduation, starting new and all of the endless opportunities ahead of me wore off, I was just sad.

I was sad all of the time. I came home every day after work and cried to my mom. I toured apartments I couldn’t afford because I was so desperate to move out. I was desperate to build the life that I had planned on having, but it simply wasn’t possible at that time.

This killed me.

I said no to every opportunity and would rather be at home alone than anywhere else. I was constantly inside of my own head. I just thought I was going through a rut, but I was wrong. I was ignorant, too.

I’ll admit, my idea of depression was similar to yours. I have friends with depression — that’s not me. I don’t want to hurt myself, I rarely cry except to my mom sometimes. I can’t possibly have depression, I thought.

Anxiety on the other hand — that I knew deep down inside was a likely possibility for myself. I was always a high-strung and nervous kid, so it would kinda make sense, I guess.

I went to the therapist for the first time, just thinking that it would help me get settled. I figured it was probably situational — getting used to graduating and the real world and all of its quirks. That was until the therapist sitting before me asked me a question I wasn’t expecting:
“Do you want to know what you have?”

I left there with two diagnoses, one that felt like a relief and one that felt scary and unexpected. So I started reading. And I learned that out there in the world, there are plenty of people just like me.

I may not be the typical picture of depression but I am living with it every single day. And there is no typical picture of it. I constantly have to remind myself to get out of my own head, to ground myself in the present, to remind myself the world around me is happening and it’s happening to me. It’s the weirdest, hardest thing to explain and even harder to understand when you’re living it. So I can’t fully blame you, Mr. Nurse. I don’t get it either.

Since getting my diagnosis at 22, what was once scary and unexpected has made me the strongest I’ve ever been. Fighting off the demons I’ve dealt with since I was a kid has made me feel like I won a battle and came out on top of it.

So yeah, just because I’m 5-foot-1 of smiling, happy blonde girl doesn’t mean I can’t have demons of my own. Just because I’m 23 doesn’t mean the chemical imbalance inside me doesn’t exist. Just because I take medicine doesn’t mean my life is out of control. And yeah, my life is effing awesome, but I’m still depressed. I know, Mr. ER Nurse; it’s frustrating and makes no sense. Try living it.

I’m wrestling with perfection every day still, learning how to overcome my anxiety and reminding myself of all of the good things I have around me and filling my heart with gratitude for that.

To everyone else, never let anyone make you feel bad for how you feel. Never judge a book by its cover. That man was lucky he crossed paths with a girl who is overcoming her demons and isn’t afraid to talk about them. If the conversation about these things doesn’t change soon, he and others like him may not be so lucky next time.

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Thinkstock photo via Halfpoint

Originally published: June 23, 2017
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