The Hell of Healing
The stigma of mental health problems and the courage in confronting them
[Content warning: this piece discusses depression, suicidal ideation, and mentions abuse, including sexual violence. Please take care in reading.]
One in ten Americans will suffer from depression at some point in their lifetime. I am that one in ten.
Two months ago, I asked my fiancée to drive me to the Emergency Room. For weeks before that, I was plastered to our bed. I slept for twelve to eighteen hours. I lost interest in everything I hold dear, including writing. I wasn’t eating, and the thought of making myself something as simple as a sandwich filled me with dread. I couldn’t even summon the energy to make myself a cup of coffee.
Thankfully, I wasn’t having any suicidal ideation, which has plagued me in the past. I did have a Freddie Mercury lyric from “Bohemian Rhapsody” stuck in my head:
Mama, oo-oo-ooh
I don’t wanna die
I sometimes wish I’d never been born at all
I didn’t want to die, but it seemed my body and brain forgot how to live.
Depression is maligned and misunderstood.
People who don’t know what it really is will offer useless advice. Smile more. Just get up and do something. Why don’t you try yoga?
Depression is a chemical imbalance in the brain that often needs to be treated with medication, behavioral modification, and therapeutic aid including learning coping skills like Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT).
Depression is not “feeling down” or “a case of the sads.” Everybody deals with these at some point in their lives, and they are relatively transient. Depression is intense, and it can often begin with an inciting incident—trauma, the death of a loved one, financial problems, and many more—then get progressively worse.
My latest severe depressive episode began with the death of a loved one, followed by a bad case of the flu that left me bed-bound for three days, plus a steady rise in chronic back, neck, and body pain that stem from multiple chronic illnesses. All of this was exacerbated by a severe change in medications by my psychiatrist that was supposed to make me feel better. It made me feel much worse, but I was told to give it time and it would help. It didn’t.
Depression set in and got worse over six weeks. The wheels of this illness were greased by financial problems, family issues, and obsessive reflections about the past year of my life, where I almost died twice and experienced a long series of other traumatic events.
On the day I asked my fiancee to drive me to the ER, I thought of the poker phrase, “Know when to hold ‘em, know when to fold ‘em.”
It was time to fold. It didn’t mean I was giving up—far from it. It meant I recognized I couldn’t deal with this problem on my own anymore.
Asking for help takes strength and courage. I am proud that I did.
The ER admitted me to the hospital’s psych ward, a locked unit where patients are carefully monitored. This is often referred to as “inpatient.”
I stayed for a week. It was hell.
It wasn’t the hospital’s fault. They gave me compassionate care, changed my medications for the better, and helped to begin breaking the cycle of depression where I was stuck. Many of the nurses and staff who work on this unit are angels on Earth, full of patience and understanding.
It didn’t change the fact that for most of the stay, my pain was at a constant ten out of ten, and I still battled sleepiness and anhedonia, the loss of interest in everything.
To make matters worse, medical environments are triggering for me. I have suffered from chronic illness for twenty-three years. I endured three neurosurgeries, radiation, and countless doctor visits and outpatient procedures. There were weeks where I was tethered to a hospital bed, catheterized with a central IV line going to my heart. I have been poked, prodded, and stuck with needles countless times. In my medical odyssey, I faced all types of abuse: physical, emotional, psychological, and sexual. It shouldn’t be difficult to see why being stuck in an institutional environment is itself stressful, painful, and activating for me.
The first few days, I begged to be released. The doctors urged me that I was in the best place possible, and deep down, I knew they were right. I stayed in bed a lot, but I also forced myself to attend group sessions and socialize with my fellow patients, who were overall incredible people.
I wish society could remove the stigma from seeking mental healthcare, especially inpatient. It’s not like One Flew Over the Cuckoo’s Nest, at least not in better facilities. The other patients are not a bother but a balm. They know what it’s like to suffer the same way I do, and in two separate inpatient stays, the people I spent my time with were the most helpful aspect. We all had different backgrounds full of various types of trauma and pain, but we shared one thing in common: we knew what it was like to suffer. The reciprocal compassion that is present in psych wards reminds me that there are good-hearted people on this Earth. Other patients offered me help and hope. I reciprocated.
Two days before discharge, I turned a corner and felt the first relief I had in months. It was a gift. I wasn’t healed, but I was on the slow start of improvement.
It took me months to sink into the mire of depression, and I recognized it would take a long time to get out of it.
I was discharged from the hospital on a Monday. Tuesday morning at 8:30am, I was in an intake meeting for a two-month long recovery program. It is similar to many other programs, but of course each one is unique.
The first two weeks were a Partial Hospitalization Program (PHP), which is five days a week from 9am to 2:30pm at an outpatient facility. Everyone in program with me agreed on one thing: it was more grueling and intense than a standard work day. Talking about mental health and opening wounds of trauma for five hours straight is draining. I left program every day feeling like I’d gone ten rounds with a pro boxer.
The morning of PHP includes three one-hour group sessions, then a break for lunch, and the afternoon is made up of two more group sessions. Some groups are open processing, where everyone checks in and receives feedback, but most are structured around a topic, like coping skills or the physiology of depression. Once a week, patients are seen by a clinician for a therapy session, and once more by a psychiatrist who helps with medication management. The clinicians also act like social workers–many are–helping address any needs outside the program, like work-related issues and housing.
After two exhausting yet enlightening weeks in PHP, I dropped down to an Intensive Outpatient Program (IOP), which is three days a week from 9am to 12:10pm—three morning group sessions without the two in the afternoon. Patients still meet once a week with their clinician and psychiatrist, but the focus becomes transitioning back to regular life. It’s still challenging, but it’s a tremendous relief from PHP. I’ve completed three weeks of IOP with two more to go.
If you’ve never been through serious depression, know that it requires time, hard work, and patience before life begins to return to a sense of normalcy.
PHP and IOP are worth it mostly because of my peers who are resilient, kind, and compassionate. In the people who society sees as broken, I find the opposite to be true. I believe that every person is “broken” in ways large and small, but those seeking help are doing the hard work of mending our wounds. We have hurt people in the past, most of all ourselves, and there is nothing braver than the work of repair, both internal and external. I am inspired daily by those in recovery with me, and I have been thanked for inspiring them, too.
Connection with others is one thing that makes life worth living, and this becomes evident inside a room full of people being vulnerable, both seeking and giving help to others.
I cannot think of anything more beautiful and uniquely human.
Programs like PHP/IOPs are an essential pillar of mental healthcare, and they can be completed on their own, not only after an inpatient stay. Unfortunately, they are often underutilized because of the time commitment, the worry of missing work even though many states have allowances for this, and the intimidating prospect of focusing on mental health for so many hours, days, and weeks.
There is also, of course, the stigma of admitting mental health problems and the need for care. This can be the hardest barrier to overcome. The first step is the hardest.
A person might be more inclined to take the time for treatment and rehabilitation of a serious physical condition, and the same should be true for mental health issues like depression and addiction. They are serious medical problems, too.
The fact that society doesn’t see them as such is a critical issue, one that leads to untold amounts of suffering of people who need and deserve help.
I know because I resisted PHPs and IOPs for years, not wanting to admit to myself or anyone else that I needed help.
I do, and I’m finally getting it.
My journey is far from over. It’s just beginning.
I have two weeks left of program, and I am grateful for the help it’s given me.
Patience is a quality that I’ve had to cultivate over my life. In twenty-three years of chronic illness, I have suffered so much, and I always want relief to come sooner, faster, and with minimal effort. It doesn’t work that way.
Following three separate neurosurgeries, I needed to remind myself, “Surgeons were messing around with your brain. It’s going to take time to heal.”
The case is similar with depression.
Life messed around with my brain, causing chemical imbalances and physiological changes, like increased sleep, little appetite, and flare-ups of my chronic pain.
It took a long time for me to get as bad as I was. The events of the past year affected me greatly, with the two months leading up to my hospitalization cementing and ramping up my depression.
Again I am impatient, but I remind myself it takes time to heal.
The cure isn’t as easy as putting a smile on my face or a skip in my step, although I am trying chair yoga led by my certified yoga instructor fiancée. The battle against depression includes a complex mixture of treatments, including a balance of medicine, therapy, and behavioral changes. I am far from cured, and I might never be. Depression is a foe I fight every single day. It’s insidious, relentless, and bleeds into every aspect of my life.
Still I go on.
The voices of depression tell me I’m a failure, that I’m never going to get better, and that my shame is warranted. I know it isn’t true, but depression is a convincing liar.
I am doing the best I can to prove it wrong.
If you are experiencing mental health issues and need help, please call The National Alliance on Mental Illness (NAMI) at 1-800-950-6264, or text "helpline" to 62640. Their website also includes state-specific resources, so you can find local care.
If you are in crisis, please call 988, The Suicide and Crisis Lifeline. I have called it several times, on behalf of myself and others, and every time was helpful and healing.
❤️thank you for sharing your feelings and thoughts and most of all…for being you.