There is no one untouched by crises of mental health. And yet, when you or someone you love is struggling, it can often feel like you’re alone in the dark, searching for a light. In honor of World Mental Health Day, we are publishing a series of essays, starting today and running through the weekend, that tackle this topic through a personal lens. We hope these essays offer insight into the many ways that people struggle, and how they can come out the other side with dignity and grace.
My dentist recently told me that my gums were healthy. An unremarkable observation to most people but one that, for me, caused a surge of relief and joy. When I left her office, I wanted to text someone about what she’d said before realizing that even my best friends would only be able to pretend to care all that much about my gums.
Nine years ago, when I was 27, a dentist told me the bone levels on the lower left-hand side of my mouth had already depleted to the levels typical of a 50-year-old, due to chronic inflammation and disease. “Lifestyle factors” were most likely to blame, I was told. The lifestyle in question? Well, it consisted of sick leave from my office job, lying on a mattress on the floor of my rented bedroom in south east London (an flatpack bed frame was still in its unopened box in the corner) for days at a time, occasionally getting up to smoke a badly assembled roll-your-own cigarette or, when it was very bad, to drink my housemate’s wine in the fridge straight from the bottle before passing out in the same dank squalid spot where I’d spent the past week. No, I didn’t brush my teeth often enough. I became severely vitamin D deficient too. It’s still on my medical record. Severe depression, gender identity issues, vitamin D deficiency. It’s giving vampire, as the Tik Tok kids say.
To have survived a major depression is to be forever haunted thereafter. I’m now many years past the last episode but all it takes is a single bad day, perhaps due to hormones, or low mood in the coldest depths of January, for me to fear I am being dragged back by my ankles. Depression reveals one’s own brain to be a double agent, an enemy within. How do you ever fully make peace with it again? Like a marriage after infidelity, the trust may never be restored. Would I survive another round?
The first time I became depressed, I was 19 and had no idea what was happening to me. It left me permanently terrified by the strange solemnity of a life with no access to the emotional register I remembered. Imagine forgetting a language or how to play an instrument, then imagine the instrument is pleasure. Like most people who have heard of depression but not experienced it, I had supposed depressed people simply felt very sad. I could not have fathomed the reality of the condition being so much worse than sadness: a deep, cavernous void which opened inside me and seemed poised to split me in two. That first time it lasted 18 months, then after a year on antidepressants it left me as soon as it had come. I started to find enthusiasm again, to make friends again, to live, to work, to fuck, to dance, to laugh, to trust. Then, five years later, it came back.
On my twenty-seventh birthday, I prayed for death. Just a little terminal illness, please? I don’t mean to sound flippant or callous about such terrible things. But we ought to be honest. Too frightened to bring about my own end, I wished I might get sick instead and go that way. The brutal reality of life is that there are sick people who are desperate to live and whose bodies will not let them and sick people whose minds make living repugnant while their bodies crawl on. Two different forms of sickness, the sufferers often unintelligible to one another. Though my basic life processes continued to trundle on, the sense of any real futurity was hard to muster. It made other people’s attempts to help me futile. Get a better job? What for? Spend time with people who care about you? That only makes me feel more alone as I can’t feel their love. Drinking all day isn’t a good idea. It’s the only thing I enjoy. Go outside for a walk and feel the sun on your skin. I’ll try.
During the second episode, just like the first, I was prescribed and took SSRI antidepressant drugs. I was told not to drink while I took them: a recommendation I duly ignored for a year as my condition steadily worsened from a position of detached resentment about my own survival to darker thoughts. But, in some small, inconsequential moment lying on a mattress, I once again made the choice I have had to make several times in my life. I chose to try and live, no matter what.
The first thing I had to do differently was the medication. I had to give it the best chance to work. Uncontrollable drinking and depression are distinct illnesses, and I had both. I needed to try and arrest the first to treat the second. I swore off alcohol during Christmas 2016 and went dry. I eventually relapsed the following summer (true recovery eluded me until my early thirties), but by then the SSRIs had already improved my condition enough for me to go outside for walks, spend time with people who cared about me, and to get a better job. The depression lifted, piece by piece.
Recovery from acute depression can feel like a cloud suddenly lifting. But maintaining appropriate defenses and buffers against future mental ill health, the secondary work, is an ongoing practice. In my recovery I had the means and resources to access medical treatment and talk therapy and flexible working hours. I would not presume to preach to another depressed person—a minimum wage worker or a single mother—about what they ought to be doing to get better. Odds are they have tried it. Lest we forget, there is a political aspect to all mental illness: Much of it is driven or exacerbated by economic and social circumstances that can’t always be prescribed for. It is fashionable for politicians to portray the depressed as scroungers: challenging this narrative in the media and at the ballot box is as important as any personal confession aiming to destigmatize mental illness.
Flossing my gums every single day was the healthy practice I got back last. After brushing my teeth, washing my hair, then exercising, then showing up for a job five times a week, then—over time—learning to live without antidepressants, then without alcohol, then without cigarettes and various other patterns of behavior that I had to change or cut completely to sustain my wellness. Eventually, I got brave enough to return to the dentist, to get check ups and X-rays and to look after my gums. Eventually I had to tell the new dentist who recently approved of them as healthy specimens about the warning I’d received all those years ago. “Oh really?” she replied. Confirming that the warning signs are now only ever noticed by me: In my memories and in my fears.
If you or someone you love is suffering, please seek help.
