“Things are not always what they seem; the first appearance deceives many; the intelligence of a few perceives what has been carefully hidden.”
When I moved to Marquette I established care with a doctor in town, and she put me on a new medication for depression and anxiety, Paxil, as the one I’d been taking for the past year, Lexapro, hadn’t been cutting it for some time. My first week on Paxil was just as severe as I’d been warned it could be. The doc had said, If you start having thoughts of suicide, stop taking it immediately and call us. The pharmacist pulled me over to a special window where she warned me of the same possibility, as well as manic and depressive mood swings and insomnia. And I experienced them all. But because I knew what was happening I was able to push through, acknowledging where the thoughts, feelings, and compulsions were coming from, and though it didn’t make it feel any less like hell, I knew, at the very least, they would abate eventually.
Things evened out for a while, but depression is a powerful, relentless motherfucker—anxiety, too—and when it came time for my checkup with the doc to see how the medication was working, I knew I needed to up the dose. But when she asked me, straight up, if I needed to, I said I was fine. She pushed, asking if I was sure, said I seemed like the kind of person who would probably say I was fine even when I wasn’t. She called me out, but I insisted I was fine. Still, she said if at any point I felt like I needed to up the dosage that all I had to do was call.
I’ve thought about why I did that, lied and told her I was fine when I knew I wasn’t, and I can’t put my finger on any one reason. Was I afraid she’d think I was just a twenty-something taking advantage of more medication? Was it the guilt of needing more? Or was it the fear of saying out loud just how depressed and fragile I’ve actually been? Maybe I was self-sabotaging, which wouldn’t be unlike me at all. Whatever it was—one of these reasons, each of them, or something else entirely—I left without advocating for myself.
It took me another month of day-and-night struggles with deep depression, anxiety, and insomnia to finally call, today, and request that increased dosage. When the woman at the desk answered she asked the usual questions to look up my account and then asked why I was calling. I told her the situation, that my symptoms have become more severe since my last appointment and that my doctor had okayed an increase. But before putting in the request she said, You just sound so happy…, and I did my best to explain to her that I have a hard time not being enthusiastic when I’m speaking with people.
I know this woman didn’t mean any harm, but the second I hung up the phone I started to cry. Because while I’m assuming, to her, it was just an observation or a novelty, to me it was an accusation. What I heard was, Huh, you sound fine to me. Are you sure? But what exactly did she expect from me? I think it’s pretty obvious and a direct reflection of how our society expects, and sometimes demands, mental disorders to manifest. When even a person who works at the city’s main hospital expects my symptoms to be identical to the caricature from the Zoloft commercial—woman staring at her feet, not noticing the beauty of the world; her tears indistinguishable from the fat raindrops falling from the dark, angry cloud hovering above her head—I think it’s fair to point out just how deeply rooted these expectations are and how quickly we dismiss the possibility of a mental disorder when symptoms don’t present to the world in the ways we’ve come to expect; in the ways we’ve been force-fed by (surprise, surprise) Hollywood, the media, and commercial advertisements, by those who are playing into these stereotypes to make money and exercise further control over how we think about the world and others, over our own behavior and preferences.
Here’s something I’ve learned: Depression doesn’t look or sound like anything. It isn’t always, perhaps even often, someone who’s discernibly miserable, and just because a person is chipper, friendly, or quick to laugh certainly isn’t indicative of depression’s absence. And, damn it, if there isn’t anything that makes me feel smaller or more defective, as a person who struggles with depression every moment of the day, than hearing, But you just seem so happy… The sooner we liberate ourselves from this narrow way of thinking about mental disorders, as a society with over 50% of the population struggling with one or multiple, the sooner we can offer a level of understanding and empathy that might prompt people to start asking for the help they need.