One out of every four Americans has a diagnosable mental illness during any year.  One out of five Americans will have a diagnosable mental illness in their lifetime.  That’s a lot of people.  I’m one of them – have been since my early 20’s.  I’ve been diagnosed with Bipolar Disorder, but mostly I just get depressed.  Just depressed – sounds so innocuous for something that brings my life to a sliding halt every time it descends. 

Depression and sadness are not the same thing.  To compare clinical depression with the day to day sadness that everyone suffers from time to time is like comparing apples to oranges, or more appropriately, grapes to watermelons. They are similar in a general way but very different in the details.  Depression is more than just feeling sad. It's the absence of feeling joy.  All the things that used to bring happiness into your life lose their meaning. Your emotions become a plain of unending desolation, like a parched desert empty of life. The only thing that lives there is hopelessness and despair.

Hopelessness is an all pervasive feeling, always hanging over and round you like a noxious mist.  Despair, however, is heavier than that and comes in tsunami-sized waves. Out of nowhere it crashes into you over and over, then recedes leaving you cold and alone. You wish it would sweep you far out to sea with it when it recedes, but it leaves you on the desolate shore waiting for the next wave.

Suicide and self-injury are also not the same thing. Self-injury, or SI, is often an alternative to suicide -- a way of dealing with the thoughts and feelings that might lead to suicide. It's hard to describe why people who are quite sane would take a razor blade and cut themselves in order to "feel better." Like most things in life, it's a complex issue and varies with the individual. For me, among the many factors, there is a need to feel a release from the overwhelming despair and hopelessness of depression, there is a need to feel like a real person, there is a need to express the emotional pain in a physical way, and there is a need to feel punished for all the nameless wrongs in my life. No, it still doesn't really make sense, not to someone who has never used cutting as a coping mechanism.  It doesn't even really make sense to me.

Suicide is actually more socially acceptable, in a tragic sort of way. I think that most people who SI have suicidal thoughts, but retain a desire to find another way to end the pain. For many, that's what suicide means. It's not a desire to end life, but to end the pervasive pain of life. Even people who seek to end the pain by using alcohol or drugs are better understood than people who SI. I know that when I admit to someone that I have cut or hit myself, I feel like a freak -- a sideshow monstrosity.  In reality, I'm not that freak. I'm just a person who is hurting and wants the emotional pain to stop.

Being a victim of child abuse, the depression, the self-injury and suicidal thoughts, it all relates to mental illness, another misunderstood concept. When you say that you're mentally ill, people automatically picture the poor homeless guy standing on a street corner talking to himself. Yes, that is mental illness, but it's also so many other things, like clinical depression, bipolar disorder, post-traumatic stress and anxiety disorders. These are the things that most people try to hide because of the stigma of mental illness.

I suppose I tend to go back and forth on the stigma thing. On one hand, I don't exactly go out of my way to tell everyone I meet that I have a mental illness. On the other, I hate the ideal of keeping a secret -- that perpetuates the stigma by implying that it's something that needs to be hidden (think crazy, old Aunt Lydia who live in the attic). I guess, like most things in life, it's a matter of balance. If you're in a situation where it would be appropriate to mention that you have high blood pressure or diabetes in the course of a conversation, then it would also be appropriate to mention depression or bipolar any of the other disorders. After all, we will only be allowed out of the attic if we are willing to come out of the closet.