Depression and mental illness are far more common than people realize. According to the World Health Organization (WHO), one in four people will be affected by mental illness at one point in their lives. Nearly two-thirds of people with mental illness never seek help for reasons including stigma, discrimination, and neglect. This is a sad state of affairs, and it needs more attention.

For my entire adult life, I have battled with depression, anxiety, and PTSD. I believe many people only think of first-responders and military service men and women when they think about PTSD, but that’s not always the case. My PTSD stems from childhood-related trauma, such as physical and mental abuse, and from witnessing domestic violence. I think the depression and anxiety are results of the PTSD, and it has been a long and excruciating journey towards healing. Just when I feel I have a handle on my symptoms, they rear their ugly heads and the cycles of emotional instability begin.

I am currently going seeing a therapist on a regular basis and taking medication for my anxiety. I have seen several therapists over the years and have been on different medications. I often ask myself why I haven’t been able to get a grip on this depression and anxiety. It’s frustrating to live for a period of time free of depressive episodes, but the fact is is there are many facets to my battle. There are so many different triggers to my PTSD-related outbursts and a gambit of sources of my anxiety and depression. I am only recently getting past the tip of the iceberg. I still have to brave the cold waters below.

With my depression, I have experienced all sorts of emotions: loneliness, desperation, anger, and thoughts of suicide. I have to tell you, the worst feelings, for me anyway, has to be the hopelessness and  desperation. I cannot begin to describe how painful it is to feel imprisoned by your emotions and thoughts, and to feel like there is no chance of feeling happy again. It is even worse when you are surrounded by people but still feel alone. When I get to this stage, I begin to understand why some people choose to end their lives. At some point, dying seems better than to live feeling empty, alone, and hating the feeling of your own skin. This is heavy and dark, right? Some of you may be surprised to know I have EVER felt this way. Those who know me may be saying, “I had no idea, Rich!” But that is the thing with people who battle depression: we’re good at putting on a convincing game face.

Enter the likes of Kate Spade, Anthony Bourdain, and Robin Williams. What were your initial reactions when you heard Robin Williams committed suicide? How about when you heard the news that Chris Cornell and Chester Bennington passed? I am sure many thought, “What?! No way!”, or “He didn’t seem depressed!”. Like I said, some of the people who suffer the most are great at keeping it hidden.

Some people I know thought “Well, that’s what happens when you don’t have God in your life. You need to pray more and ask God for healing”. It’s just not that simple. The most holy people in history who battled depression experienced a dry faith-life. Mother Teresa talked about how she would often feel distant from God and would struggle to feel His presence. St. John of the Cross wrote “The Dark Night of the Soul”. So if these holy people, who are now saints, battled with depression, imagine how people like me, whose faith is nowhere near the likes of the saints, must feel when we can’t feel the presence of God. It’s indescribable, and I often wonder if this is what hell must feel like.

Another question we often here is, “Why don’t you just get help?” Oh! Duh! Why didn’t think of that?! Oh, because I’m afraid of looking weak, or broken, or unstable. Because I don’t want to admit that I don’t feel close to God. I’m afraid people will look at me differently, like I’m ready to breakdown in tears at any moment’s notice. It’s just not as easy as saying to myself, “That’s it. I’m tired of feeling this crappy, so I’m gonna pick up the phone and talk to a therapist”. This is why there are high rates of suicide among veterans and first responders. There is a stigma attached to being what they call “broken”. So rather than face this label, they would rather deal with it on their own, often using alcohol or drugs to self-medicate.

Often when people are at their lowest, their motivation to do anything sucks. On some days we can’t even get out of bed to eat or shower. A few years ago, I had to call in to work while I was having a panic attack and tell my boss I wouldn’t make it in. The next day I came in to work, I was embarrassed and felt like people were intentionally trying to be nice to me. I hated that. I was worried that my boss wondered if I could still perform well at my job.

So you see, even when we know we need help, reaching out can be daunting. Now try adding substance abuse and a plethora of pysch meds into the mix, and you can see why it’s often too late for some people. I’m guessing this why we are seeing big names in the news committing suicide. Think of the amount of pressure they’re under to maintain this public persona. You can’t just walk into a therapist’s office and say, “Hey, you may know me from my movies or rock band, but I’m hoping you can forget that I’m a huge celebrity and keep this under wraps”. Can you imagine living under the fear of the world finding out your most sensitive battles? Look at how well the media is at blowing up one stupid misconception and convincing the world it’s true. Sure, the therapist is under oath to maintain client confidentiality, but he or she can’t stop the paparazzi from following the client’s every move.

Sure, some of the battles people go through are brought on by your their own doing, like living dangerous lifestyles involving drugs and alcohol, which eventually leads to mental health issues. But that’s just a small percentage of cases. Most of the people who battle depression and anxiety are those who you least suspect. I know some really sweet, friendly, and caring women who battled severe post-partum depression and could not be left alone with their babies. I know men who are calm and quiet, but can have a violent outburst caused by the slightest sound. I also know people who are depressed for no other reason than genetics. Depression and anxiety are just part of their chemical makeup.

For me, I have deep emotional wounds that cause much of my anxiety, depression, and PTSD. Yes, with God I have overcome some intense periods, but it also took the support of my friends and family. It took therapy and some medication. It took understanding and empathy. But most of all it’s taken time. There is no easy fix solution and I will probably battle this stuff for the rest of my life. But I am hopeful I will learn to control the triggers and symptoms.

So if you know someone who battles depression and you’re not sure what to do or say, just be there. Lend an ear and shoulder. Don’t try to give advice unless you’re asked. Don’t make them feel bad for not reaching out for help. You can never understand what’s going on inside unless you’ve experienced it too. Learn what they are feeling and ask how you can help. They may not know the answer, but at least they know they can count on you to just be there.

If you or someone you know needs immediate help, here are some resources.

National Suicide Prevention Hotline – 1-800-273-8255.

Peace.