Leah Reich was one of the first internet advice columnists. Her column "Ask Leah" ran on IGN, where she gave advice to gamers for two and a half years. During the day, Leah is Slack’s user researcher, but her views here do not represent her employer. You can write to her at askleah@theverge.com and read more How to be Human here.

Hello, Leah.

I'm O, 20 years old, and have some issues that I can't seem to control at all. I've been reading your column since it started, and I could relate to most of the topics you've talked about, but I was always doubting if I should write to you.

I've been struggling with depression for about 6 months now. I don't really know how or why it started, but during this period I realized that the career I was studying was not what I was expecting, so I dropped out of it. After doing that, I was having a hard time living a normal life. I had difficulty with getting out of bed, I didn't feel like eating and I would cry for no apparent reason.

During the early stages of depression I had two main supports, which were my girlfriend at the time and my best friend. I was in a long distance relationship with this girl, and we had dated for around two and a half years. We saw each other frequently and we had even discussed marriage at some point.

My depression started to show around May, and by June, my girlfriend started acting distant and wasn't talking a lot to me. She started to argue a lot and to get angry at everyone. At that time, I thought it was the stress of ending the semester, but three weeks later she broke up with me and didn't give me an explanation.

During our last week of relationship, we fought almost daily. This is the same week that my best friend got in a car accident and stayed in a coma. I didn't want to tell my ex about the accident because we were already dealing with our own problems, so she never knew about it. The break up happened on a Wednesday, and by Friday, my friend had passed away. Exactly one week after that, I tried committing suicide by taking a bunch of pills but I ended throwing them up.

Since then, I've been helped by a therapist, but there are some days where therapy doesn't seem to be enough. I've been battling with making new friends, I don't want to start a relationship because I still miss my ex. Luckily, the suicidal thoughts have gone away. I've been feeling alone since June because all my friends were common friends with my ex and we fragmented after the breakup. I don't find the motivation to seek for a career that I like and I'm not ready for a new relationship.

Is there any advice you have for dealing with times like this?

Hope to hear back from you.

-O

Hey O,

About 15 years ago, I was deeply depressed. I’d had some problems with depression before — especially in college — but this depression seemed different. It was longer and more relentless than any episode that had come before it. For months I dragged myself around, feeling more worn down with each day. I remember people telling me I didn’t at all seem myself. Even people who knew me and who had seen me depressed were concerned.

It was terrifying. I felt like a burden to the people who loved me, and like I was a pain in the ass who was always fucking up and letting them down by not getting over it. The more I sank into that feeling, the more alone I felt. And the more alone I felt, the more depressed I became. Things felt bleak.

I felt like a burden to the people who loved me

One day I had what must have been a small jolt of self-preservation. I remember feeling very scared: If I didn’t get help for real, shit was going to get very bad. I called a therapist, a brand-new one I’d never visited before, and asked for a consultation. I sat in his little waiting room and I filled out a form and I cried, and then he called me into his office and I cried, and then I started seeing him regularly and I cried every single time.

In the beginning I asked my therapist if I could come two or three times a week. There were times I would have gone every day if I could have. We scheduled session after session, and I went to every single one, so I could cry and talk and slowly climb my way out of that deep, dark hole. I even went on medication, despite having resisted it for years and hated the few I tried. I was willing to work through the therapy, work through the shitty side effects of various medications until I found one that worked, willing to do everything that seemed impossibly hard and unpleasant. I bet you know why, O: Because as hard as all that was going to be, staying where I was would be even harder, and much worse.

This is why you wrote me, right? Something in you gave you a jolt. You’ve already asked for help—you have a therapist—but there’s more you need. You feel better, but you still don’t feel anywhere near okay. I understand that. Even though I started to feel better after a few months with my therapist, it was a while until I felt good. It took a lot of work! Enough work that, over the years, I got a lot better at making healthy choices to keep feeling better and to navigate the depression when it returned. Because it did, and does.

O, I know you want advice on how to deal, but let’s be real. I want you to do more than deal. I want you to get back to a good place. Depression is hard enough on its own. But you were severely depressed and then you were hit with devastating loss, grief, heartbreak, isolation, and more. It’s too much. I’m not surprised you still aren’t feeling anywhere back to okay after four months in therapy. I’m glad you’re not suicidal anymore, but I’m still worried about you. I want you to call your therapist and tell them what you told me: Some days therapy doesn’t seem to be enough. You need more help.

I don’t know if you happened to see it, but the other day Kid Cudi posted about his severe depression on Facebook. You can read his post here, along with some thoughts on depression, black men, and masculinity. I don’t know your race or gender, so some of the writing about his post may not apply to you. But maybe when you read his words you’ll connect with them like many of us have.

One of the worst things about depression is the feeling that somehow you’re responsible

One of worst things about depression is the feeling that somehow you’re responsible for how terrible and hopeless you feel, which of course makes you feel only more terrible and hopeless. It’s easy to feel it’s all your fault, like you’ve burdened your friends and family, especially those who haven’t been depressed and get frustrated with how you feel. I’m thinking here about your ex, and how you didn’t tell her about your best friend. I wish you had told her, but it’s okay you didn’t. I also wish I had more to say about her, because I don’t like how she broke up with you. But maybe she didn’t know how to handle your depression, or how to talk to you about it. Being in a relationship with a depressed person is hard, especially when you don’t have depression, or are young, or when you’re in a long-distance relationship. Or, you know, all three. Anyway, I want to leave her out of this, because she’s got very little to do with your plan to feel better.

At the end of Kid Cudi’s post, he apologizes for those he feels he’s let down. Maybe he’s apologizing for bad choices he made when he was depressed, but I think anyone who’s been seriously depressed recognizes a deeper “I’m sorry.” The one that says “I’m sorry for being so fucked up, I’m sorry I can’t seem to fix it on my own, I’m sorry I’m not strong enough to just deal with it.”

Can you imagine someone with a life-threatening physical illness saying “I’m sorry I can’t just will this disease away with the power of my mind?” Of course not! The same goes with depression. Depression has nothing to do with weakness. Asking for help is not weakness. Being scared and in pain is not weakness. Navigating your way through this shit every single day—and it is absolute shit—requires a lot of strength. You start your letter saying you can’t control all these issues. But it’s not about control. It’s really about doing the work, every day, in therapy and elsewhere in your life. Part of that work is recognizing you don’t need to be sorry.

Depression robs you of your energy, joy, desire, focus, motivation. You have also been robbed of people you loved. I want you to find the tools and structure that will help get you deal with all of this, get healthy, and get back on track in school and elsewhere. Therapy is one of those tools, but there are so many more.

What can also you deal with times like this are activities that aren’t about career or relationships. Instead, do things that rebuild your connection to your physical self and the physical world. Like exercise—hiking, climbing, running, yoga, dance classes, lifting weights, swimming—something that gets you into your a different kind of feeling mode, a physical one. Maybe something that gives you a little endorphin rush. You might also try spending some time volunteering, which will give you some space in which to focus on something other than what you’ve been going through. Plus it might introduce you to people who can become friends. Look into some mindfulness meditation if your therapist thinks it might help. Take a class that has nothing to do with a career, like a pottery or woodworking or cooking class. Do something with your hands that requires you to focus on it.

Times like this require tools and structure, because times like this are likely to return. Talk to your therapist and ask for what you need. And in your own time, do a little exploring and find what it is that gives you back some physical and mental joy. Should depression and loss visit you again, those habits plus therapy are the scaffolding that can help you more easily climb out of any dark hole you find yourself in down the road.

Lx