The following article was rejected by The Huffington Post due to its length and although it isn’t discussing Dermatillomania, I felt it was relevant to publish here as it concerns mental health in general and affects many of us with this condition due to the lack of awareness of it, stigma surrounding it, and the isolation it breeds.

You own a home, have a family, and are generally happy but have been feeling “off” lately. You work hard, you are feeling more tired than usual, and don’t know why. One day, you return from work and sit down to watch some television to unwind from your hard day. Your family hasn’t come home yet so you head to the kitchen to fix yourself a PB & J sandwich to tie yourself over until supper.

When you get to the kitchen, you realize you forgot to bring the jam up from the pantry in the basement. Actually, you’ve been forgetting a lot lately and have even begun misplacing things as you are recognizing when you can’t find the jam. Frustrated, you head back up the stairs to search through the cabinets but can’t because the door had already shut firmly behind you. You’ve been meaning to get that door fixed and it’s been one of the many things on your mind that you’ve put off until you’ve gained enough energy to deal with it. Your wife has asked you a few times to deal with it but you didn’t think it was that much of a problem. Usually a bit of grease to its hinges and a solid nudge flings it open. This time, the door wouldn’t budge.

A common mistake people make is that depression is sadness when it is truly a cluster of symptoms that can worsen over time without the proper treatment. While being down is the greatest indicator of depression, accompanying symptoms can include (but aren’t limited to) a loss of interest in what you enjoy, a lack of motivation, body aches, poor memory, fatigue, and a loss of focus on a task at hand.

Now you’re sitting on your basement steps alone, at 6pm, waiting for the family to come home and bail you out on this unfortunate situation. You become restless as daylight begins to fade and your stomach gurgles from hunger. You try to escape by kicking the door down but it’s too solid to break through so you peek through the tiny window on the other side of the basement to see if you can scream for your neighbor to get you out of this “jam”. Unfortunately for you, the window is too small and the neighbors are in for the night so your screams are left unheard. You’ll stick it out longer though — you really didn’t want your neighbors to see you in that situation because you feel guilty for not being mindful of the faulty door and embarrassed that you are now vulnerable and needing help.

At 8pm, your wife and children come home and you are elated that someone is there to help you. Your wife rushes to the door and you feel like there is hope you can get out of this damp setting and get back to your shows with some real grub. She made a few attempts at opening the door and she’s crying now because she’s unable to succeed. Slightly aloof, feeling like she isn’t doing everything possible to accommodate to your situation, you create a makeshift bed because you’re very sleepy and will need a lot of energy to tackle this problem tomorrow.

The next day you wake up smelling like must with your clothes all disheveled from the rickety couch you made into a nighttime dwelling. Despite your back hurting and your stomach audibly growling for food, you are feeling positive that you’re getting out of this basement today no matter what! In fact, you hear your wife and the neighbors on the other side of the door chiseling away at a rotten edge to create a way to physically interact. Shoot… the neighbors know now but hopefully this situation will blow over so they won’t be judging you forever. Why isn’t the love of your life calling the fire department to get you out?! If anything, she can now hand you the phone so you can make the call and get them over here to do their job.

Mental health services are not always readily available with long waiting lists and stigma attached to a person who seeks out the advice of a professional. Often times, someone with a mental illness will try to “handle it on their own like normal people” because of misconceptions such as, “all you need to do is suck it up” or “you have every reason in the world to be happy.. just snap out of it and be grateful for what you have.”

Now that there’s a glimpse of hope through this rectangular break in the door, you are given scraps of food to get you by but now you’re pretty upset because you have to call in sick for work. There is no way you’re going to tell your boss that you went down into your basement looking for strawberry jam and you got trapped just because you forgot to tie the door open, place a wedge near the door frame, or even get that thing fixed. So *cough cough*, you have a cold which will help for a day or two, but you hope you will get back up on your feet and figure this mess out.

Your family is out again for the day with your kids in school and the wife at her job, so you’re alone but you take this time to rummage through old memories in photo books and old love letters. You start to remember when life was much easier and you tell yourself that you just need to get back to that — once that damn door is open. Luckily, you found yourself some used candles and a few matches in case you end up spending another night down in your dungeon but your boredom and reflections from the past have caused you to take some time for yourself. You use this opportunity to nap, replenish energy, and break this damn door down!

You wake up around supper which now marks 24 hours in the basement and tell yourself that enough is enough. Your wife tells you that the kids are feeling ignored because she’s spending her time trying to figure out how to help you and you are virtually absent while still being in the same proximity to them. She tells you she’s disappointed that you haven’t found any tools in the basement that can get you out. She becomes disgruntled when you disclose that you were napping instead of actively searching for a way out. You are now feeling like a burden to those around you, the ones you love the most.

Suppertime turns to night and she feeds you through the door but her demeanor is less concerned than the day before. You hear the neighbors in the house and her complaining about how all you did was sleep instead of getting your ass out of bed to work on an exit strategy. The basement is exceptionally cold tonight so you light the candles, with only 2 matches remaining, hoping that this nightmare will end soon enough.

The third day begins and not only are you smelling bad but the bucket you found in the corner you use for numbers 1 and 2 could use a Mr. Clean makeover. You’re starting to feel nauseous and increasingly more tired but use the rest of your energy to scrape at the door with a rusty nail, throw heavy objects at it (which furthers your exhaustion) and even set it on fire with one of the matches you found. Your wife, who now serves you food with a sad look on her face, remains quiet except to tell you that your boss called and you no longer have a job because the call center “needs dedicated employees who won’t let the sniffles take them away from the work place”. Crap, you also forgot to call them today and yesterday to tell them you couldn’t make it in all because you’ve been preoccupied with surviving the rough terrain of the basement. Now you’re feeling like you’ve really screwed up and this will put your family in a tighter squeeze financially, so you need to find some way to make it up to them.

On day four you hear a familiar voice upstairs alongside your wife — it’s your big brother’s! He’s someone you’ve always admired with his “tell-it-like-it-is” attitude and of course, his ability to bench press someone twice your size. You hope he will break the door down because his beastly physique has gotten you out of pickles before, but instead, he laughs at you for being “an idiot” for all of the reasons you were worried about. You swear to yourself silently that when you get out of this, you will not even have a door from the basement to the kitchen to ensure this can never happen again. You are surprised at one thing though.. he doesn’t even try to open the door for you. He tells you that you really are strong enough to open it if you truly believe in yourself. What the hell? This silly game is over, but to him you’re just staying “locked” down there because you want the attention. You yell at him to go away if he’s not going to help you and then all voices in the house quiet down for the night.

Do not judge, assume, or ridicule someone who is in despair. It will not motivate them — it will further isolate them. While this man in the staircase is trapped in a basement, someone with clinical depression is trapped in his own mind and cannot escape the negative thoughts or physical symptoms that accompany it. He needs you to talk to him through the door, to listen to him, to advocate on his behalf and most importantly, he needs you to be there.

By the fifth day, your wife comes down and asks you if you’re staying down there, much to your brother’s suspicions, because perhaps you don’t want to come out. She suggests that maybe it’s her or maybe the responsibility of being a parent is too much. You try to assure her that, no, you want out of this dungeon to get back to life but the heaviness in her eyes says she’s not convinced. The smell of your dump of a living arrangement now has you throwing up in the same bucket that cannot be emptied. You are no longer hungry for much because your stomach is upset and it now hurts your back to walk up and down those stairs. Your wife isn’t putting much effort into the meals she delivers to your cell anymore, but she did give you the jam you originally went searching for on a peanut butter sandwich. As she passes it to you, you hold her hand dearly and plead with her saying, “I’m sorry.. I want to make things right” and her half- hearted smile still shows that her belief in you has disappeared.

On the sixth day (or is it now the seventh? Fifth?) you no longer hear your children in the house. Your wife said it was in their best interest to go to their grandparents’ house because the smell from below was seeping upstairs and it bothered them seeing you through the rectangular cut in the door- they also feel like you don’t love them. Food is starting to build up on the top step because you are no longer able to keep yourself nourished without vomiting so even your hunger pangs are no longer present. You feel like you’ve done everything including ripping up the cheap floorboards of the house to dig a hole in the dirt with an old spoon to get out. She got mad, asking if you wanted the whole house to collapse and maybe she’s right, maybe you’re not thinking straight anymore. Of course you’re not trying to collapse the foundation of the house, but you need to get out of the basement because your world is falling apart.

The next day, you see a note that was slipped under the door from your wife. It says that she loves you but feels like your actions lately (or lack thereof) have affected her and the children. It is her belief that if she leaves you that you will get hungry for food, hungry for love and affection, and will miraculously break down that door. Only if you want it bad enough. So now you feel isolated, entombed, and utterly hopeless. The neighbors don’t care about you, your brother blames you, and now your wife and kids are gone. Your job is long gone, you’re in pain, and the problems you feel you’re causing are piling up with the stench around you making it hard to breathe. You are dying on the inside and everyone believes you are the one who has to try harder and that you are copping out of your duties in life. What do you do? What choices do you have?

The lack of education about mental illness leads to a societal attitude that it is an excuse for people who lack motivation to do whatever they want without holding responsibility for their actions. For each day that goes by in the above story, a month passes for someone with depression with each aspect of life crumbling around him. When your mind is ill, it means it is not healthy and that medical attention should be sought out. Loved ones are frustrated and many don’t know what to do when someone dear to them is affected with a mental health crisis.

When you see someone slipping, leaving him alone to “find his inner strength” only further isolates him which breeds the vicious cycle of negative thinking. Some people continue to get trapped in their basements to no fault of their own. Sometimes, other people slam the door behind them and lock it unexpectedly. Other times the door becomes heavy with humidity and swing shut from a breeze. We need more handymen with effective and various tools to help us break through the basement door that keeps us away from our homes with friends and family helping us along the way. Until you are ever trapped within the walls of your mind, please don’t pass judgment on the homes you haven’t visited or the doors you haven’t walked through because there are always locked doors out there that you do not have the key to.



If you are experiencing a mental health crisis and don’t know who to turn to, please visit your local emergency department or contact a suicide helpline in your country. Help is always available.