Sarah Silverman is best-known for her comedy. But the new film I Smile Back is a drama, in which she plays a woman who suffers from profound depression.

It's a subject with which the comedian is intimately familiar.

Silverman tells Fresh Air's Terry Gross that she first experienced depression as a young teen. "The depression I experienced [felt] like a chemical change," she says. "It was like my perspective of the world changed about three degrees, and everything I saw was different."

Silverman remembers telling her stepfather, "It feels like I'm terribly homesick, but I'm home. There's no way to satiate it." She adds, laughing, "I don't know that I knew the word 'satiate' at that time, but ... that's what it felt like."

By the time she was 14, Silverman was taking prescribed Xanax for depression, but that regimen left her feeling numb. Eventually she switched to a different medication.

As an adult, Silverman still falls into what she refers to as "intermittent downward spirals," but, she says, she pushes though with the help of her current medication and her past experiences.

"I have lows, you know, everybody does ... but I kind of know how to handle it," she says. "I like to let myself wallow in it. I enforce it with terribly sad music, and it kind of pushes me through to the other side eventually, and I always know it's going to pass."

Interview Highlights

On her character in I Smile Back looking at herself in the mirror and judging herself harshly

It's funny because there are weird mirrorings of my stand-up [in] this movie and ... they're yin and yang of each other, and I guess that means that they do kind of go together in an odd way. You know, when I say, "Nice try mirror! Those are obviously my mother's boobs." I don't think there is a woman in her 40s who doesn't, kind of, examine herself in the mirror. ... When I catch myself doing that, I make myself say, "I'm strong and my body works!" It helps. One of the greatest things my therapist said to me ... and it really blew my mind in the greatest way, he just said, "Look in the mirror less." And I just thought, "Oh right. That's great! Of course."

On what depression feels like to her

I can only speak from my own experience, and I would say that the depression I experienced feels like a chemical change. When it came over me, when it comes over me, it feels like it's coming over me like a flu. You ever just sit ... and you're fine and the next moment you just go, "Oh, Jesus, I have the flu." It's just that fast. It felt like that. Especially when it first happened in my early teen years. I was about 13 ... and I had been an extremely social person with best friends and the class clown and all of that meant nothing suddenly. Being with friends felt like a burden. I remember just sobbing.

On being put on medication when she was 13

I was sent to a psychiatrist who said, "I'm going to give you a prescription for something called Xanax, and whenever you feel bad, you take one." And my mother dropped me off for my second appointment with him and I remember being in the waiting room and reading an entire People magazine, and I thought, "I've never read a whole People magazine; that must've been so much time that's passed." I didn't know where he was. He shared an office with a hypnotist ... [who] came down ... and he was sobbing and he just screamed at me that my doctor had hung himself. It's really over the top. This is before cellphones or anything, way before, and I just had to wait for the hour to be over for my mom to pick me up. ...

After that my parents, who just wanted to help me, they found this woman who was a registered nurse in Boston. And so we would drive an hour to Boston before school, and I would talk to her. And she would just prescribe more Xanax, more Xanax, and her husband was a doctor, and he would write the prescription. Really, this woman should be in jail. ... By the time I was 14 I was taking four Xanax four times a day. Sixteen Xanax a day. ... I would keep the empty bottles of Xanax in a shoe box, and I just thought, "If somebody finds me, and I'm dead or something, they'll know what was happening." I eventually went to another psychiatrist in New Hampshire ... who was shocked and mortified at how much Xanax I was taking every day, and ... very, very carefully got me off of it. ... By that time I was back. I was 16 and I felt like myself again.

On her more recent experiences with depression

Since '94 I've been on a low dose of Zoloft that has been a godsend to me; it was the perfect fit for me and I feel like I can live life. ... I'm very lucky in that I still experience highs and lows and I think those lows are important, but I am not totally paralyzed and it keeps me from just complete state of paralysis emotionally and almost physically.

On sexism she faced early in her career

I remember a club owner telling me, "Nobody wants to hear that from a girl," you know, but even then I was just like, "Yeah right, old man." It very much was a male-dominated world — despite a lot of great woman comedians, it still was. And my mentors were male ... the people that influenced me and taught me, and I remember that the big thing that they would say and I would listen to it, like, it was OK and true at the time, which was they said ... "Paula Poundstone is a real comedian because you can take her material and a man can do it, and it would be just as funny. She's not talking about tampons and stuff. That's what hacks talk about."

I really took that as truth; I just accepted it as the way things were, and that that was cool, and of course I do love Paula Poundstone. I think she's brilliant. But that that was the only way to be a "real" comedian, the fact that I accepted that, looking back, is so odd. And there was a conceit that you had to make the men laugh because the women were just there on dates and they would only laugh if their dates were laughing, so you had to get the men to laugh — and that was, like, a real conceit. It took years for me to realize: F*** you! Comedy is about talking about my own experience, and I'm a woman, and that's my experience, and just because it isn't yours doesn't invalidate it. It's so obvious now to even argue or talk about, but it was a real thing.

On talking about taboo subjects onstage

I like talking about things that are taboo, because it makes them not taboo anymore. I grew up in a house where there were no taboos, so it came originally from a pretty innocent place, where I was shocked at the things that shocked people. But I do enjoy and feel compelled to talk about things that are taboo. One, because I think I'm a troublemaker inside, if someone says, "Don't say that," it's all I want to say. And also, something I learned in therapy ... which is darkness can't exist in the light, and then that made me think of something that Mr. Rogers said, which is, "If it's mentionable, it's manageable."

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