Depression is not all-powerful and treatment is available, but to get help, you need to lean on the people around you and seek assistance from experienced professionals.

From the king’s hand the black staff fell clattering on the stones. He drew himself up, slowly, as a man that is stiff from long bending over some dull toil. Now tall and straight he stood, and his eyes were blue as he looked into the opening sky. “Dark have been my dreams of late,” he said, “but I feel as one new awakened.”—J.R.R. Tolkien, “The Two Towers”

Mornings are when I feel the most broken. There is a tug-of-war between mood and action. Unfortunately, all too often, mood wins this battle and imposes a sort of maddening paralysis. To the outside observer, it looks as though I’m just getting some additional rest. Those who have struggled with clinical depression know there is no rest in those moments, and for many of us, it’s the worst part of the day.

I have dealt with major depressive disorder for most of my adult life. Sometimes, people with this condition say they “struggle” with depression, but in my case using that word would be a lie. There have been times where there was no struggle. Instead, there was more of a resigned acceptance, because struggling would require reserves of emotional energy I did not have.

My worst depressive episode was in the months after I graduated from a master’s program and could not find a job. At one point, I spent multiple days in the same clothes, did not bathe or shave, and spent as much time as I could in the dark. I have no clear memory of those days, which is both frightening and a relief.

Last spring, I felt the first stirrings of a major depression and struggled (honestly this time) with it over the next few months. When the summer ended, I was exhausted and stopped fighting. I fell into a hole because it was easier than pushing back. I told no one, because I figured I was already taking medication for it and I just had to once again weather the storm. That resigned acceptance could have turned into the worst decision of my life, because it led me to the point where I considered ending it.

On my darkest days, I engaged in what is known as “suicidal ideation.” I was not actively planning to commit suicide, but I was definitely nearing the exits that led to that destination and realized I needed to get off the road. When I started to seriously wonder whether my family would be better off without me, it was time to call in the experts.

It’s Hard to Tell Others the Truth, But Worth It

Since then, I have learned there’s a vast chasm between admitting one is depressed and walking into a psychiatric hospital for treatment. Willingly entering a hospital is not easy, and normally I have only done so when some sort of physical problem is too acute to ignore, such as the time I cut off part of my thumb while slicing lettuce or realized I might have some sort of lung infection. The psychiatric hospital is different, because my only symptoms were in my head, and I wasn’t sure they could be as easily mended as a cut thumb or an infected lung. But I went in.

I talked to specialists, and they adjusted my medication and recommended therapy. Following their guidance has led me to the point where, like Theoden, I feel the stirrings of being “one new awakened.” I’m not cured, because I don’t think that’s possible with this. In the past, I’ve been encouraged to treat my depression as a chronic condition like diabetes. That is a good approach, but the flaw in the comparison is that being a diabetic, or having chronic pain, or some other physical ailment are all tangible. They can be seen, and felt, and diagnosed with confidence.

Depression is different. It’s a phantom. You can’t see it with an MRI or a CAT scan. It doesn’t show up in blood tests or manifest itself as a tumor or cyst. It is subjective, fleeting, and invisible and the people treating you and around you only see how it affects you, not what it’s actually doing to you. Depression is not diabetes, or chronic pain. It’s like falling into a cold hole with smooth walls, where escape seems impossible.

Fortunately, it’s not. Depression is not all-powerful and treatment is available, but to get help, you need to lean on the people around you and seek assistance from professionals who are trained to treat diseases of the mind. The first step to treating an illness is to acknowledge it, to yourself and others.

‘I’ve Been Down Here Before and I Know the Way Out’

“The West Wing” was a brilliant series for a few seasons, and one of my favorite moments was in season two, episode 10. One of the characters, Josh Lyman, is struggling with drug addiction, and his boss Leo McGarry, a former addict, knows what he’s dealing with and tells him a story that moves me every time I watch it.

“This guy’s walking down the street when he falls in a hole. The walls are so steep he can’t get out. A doctor passes by and the guy shouts up, ‘Hey you. Can you help me out?’ The doctor writes a prescription, throws it down in the hole, and moves on.

“Then a priest comes along and the guy shouts up, ‘Father, I’m down in this hole. Can you help me out?’ The priest writes out a prayer, throws it down in the hole, and moves on.

“Then a friend walks by, ‘Hey, Joe, it’s me can you help me out?’ And the friend jumps in the hole. Our guy says, ‘Are you stupid? Now we’re both down here.’ The friend says, ‘Yeah, but I’ve been down here before and I know the way out.’“

Major depression is a hole. I have been in that hole, and more recently than I like to admit, it’s led me to the darkest thoughts in which one can engage—the idea that those around you would be better off if you were gone. If you’re in or have struggled with being in a similar hole, I know what you’re dealing with. I cannot lead you out of it. I can, however, share a few tips that have helped me find my way out.

1. Accept and Admit

This is a difficult step, because depression seems like failure and admitting and accepting it can feel like defeat. It is not. The reason for depression has nothing to do with who you are, how you live, what you do, or what you’ve done. If you have any of the symptoms of major depression, please proceed to step two.

2. Tell Someone

Sometimes, it seems as though there’s nothing better than being alone with my thoughts because I can easily distract myself with a good book, movie, or social media. At those times, introversion equals peace, but that peace is always temporary because depression thrives on loneliness.

Seek out someone to whom you can be honest about your feelings. If that’s a friend, invite him out for dinner or a drink and tell him everything that’s going on in your head, even if you can’t fully explain it. Tell your health care provider at your next appointment. Tell your religious leaders. If you’re on social media, be honest with your followers. Depression cannot be fought alone.

3. Seek Treatment

Every depression is different, and to get proper care, you need to seek the opinion of someone trained to diagnose and treat it. Talk to your health care provider and if he or she prescribes a drug for you to take, do it. Drug companies are too often perceived as villains, but their work has kept me alive. That’s not something I say lightly, or to be dramatic. When depression descends, your brain needs help to fight it. At its worst, depression can be a fatal condition, and I am thankful drugs exist to help those of us who deal with it.

4. Realize Therapy Is Not Weakness

When I realized the extent of my current depressive episode and where it could lead, I made arrangements to meet with a therapist every month for as long as it takes to figure out how to deal with the darkness that invades my head and interrupts my life.

I do not want to be in therapy. I do not want to talk to a stranger about my mood and the dark thoughts that threaten to overwhelm me, but I have, and will continue to do so for the same reason I take blood pressure medication—there is something happening with my body that I cannot fully control and need help to treat.

Living with depression is not easy, and it takes much more than these four steps to deal with it. The good news is that medical science and psychology have developed ways to fight it, but that battle should not be waged alone. I will end with a plea: if you are depressed and struggling against a sadness you don’t understand, reach out to those closest to you. You don’t have to stay in the hole.