Article updated August 7, 2018

It was a couple of months after my wife left me that I asked a trusted doctor friend a hypothetical question.

“Jalal,” I asked, ”if you had a patient who told you he worked all the time, and slept 19 hours a day on his days off, and barely got out of bed until it was time to go back to work, and had no appetite and felt tired all the time, what would you say was wrong with him?"

The Code Green Campaign has educational content, support and referral services to erase the stigma of mental illness in EMS. (Photo/Code Green Campaign)

"I'd tell that patient that he was clinically depressed," he answered soberly, "and tell him he needed to get help, right the heck now."

"Crap," I sighed. "I had a feeling that's what you were going to say."

Looking back on it now, it wasn’t the end of my marriage that resulted in my depression. In fact, my depression was what ended my marriage. I was uncommunicative and withdrawn, and my wife needed a husband, friend and lover, not the stranger that I had become.

I blamed it on the pressures of work and being new parents of a special-needs child. I was trying to be strong for my family, and I was raised believing that a man doesn’t pass his burdens off to his wife.

But in truth, my stoicism just isolated me more. In the years since, I’ve learned to recognize the pattern, repeated a number of times before I even got into EMS. I get overwhelmed by deadlines and commitments, isolate myself from my friends and loved ones in an effort to get more work done, and without any outside interaction, I lose any creative spark I might have had … which makes it impossible to get any more work done.

At the end of the spiral, I find myself slumped on the couch for days on end with an open Microsoft Word window on my laptop, with nothing but a title at the top of the page. But instead of writing, I’m doing drive-by witticisms on Facebook at 3 a.m., because making funny and sarcastic comments via keyboard is what passes for human interaction when I am depressed. It’s easier than making a real human connection — easier, and infinitely more unhealthy.

Don’t deny depression, fix it

My depression was easy to deny. I never felt suicidal, never had feelings of worthlessness, never wallowed in the proverbial dark pit of despair. I just had … nothing. No energy. No creative spark.

I was tired 24 hours a day, seven days a week. It was easy to tell myself that it was simply overwork, that too many night SSM shifts had taken their toll. I needed rest, not therapy.

It was close to two years ago, when I was going through a rocky patch with my girlfriend, when my ex-wife asked me out of the blue, “So tell me, when are you going to get help for your depression?”

I was flabbergasted. Despite my doctor friend’s diagnosis, I had never admitted it to myself, much less to another human being. I vehemently denied it. I told her she didn’t know what she was talking about.

“I’m not depressed,” I protested. “I get up, and I go to work. I function, I take care of KatyBeth. I’m just tired.”

Her answer was to roll her eyes tolerantly.

“You function, but I’m a mental health nurse, and I’ve known you for 16 years. The way you are now is not you. If I administered a screening questionnaire right now, you’d be classified as major depressive.”

“Major depressives are fat ladies who sit in the dark all day, watch soap operas, eat bonbons, and contemplate suicide. That is not me. I am not depressed.”

“No, that was your mother,” she retorted. “You hide it well, and people who don’t know the real you would never guess. But I was your wife for 10 years, and I’m still your friend. I know what the real you is like, and this is not it. And if you’re not careful, you’re going to lose Nancy the same way you lost me. Fix it.”

Fix it I diD

I’m still fixing it today. Medication didn’t work for me, and psychotherapy doesn’t tell me anything I don’t already know. When I find myself retreating from life, I rely on the awareness of friends and loved ones to call me on it, and I force myself to do those life-affirming things my depression tells me I’m too tired to do.

I go out to movies. I go for walks with my girlfriend. I take my kid fishing. I turn expensive ammunition into smoke and noise. I hit the lake on my jet ski.

Pretty soon, I discover that I no longer have to force myself to do those things. I look forward to them. I go on with living my life, and my energy and creative spark returns.

The biggest hurdle is admitting to myself that I am depressed.

And so here I am, naked and exposed in a public forum, making a confession that, quite frankly, scares the crap out of me: "Hi, I’m Kelly, and I suffer from depression."

Breaking the code of silence

That’s not an easy admission to make, especially for me. I’ve been described a lot of ways; funny, passionate, uncensored, inspirational, confrontational, committed, uncompromising, even being a unreasonable and arrogant prick.

Morose has never been one of them. Only a very few people closest to me would ever even believe it applied. But it does.

I only admit it now because I am tired of reading stories of fellow paramedics committing suicide. I’m tired of seeing EMTs with only a few years in EMS burn out. I’m tired of seeing PTSD turn a partner and a good EMT into an emotional wreck because he was too afraid to reach out for help.

I’m tired of seeing marriages and personal relationships founder because of some twisted ethos that has us believe that the healers should never need healing themselves.

And if me admitting my frailties in front of God and everyone makes it easier for a reader to admit that he needs help, then it will be worth it. That’s why I’m doing this in the most public forum available to me. It’s time to erase the stigma of mental illness.

It’s time to break the code of silence.

One poster on a Facebook page aptly described how EMS people deal with job stress: “We take all the pain and loss and death and horrible things men visit upon one another, and we put those feelings in a box so we can do our jobs. And then we slide that box out of sight under the bed, and we make jokes about the existence of the box.”

If we don’t air that box out now and then, it fills up, and what we put in it festers. It drives good people from our profession. It embitters many who remain, and makes them less than the providers they once were.

Too many of us, it kills.

Recently, a friend formed a group on Facebook aimed at erasing the stigma of mental illness in EMS. It’s called the Code Green Campaign, and they offer an anonymous safe haven to share your stories of depression, or PTSD, or bipolar disorder, or whatever it is that plagues you. They have a website and they offer educational content, support and referral services.

Think of it as crowdsourcing EMS mental health care and peer support. Like the Code Green Campaign on Facebook, and share your story. Show your peers that they’re not alone, and that admitting you need help is not weakness, it is strength.

It’s easier than you think, and it’s empowering.

Hi, I’m Kelly. I have depression, but depression doesn’t have me.