For a very depressed person, it can feel impossible to "ask" or "reach out" for help. Give them your words instead.

Maybe if we changed the name.

Maybe, not "mentally ill" anymore, which, in the minds of very sheltered, unenlightened people still conjures grainy images of abandoned brick buildings and barred windows, vacant, aimless hall walkers, and wards of untreatable outcasts shouting at ghosts in the overhead lights. 

Not helpfully, in my town, our former "state hospital" (you know what that means) still looks like this on one unattended side----->

And, yes, those are bars.

We can't correct the terms of the past. We can't retro-label those lost souls who did wander halls and battle with overhead lights as mentally more-than-just-ill. 

But we can distance from the old associations with the words mental illness; a scar on the psyche - easy to cover up, but you know, there just the same. 

It is these perceptions that lodge like splinters in the minds of sufferers who are not crazy, or damaged or doomed, but are as nice and earnest and hard-working and kind as anyone, with one exception: 

However they got there, they've found themselves at the bottom of a hole feeling so deeply, impossibly, and hopelessly sad and disoriented, they sometimes don't have the energy to cry. 

For a person who is in that hole, this does not feel like a setback or a lack of energy. It feels like the new truth of their life. It feels beyond the reach of a friend's encouragement, or counseling, or chemical intervention, or a change in diet or location or career. 

It feels like forever. 

As a co-worker used to say before showing me how to avoid a disastrous mistake: "Ask me how I know." 

My first experience with depression came with a move to the opposite coast, one day after marrying my husband. I left my friends and family and job behind, not to mention a sweet, single-girl apartment which offered a view of the water if you carried a chair to the roof, stood on it, and looked through the trees in February with binoculars. 

The second came after the birth of one of our children. Every morning, I woke tired. Every day felt dense with fog until I stopped expecting sunny weather at all. I was exhausted of course, but oh my God, the guilt, because, oh my God, look at this gorgeous baby. And yet, there I was with a brain full of this: 
  

I knew I'd moved from an early to later stage when I couldn't shake the frightening feeling  that this would not get better.  For weeks, I scrutinized my mood. Is it better? Is it better yet?  

I was lucky. In both cases, my depression lifted spontaneously; in the first case ,with intensive contact with my family and friends back home, and in the second, with a hormonal makeover almost three months to the day of its onset.

Depression used to be explained in terms of a person's fit with their life; their ability to cope with setbacks, or their negative self-talk, or, in the minds of the sheltered and unenlightened, their weakness or strength. It is no wonder that sufferers are reluctant to ask for help; the most remote possibility that they will be accused of failing themselves, or not helping themselves hard enough is unbearable. 

Please hold while I feel my full contempt for sheltered, unenlightened thinking.

Okay. 

Good.

We know better, now. We know we can be mentally healthy, develop a problem, become mentally unhealthy or "stalled", but regain our health with attention, intervention, and action and become stronger than we ever might have been otherwise. More and more we are seeing this recovery the way we see people take exercise to heart after a serious not-mental-illness, and wind up running marathons, or teaching others to honor their own bodies.

And, you'd think we'd be blasé now, nonchalant about someone struggling with a mental health issue, the way we would be if Karen in Accounting had bronchitis, another not-to-be-screwed with ailment which is highly treatable with medication or other treatment. 

You wouldn't tell Barry from HR about Karen's bronchitis in hushed tones by the coffee maker, but that's how a lot of people talk about someone who is coping with depression or some other disorder. Worse, it's how a lot of people fighting it think about it.

Even with celebrities coming forward and nice people saying, "it's okay, it's okay," people suffering their own mental health disorder often will not - without swift and meaningful attention - see themselves in those shoes. 

Their shoes are different. They aren't even shoes. They're slippers. Nobody talks about slippers. 

Very depressed people often have given up and simply want to avoid scaring others, shaming themselves, or discovering the worst thing of all: that they can't be helped like the ones who wear shoes.

This is what they do, before they are saved.

Before they are saved.

And that is the way to think about people who are struggling with mental health problems, whether fleeting, chronic, or hidden.

They are stranded, in their dark holes, wearing their slippers-not-shoes.

Struggling with a mental health issue alone is the loneliest thing in the world and it breaks my heart to know there are people who would do anything for someone in their kind of pain, but won't do it for themselves.

So, I plan to be brave enough to approach someone who might be underwater. If it's too hard for them to converse, I'll write them a card, or pass them a note.

I plan to make noise about this. I've got some words and I know how to use them. I hope you will, too.