Whether you or someone you know suffers from it or not, you probably don’t need me to tell you that depression is a pernicious affliction. Its milder forms can be debilitating, while the more serious forms can be fatal; not because depression itself is a fatal disease, but because of the lost and hopeless state it creates within a person.

We have numerous drugs to deal with the ways in which depression manifests itself. The medications usually work – if you take them, which many people stop doing once they begin to feel better. They think, “Oh, I’m all better now,” so they leave off the medications. What happens next is as predictable as, and rather like, night following day. There is a long, or perhaps not so long, descent back into a depressive state, which sometimes becomes so severe that the person considers taking her or his own life. Sometimes they follow through on the thought.

It’s a very quiet epidemic, these depression-induced suicides. The epidemic isn’t quiet for those affected by it, though: the families and friends and children left behind, with dozens of unanswered, and now unanswerable, questions.

I’ve suffered from depression for a long time. Recalling how I felt in 1967 and 1968, just before I joined the Army, and reading things I wrote during that period of my life, it seems pretty clear that I was often in a depressive state. At the time, people probably called it “melancholy” or “feeling blue” (an evocative and accurate phrase); unless you were a woman, in which case you were likely to be described as “hormonal,” or some other dismissive term. “Hysterical” was a popular word to use, as were “overly emotional,” and “being too sensitive.” Or the person was written off as being “weak” and “unable to handle it,” whatever it is. Pressure, I suppose, or life.

I wrote that they were being used, but the truth is that people, men and women alike, are still be ignored or marginalized by the use of descriptors like the ones I just mentioned. Those words and phrases are used as ways of writing off someone else’s feelings and difficulties; judging them as abnormal or out of control, and we all know how important control is, right? Because if someone else is out of control, their lack of control might taint you, or worse yet, throw you into an out-of-control state, as if depression is contagious.

Well, actually, it is contagious: emotionally, not physiologically; in the same way that suicide is contagious. It often happens that a suicide in a family is followed, perhaps years later, by another life being taken by one’s own hand. The depression and sense of being lost or overwhelmed gets transferred to another person, because the reasons someone you know and love takes her or his life are so often mysterious; hidden beneath layers of hopelessness and disconnectedness that the person has kept buried as much as possible, because it’s just not ok to be hopeless and disconnected in our bright, shiny, modern world. That behavior is for those people you see wandering the bright, shiny streets, pushing heavily laden shopping carts and having animated discussions with someone only they can see. “Probably off his meds,” people might jokingly say, seeing one of those afflicted, modern gypsies.

This is America, damn it, and it’s not ok to not be ok in America; whether that means mental illness, poverty, or one’s ethnic or gender identity. It seems our rugged sense of individual expression has limits after all.

The only reason I can sit down today and write about depression is because I’m not feeling depressed. Unlike love, which is incredibly easy to write about when you’re feeling it, depression impairs both your vision and your motivation. It narrows your view so tightly that you can only see the negative and destructive things that are immediately in front of you. At the same time, it narrows the focus of your memory, such that you can only recall the negative and destructive things you’ve experienced.

“Feeling blue” is actually not quite accurate, at least not for me. It’s more like “feeling black” – black and tired and hopeless. The more accoutrements of success and happiness you possess – job, car, house, beautiful/handsome significant other – the more difficult it is to live with your depression, because all those things are supposed to add up to happiness, not sadness. They don’t, though, not for everyone, but no one wants to talk about it, until it’s too late, after which survivors are left to divine what went wrong and why.

My depression became more pronounced some twenty years ago, or perhaps it just became more recognizable. I’ve been taking an anti-depressant (Wellbutrin) for almost fifteen years now, and it helps. But the drug is no panacea. There have still been periods of time when I’ve felt severely depressed, despite faithfully taking my pills every day.

Fighting depression is a lot of work, and sometimes I don’t feel like fighting. At times like that, I pull my depression around me like a shroud, as though it will protect me from some unknown, and perhaps unknowable, threat. There have been times when my depression has become so deep that I have thought about suicide. I have a 9mm, semi-automatic pistol which sits in the back of a drawer in my desk, and during those times, I have wished I didn’t know it was there.

It’s thoroughly illogical. I have so much in my life about which to be thankful; so much to live for! But during the black hours and days, none of that seems to matter, because the losses and the failures and the disappointments crowd out everything else. Oh yes, medications help, and exercise helps, and love helps – except when nothing helps. I’ve been fortunate that when those times have come into my life, I’ve been able to talk myself through it, and out of it.

I’m also fortunate that I haven’t been through a period like that for almost three years. At that time, I was in a relationship in which it was not helpful to talk about the kinds of feelings I’ve been describing. I am no longer in that relationship, which is a blessing on many levels, but I do still feel depression at times; medications, exercise and love notwithstanding.

I’ve pretty much resigned myself to the fact that I will live with depression, and struggle against it, for the rest of my life. I’d like to say that familiarity makes the struggle easier, but that’s not always so. Occasionally, familiarity makes it more difficult, because “Oh no, here it comes again.”

So, I will continue to take my medications, and exercise, and eat properly (whatever that means), and I will continue to cherish those who love me, and whom I also love. One thing I am not going to do, though, is be quiet about my depression; or the suicidal thoughts I’ve had, for that matter, because with depression, silence really can mean death.