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When I grew up, it was a time of denial, not acceptance. “Retarded” was commonly used as a derogatory slur, and terms like “mental illness” and “depressed” were indistinguishable from crazy or bug-nuts.  People suffered silently, desperate to appear “normal,” whatever that meant to them.

Over the last several decades, developments in psychology, neurology and related fields have challenged prevailing prejudices around depression. Millions of people who live with depression now have many more options for treatment. Unfortunately, the progress in public acceptance doesn’t seem to have kept pace with the research. 

As I started to write this blog, I intended to tell my story, as I always do, about how my life has been impacted by this particular disease. I expected to speak out, the voice of one impacted by the illness of loved ones. Ironically, I am caught in an internal battle over what to share, and what to withhold, in this blog about the absurdity that we (feel the) need to withhold anything. I have stories to tell. And they are not mine to tell. And the battle wages on. 

When you’ve lived with depression – I mean really lived with the perniciousness of that invisible disease – it leaves an indelible mark. But like the battered wife who covers bruises with make-up and dark glasses, the vast majority of people living with depression continue to suffer in relative silence. 

You see, depression still hasn’t really hit the realm of an “acceptable” illness. 

Cancer, for example, is a deeply respectable illness. Instead of whispers, we have marches and walks, wear wristbands, and call for more research without apology. We have launched a war on cancer, as well we should. Similarly, with up to one in 90 boys now diagnosed with autism, we accept the disease and its impact on families who live with it as legitimate, difficult, worthy of our attention, and most of all, (mostly) shameless. There is a different kind of war on autism – after all, it’s a disease that you live with, rather than try to defeat – but its vogue is no less tangible.

With a difficult “disease du jour” you can speak publicly, telling your story, without fear of recrimination, and without shame. In turn, you get support, sympathy, encouragement, and messages of hope from the outside world. 

But what if you suffer from depression? What if you are living with some combination of depression, anxiety, bi-polar or ADHD?  More than likely, you are still (at least partially) in hiding. 

Hiding. It hearkens back to secret panels in walls across Europe during the war. It brings up images of gay men and women in the pretense of living heterosexual lives. Hiding – without acknowledgement, suffering pain and shame for a situation beyond one’s control. When it comes to mental illness, it doesn’t feel like we’ve come very far. Still, we speak of it in hushed whispers in the dark. 

Fear around the admission of mental illness is all too real. There are genuine risks –of being deemed “unfit,” of recrimination in employment, of losing custody of a child, or becoming uninsurable.  It is just too dangerous, the risk of adding insult to injury too great. And so, as I dance with my internal struggle, I’ll tell you a story that I know all too well, but is not really mine. 

At a time when photographs were still in sepia tones and airplanes were a rare adventure, my cousin Ruthie is said to have taken her own life. I know very little about the girl in the photograph, except that she wore a jaunty hat and showed a lot of personality. I can’t tell you Ruthie’s story. But I bet I know a lot about the story her mother, or sister, or daughter, or spouse, or friend might have told before depression, and the secrecy and ignorance surrounding it, took Ruthie’s life. 

With some degree of certainty I can tell you that Ruthie’s mother suffered greatly, knowing that there was something her child needed that she couldn’t provide. I know her sister felt the weight of her parents’ inattention, exacerbated by the unspoken suspicion that she might ultimately become her sister’s keeper. Ruthie’s daughter, had she lived long enough to have one, most certainly would have felt responsible for her mother’s illness, eager to please and hungry for her attention. 

Ruthie’s spouse, I assure you, would have lived a dreaded daily existence, unsure as Ruthie left the house in the morning whether she would, in fact, return in the evening. Her friends would have found her charming, and difficult, fascinating, but unreliable. Some had long since given up on her, others stuck close because they saw a glimmer of hope – a glimmer that Ruthie never saw herself. 

All of these people – the mother-sister-daughter-spouse-friends – lived in the wake of Ruthie’s Depression.  And so it goes with mental illness – it is silently devastating, either because we don’t know it’s there, or because its secrecy makes liars and deniers of us all. 

At this point, the whisper of depression may keep us quiet about our personal circumstances, sketchy about the details, for our own personal safety. But there is no denying that this silent disease looms larger than life, and the least we can do is speak clearly about its existence. At the end of the day, it’s the only way to get us all out of hiding.