My Friend Jen: A Mental Health Story

It was midmorning on the Friday after Halloween in 2017 when Jen called me. She wasn’t crying, not really. Instead her voice was thick with fear, panic and utter exhaustion.

Carly, I want to die. Carly, I think I’m going to kill myself.

Jen. Where are you?

Twelve years ago I worked as a crisis counselor. As a part of my job I answered a 24-hour hotline. In this position we were trained to ask one question at the very beginning of every call: “Where are you?” This question translates to something very important in the middle of someone else’s emergency: How can I get to your location?  If this call becomes dire, desperate or messy – How can I get a human being next to you?

How do I save you?

Jen! Where are you?

I held my breath - praying for an answer.

A Worrier

Jen and I met when we were twelve and thirteen - blue-eyed, straight-A students trying our hardest to be good Christian girls. Jen had brown hair and freckles and lived in a doublewide trailer close to the youth group we attended. I remember sleeping over at her house for days at a time, running around the neighborhood with Jen and her sister in the Florida heat, our flip flops slipping on the gravel as we visited other trailers, ducked under fences, caught rides to Blockbuster. I lived 20 minutes away, on an acre of land with a pool and a big house. Nobody smoked inside at my place, I had my own room, and a lot of space to call my own. But I felt immediately and completely at home with Jen and her family, I loved being over there.

As Jen and I grew up together we watched our stable homes become broken ones, navigating divorce and moves and single moms with the bossy grit and heartache of eldest daughters. We watched giggling crushes become awkward boyfriends. We watched high school fly by. We graduated, went away to college. I watched Jen get a responsible degree and a responsible job. She watched me do the same. We danced at each other’s weddings. We both slowly decided not to have kids. Jen moved in with me when she separated from her husband. I sat next to her and held her hand in court for the divorce. Two blue-eyed, straight-A students - trying our hardest.

After Jen’s divorce was finalized, she got a degree in business and moved to Detroit. She works as a sales coordinator at a major company and has a cozy and cheerful apartment outside of the city. Last November I flew out to see her. We curled up on the couch, watched the snow melt off the trees beyond her balcony and talked about the depression that has plagued her since college.

“It’s just, such a real and big part of my life,” she tells me. “It’s so tangible.”

We’re both in our mid-thirties now, and have long since replaced running around and ducking under fences with take-out and Netflix – but ultimately we spend the weekend doing the same thing we’ve always done: watching movies, spending time, gossiping, listening. I feel immediately at home in her apartment. I closely examine the walls, decorated with positive quotes in frames and plaques. Pictures of friends and family are on every surface. She has made a nest for herself that radiates happiness. But it doesn’t always take.

“You don’t feel sad, you feel hopeless,” she describes. “When I get real low, beyond feeling hopeless, I feel very broken. It just stands out to me that there’s something wrong with me. That I’m not normal. That I’m broken and nothing’s worked to fix it. So the thought of continuing to try, just sounds like too much.”

Jen first started taking anti-depressants when she was nineteen, to address increasing anxiety. She was always a very anxious kid – she remembers a panic attack at Disney at age ten – but it was never truly addressed as a problem. She was seen simply as “a worrier,” a kid who got stomach aches (and maybe not great in crowds). But when she went away to college, physiologically she felt a change. A free-floating anxiety and a full-body emotional ache.

“People imagine it like where you're crying all the time and stuff. It’s not like that,” she says. “It’s physical, for lack of a better word. It's an ache; it's like my whole body just struggles to do anything. Like it’s physically exhausting to stand up and go to the bathroom. Put my clothes on. And these times aren't constant, but I would say the majority of time there's always this fatigue even when I'm in a good spot. Have you ever heard of the spoon theory?”

I hadn’t. The Spoon Theory is a concept that was introduced by Christine Miserandino to illustrate the burden of chronic illness. The theory is that those with chronic illness only have a limited number of “spoons” that they can use to get through their day. Everyday activities such as taking a shower, getting dressed, making a meal – all take away a spoon. On harder days these activities may take more than one. Spoons are only replenished with a good night’s sleep.

“I only have so many spoons in a day. You can borrow spoons from the next day to get through your day but that just leaves you with even fewer the day after that. Till eventually you're just out of spoons and your body just stops. I always tell [my sister] when I'm really feeling bad, ‘I’m just outta spoons.’”

Jen was put on a series of anti-depressants, always prescribed by a primary care physician. “Nobody ever did a psych referral, not once. Nobody even ever suggested it. Even after I was married and the depression got bad.

“I can't remember how far into being married I was, but I started noticing [less] good days [than] bad, the extra sleep.” Married, in a steady job and a beautiful home, Jen was supposed to be happy. But her depression was getting worse.  I remember hugging her goodbye at the end of an impeccably put together Christmas party at her house. She was gorgeous, in a red dress, her hair styled in waves. “This was a great party,” I said to her. “I just want to kill myself,” she whispered into my ear. I leaned back from our hug and looked into Jen’s face, shocked. She pulled away and laughed, making it into a joke about party stress. It wasn’t.

And so it continued, the good days and bad. Rationing spoons to make it through a marriage that wasn’t working, business school for a new start, a divorce, five moves, a new career, two new states - things that would be difficult for anyone to do, let alone someone fighting this insidious disease. “It’s lonely, so lonely,” she tells me. “It’s embarrassing because you feel like there’s nothing physically wrong with you.”

There’s nothing anyone can see. Jen is beautiful. She’s almost always perky. She has a wonderful smile; she’s smart, a hard worker, a great conversationalist. And she’s a people-pleaser. Much like myself, she feeds off of impressing the people around her. To disappoint is to fail.

“It’s frustrating having a disease that people don’t see or understand. I know it sounds really bad but sometimes I wish I had a terminal disease. It would kill me so I wouldn’t have to feel bad about killing myself. People could understand my struggle. Because if I give up now and I lose this battle, I’m going to make people angry. Nobody’s gonna say ‘Wow, she fought so hard but the disease took her.’ That’s not how people look at that. People look at you like you’re weak.”

I tell Jen it doesn’t sound really bad, it sounds honest. Because it fucking is.

I tell her I don’t think she’s weak. Because she fucking isn’t.

I watch the snow drip off the trees outside.

“Tell me about the what happened.”

Done Fighting

She had been feeling herself slipping for days before, what she calls getting into a “bad spot.”

“I wish I could explain the feeling but it's a particular like… You know kind of like you would have if you had a bad knee or something, and you could tell it was flaring up? I can tell when my depression’s flaring up because there's a state of mind, and there’s a particular feeling my body is in.”

She tried to trick her way out of it. She went to Halloween Zumba on Tuesday. She forced herself to go to work. She reached out to loved-ones. But she could feel it getting worse and worse and by Friday she had reached the end.

“It got to the point where I was just so tired and I was just done fighting. When you go through periods where every day is a fight to get through, you just get to the point where you're done fighting. And it starts - and I say it starts because I still get to these points - it starts where you start thinking: It wouldn’t be bad if I went to sleep and didn't wake up. It actually sounds relieving. I knew when I started having those thoughts about going to sleep and not waking up that that was kind of bad. But when it got to: Okay well I've got this pill and that pill and this many of everything - the actual planning. And then you know: Well, I could take this that'll make me sleepy. So that at least when I OD on this like maybe, hopefully, I'll sleep through the bad part. And I'll be honest like I even thought about: Okay, I'm gonna take a bunch of stuff to make me sleepy, and then I’ll just slit my wrists. You start having plans and it scared me and I called you.”

I ask her why she called me from work instead of from home. She shrugs her shoulders and in her most matter-of-fact “Jen” voice replies, “I had to go to work.” The absurdity of Jen trying to work a full day in the middle of this crisis hits us both and somehow we crack up laughing. Jen has just bravely shared her most secret and terrifying thoughts and yet suddenly we are teenagers again, cuddled on the couch in blankets and socks, fighting back the darkness by laughing in its face. Jen shakes her head.

Sometimes you just try to hold some semblance of order together as everything goes to shit, and sometimes that means trying to sit at your desk, the office humming around you, like it’s any other day. But the thoughts wouldn’t quit. This pill, that pill, sleep through the bad part...

“I was scared. Part of you – it’s logic like: Okay well, you're hurting and you're exhausted so, give up. But then a part in the back of your head says: No, that's not you. You know self-survival, like: Get help. So I called you.”

~

Jen. Where are you?

She was huddled in the hallway by the bathrooms, trying not to be heard by passing coworkers. She was 700 miles away from me.

How could I save her?

My mind scrambled for an answer.

I knew my friend, and I knew her struggle with depression had been long and hard – but this was a new moment. Within seconds it became clear that she had a desire and a plan and the means to execute the plan. But it also became clear that those means were not in front of her at the moment. She had driven to work; she had separated herself from these resources for a little while longer. And she had called me. Jen was saving herself.

Together we came up with a plan that didn’t involve razor blades or too many pills. Within hours she was in her psychiatrist’s office.

Later Jen’s doctor would tell her that he did not see things ending up the way they did when she first walked in. My friend Jen, cool calm and collected entered his office and then all of a sudden just fell apart. “I think I was just desperate at that point to be heard because I was so scared of where I was at.” After a while he told her that he didn’t want her to be scared, but he wanted her to go to the hospital. They will adjust and add in some medications there, he said. They would get her balanced out and make sure she’s okay and safe.

“At that point I was so desperate to be fixed. I was scared to death. I wanted to feel better. So, you know going to the hospital - I was like okay, fine if that's what you think. If that's gonna fix me, then let’s do it.”

And then she drove herself to the hospital, had a wonderful experience and now she’s fixed.

Just kidding.

“Were You This Hysterical Downstairs?”

Jen did drive to the hospital. Alone and brave, waves of despair washing up around her, this pill, that pill, sleep through the bad part playing through her brain, she steered herself towards hope.

And when she first arrived at the hospital hope looked good. It was a very nice hospital. Bright and shiny, and everyone kept telling her that she was checking herself in voluntarily and she could leave any time she wanted.

“And then you get up to the psych ward and it's not nice. And it's very old and worn down and there's bars and the rooms aren't the nice looking hospital rooms because they can't have things in them. The beds aren’t even made until you get there. And it was scary looking and it smelled weird.  So I started having a total meltdown, like crying hysterically.”

It didn’t feel much like hope anymore. It felt like a fucking mistake.

Two men in scrubs were there to check her in. They instructed her to sign a form that said she would stay in the hospital for three days. Through tears Jen tried to explain that this form wasn’t for her. She was told she could leave any time she needed. One man sneered at her, “Were you this hysterical downstairs?” They demanded that she calm down. “Just sign the form.” They told her that it was the weekend and the evening and even if she tried to leave now it would to take three days to checkout.  Jen sought help in a dire situation and somehow found herself in central casting for Snake Pit (with Hotel California on loop). “Calm down, sign this and go to bed.” She looked around. The doors were locked, the ward was dark and everyone was in bed. She had no other choice. She signed the fucking form.

The men assigned her a room, but there was no way Jen was going to sleep. Armed only with Harry Potter and the Goblet of Fire and a soft pink polka-dotted blanket from home she found a little rec room down the hall. In a hard chair at a hard table with harsh fluorescent lights glaring down, Jen wrapped her blanket around her and read, trying to find refuge in her only two sources of comfort in this scary place.

Eventually the morning came. In the place that was supposed to be hope. Jen found her way back to her room and lay in bed, curled up in her blanket, hiding from whatever this place was. Eventually she had to leave her refuge for a phone call. When she returned to her room she found her soft pink blanket gone. An ugly white sock was left in its place.

Shocked Jen peeked out of her doorway and spotted a woman, regally walking through the ward with the blanket knotted firmly under her chin, one sock on, wearing one of Jen’s only two sources of comfort as a cape.

“And the bitch kept leaving me a sock,” Jen tells me, doubling over laughing on her couch in Detroit. The socks kept coming for the rest of Jen’s stay. Sometimes the woman would take the blanket, sometimes not. Sometimes Jen found her soundly sleeping in the bed next to hers when Jen came back to her room, two gifts in one.

Jen’s sister joked with her when Jen would call her from the hospital phone, “Maybe she’s trying to set you free. Like Dobby!” Like Dobby the Elf, from Harry Potter, who was freed from captivity by the gift of a single sock. Jen’s blanket and Jen’s book - two gifts in one.

And maybe she was. After the first sock incident Jen went from laying in bed to, “I'd better clear my head or I'm going to be here for a while.” She started to self-reflect, to participate in group therapy. And although some of that was a little scary – one member shared his homicidal thoughts – she got to know people. “There was something about being around other people too. People that were struggling with similar things that almost kind of pulled you out because you realize you're not alone and that if these people are surviving it you can too.”

And then suddenly she was released.

That Magic Fix

“They let me go fast. And I think probably too fast. I’m pretty good at faking it. I’m pretty fucking good at it.”

She really is. The hospital didn’t adjust her medications like the psychiatrist hoped they would. In fact they barely changed her medication at all. She didn’t have a major breakthrough in therapy. She basically had a long weekend at a horrific hotel. But she went in with suicidal plans permeating her every thought, and when she left she no longer wanted to die. I ask her, “What do you think got you through that crisis? Was it just being somewhere that you couldn’t hurt yourself?”

She tells me that that was a big part of it. Staying safe through that desperate moment. But another part was an acknowledgement to herself that she was, in fact, in need of care.

Once Jen was released her psychiatrist adjusted her medications himself, started her on a consistent therapy plan to get her to a point where she actually felt better, instead of pretending to feel better. She learned about spoons. Jen told him she felt like maybe she would need a week off from work to readjust. “Jen,” he told her, “You need to take at least a month.” She was floored. She had almost lost her life, but the gravity of the situation still had not completely sunk in.

The hospital gave Jen an understanding of how serious her illness is, it gave her a therapeutic plan that is helpful to her, it gave her time to take care of herself. But it didn’t give her a cure.

“You want that magic something so that you feel what you assume normal feels like,” she tells me.  “Because I know my normal, but I don't imagine that other people's normal feels like my normal. So you want that magic fix.  But knowing, knowing, that that's not out there, you become hopeless. You feel like there's nothing left for you. Nothing left that's going to fix you. You've done what you can, you may as well give up.”

What keeps you from giving up? I ask. She pauses and for a moment I panic. What if she has never truly addressed this question? Will she suddenly realize she doesn’t have a good answer and her reasons for holding on will fall apart like a house of cards? But it is a question, of course, that is nothing new to her. It is the question in fact. What makes her stay? When she’s broken and drowning in these waves of hopelessness – what does her life raft look like?

Her first answer is a tough one, “Guilt.” Guilt. As I write it down I want to transform it into love for her family, but the honest answer is guilt for how she would break their hearts. Fear of how angry they would be. A heartbreakingly honest answer that leaves me breathless when she gives it, “Knowing how bad that would hurt for them. That they wouldn't understand, and they would be mad at me. I don't want to die thinking people were mad at me.”

Guilt is a difficult place to live. It shares a hovel with shame and self-loathing. What keeps her here is sometimes the very thing that makes her want to leave.

But sometimes it’s something more. It isn’t easy to pin down. It changes when Jen’s disease has her under the waves. She grasps at what she can. The horizon moves. As we’re talking later she shares more about what keeps her holding on. At first she calls it ambition. As she unpacks it we realize that it’s hope. “Somewhere some little piece of you says you're not done yet. I want to rock my career. I want to feel like I've accomplished something.” She wants a family, but not in a traditional sense – there’s too much risk for her when it comes to children and her depression and medication.  “I really still feel like I will find that special someone to spend my life with. And it's something I really want. And I don't want to give up without that support and that person by my side.”

And Jen is working hard for this. She is building a life in Detroit. She has a job that she loves. People that she loves. She travels, she pursues her passions. It’s January now, over a year since her stay in the hospital. Her depression remains a daily struggle. On the couch in Detroit I say to her, “I look at you and all the things that you do to help yourself and they seem incredible to me. And to you I think they seem like they’re not enough.”

“You see me as strong, I see myself as weak, because I’m not strong enough to overcome what I go through. I think it boils down to: In the back of your head, you think that if you fight hard enough it'll just finally go away. And it never does. It never does. So your efforts seem like a waste of time, almost. And they make you feel like, because it's not going away, you're doing something wrong and you’re failing. It feels like you’re always failing.”

I float my personal philosophy of recovery to her. I tell her that I try to no longer fight with my body and “battle” my chronic illness; that I have tried to negotiate peaceful resolutions instead. That language could never work for her, she says. “It feels like a battle. I don't know what it would mean to be at peace with it. I don't even know what that would look like. But to me right now, it's either fight it or give into it. And there's a difference between being at peace with something and letting it win. And I feel like not fighting is letting it win.”

“And that means giving up?” I ask

She nods. “And that means giving up.”

It’s been over a year now since the hospital stay. She just texted me a few days ago, “Had a bad week last week. I even skipped out on a concert I have been excited about for months. My favorite artist.” She’ll text me and let me know, little SOS’s. She doesn’t want to call and chat, she wants to know I know. And I always want to know. “Bad day,” she’ll text. “Bad spot.” The waves are too high.

And she’ll tell me where she is, because she knows I want to know. “Home, work, business trip.” Jen, where are you? Jen, how do I save you?

But the truth of it is that in this story, Jen always saves herself. She rises, she falls, she rises again - her own hero in an endless battle. I ask if she has advice for anyone who struggles like she does. “Only the things that I’m hypocritical about doing for myself,” she says. But she goes on, “Give yourself some grace. Accept where you’re at in a moment because that moment can change so quickly. Sometimes, I don’t know how or why but I wake up the next day and that feeling I was trying to explain to you, like it’s just gone. To somebody else struggling, just know, you’re in that moment but that doesn’t mean you’re stuck in that moment forever.”

If you are having thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255, The Samaritans (New York City's 24-hour Suicide Prevention Center) at 212-673-3000, or text HOME to 741-741, the Crisis Text Line.