My Fish Are Dead!

Or the Importance of Treating Mental Illness

When I was about 16 my OB/GYN diagnosed me with PMDD (premenstrual dysphoric disorder) and recommended that I start taking Sarafem (Prozac for women). This diagnosis and treatment plan excited me because for the first time in my life I felt like someone saw me, understood me, recognized my struggle, and was going to help me. Up until that moment I thought I was broken, too sensitive, melodramatic, should just "stop it." Now, I had a real thing. A real thing that could be treated. I could stop having all these feelings all the time. I could get better. I could be "normal."

Then, I drove home and told my mom about my appointment. She immediately discredited the doctor and forbid me to have the prescription filled because "didn't I know what happened to kids under 18 who take SSRIs? They commit suicide." End of story. No discussion. You're fine. You absolutely do not have that. Now, let's have dinner.

To say I felt deflated is an understatement, and I often wonder how the trajectory of my life would have played out had I been able to start getting treatment for my depression at such a young age.

Instead, it would take me ten years, countless poor relationships, 70 pounds, and numerous risky behaviors to seek out and get the help I needed. I was most definitely not fine and I most certainly did have that. I just couldn't always see it and neither could those who loved me.

I don't blame my mom; I know she was just scared. And I've mostly stopped blaming myself; I was scared too.

But I haven't, and I won't, stop blaming our society. Did you know that 80% of all people who had a physical illness got treated for their medical condition last year, while only 40% of those with a mental illness did? Or that one and ten adults report being depressed? Yet, nearly two out of three don't seek the treatment they need.

This is not okay. The stigma we have created around mental illness is not okay.

Mental health issues are just as real as physical ones. I'd even argue that they're more powerful, more influential, more detrimental (at times) because they come with a large dose of guilt and shame. And they permeate our whole entire lives, including our ability to genuinely connect and be in this world. To experience love, joy, and contentment which are just as much birth rights as health, or did we forget that line about the pursuit of happiness?

No one finds fault with the person who gets treated for cancer. No one whispers about them, questions their abilities, denies their symptoms, criticizes their choices, tells them to "just get over it." But those are all things I've heard, things my clients have heard. 

Things that cause millions of people to suffer in silence each year. And that is not okay.

What happens to people, to families, to towns when mental health issues go unresolved is not okay.

So, in honor of National Depression Screening Day I beg of you to begin thinking about health differently. Take your loved ones seriously when they reach out to you and even more so when they don't. Take yourself seriously. Your feelings are real and you matter.

Let's start making getting our souls "fixed" just as important as our bodies.

And because there are many people who've said it better than I ever could, here are some of my favorite depression related links:

A hilarious and accurate description of depression.

It would be like having a bunch of dead fish, but no one around you will acknowledge that the fish are dead. Instead, they offer to help you look for the fish or try to help you figure out why they disappeared. 

An incredibly moving podcast about how depression is treated in rural Africa. Transcript here.

He said, “You know, we had a lot of trouble with Western mental health workers who came here immediately after the genocide, and we had to ask some of them to leave.”
I said, “What was the problem?”
And he said, “Their practice did not involve being outside in the sun, like you’re describing, which is, after all, where you begin to feel better. There was no music or drumming to get your blood flowing again when you’re depressed, and you’re low, and you need to have your blood flowing. There was no sense that everyone had taken the day off so that the entire community could come together to try to lift you up and bring you back to joy. There was no acknowledgment that the depression is something invasive and external that could actually be cast out of you again.
“Instead, they would take people one at a time into these dingy little rooms and have them sit around for an hour or so and talk about bad things that had happened to them. We had to get them to leave the country.”

Sciencey things and resources.


  1. Very, very good article. I am still concerned with the wrong treatment for depression. Fortunately in the last ten years, medicating depression and other mental illness has dramatically improved. Sadly, it has been my personal experience that the quality of mental health professionals varies greatly. I have worked with a lot of mental health professionals and way too many should not be in the field. I know someone who went to two different counselors. Both counselors insisted that this person relive and relate a very traumatic event. Both counselors decides at the end of the session that they couldn't handle this person's trauma. So basically these mental health professionals insisted on ripping off the scab, dig around in the wound and then refuse to wash and bandage the wound. This is not unusual.

  2. Sadly, I agree with your assessment about the quality of professionals in the mental health field (and I'm a therapist!). I've come into contact with numerous counselors I've had serious concerns or doubts about. How we police ourselves, practice ethically, and "weed" out those who are discrediting our profession and causing harm is something I often think about. Ethically, schools have a responsibility to "deal with" students who are questionable and maybe shouldn't be in the field. However, I don't often see that happening in a meaningful way. Those sorts of conversations are hard/some what subjective and often academic institutions are more interested in cashing in on tuition fees than adhering to ethical standards. I read somewhere once it takes an average of seven therapists before a client's problem is resolved. Such a sad statistic, and one that as professionals we need to have a good hard look at. Thanks for raising this point. And I must say, I'm pretty horrified by your story. It certainly doesn't help mental health treatment become more accessible if people are coming into contact with these types of professionals.