It is June. As I sit in my psychiatrist’s office for our first appointment, my first thought is, like most of my thoughts, self-flagellating: “I can’t believe you’re back down here again, how can you be this bad at recovery?”

For a majority of the six years since my diagnosis with chronic depression and panic disorder, I dedicated ample time and energy to building an invisible and wobbling house of cards, shielding my vulnerabilities from the people around me. I am, by nature, extremely emotionally open and communicative; however, I found that perceptions about mental health I had drawn from the two cultures I straddle, American and South Asian, effectively dampened my actual personality and dictated my choices in managing my own mental health. Stigma, discrimination, and misconceptions about mental health and its impact, particularly in the South Asian community but also perpetuated by American media and culture, made me feel ashamed of my illnesses and compelled me to hide them from most people in my life for far too long. This meant that I consulted with very few people about treatment options, leading to missteps and misdirection that lead me far away from true mental wellness. I had been in analytical “talk therapy” on and off since my diagnosis, hating every minute of it but convincing myself it was helping. I was on medication, at heightening doses, that made me numb to my surroundings, my heart, and my brain for 10 months. I stopped taking this medication at its maximum dosage without telling anyone, continuing to fill prescriptions but letting the bottles pile up in the trunk of my car. I added yet another card to a house that only I knew existed.

In early April of this year, five years since the last time I’d taken medication and months since my last therapy session, that house of cards collapsed. One day, I woke up and couldn’t hear anything but my own brain, which, for a person with depression and anxiety, is a pure nightmare. All day, my brain fed me every negative thought I have ever had about myself, even adding in some new ones related to my new job that I love and new people in my life who I care about. My insides and my skin were both buzzing with self-hatred. I moved through the day robotically, unable to engage completely with anyone or anything. As the day went on, I began to feel like I had felt pre-diagnosis: 19-years-old, a kid, confused, scared, and isolated. I spent the entire subway ride home berating myself: “It’s been six years. How could you backslide this far?”

I texted my closest friends, who all responded quickly, but still couldn’t cut through the thick layer of negativity that seemed to surround my body like a straitjacket. I turned the TV to Buffy the Vampire Slayer, but my brain shouted louder than the loudest volume on my television. I colored, I read my favorite books, I did yoga, I tried every possible positive coping mechanism in my therapy arsenal. My negative thoughts only became more persistent and my contempt for myself concretized into my only identity -- I no longer recognized myself. Exhausted and terrified, I finally called my parents, the people from whom I hide my mental health most diligently. My parents are South Asian immigrants who, like most immigrants, left behind family and home to create opportunities for their children. I hid my mental health from them not because they wouldn’t be supportive, but because I felt that I had failed them; I had ruined immigrant narrative they worked so hard to build. They came here so that I could succeed, and here I was, a ball of self-loathing, unable to interpret my own thoughts or even move. I felt a guilt so powerfully revolting that the only choice I felt I had was to hide the severity of my illness from the two people who love me most. That day in April, however, changed all the rules. The house of cards had fallen; I panicked on the phone, breathless and screaming for help. The (retrospectively) funny thing was that even as I asked for help, I was unable to think anything but “I hate myself. Why are you doing this to them?”. Guilt and shame are toxic. My depression clutches to and amplifies toxicity, feeding it to my anxiety, which then ensures that it shapes my entire reality.

Since that day in April, and on every day since, I’ve thought critically about the idea of recovery. We who have depression and/or anxiety disorders, doctors who work with patients with mental illness, the loved ones of people with mental illness -- we all have one thing in common. We would like to see recovery as a linear process. I have grown in the way I think about recovery. The truth that I’ve learned and tried to internalize in the months since my delicate, misguided house of cards collapsed is that recovery is a labyrinth, a learning process with no clear endpoint.  

What I was so quick to call “backsliding” actually improved my recovery process in every conceivable way, for the simple fact that it forced me to open up to everyone in my life, fearlessly and shamelessly. I can no longer hide behind anything.  My parents, brother, and sister-in-law are staunchly in my corner, refusing to let me escape to my brain for very long. My friends check in on me regularly, never letting me forget that I am loved. My current psychiatrist works with me on medication management and dialectical behavior therapy, a very active and collaborative form of therapy focused on mindfulness and emotional regulation. She is honest, frank, and responsive. She can read me like a book, and sometimes her prescience scares me. And yet, even with all this support, the right medication, and the best people in my corner, I still have bad days; days where the weight of my diseases feels like the weight of the cosmos on Atlas’ shoulders -- a punishment I have no choice but to bear. I have to constantly remind myself that those days don’t mean I haven’t progressed. It means that I, like everyone else, am in progress.  

It is June. As I sit in my psychiatrist’s office for our first appointment, my second thought is: “You don’t deserve to be better, but the people who love you deserve for you to be better. Do it for them.” One day, I hope to get to the point where I can believe I deserve to be better. For now, I sit, scratching the scars on my wrists and the backs of my hands, curling my toes with anxiety, but ready for the session to begin.