I look at other people and I think, “He lives without meds. She does. What is wrong with me? Am I so biochemically screwed up, so neurotic, so narcissistically self-absorbed that every hour is an obstacle course for me?” I don’t know, but this can’t continue. I feel like I am dying. A slow torturous death. And the worst thing is that I’m taking other people along for the ride. But I swear, I don’t know how to do it differently.

I am afraid. Afraid of managing the desolation of each second. Afraid that I won’t make it to the next hour. These feelings are still so alien to me. Time used to be something I loved to play with, to tease, to race. But there is no contest now.

Depression is such a cruel punishment. There are no fevers, no rashes, no blood tests to send people scurrying in concern. Just the slow erosion of the self, as insidious as any cancer. And, like cancer, it is essentially a solitary experience. A room in hell with only your name on the door. I realize that every person, at some point, takes up residence in one or another of these rooms. But that realization offers no great comfort now.

Depression is not a sudden disaster. It is more like a cancer: At first its tumorous mass is not even noticeable to the careful eye, and then one day—wham!—there is a huge, deadly seven-pound lump lodged in your brain or your stomach or your shoulder blade, and this thing that your own body has produced is actually trying to kill you. Depression is a lot like that: Slowly, over the years, the data will accumulate in your heart and mind, a computer program for total negativity will build into your system, making life feel more and more unbearable. But you won’t even notice it coming on, thinking that it is somehow normal, something about getting older, about turning eight or twelve or turning fifteen, and then one day you realize that your entire life is just awful, not worth living, a horror and a black blot on the white terrain of human existence. One morning you wake up afraid you are going to live.