For a long time I have been asking myself this question: why, in the wealthy, western, space-affording world we live in, does our continued and happy existence consistently prove so difficult for us? Why is mental illness perpetually “on the rise”? The number of Americans who struggle with depression and anxiety alone is in the millions, and SSRIs and benzodiazepines are prescribed as a matter of course. To say this is an issue of individual weakness would be to a) deny the existence of very real illnesses, and b) stigmatize the sufferers. Thinking along these lines constitutes a massive leap back into the dark ages of our national thought, when popular wisdom told us that women emoted out of hysteria and hormones, men didn’t emote at all, and there were no genders in between. To dismiss our nation’s struggle with mental illness as a whiny first-world problem — one affecting only the noxiously privileged and self-absorbed — would be similarly regressive, simultaneously erasing the experiences of those with mental illnesses while making them feel bad for having mental illnesses in the first place. We’re better off just accepting the facts of the situation, and they are as follows: for a large — and steadily increasing — number of Americans, growing up means being at fundamental odds with your own brain.

I’m guessing the average reader of this column has some sense of the discomfort involved in the process of living out a human life. Even those lucky enough to lead conflict-free and resource-rich lives are going to experience some profound unease. This unease may manifest as exhaustion or annoyance with the facts of being alive, as Major Socio-Psychological Qualms with being at one end of the quality-of-life spectrum while so many are at the other, as fear of the awful unknown, as dissatisfaction with oneself on a cellular level. Any combination of these items is enough to sink the serotonin levels in someone’s brain, to send them anxious and miserable to a psychiatrist’s office for Zoloft and Klonopin. And there’s no contesting that some of us are just born with a neurochemical dearth that predisposes us to these conditions. But our national tendency to rely on psycho-pharmaceuticals as panaceas makes it easier for us to gloss the social component of mental illness, which is in desperate need of address.

For those mental illness sufferers who are not white, straight, cisgender, thin, neurotypical, middle-class, able-bodied, or male, to grow up is to get acquainted with the fact that your continued existence requires constant mitigation of the internalized worthlessness you will feel while living in a dominant culture designed to exclude you.1 You will learn this about as quickly as young children learn anything. Maybe you’ll be strolling the playground and some other kid will jump down from the monkey bars and politely (or not politely) inform you that the two of you are now playing house or war or science lab and that you are now the wife or enemy or Igor. You’ll be a little surprised by the role assigned you, because you always thought of yourself as the goofy family Labrador or the code-breaker or the scientist, but apparently not everyone sees you as you see yourself. You’ll become a little more self-conscious as a result — you’ll get used to the role assigned you, you’ll play along, assuming that as long as you’re faking it you’ll eventually make it.

It’s not until adolescence that you’ll find out you’re not going to “make it,” at least not in the way you imagined for yourself. Well-meaning adults who’ve wisely purged all their high school memories often refer to adolescence as a “rocky” time during which “kids are figuring themselves out.” It’s true that this time is rocky in ways both emotional and physical, but I’ve always found the upward-lilt of optimism in the phrase “kids are figuring themselves out” inaccurate. It implies some unfettered self-exploration, a sixteen-year-old trying on new identities like a happy toddler rooting around in her mother’s closet for different pairs of shoes: after some murky-but-pleasant finding of herself, the teenager emerges a young adult ready to dispatch the many and bewildering tasks of adulthood. Problem is, that’s not what happens at all. “Figuring yourself out” is actually a years long mental calculus delimiting the acceptable and unacceptable, the various ways you can fit into the world that will minimize your amount of psychic pain. For most of us, “figuring yourself out” isn’t about trying on a lab coat and announcing that you’d like to be a doctor instead of a firefighter. It’s about realizing that you’ve got to halve your weight, lie about your real gender, or avoid the cops. It’s about coming to accept that through some accident of birth, you’re not exactly what America had in mind when it was searching for a fine young specimen to carry forth the torch of its social and economic progress. Luckily, you can make up for this by playing by an insane and stultifying set of rules that will virtually obliterate your sense of self-worth.

I’ve heard depression described as many things, and have experienced a few different flavors of it myself. For better or worse, we have a need to make meaning of our experiences, and depression is the deletion of that meaning. Depression is an unpunctuated sentence: every meaning-making aspect is there, but the small machinery that renders the sentence a bona fide module of meaning is gone. Consequently, you’re in a perpetual state of watching the paint dry on the inside of your skull. You’re immobilized because the things you were doing were worthless, and everything you could do to rectify the situation would be worthless as well. Sometimes you’re hit with a big, flu-like mental ache, which makes being awake and alive feel like living inside a shattered tibia. These are some of the worst ways to feel. And it’s always possible to be brought back up to sea level with medication, therapy, and the passage of time. But that’s no reason to gloss the fact that depression has some antecedents more social than chemical. Bullied kids who take their own lives haven’t done so in a vacuum, for instance — they have “figured themselves out,” internalizing the cruelty of their peers to devastating effect. No one who takes their own life does so in a vacuum. Everyone who takes their own life has perceived a hopeless stacking of the odds against them, has decided long before commission of the fatal act the best way to “solve” the situation. It should be easier to get help than it is, and it should be easier to know one’s self-worth.

This is one of the heartbreaking consequences of living in a social order which lends its approval to the very few over the many.

Anxiety is the fear the worst is going to happen and depression is the indifference to its happening, or the secret hope that it will. These are two mainstays of adult life in America, and they shouldn’t be. The fact that they are is everyone’s problem. We will continue to have this problem until we eliminate the dominant culture, which insists on passage through a very narrow and privilege-intensive pinhole in order to be considered human. It’s hard to be a woman in a culture which degrades and mutilates the female body and blames victims of rape; it’s hard to be Black when Black people are routinely murdered by white cops who walk free; it’s hard to be transgender when transgender teens have been beaten and murdered by their own parents and significant others. This is not to speak of the constant pre-judgment and microaggressions suffered by members of these groups every day

Having come of age among the flotsam of this messed-up culture, I’d draw a stuttering blank if someone were to point to me and say, “Imagine a non-hegemonic America that is compassionate and socially pluralistic and describe that to me in detail.” I believe the most progressive and humane elements among us are now in the process of negotiating what such a thing would look like. At the risk of sounding utopian,3 I believe such a thing may even be achievable. I have witnessed enough gestures of true kindness, empathy, and ally-ship to keep me optimistic about our investment in the preservation of each other’s lives. But while things remain in disequilibrium, I submit the following: you, reader of this column, are an extremely valuable person — I can promise you this much — and your value inheres in you regardless of whatever’s being said or done around you. Try not to forget that.

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If you are in crisis
and need help, please call:
(National Suicide Hotline)

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1 This is not to say that you can’t be one or all of these things and still suffer from a mental illness. Yes, thin, white, able-bodied, straight, middle-class, neurotypical, cisgender men: you’re certainly accounted for here. Now sit down for a while, because this part of the essay — unlike so many other things in our culture — isn’t about you.

2 The DSM lists ages 16-25 as the onset period for many mental disorders, and “stress” as one of the most frequent triggers. You do the math. (Or the literary arts, as the case may be.)

3 Or “hesitatingly utopian.”