“You don’t understand.”

I remembered a conversation I’d had with my mom about her anxiety and depression. Our family never used the word depression properly; I understood it to mean sad or pessimistic. We were out for pizza one day, and she was sitting across from me, wringing her hands and looking both distant and fearful. This is often how she looked. I had come to adopt a particular way of being around my mom. I so badly wanted to help her, but I didn’t want to treat her like a helpless, sick person. So I would pretend that what she was going through wasn’t a big deal, pretend that I wasn’t worried, and pretend that I knew she was going to be just fine. I always forced peppiness and levity.

Sitting across from her over pizza, I asked if she wanted a slice.

No, she said, as she usually did. She wasn’t hungry. She didn’t feel well. Something didn’t feel right.

“Are you sure? This pizza is SO good. Don’t you just want to try?”

No, she shook her head.

“It might make you feel better. Maybe you don’t feel right because you’re hungry.”

She continued looking through me.

Thinking I could appeal to her reasonable side (surely she had a reasonable side, somewhere buried under her chemical imbalance…), I said this: “Mom, think of all the children starving in Africa. Literally starving and dying from starvation. We can’t let this pizza go to waste. We are so lucky to have this food.”

I’ll never forget the way my mom’s distant stare shifted into focus, directly at me. I saw the dragon in her awaken, and she snapped, “You don’t understand.”

And she was right. I really didn’t.

This memory came flooding back to me as I was sitting at home on the couch a couple years ago, feeling crippled with anxiety. R was sleeping, and with my husband out of town, I was terrified that I would be hit with a panic attack while being responsible for our child. What would I do? Who would help me? I tried to talk myself out of it: You’re fine. You’re safe. You have food in the house. You have money in the bank. You have a doorman downstairs. You are so lucky for everything that you have. Transmute all this anxiety with gratitude. Focus on the positives. You’re just focusing too much on the negatives. There are children starving in Africa.

And for the first time in my whole life, I understood what my mom must have been feeling. I wept with heartbroken compassion for her. Poor Mommy, I thought, over and over again. I felt like a failure as I realized I probably never said anything that brought her any peace. I probably made her feel worse by bringing up starving children. I thought about how she suffered for years. And it suddenly made sense. Why she felt she had to give up.

Many of us misuse the word depression and this adds to the general misunderstanding and stigma of the illness. It is not accurate or okay to use the word to express that you feel sad or down. Depression is a complex, symptomatic condition and it looks different on different people. According to the National Institute of Mental Health, having any of these signs and symptoms daily for at least two weeks can indicate depression:

• Persistent sad, anxious, or “empty” mood
• Feelings of hopelessness, or pessimism
• Irritability
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies and activities
• Decreased energy or fatigue
• Moving or talking more slowly
• Feeling restless or having trouble sitting still
• Difficulty concentrating, remembering, or making decisions
• Difficulty sleeping, early-morning awakening, or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts
• Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

Having to live with these symptoms is not normal. It is not our natural state as human beings. It is not a personal flaw or a character defect. It is not something you should feel embarrassed or ashamed about. It is not something that we brought upon ourselves. It did not happen because everything happens for a reason.

Depression is an illness — an actual illness no different to physical illnesses or injuries — and it requires support.

Each person’s treatment and recovery will be unique and I firmly believe you need the professional expertise of a doctor and / or licensed therapist.

I will continue to share more of my personal experience with postpartum depression, but in the meantime, I think it is important for all of us to consider how we are speaking to loved ones that may be suffering. What language are we using? Are we speaking to something we know nothing about? Are we misguided in our advice? Where can we be more compassionate and less judgmental (even if we didn’t realize we were being judgmental)?

I will forever regret not having been able to help my mom. I know I have to work on absolving myself of this impossible responsibility. But I will do whatever I can to support mental health awareness and to stop the stigma now. I think we can all do something.