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Illness Invisible

When I was younger, I wanted desperately to break a bone. I wanted the bright red cast, the steely crutches, the velcro sling — I wanted to be surrounded by Sharpie-wielding classmates, to retell the glorious story of the crash, to decide who would have the privilege of swinging on my crutches at snacktime. I wanted the attention, glory, and power that came with a visible ailment like a broken bone. Some amateur self-analysis has led me to believe that I’d wished to be injured simply for the obvious explanation of any inadequacies — as long as my limb was encased in plaster, I was excused from the stressful expectation of perfection .

Much of this stress came from my family. I was the second child of immigrants who’d sacrificed their entire world for their children, and their first child — my sister — had already set ridiculously high expectations. I was never quite as good as her at piano, math, or art. I was painfully shy while she was outgoing, uncomfortably serious while her presence assured laughter. Though my parents noticed these differences, they always insisted that I, like my sister, had the ability to excel. For a young child, however, there is a terrifyingly fine line between “you can” and “you must.” I, therefore, placed myself under unending pressure, determined to best my sister, resolved to earn the admiration of my family.

Somehow, this internalized motivation slowly seeped into my external world, until I believed that perfection was required of me, that success was a prerequisite to being loved and cared for. So, when this pressurized version of this earth became overbearing, I craved the ease of a simple broken bone.

I still have never broken any of the 206 bones in my body. I know now that I am absurdly lucky to have survived five years of figure skating, eight years of gymnastics, and nineteen years of clumsiness without a serious injury. It is also clear to me how wildly unreasonable and insensitive it was for me, a perfectly healthy child, to wish for the suffering my classmates prayed to avoid. Every once in a while, however, the desire to be visibly sick still tugs at me.

The key concept here is that of visibility. I never wanted the pain, discomfort, and inconvenience of an injury — just the outward appearance of it, the discernibility of my suffering. There must be a pretty messed up version of karma out there, because the only serious disease I am living with now is one that is completely torturous, and utterly invisible.

They call it an invisible illness, depression. For the past three years, I’ve been forced to see just how terrifyingly accurate that label is. There is no way for people to see the chemical imbalances in my synapses, the oversecretion of hormones from my hypothalamus, or the DNA sequences that leave me genetically predisposed to the disease. What is visible is the irritability, the weight fluctuations, the dropping grades, the oversleeping, and the panic attacks.

These symptoms, however, don’t invoke pity, they invoke judgment: a teacher shaking her head as she hands back another test, a boyfriend who asks oh-so-passive-aggressively if I’ve been working out, a friend who just stops calling when I don’t pick up, again. It took months of this for my denial to be outweighed by my need for an answer, but just moments for the cold, bespectacled psychiatrist to diagnose me with clinical depression.

The first thought I had when I was diagnosed was that I had to hide it. I was petrified of being perceived as weak, broken, lazy, or useless. I’d gotten used to a certain standard of living both academically and socially, and I refused to let go of my image as the perfect student, the perfect friend. I adapted, behind the scenes, as my symptoms grew in frequency and magnitude, to preserve my lifestyle. Again, it was all about visibility — I was ridiculously far from perfect, but I did all I could to appear so.

This involved small things, at first. Dry shampoo for the mornings I couldn’t drag my body out of bed early enough to shower, concealer for the dark circles that crept up under my eyes, boxy shirts to hide my exposed ribcage or swollen stomach — depending on where I was along the sine curve that defined my weight. I kept my grades up, maintained a small circle of good friends, and powered through my weekly club meetings. For a while, it worked perfectly — I seemed okay, and the only one who knew I wasn’t was me.

Honestly, I was proud of myself for how well I coped, and was fairly disgruntled that I never received any sort of praise for it. I’d gotten used to the sequence of putting in effort, reaching a goal, and accepting congratulations. But how you’re dealing with your imbalanced neurochemistry isn’t something you brag about at the dinner table, really.

After a few months passed, though, it didn’t take anyone much looking to see the moments I let slip through. First, it was a breakdown in the middle of a French class that led to weeks of uncomfortable looks from my peers. Then, it was a biology test period spent hiding in the girls’ bathroom that necessitated ten emails begging for an opportunity to retake it. Finally, it was my friends calling a teacher to my dorm room when I was so exceptionally cried-out, so exhausted that I could not form a single word to respond to their questions.

It says a lot about me that I didn’t care about what was actually happening to my mental health until my facade of perfection began to fade away. It was at this point that I really began to contemplate the invisibility of it, that I started to see how much difficulty this was going to cause. There was an absurdly frustrating duplicity to coping that flipped back and forth as my mood swung.

I could shut down at a moment’s notice. I never knew when I’d stop having the energy to speak or when I’d hyperventilate until exhaustion forced my diaphragm to relax. And when I was surrounded by perplexed friends and teachers as they tried to fix me, there was nothing I wanted more than to explain to them what was happening — that it was okay, that I was okay, that I’d dealt with it countless times before. It was exactly those times, however, that I did not have the capability to explain what my mental illness was. The invisibility of it stabbed me firm in the back, then, when I would have given anything to have a bright red cast with “Sorry, I’m depressed” blazoned across it.

When I felt fine, though, when I could sit through a class and barely notice the heaviness in my chest, I was terrified of the idea of telling someone that I’d been diagnosed with severe depression. I couldn’t see anyone believing me, not when I’d perfected my image of perfection — at times, I couldn’t even believe it myself. So when I was in the prime mindset to explain what I was going through, I kept my mouth shut. At these times, I was thankful for the invisibility of my illness, for how it stayed quiet when I wanted to pretend my life was flawless.

The solution, I decided, is to do what I’m doing right now. To say when I can that I’m really not crazy – that if you see me hyperventilating in Sig Ep or crying outside G-Heav, I’m okay. Over time, I’ve become more and more comfortable with speaking while I have my voice, more and more accustomed to explaining what my depression is.

However, in doing so, I’ve stumbled across the much more difficult question of why my depression exists. Though modern psychiatry has shown that depression is caused by both environmental and biological factors, I cannot fully face the raw realities of just how much my childhood has contributed to my illness. I wrote this piece in an effort to be honest, yet you may have noticed that I describe my depression solely in terms of my physical chemistry. Even here, on paper, it is hard for me to write of the lasting negative impacts of my childhood — it feels too much like an accusation, feels too ungrateful to place blame on those who love me. And it is altogether too simple to ignore that part, to focus instead on the intangible mutations in my genome, the imperceptible chemicals in my skull.

Yet the more I explain — to friends, to family, to therapists — the more difficult it becomes to see my depression as the product of just my internal biology. Truthfully, I am beginning to think that perhaps they are wrong when they call it an invisible illness. Perhaps an informed spectator could have taken a look at my nineteen years and pulled out, piece by piece, everything from my life that made me so vulnerable to this disease. Perhaps, two years ago, someone could have recognized my struggles and told me then what I have only just begun believing: that I am not weak, or broken, or useless. Perhaps, it is only because they called it an invisible illness that I forced it to be.

By Rebecca Ju.