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 should come with a consumer warning, like the labels that say "Handle with care" or "May be hazardous to your health." I am unfit for human consumption. I struggle to articulate how awful and isolating this feels, but I can't find the words.

The bottom line is that my life has already almost slipped away from me. I have two choices: I can end it or I can fight like hell to save it.

It's enough just to speak when spoken to, to give some minimal reaction to a stimulus. But to actually be the stimulus doesn't even occur to me.

Sometimes hell has no words.

In the psychological literature, depression is often seen as a defense against sadness. But I'll take sadness any day. There is no contest. Sadness carries identification. You know where it's been and you know where it's headed. Depression carries no papers. It enters your country unannounced and uninvited. Its origins are unknown, but its destination always dead-ends in you.

People say, "I have heart disease," not "I am heart disease." Somehow the presumption of a person's individuality is not compromised by those diagnostic labels. All the labels tell us is that the person has a specific challenge with which he or she struggles in a highly diverse life. But call someone "a schizophrenic" or "a borderline" and the shorthand has a way of closing the chapter on the person. It reduces a multifaceted human being to a diagnosis and lulls us into a false sense that those words tell us who the person is, rather than only telling us how the person suffers.