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.

I always feel bad laughing at people who act crazy. But sometimes the things they do are so damned funny. I wonder what I'd look like if I slipped a few notches on the mental-health index.

Sometimes hell has no words.

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.

The infinity of this vacancy, the pervasive pain, the longing for some spirit, some lightness, some joy - that's all that is left.

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.