Crystal

Age at interview: 20
Age at diagnosis: 15
Gender: Female
Outline:

Crystal’s depression began in childhood. Her parents were reluctant to seek services, but she eventually got professional help through the school system. She has found therapy and the support of good friends helpful, though still struggles with depression. She does not take medication.

Background:

Crystal is an African American college student. She works campus jobs during the year and internships in the summers.

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Crystal grew up in a low-income household. Abuse was part of her family’s home dynamic, as was the formation of some strong family bonds which remain central to her life’s purpose. Crystal’s depression began during early middle school when things began to feel “very blank” in her life. She also felt unfocused and unable to get excited about anything the way people around her could. 

Crystal first began getting professional help for her depression after a couple of suicide attempts in high school. Her parents were not in favor of bringing in “outside resources”, but her school required that a therapist get involved. However, her family’s mixed feelings about getting help and limited financial resources combined to make that first effort unsuccessful.Therapy she got later, through the health service at her college, has been much more helpful.

Throughout high school and into college, Crystal has used hard work as a distraction from her depression, and as a way to stay focused on her longer-term goal of helping her family and being a role model for her sister. She excels at academic studies of all kinds. She engages in multiple campus activities at her university, volunteers for community organizations, and works at internships during the summer. Her depression continues to exist alongside this highly successful external life, leading her to feel like she has to “navigate two personalities.”

During times of transition she often tries to “start all over” and is optimistic that she can overcome negative thought patterns, but finds that depression and thoughts of suicide return. She believes a focused effort to address her depression, perhaps in a hospital setting, might be useful but does not feel the right time for that process has yet arrived.

Friends, roommates and intimate partners are key supports for Crystal. She is comfortable with her bi-sexuality, and clear with romantic partners about what she can and cannot commit to at this stage in her life. On-going behavioral therapy has been helpful for generating short-term solutions for daily struggles, as have specific tools like journaling or setting discrete goals.

She reminds other young adults that “time is a really great resource in dealing with depression,” so don’t be afraid to realize that “life is going to be slower for you, you are going to operate at a different pace and that’s completely ok.”

She also believes it would be helpful to teach children in school about mental health issues so that there is a basic shared understanding and eventually more acceptance and compassion in society at large.

 

Crystal's parents came from a culture that is averse to looking for help from the outside; they thought she should learn to feel better on her own.

Crystal's parents came from a culture that is averse to looking for help from the outside; they thought she should learn to feel better on her own.

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I realized at that point that there was definitely there was definitely something more serious. I didn’t have the resources to really talk about it with anyone. My parents kept saying you know, “You just need to learn to be happy and to stop being anxious and you, you can do all of this yourself. It’s a self-care thing.” And although self-care is really important in learning how to kind of regulate your own mood, they’re just some like, after the years of experience in traumatization I got from depression, anxiety, suicidal thoughts, I did not know how to handle it myself and I did not have the resources to but because there were people around me, not knowing what was really going on and telling me you know, “You can just get over it yourself,” I wasn’t able to access the proper help that I needed to at that point.

And I realized that you know, “Something is really wrong and I can’t so this on my own but I really don’t know who to talk to. And I don’t think I am brave enough to go seek help,” Because I was, because of how my family perceived getting help, you know therapy and mental illness I didn’t, I thought I’d be shaming them if I went to go seek help and this is a dangerous mentality to get into because if you, if you allow other people to influence your thoughts like that then it’s just it’s not a very good situation and so.

Everyone is already assumed to be mentally healthy. Everyone well I mean especially in my family and you know talking about some of these issues with other people, I have very strong people in my family tend to have very strong sense of self and a very strong sense of how we handle our own emotional mishaps. And so it’s not in our vocabulary to say, “Oh you think, you, you know, you tend to be sad consistently.” This is not really what they understand and of you do end up in that situation, they’re just like, “Well you pick yourself up and you deal with it,” Or you know, “Just be happy.” And you know it’s I really do hate the just be happy things because it’s really like first of all I really don’t want to be happy. Second of all, how, I can’t just be now.

Right.

So just be, just being aware of the fact that you know often times families just don’t have the vocabulary for these sort of things.

 

Crystal says the world is going at a faster and faster pace, which creates struggles for people with a slower personal clock.

Crystal says the world is going at a faster and faster pace, which creates struggles for people with a slower personal clock.

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As a young adult at least now, in this day and age the world is getting more competitive, life goes at a faster pace. I mean unfortunately we live in a society where people tend to be really in a hurry to do things. So you know often times it’s like you know, you really shouldn’t be taking a break right now because you could be spending your time doing this, you could be so much more effective. But how you know, if we switch back 100, 200 years earlier, life was a little bit slower and people took their time with things and you know. So advice that I’d give to people to follow as much as you can is, take yourself outside of this day and age and imagine that you have all the time in the world and just follow your own personal clock. Because time is a really great resource in dealing with depression, it’s a difficult one because often time it forces us to, you know lose time.

 

Crystal managed her emotions about past abuse by using self-harm.

Crystal managed her emotions about past abuse by using self-harm.

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I realized without that abuse as present in my life as it was before, that I actually needed it, and what I mean by that is that I needed to express in other ways. And so part of me at least, how I, you know talked about this with my therapist and how I understand is, that to replace the abuse that I had before, I abused myself. And so that is when, you know, active suicidal attempts, and cutting and everything, and self-harm, that’s when that arose because I just needed something, and what’s interesting is that, when I have panic attacks, I tend to really tense up and then I claw at myself, just because I’m just like, “I need something to hurt me.” Because when I was little, if I didn’t know what was going on or I thought that I did something wrong, I would expect to be hurt in some way, right?

 

Crystal kept vowing to start over, but cycles of harder and easier persisted.

Crystal kept vowing to start over, but cycles of harder and easier persisted.

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So when I graduated from high school, summer after high school I was trying, I was convinced you know I was going to start over. This always happens you know elementary school to middle school, middle school to high school, high school going on to college, I was convinced you know. I know I, the thing is, I have a journal and I keep one and I write in it often I started in high school just to cope with my depression, and I found it helpful but looking back at my journal it’s interesting because I do say some of the same things after a while, like during my transition periods I would always say, “Ok I’m going to start all over,” And then every year for my new year’s resolution would be I’m going to try something differently. But every year there are some setbacks and there are some cycles and there’s some, and there’s some difficulties and I end up, I ended up going back right to where I started. So in between high school and college I was trying to see if it was possible for me to even move my, adjust my thinking.

 

Crystal says taking daily things like eating and chores one at a time slows things down to a level that is more appropriate for a depressed person than is the rush of modern life.

Crystal says taking daily things like eating and chores one at a time slows things down to a level that is more appropriate for a depressed person than is the rush of modern life.

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The world’s always going to go at a fast pace unfortunately that’s how we live right now but what you can do is say, “Ok I’m going to take things step by step.” If you can’t really do anything with your body and you’re not physically energetic then maybe writing something down or just thinking about your thoughts that could be a good place to start. But if you can do something you can say, “Ok I’m going to relocate place, myself to some other place. I’m going to pick up things and I’m going to knit, I’m going to watch a movie.” Take things at a really basic minute level that is a really great, that’s a, that’s at least a really great suggestion for me just because you’re not focusing on the high level parts of your, I don’t know your day to day life or your obligations but you’re focusing on basic things that you need that are run by your own biological clock. Like, “I’m hungry,” So you should go eat or just then while you’re eating take time to process the food and think about how good it is or I don’t know just interact more at a basic level because you just have to admit you know with depression, whether you’re on medication or not, life is going to be slower for you, you are going to operate at a different pace and that’s completely ok.

 

Crystal found that many small goals help her manage day to day, and hopes they may add up to a larger, healthier goal over time.

Crystal found that many small goals help her manage day to day, and hopes they may add up to a larger, healthier goal over time.

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I definitely think that it is very useful, I find, to find something that you can latch onto in life. I know that mine is transient and may not be the most healthy in the long run but it’s appropriate in the short run and it’s reasonable in the short run and while I’m also continuing to seek help, this is a rock that gets me through to the next day. And as I keep you know ticking off and making check marks and how I’m making my way through to that goal, I can also work with my therapist, so I can work with friends and I can talk to people and I can reflect on myself and I can find, find out, you know, how can I then morph that goal into something else, maybe it can turn into another transient goal and then, in which case I still count that as a success.

But perhaps it can be morphed, morphed into a more permanent and more effective and healthier one in the long run. But I definitely think that whatever it is you should have something that grounds you. Feeling up in the air will only cause you more anxiety.

 

For Crystal, telling significant others about her depression is a sign of commitment.

For Crystal, telling significant others about her depression is a sign of commitment.

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It’s really ok to just tell people that, you know, you’re figuring things out on your own, and I’ve found that, that’s been actually really positive in my life, just because, people have shown to be more committed to me when they understand that I’m really trying to be in a, get myself to a better place where I can be fully committed to them. And it shows that there’s care on both ends. And so I, I definitely do respect that. So, anyway, that’s my …

Yeah, and so, and some honesty it sounds like …

Yeah, very much so …

… And you’re really, self-disclosing and clear.

Yeah. I mean, they don’t, they don’t, not all of them know all of the details, but I mean it is definitely enough to say, you know, “I’m, I care about you enough that I want to, you know, really seriously, whole-heartedly, take care of our relationship and our interaction with each other, and part of how I’m going to do that is take care of myself, so that way I can be better able to enrich what we have.” And under that, everyone I have been with has been very understanding, so.

 

As a young student, Crystal describes how her functional self can help her concentrate, but she still struggles to navigate her two personalities.

As a young student, Crystal describes how her functional self can help her concentrate, but she still struggles to navigate her two personalities.

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And so, drained mornings, going through school and, you know, having this other side of me come out I, it brought up kind of a dual personality, because, you know, around people, I knew that, you know, I can’t act how I would if I was just alone by myself in my room. Or with no one around, not even my parents, and so everyone, if they were to describe me they’d describe me as an extroverted person, as someone who is very excited about life, ebullient, and very intelligent, and what not. But, deep down inside, I knew, you know, “Only if you understood how I feel the minute you walk out of this room or walk out of this interaction with me.” And so, I had to navigate those two personalities, it was, I felt, often times I did feel unfocused in school just because, my default train of thought is, you know, “Why are you here? Why are you alive? What’s happening to you? Why can’t you appreciate life as other people can? This is all just pulling to the fact that you shouldn’t be here, you should do something about that.” And so, that train of thought kept going in the background and so I had to find ways to distract myself and what distracted me was my school work. And so I carried through and I ended up doing well in school simply because I was so desperate to avoid that underlying train of thought. But in what, but what that caused, is the cycles of depression, because as I was on my high of being able to just, you know, focus on everything and, you know, just do all my school work, I was able to ignore the underlying issues that I was having and all the thoughts that were jumbled up in my mind. So that’s how high school was for me.

 

Crystal was reluctant to get professional help because of cultural/familial stigma about mental illness but eventually did through her college in a way that was both confidential and affordable.

Crystal was reluctant to get professional help because of cultural/familial stigma about mental illness but eventually did through her college in a way that was both confidential and affordable.

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And then, going into spring semester that’s when, kind of the real traum- traumatizing periods of high school came back. And I realized that, you know, “Something is really wrong and I can’t do this on my own but I really don’t know who to talk to. And I don’t think I’m brave enough to go seek help.” Because I was, because of how my family perceived, you know, therapy and getting help and mental illness I didn’t, I thought I’d be shaming them if I went to go seek help. And that’s a dangerous mentality to get into because if you, if you allow other people to influence your thoughts like that, then it’s just, it’s not a very good situation and so … I really struggled through that semester and then, over the summer, that’s when I officially start-, I just happened to be taking summer classes and so that’s when I was able to seek help through my institution. Because it was, you know, affordable and available to me through, you know, school health care plan. So, and, confidentail- confidentiality is, you know, greatly appreciated and everything, so I was able to do that. And so, to this day I still seek therapy from my institution and what’s nice about it is that, you know, my family for right now doesn’t need to know and I can try to help myself, as I go through.

 

Crystal describes what it feels like to be unable to get out of bed.

Crystal describes what it feels like to be unable to get out of bed.

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I mean, I still suffer from it now. Some of the things that I go through on a daily basis that, you know, you know, kept happening in high school was, you know, it’s really hard to get up, you feel completely pulled down and drained in bed and you, you just can’t get up sometimes.

 

Crystal knows that for some people sexuality is a big part of their depression, but she is among those who 'handles it fine.'

Crystal knows that for some people sexuality is a big part of their depression, but she is among those who 'handles it fine.'

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…There are some people who find that sexuality is a big part of why they have depression or why they have trouble like, you know, learning more about themselves, you know identity issues and things like that, and there are some people who like handle it fine. I tend to be in the category that handles it fine, sexuality has never been really an issue for me. It was, it’s weird because you know I grew up in a traditional family that and I didn’t have the vocabulary for a while to understand you know I am attracted to not just guys, so. And then once I gained that vocabulary I quickly adopted and I didn’t need you know, like to go through this whole like self-discovery phase where I’m like trying to figure myself out in addition to you know figuring myself out on my depression scale and everything. I think part of that is the fact that I’m just so, because I’ve treated life so transiently, I’ve been really comfortable with a lot of things. I’m comfortable with putting myself in weird situations, I’m comfortable like with my sexuality.

 

Crystal says that in the African American culture her family comes from there is no framework in which depression can easily fit. The attitude that sadness can be just dealt with has made depression more difficult for her.

Crystal says that in the African American culture her family comes from there is no framework in which depression can easily fit. The attitude that sadness can be just dealt with has made depression more difficult for her.

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…Everyone is already assumed to be mentally healthy. Everyone you know, well I mean especially in my family and you know talking about some of these issues with other people, I have very strong people in my family tend to have very strong sense of self and a strong sense of how we handle our own emotional mishaps. And so it’s not in our vocabulary to say, “Oh you think, you, you know, you tend to be sad consistently.” This is not really what they understand and if you do end up in that situation, they’re just like, “Well you pick yourself up and you deal with it,” Or you know, “Just be happy.” And you know it’s I really do hate the just be happy thing because it’s really like first of all I really don’t want to be happy second of all how, I can’t just be now.

Right.

So just be, just being aware of the fact that you know often times families just don’t have the vocabulary for these sorts of things.

 

Crystal found that putting her feelings in context and learning from those who've overcome stigma gave her a healthy perspective on the stigma she faces.

Crystal found that putting her feelings in context and learning from those who've overcome stigma gave her a healthy perspective on the stigma she faces.

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And there are tons of people across you know the sands of time who have struggled with prejudice and perception and everything like that and you’re one of many who go through those issues. And you know how, if you look back in time and at how people have dealt with it, they’ve dealt with it full on force and it’s been a struggle and sometimes it can be painful but they’ve dealt with it and that’s how you have to do it in order to come through to the other side. So adopt the tradition of facing it instead of constantly seeking to avoid it because avoiding it will only put yourself back, in your little comfortable space of being anxious, enclosed and everything. And facing it will give you an opportunity to say there’s another side of this.

 

Crystal knows she can turn to her roommate when she hits a low point, but would not expect help from friends who think of her as an extrovert.

Crystal knows she can turn to her roommate when she hits a low point, but would not expect help from friends who think of her as an extrovert.

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What’s really nice is having someone who has gone through what you have been through. And really understands you know what you need.

Because it’s hard to say to like, I don’t know some of my friends and my acquaintances who know me in my extroverted sense. You know, “Hey I’m having a crash right now. I need you to help take me to the bathroom and like take off my clothes and like put me in the shower like I can’t do that on my own.” And they’ll probably ask me you know, “But you’re such an energetic person you know, you can,” They won’t, they won’t really understand, there’s a disconnect but my roommate since she’s been through that kind of situation and she knows, and like we’ve had like more deep in depth conversations about what it’s like and on our own personal ways going through depression. You know she, you know completely understands and she’ll like do whatever is, whatever is possible to like help me out because she knows what it feels like.

…she knows exactly what to do to help me when I’m in my low. Typically when I’m in that dark place, I’m anxiety takes over my entire body, my muscles hurt and I’m not really able to move so what she’ll do is she’ll take me, help me get into the shower like the basic things, I can’t really eat on my own, she does a lot of those things for me and it’s been really helpful.

 

Taking care of her family gave Crystal motivation to keep going even in really bad times.

Taking care of her family gave Crystal motivation to keep going even in really bad times.

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My family’s had to rely heavily on me to help them through a lot of scenarios and situations. And so you know what, part of what has helped me stay here, stay alive is the fact that the rock that I’ve put in my life to hold on to, well the goal that I’ve had to help keep me going through each day is you know, take care of my family. So that’s the main rock that I go through because otherwise, I mean I have to take care of my family and I also have work but I kind of put those two in the same bucket just because by doing you know my school work and my extra-curricular activities and everything I am indirectly helping you know my family you know get to a better place or helping be a role model for my siblings. So that has been the rock that I have put in place in my life and so when I think about suicide now I’m thinking you know, “If you do this you realize that you won’t be able to fulfill that role anymore. And so you’ll probably feel really bad for not being able to you know, uphold that duty again.”

 

Crystal discusses the complexity of mental illness and different treatment choices including medication.

Crystal discusses the complexity of mental illness and different treatment choices including medication.

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For me I find that mental illness is extremely complex and you know it’s medications can help sometimes and they can be beneficial but the medications that are out there, they, at least the most effective ones can take the longest to really take effect so there’s a lag in how effective they can be. It can cause other side effects and I mean in the grand scheme of things if you’re trying to get better in everything I think like medication plus therapy I do think is a really powerful combination. But I do think that sometimes depression issues can be really more of a thought process thing, that may not have to do with the fact that you know you have low serotonin levels or you have low dopamine levels or anything in your brain and you, you legit have a problem accessing happiness period.

And it’s a biological issue. I mean I’m not saying that I’m for or against one perspective but I do think about those things and I, maybe at one point I might want to consider it if I feel that it’s, my depression is debilitating enough that I do need to go down that path. But I have fallen down a lot of times and I’ve kind of made it through and I feel like there could be light at the end, at the end of the tunnel, if I continue to seek help and I continue to be just aware of it. But yeah I mean another medication to you know a list of medications that you know people are already on or that I’m currently taking and everything is just another thing to think about.

 

Crystal talks about her therapist's advice to listen and observe her depression.

Crystal talks about her therapist's advice to listen and observe her depression.

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Advice that my therapist gave to me which is really listen to your depression. It’s hard to do because you think, “Oh my gosh its so, it’s so negative, it’s so painful to do,” But often times just observing it can help. I know that you know I, I started to do this, this past semester, I definitely think it helped, when I’d feel like I as about to have a panic attack or go through a really rough crash, I was actually able to elongate it and mitigate the intensity of it by just saying, “Ok I know I’m about to have one, I feel the rush of emotions coming forward. Let me try to just like accept the fact that they are coming forward and write about it in my journal or like just think about it. And you know work is always going to be there unfortunately I can’t get it done right now but what I can do it just like, just talk to myself and just sort out what’s going on and look at the issues.” And sometimes just talking about it or looking at it just face like right in front of you is helpful because then you’re just like, “Oh this is a thought, not oh my gosh this is happening to me and having all these implications,” You can just kind of look at things as, if, as if, as if they are written on a page right in front of you and so it’ll take you, it gives you a chance to process them instead of live them, if you know what I mean.

Yeah it sounds like maybe getting a little bit more of a dispassionate distance like, “Oh this is happening to me, I observe that this is happening to me and I’m going to not judge that it’s happening, I’m just going to be in it and write about it and live through it.”

Exactly. Yeah. Yeah it kind of takes the anxiety off of it so instead of thinking, “Oh my gosh this is happening to me, I have to deal with it someway I’m not really sure what to do, oh my gosh I’m so worried.” Now you can say, “Ok this is happening to me period.”

Yes.

“What am I going to do next; I don’t have to anything next.” That’s a perfectly logical answer. And you could sit there and you could just let the thoughts happen and you could just keep reminding yourself every couple seconds, “This is happening to me,” And just, just put a period at the end of your thoughts that way they’re not rushing on.

 

Crystal was reluctant to get professional help because of cultural/familial stigma about mental illness but eventually did through her college in a way that was both confidential and affordable.

Crystal was reluctant to get professional help because of cultural/familial stigma about mental illness but eventually did through her college in a way that was both confidential and affordable.

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And then going into spring semester that’s when kind of the real traumatizing periods of high school came back. And I realized that you know, “Something is really wrong and I can’t so this on my own but I really don’t know who to talk to. And I don’t think I am brave enough to go seek help.” Because I was, because of how my family perceived, you know therapy and getting help and mental illness I didn’t, I thought I’d be shaming them if I went to go seek help and that is a dangerous mentality to get into because if you, if you allow other people to influence your thoughts like that then it’s just it’s not a very good situation and so I really struggled through that semester and then over the summer that’s when I officially started, I had, I just happened to be taking summer classes and so that’s when I was able to seek help through my institution. Because it was, you know, affordable and available to me through you know, school health care plan. So and confidentiality is you know greatly appreciated and everything so I was able to do that. And so to this day I still seek therapy from my institution and what’s nice about it is that you know my family for right now doesn’t need to know and I can try to help myself as I go through.

 

Crystal discusses the pressure she feels and how it relates to her suicidal thoughts.

Crystal discusses the pressure she feels and how it relates to her suicidal thoughts.

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Part of me is just continuing to feel like you know there is an end, and for, for me like nothingness is a really great end for me because I am so tired of you know the daily struggles that I go through and all of the voices and things that go on in my head, all of the anxiety that I feel, and all of the pressure that I feel, it’s hard to move, how to get up and when you even have a taste of that it, it makes me just wish that I could just erase myself completely and just forget about everything.

 

Crystal describes how she uses self talk to prevent suicide.

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Crystal describes how she uses self talk to prevent suicide.

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Sometimes life just feels really meaningless to me and sometimes just the daily work that I do to just distract myself from what’s going on in my head, some of that is just like, “Well it’s still meaningless, I don’t want to be alive even, and so then you think about ok, how do I make what’s more permanent imitation and what makes more of a lasting impression on people those sort of things are more abstract and float above more of the daily sort of material things that happen in your life. And so being dedicated to continuing to be a role model and continuing to help my family in whatever ways that I can is what has occupied myself. So whenever I have a question like, whenever you know I get distracted, I, I sink back into my negative thought process and I asked myself, “Ok what are you doing here?” Instead of, either I’ll say you know, “I’m here because I need to finish this homework assignment,” And sometimes that helps or I say, “Oh I’m here because I need to finish this homework assignment, that way I can get a degree so that way I can help make money so that way I can help bring my family to a better situation.”