If at times I am a little unsure as to the state of my mental health, my dreams serve as a fairly good barometer. When I am feeling well, I remember few dreams, and those I do recall are cheerfully weird, like the one about the miniature albino hedgehog I decided to keep in a rice and lettuce wrap in the fridge. When I’m not, my dreams are convoluted and violent, full of people that I try hard not to think about when I’m awake. They leave me exhausted in the morning.

Last week I had a dream that I had a number of large blisters on my….well, I guess that vagina is as good a word as any. I popped the blisters and out of them came a number of very tiny embroidered sheep. My mom loves sheep, so I collected them all into a little pile and was pleased that I had this nice gift to send to her.

I’m pretty sure that’s not good. Right? I don’t see how that can be good.

If the word illness is right there, one half of “mental illness,” why don’t we treat it as such? If I had pinkeye I could stay home from work, but if I’ve summoned all of my stores of energy to get out of bed only to run out when I get to the shower, that’s not a good enough reason. If you have the sniffles and a low-grade fever, you’re allowed to take the day off. If you stare listlessly at your computer with your hands in your lap, taking frequent breaks to run and have a silent cry in the bathroom stall, you’re still expected to do 9 to 5.

I have been on medication since I was sixteen. If they make it, I’ve probably tried it. After a battle with my father, who insisted that if I prayed harder I wouldn’t be depressed, I was an early Prozac baby. When that stopped working I moved to Paxil. And then more, and more, and more, up to five at a time, until my bedside table resembled a pharmacy. I have the pill organizers that you see in catalogues for the elderly, pill cutters, and even empty capsules for when you’re trying to get off of Effexor, one bead at a time. I have slept through years on Ativan, had a full-scale freak-out on Adderall when I made my mom turn over a book because the boy on the cover was looking at me, and I even survived the Lamictal rash. I’d become accustomed to thinking, after four years on Pristiq, that the two of us would ride off into the sunset together, but in the past few weeks, for no particular reason, the world has shifted off of its axis, and a perfectly normal moment can segue seamlessly into a waking fever dream wherein my body cannot understand stairs, my brain cannot prevent me from losing hours staring at nothing, and if that first tear gets out, nothing will stop it turning into a river.

I’ve always wondered what it’s like to be clinically insane. I wonder how aware you might be of your own insanity. I wonder if it happens so gradually you don’t notice, or if it’s sudden, like a light switch being flicked from off to on. Can it be flicked back, or is it irrevocable? If you’re not aware of it, mightn’t it just seem…normal? It’s not that I’m aspiring to be declared clinically insane. But maybe once you are, you can relax. You can stop thinking about all of the things that you are never going to do, because you’re clinically insane, and it’s no longer expected of you.

I have not experienced much tragedy in my life, other than losing my father eight years ago. Some people don’t like that term for it, but I do. Like with a lost thing, I still look for him all the time, and I never find him. Depression is not sadness, or even grief. But when depression collides with sadness or grief, it’s like a hideous chemical experiment that can’t be undone. A poisoning with no antidote. The circumstances of my life right now are dissatisfying. But mental illness transforms them into something much worse.

Every therapist I have had (I am too embarrassed to say how many) has done some gentle prodding, asking if maybe I suffered abuse as a child, since many of my symptoms seem to align with those of people who have. I spent years racking my brain, trying to remember, wondering if there’s someone I could blame in all of this. In some ways it would be a relief to know that something caused all of this. But on the other hand, I’ve stopped looking for a reason. Maybe there isn’t a reason, maybe there is, but finding one wouldn’t fix anything. And it might start a whole new nightmare. If there’s something I don’t remember, I think I prefer to keep it that way.

When you’re depressed, you want to sleep. When they give you medication to combat your depression, one of the main side effects is drowsiness. I can easily sleep twelve hours in a row and then have a nap a few hours later. It’s hard to stay positive when you’re constantly plotting how soon you can be unconscious, honestly wondering if anyone would notice if you curled up on the sidewalk for a bit, or a subway platform. I once spent an hour lying under a jungle gym at night, and I only got up the willpower to leave because I was worried that someone might call the police and report a dead body. On top of the physical sensation, there is a weariness that hovers around what you might call your soul. My brain is tired, my heart is tired. If I knew where to go to officially give up, I would.

You would think that being so tired, I would get to feel numb, but I feel the polar opposite of numb. Numb is what I’m striving for, in all of the worst ways possible. I know that there is a special magic weight which, if I get down to, will grant me emotional numbness. I don’t know what that number is, specifically, and I don’t own a scale anyway so I wouldn’t know it if I saw it, but by God, I’m doing my best to get there. This is a Bad Idea. I absolutely know this. But I’ve had worse.

Oh, I know that I look like I’m walking around like the rest of you, laughing at jokes and saying excuse me, buying snacks and thinking about the kind of shoes I like, and sometimes I am. But sometimes I am walking around with the distinct impression that my air is running out and I am flailing my hands, and no one sees me. Or if they see me they mistake it for waving. Because who wants to go get a drink with the drowning girl? Not me. I have drinks with myself on a regular basis and it rarely ends well.

I have not cut myself for over seven years. But it doesn’t mean I don’t want to. The other week I ran a rotary cutter blade across my leg (because along with being mentally ill I’m also a dork who sews), but luckily I’m pretty lazy and the blade has needed replacing for ages and was too dull to break the skin. I didn’t really try and then I gave up, because i wasn’t depressed enough to break a seven year streak. I’ve thought a lot about it, and I’ve had friends and family members ask me why. It’s not because I have a thing for blood, or because I’m really into pain. This is the best way I can think of to explain: The late, great Barbara Park wrote one of my very favorite books, Skinnybones. I loved this book so much that I was once Alex Frankovich for Halloween. In the book, there is a part where he gets punched in the arm by his best friend, and he keeps checking it on the way home to see if it’s bleeding. And then he thinks this: “When something hurts this bad, the least it could do is bleed a little.” I do it because then I can point to it and say, here, look. This hurts. Doesn’t this look like it hurts?

I don’t consider myself suicidal, I never have. In Andrew Solomon’s life-changingly excellent book The Noonday Demon, he talks about the often-misunderstood relationship between depression and suicidality. They are definitely not the same thing, and for many people, like me, they have never co-existed. For one thing, when you’re depressed, you are way too lethargic to get up the energy to actually take your life. Personally, I’m way too petrified of death. I have also promised my mother, and since she’s gotten me through so much so far, it’s a promise I mean to keep. And if I ever did it, I would not put it past her to charge into the underworld Orpheus-style and haul my ass back, yelling at me the whole way. That’s how upset she would be.

That said, it’s been on my mind a lot lately. Not on my mind in a Google-search-of-popular-methods-and-techniques kind of a way, more in a Ryan Adams kind of a way, as I like to call it. Some days that line from ‘Dear Chicago’ runs on a loop through my head: “I’ve been thinkin’ some of suicide, but there’s bars out here for miles.” It’s punctuated by another line a little farther in, “I’m gonna die alone and sad.” I know I’m going to be a crazy cat lady someday, which worries me. I have allergies and I don’t actually like cats.

It’s not quite a voice in my head, it’s not a voice, but a sentence that has taken up residence somewhere near my ears. “I would like to kill myself.” Hush, I think. No I wouldn’t. I think about plunging a knife into my temple. Which I’m sure would be a really terrible way to do it. But once my brain has thought the briefest thought, I can’t get rid of it. Think about it: the first few times you hear something silly, you dismiss it out-of-hand. But the longer it sticks around, the more it might start to make sense. If you told the Molly of five years ago that she would now own a pair of harem pants, she would slap you in the face. But own them she does. (They’re really pretty, okay? Black, and kind of minimal, with this drapey belt…) I’m afraid if I keep listening, suicide might start to make sense. I can say that I know I will never try to kill myself, but I alsoknew that I would never buy harem pants. I am not a trustworthy person.

My past is littered with a trail of minor breakdowns. A three-hour anxiety attack in a hotel on Independence Square in Kiev after my brother’s wedding. A crack-up in the subterranean University College Dublin theatre when I sliced every finger with the shards of a broken wine glass. A gash I put in my thigh with a razor in my first grubby apartment in Brooklyn, bandaged by my roommate who found me weeping and blood-spattered, which is apparently a real turn-on to some people. A trip through Europe when I was a child that was akin to a month-long temper tantrum. A last straw upon my solitary junior-year arrival in Florence which saw me flee back to London in floods of tears. The half jolly, half sinister man at the hotel I checked in and back out of in half an hour hugged me and said, “Molly, a little girl like you should not travel alone. Always remember, the world is shit. You, you are the best!” He did not give me my money back. Trying to ask for a ticket to Paris on the overnight train in Italian would have been tricky in the best of times, but I also couldn’t breathe or stop sobbing. The clerk sniffed at me and said, in perfect English of course, “Miss, it is just a train, it is not life.”

But it was, and it is, my life. It is my life that seems to be racing past at an inhuman rate, with entire years swallowed up, and memories whose edges have been blurred by nearly twenty years of medications that no one knows the long-term effects of yet. I have lost friends due to behavior I am unable to control, and things I am unable to explain. I am a difficult person, and all I can do is apologize, and it doesn’t always make a difference.

I do not like being like this. But I have accepted it. It’s not like a cancer that you can fight, and maybe it will go away for good. For a long time I thought it was, and expended energy I didn’t have trying to draw a demarcation line between the illness and myself, pretending we were two separate entities. Now that I have accepted it as something that will most likely always be a part of me, it is easier. I do what I can to assuage the worst times. I keep busy. I do things out of the house more than I would like. I knit like a fiend. I am never without a book. I set myself immense tasks to see if I am stubborn enough to conquer them. Monsieur Proust is currently bending to my will, I bought Volume III of Remembrance of Things Past yesterday. I am bumbling my way through a sewing class at F.I.T.

There are things you have to do to keep yourself sane that other people will not like or understand, and sometimes those people end up being collateral damage. On those days when your own brain is your mortal enemy, other people are going to suffer too. You can only apologize so many times, and it’s easy to understand that there comes a point where the apologies seem meaningless, where people assume you are just willfully fucking up again and again, too lazy or unconcerned to act differently. I’m not excusing the genuinely shitty things I have done. But there are things that were not my idea, and although it may sound ludicrous for me to say there are times when I cannot control myself, it’s true.

Sometimes I do have good days, sometimes I have a run of good days. But so many days…one moment I’m dying and the next I’m fine. Mini-swings from blackest depression to mild mania wring the life out of you the way you twist water from a towel. It doesn’t stop. When the letup is the upswing, and you know that you’re too cheerful, that things aren’t actually good, even though you brace yourself against the inevitable fall, it’s always the same sucker punch. Every goddamn time it crashes into you like the first time, and you’re left reeling and confused. And once it starts, you look down and you can’t see the floor, and that makes it worse, because you just keep looking and looking and thinking oh shit not again and that just makes the abyss beneath your feet get bigger and darker by the second.

I am having a hard time writing this, because it means I have to think about it. Usually when the thought arises of My Life As It Is Now, the next thought is stop it stop it stop thinking you can’t think of this think of something else sing a song read a book be busy stop thinking please just stop.

I wish I had advice. Advice for me, advice for anyone else living through something similar. But maybe there are only two choices: keep going, or don’t. If you choose don’t, that could still be a whole range of things, it doesn’t have to be suicide. It could be quitting your job and moving home, it could be withdrawing from social life and spending every night and weekend in bed. Keeping going, just putting one foot in front of the other, sounds simple. It’s not. But it’s what I’m choosing. I hope I keep choosing it.