Depression does not discriminate. Depression doesn’t care who you are or what you achieve or how funny or cute or smart or kind you are. Depression can take anyone down. And unless you’ve been in the empty abyss of depression, I can promise you that you will not fully understand what a nasty liar depression is.

I recognize now that I had symptoms of depression beginning in childhood. The message from my parents and the culture was that caring for others took priority over caring for myself. Service to others was what “good” people did. Only selfish people put themselves first. Kid Sarah fell for all of this, hook, line and sinker. My parents cared for others every day as a pastor and a public-school music teacher. They excelled at their chosen professions, at the cost of their time and energy. Every holiday season was a whirlwind of programs and church services and gatherings. This was inevitably followed by exhaustion and, often, physical illness. Funerals and crises were perpetually sprinkled throughout our daily lives, taking Mom and Dad away from my siblings and me.

Before I started kindergarten, I learned of the existence of mental illness, addiction, death, grief, abuse, divorce and trauma. These are scary things for everyone, but particularly for a child. I did not have the words or comprehension to articulate my questions or my fears, but I was determined to not add to the pain and sadness in the world. I believed that I needed to be perfect to be worthy of love and attention, which became the foundation for decades of depressed thoughts. My thoughts told me I wasn’t worthy of anything unless I sacrificed myself. This belief, coupled with a genetic predisposition to depression, nearly destroyed me.

At the age of 9, I decided I would become a doctor, and for the next 20 years, I would pursue this dream. I excelled academically and pushed myself to relentlessly achieve. I learned how to ignore my own struggles and pain in the interest of performing as the perfect student, daughter, and contributing member to society. The price I paid was high. In high school, I developed chronic headaches and missed so many days of school that I nearly had to repeat my sophomore year. In spite of this, I maintained a perfect 4.0 GPA. By the time I was a senior in college, I was profoundly depressed, yet continued to function somehow. For me, depression took the form of constant self-doubt and a deep, paralyzing fear that I would be “discovered” as less than perfect, and therefore, unworthy of love and connection.

I enrolled in medical school in August 1996. For the first time ever, I could not perform. When I sat down to study, my brain would begin racing. I would reread sentences over and over in a futile attempt to remember what I was supposed to be learning. By October of 1996, I had failed an exam in every course. I reached out for help from the school and was referred to free tutors and courses on study skills. Deep down, I knew study skills wasn’t the problem…I was depressed!

With the help of medication and therapy, I was able to pull myself out of depressed-thinking for weeks and even months at a time. The stressors in my life, however, did not let up. The death of my beloved grandmother Ruth, the suicide of a close medical school classmate, constant financial uncertainty, and the unrelenting demands of medical school made it impossible for me to heal. Ultimately, I withdrew from medical school, just two classes short of a degree. I spent the next sixteen years trying to return to full performance mode, which left me trapped in the same cycle of depressed thoughts that led to insomnia, followed by an inability to function at the most basic of tasks.

In April of 2018, I started therapy for the eighth time. I was mere inches from losing hope that I would ever feel okay, let alone feel joy. I was numb from years of running from my own pain. If I found the energy to voice the thoughts swirling in my head, those words came out incoherently or in fits of rage. As nightmares consumed all of my waking and sleeping hours, I couldn’t find a single moment of peace.

On June 8, 2018, I picked up Cheryl Stayed’s book, Brave Enough. Her Introduction blew my mind in the first two pages. About her love of quotes, Strayed wrote:

At age twelve, when I came upon a sentence on page two hundred and something of Madeleine L’Engle’s novel A Ring of Endless Light, I was so taken by it I had to stop reading. “Maybe you have to know the darkness before you can appreciate the light,” I scrawled in semi-permanent marker on the inside of my forearm, where it stayed for the better part of a week (and in my mind for the better part of my life).

Madeleine L’Engle’s books were among my favorites, and I read those very words multiple times as a kid, but I have no recollection of L’Engle’s words. Yet, the tattoo I got several years ago says, “A certain darkness is needed to see the stars.” In spite of feeling lost and broken, I put permanent words on my body, words that I read and believed as a child. It dawned on me that my current therapist is right. There is a *me* that is separate from my depressed thoughts. I am Sarah, a curious, sassy, bright, silly, brave, loving human woman.

I am writing this to remind myself to continue on my journey to freedom. I want to be free from the lies that depression tells me. I want you to be free, too. One of our job as humans is to find a way to refute the lies that we’re told by our own thoughts, our families, teachers, pastors, doctors, and society. My goal is no longer perfection, but to be in a place where my beliefs and actions reflect who I am, not who I was told I should be. I am on a road to a place where I love myself and grant myself the same grace and compassion I believe everyone deserves. All of us will fall short of perfection, but we can be perfectly human by being perfectly ourselves.

Sarah Josephson grew up roaming the plains of Nebraska. She is passionate about Nebraska Cornhuskers’ football, the beautiful children in her life and justice for the whole of humanity. Sarah lives with her fiancé in Colorado.

Tattoo mentioned in this essay.