It was the first time I had every flunked a test. My fragile ego was shattered. It was my first year at University of California, San Diego School of Medicine, one of the most difficult to enter. I failed my pharmacology test, not because I was stupid, not because it was difficult, but because I was clinically depressed.

A dark cloud covered my head and I could not see. Much of my anxiety was rooted in being uprooted. Our escape from Iran’s revolution, the sleepless nights wondering what would happen to my family, the recent death of an uncle and two grandparents, the change of seven schools in less than five years, and three countries, and our financial struggles had culminated in my crash. I had lost all motivation to do well in school, cried at the retelling of any story, and practiced self sabotage.

The darkness in my life settled in like dense fog for months, as I searched for answers. I was offered medication which I knew was not the answer. Exercise did not help, nor therapy. After all, I was a deeply happy person, by nature an optimist. Still, I saw myself not as a sick person, but as a healthy person with a temporary illness. My faith did not allow despair, but I felt I was drowning. No one could help.

One day, as part of my clinical rotations, I took care of a man who arrived to the ICU in a coma after being hit by lightning. Somehow, the family chose me as the team leader, a depressed medical student, over the brilliant team of doctors. All communications had to go through me, highly unusual. Upon his leaving the hospital, his wife told me that because I felt her pain, because I held his hand and shed tears, that intense love for a human life would lead me to help more than anyone with technical knowledge.

A couple of weeks later, I was accused of not being a good enough student by one of the senior residents when I had spent fifteen minutes walking a terminally ill patient. The stab of her tongue was so deep that her voice still echoes in my head.

“Are you training to be a nurse, or are you going to man up and become a doctor?”

More tears. Later, I received a call from the dean that I was being honored as the family of this patient had donated money in my name to the school.

My fading gas pilot started to burn brighter. Slowly, I felt the darkness lift. My light started to shine through forgetting about myself and caring for the suffering of others.

“Why me?” turned to “Why this baby?” I realized that deep spiritual depression sets in when our soul is anchored to our sinking ego. Through reconnecting with people, healing starts anew.

As Elisabeth Kubler-Ross found, “People are like stained-glass windows. They sparkle and shine when the sun is out, but when the darkness sets in, their true beauty is revealed only if there is a light from within.” The light within can only keep aglow by lighting another’s.

Darkness is not seeing the face of a neighbor, becoming immune to the cry of a hurt child, covering our eyes with indifference toward suffering, hardening our hearts like toward the needs of those who serve us. Darkness is disrespecting a waitress, not feeding a maid, being so full of ourselves that we forget those who depend on us for sustenance.

Having felt disabling melancholy, I realize that in depression’s eclipse one becomes masochistic. Pain feels better than action. True depression robs us of courage, the most profound human trait. It takes courage to get up in the morning and face the world. Without seeing our neighbor, without feeling the pain of others, we are stagnant, unable to grow.

There is nothing wrong with physical darkness. Much of our understanding of the world comes from the teachings of the blind. Our life is a fire in between two physical shades, but we should not succumb to spiritual darkness. Paradoxically, when spiritual darkness takes hold, the cure is the difficult task of reaching deep within, and giving away our last remaining spark to another fading soul. If separation and uprooting are the cause of spiritual anxiety and depression, giving back to those who need us is the cure.

Afshine Ash Emrani is a cardiologist and can be reached at Los Angeles Heart Specialists.