Announce to friends that you have cancer, and they will probably react with sympathy and compassion. Tell them that you’ve broken your leg, and they’ll offer to get your groceries and drive you to medical appointments.

Share that you suffer from depression — and the sound of silence will fill your head.

Depression has been my companion for as long as I can remember. My maternal grandmother, who immigrated to this country from Romania, spent her days struggling to raise four children in a land whose customs and language she never learned. Her husband, my grandfather, rarely stayed home; when not traveling to eke out a living as a peddler, he would socialize with his cronies at a park or synagogue. In his later years, twice widowed and living in a nursing home, he set fire to his own leg as an expression of his inner unhappiness.

Small wonder then, that my mother grew up in a house that was filled with darkness even when the sun shone. As a child, Ma dreamed of becoming a teacher, but when her parents refused to send her to college, she succumbed to a life devoid of hope.

She tried her best to bring joy and comfort to my father, brother and me and to give us a hope-filled life. Yet even Ma, who took charge of the house like a general marshaling her troops could not overcome genetics. I inherited her size-ten feet, her fear of dogs, her love of reading — and her propensity for depression.

Even as a little girl, I knew I differed from the other kids on the street. I remember feeling heavy — not only in body but also in spirit. Although I didn’t know the word “depression,” I knew that my inner darkness didn’t come simply from my being taller than everyone else. Something inside imprisoned and disabled me.

Rather than go outside to play with the real kids, I preferred to sit in the basement with my family of dolls while Ma washed and ironed. I knew, with a certainty born of my depression, that the other kids would tease me for striking out in kickball or failing to keep the hula hoop spinning, and that they’d let me stay lost during hide-and-seek.

I filled my days and evenings with doll-playing, television-watching with Dad and canasta games with my paternal grandma. At night, after falling asleep, I would wake up gagging and gasping in panic, unable to catch my breath. My father would rush to my room and gently rub my back and hold my hand until I fell asleep again.

But neither Dad nor Ma took me to a doctor to learn why I spent my days isolated from my peers, and my nights fighting the demon that lived inside me. Doctors were for sore throats and aching tummies, not hopelessness and anxiety attacks. Psychiatrists were for people locked away in institutions, not for a little girl who made her bed, respected her elders and did well in school. My parents didn’t address my depression because, like most parents of the 1950s and early 1960s, they didn’t recognize depression as a real disease.

In my twenties, as a newly minted public high-school teacher, I thought about getting professional help; but in those days therapy was still stigmatized. I worried that I’d lose my job if my principal heard that I was seeing a “head doctor,” and I feared that my parents would look down on me for seeking counseling.

Instead, I adopted the philosophy of my paternal grandma, who’d lost her husband in the 1918 flu epidemic, endured a second marriage to an alcoholic and spent years toiling in a grocery store: “Life is about getting out of bed, going about your business and not complaining.”

Six weeks shy of my twenty-fifth birthday, I married. Eighteen months later, after my son’s birth, my marriage began to fail. Despite that, I had a second child–a daughter. With both my marital situation and my depression worsening, I asked my physician for help.

“Have a third child,” he advised. As desperate as I felt, I did have enough wisdom and self-preservation to reject that particular advice.

Over the ensuing decades, I have consulted countless other experts. I’ve spoken with social workers, psychologists and psychiatrists; I’ve tried cognitive behavioral therapy, mental and physical exercises and medication. None of these approaches has helped much. Even the most skilled therapists haven’t had the power to change my genetics, nor, seemingly, to lift the shadows that hover over me.

In recent years, though, two things have helped me — ironically, neither of them medical.

First, for the past several years, I’ve been a devoted pen pal to my twelve-year-old great-niece, who lives several states away. Walt Disney is her hero. Knowing how fondly she cherishes the timeless, hope-filled verities of the Magic Kingdom, I choose my letters’ words and content with care; I don’t want my depression to taint her life. Writing to her feels like whistling a happy tune to convince myself that I’m not afraid: The more I write, the more I believe that I can be OK.

Second, last year my children gave me a seventieth-birthday gift that inspired a feeling that perhaps I can move forward in a positive way. It’s an album of photographs taken throughout my life, from my youth to the present, showing everything from my kids’ milestones to the last pictures taken of me with my beloved parents and grandmother.

In all of the pictures, I’m smiling — not just with my mouth but with my eyes. These images give me hope: If I once was able to wrap myself in joy and embrace moments of happiness, then I can do it again.

Although my depression has exhausted me, I tell myself, it has not defeated me.

And so I start every morning by reminding myself of something positive that will happen that day, and I end each evening by reliving a positive moment that I enjoyed. I remind myself that although some battles may have been lost, the war is still mine to win.

And so, I soldier on.

Ronna Edelstein is an English professor. This piece was originally published in Pulse — voices from the heart of medicine. 

Image credit: Shutterstock.com