“So! I quit my job!”

My enthusiasm left hanging in the air for a bit until a response.

“What do you mean ‘quit’?” Said with a sharp emphasis on the “t.”

I sighed. “I mean that I had a massive anxiety attack and while lying in the middle of my apartment, covered in tears, I told my boss that I just couldn’t do it anymore. I couldn’t go to work. I couldn’t come back. I was done.”

“Oh . . .”

“Yeah. . . .”

“Well, it happens,” and a shrug.

No, it doesn’t “just happen.”

It doesn’t happen to people with normal serotonin levels, those who don’t spend an hour each month discussing mood-stabilizers and medication adjustments.

It doesn’t happen to people who don’t carry benzodiazepines in their back pockets, front pockets, and three purses because anxiety can strike at the most inopportune moments.

It doesn’t happen to people who don’t find themselves physically unable to get to work. Do you know how many times I have texted a supervisor about a generic stomach issue with an emoji frown face?

It doesn’t “just happen.”

2002 The short and dirty history of my mental health, because context helps:

On the outside, I am a regular college student in Washington, DC. During the day I intern on Capitol Hill and absorb the information from courses called Politics of the Civil Rights Movement and Advanced Macroeconomics. At night, I walk around my DC neighborhood and extinguish lit cigarettes on my arms, just to feel something. It’s suggested that I am depressed, and I am referred to a therapist whom I spend a year (and several thousand dollars) just staring at during appointments. I don’t want to talk to a stranger about why my burnt flesh is the only thing that makes me feel as if I’m actually alive.

2007 My depression has turned into incontrollable rage. Anything and everything sets me off. I scream at friends; I throw things. A friend suggests Xanax and, as if flipping a switch, I am able to calm down. I become less frantic and unclench my jaw, long enough to visit a psychiatrist who diagnoses me with Bipolar II disorder. It’s a name and names are good. A name is a tangible thing to point to and to research. I am put on a cocktail of medication and subjected to once-a-month blood draws to check my Lithium levels.

2009 During a bout of depression, I am about to take an exit and casually wonder what might happen if I drive my car off of an overpass. This time I am able to recognize that this is not normal. Progress! I get a bit more Lexapro in me and we’re good to go.

2012 Work is shit. My boss is toxic. My former roommate is making attempts to get me fired (spoiler alert: she eventually succeeds). I send apology texts to friends and family and ingest the entirety of my psych meds and yet I manage to wake up the following morning. I’m groggy but otherwise perfectly fine.

Early 2017 I am back in Washington, DC, working in an office situated between the White House and the Trump Hotel. I am anxious all of the time. The anxiety leads to terrible, regular stomachaches, which I mention to my psychiatrist, who tells me he is having a hard time diagnosing anxiety these days (“Is it real anxiety or is it this overwhelming news cycle?”). He sounds a bit depressed as well. Regardless, an epiphany, I have severe Generalized Anxiety Disorder and Unipolar Depression, not bipolar. Again, with names and diagnoses, things begin to fall into place. I am given a prescription for a hefty dose of benzodiazepines.

September 2017 Despite the benzos, stress leads to a massive anxiety attack. I scream. I claw at my clothing. I am in the middle of my apartment floor unable to complete a cohesive sentence to my boss, the chief of staff to a big city mayor, except for: “I can’t do it. I can’t do it anymore.”

In my resignation letter, I give effusive praise and apologies in between painfully brutal, possibly career-ending honesty:

“I had an anxiety attack and abdicated my responsibilities.”

“I should have been more honest about my mental health.”

“Mental health issues are as debilitating as physical health issues, and my only regret is not telling you sooner.”

In writing these words and making these admissions, I find myself for once able to talk about my mental illness without embarrassment or shame, just relief.

When you’re consistently, constantly anxious, it means being unable to breathe.

I liken it to swimming.

At first, I am casually doing a breaststroke, feeling myself glide through the chlorinated water, until, without notice, I feel sudden fatigue, which quickly gives way to attempting to push forward to no avail. I am physically unable to move. I allow myself to sink wondering if I’ll ever be able to come up for air.

When you admit to being a person with a severe mental illness, you are able to come up to the surface a bit and gasp, able to see what is around, knowing that somewhere nearby there is someone to bring you to shore.

For every story of a woman able to say to her coworkers that she is taking time off to take care of her mental health, there are those like me: we hide, hope, pretend. Everything is always okay.

By day, I am “on,” shaking hands, speaking in complete sentences. The end of the day arrives and, like clockwork, I must retreat from the world. I put my phones on do not disturb with periodic checks because my anxiety tells me that at some point at some time in the evening there will be an emergency. I want to be needed and capable, but I also want to hide from the world.

Here’s the thing: how do you tell an employer that you are mentally ill?

Just casually drop it in the opening paragraph of the cover letter? Add it to your résumé? Is it during the initial interview? “Hi! I’m Heather! I have contemplated suicide on more than one occasion and I am always and forever so anxious that my whole body aches! It’s such a pleasure to meet you!” Or do you just wait for them to find out as you fall, spectacularly, into pieces, on your apartment floor with body-wracking sobs, unable to breathe due to your anxiety?

When is the best time to mention to your colleagues that you cannot control your brain?

How?

When?

No one knows about the physical part of mental illness. The way in which it sabotages your ability to get through the day. The way in which you compare yourself with your coworkers. It’s not just, “Oh, Susan! You’re so organized!” It’s more like, “Oh! Susan! How do you go about your day not feeling as if your brain will cause you to spin wildly out of control?”

What is that like?

Several weeks later I relay this story to a former colleague. “Why didn’t you say anything? Why didn’t you tell me?”

In 2002, I would have said that I was embarrassed. Now? Now it’s because there is no easy way to tell someone that you are mentally ill except to, well, just say it. You can’t hide it. You can’t pray the mental illness away. You just accept it as if you would accept any other physical illness, except this one won’t manifest itself in a visual change others can see. It is literally all in your head.

There is no amount of hoping that the stigma around mental illness will be erased until first confessing to your own struggles.

October 2017 I have a new job. And my new boss wants to know about our expectations as employees. I write the following:

“I have unipolar depression. I will need to take days off.”

“I have a standing twice-monthly doctor appointment.”

“I have generalized anxiety disorder.”

“I am always anxious.”

“Sometimes I like my door closed because it makes me feel safe.”

“I like to write about my mental health to make people feel less alone. I hope you get a chance to read it.”

If you or someone you know is in need of resources for mental illness, the following websites, apps, and hotlines are available.

WEBSITES

National Alliance on Mental Illness

www.nami.org

7 Cups

www.7cups.com

free online counseling and listings for local therapy resources

APPS

Breathe2Relax

a free stress management app that helps with breathing to reduce stress and anxiety

PTSD Coach

a free app for those who have, or think they may have, post-traumatic stress disorder

HOTLINES

Crisis Call Center

800-273-8255

Crisis Text Line

a free 24/7 confidential text message service for people in crisis (text HOME to 741-741 from anywhere in the United States, anytime, about any type of crisis)

GLBT National Help Center

888-843-4564

LGBT National Youth Talkline

800-246-PRIDE (800-246-7743)

National Crime Victim Helpline

800-FYI-CALL (800-394-2255)

National Domestic Violence Hotline

800-656-HOPE (800-799-7223)

National Sexual Assault Hotline

800-799-SAFE (800-656-4673)

National Suicide Prevention Lifeline

800-273-TALK (800-273-8255)

The Samaritans Crisis Hotline

212-673-3000

Trans Lifeline

877-565-8860

2-1-1

dial for local emergencies in any area