I know what mental illness is like from both the inside and the outside—from experiencing my own descents into a total of three major depressions and from watching my mother descend into her own private hell.

When I experienced my first episode of depression, William Styron was experiencing his. Although I applaud Styron for going public, when I later read Darkness Visible I was very disappointed. To my mind, he did not really describe his internal state, and his solution—to dismiss his psychiatrist and place himself in a well-appointed hospital setting—was hardly helpful for the average person suffering from depression. Nor does he detail the circumstances that led to his condition.

For me, my depressions came when I was most vulnerable and feeling increasingly isolated. It was a slow downward spiral. With my first depression I had hit a bad patch in my marriage and my children were growing more independent with the inevitable tensions that causes. I had faced a cancer scarce and I developed what turned out to be irritable bowel syndrome with its accompanying pain. I did not know how to deal with it all. I prided myself on my independence and had difficulty talking about negatives, particularly the fact that my world and body were seemingly out of control. My second depression again grew out of my stubborn independence, spending Christmas alone just a year after my husband’s death and experiencing terrible IBS pain. My third, and hopefully final, depression, gradually came on as my partner at the time worked to isolate me from my family and friends. In all three instances, lack of sleep was also a contributing factor.

A person who is depressed may look sad, but “sad” hardly describes what it feels like. It is physical. It is oppressive. The world is disjointed. I felt at times like I was watching the world as if it were a jerky old-time movie. There was no future, just trying to hold on to the moment and not give in to suicidal thoughts. I would lie in bed literally unable to muster the will to get up.

My mother’s mental illness had been a Damocles sword over my head for much of my life.  When I had my first depression, I thought “oh, this is what it was like for her.” I was wrong.  In researching my memoir Examined Lives, I found that her mental illness, which was never correctly diagnosed, was not simply depression. Hers too, however, was a spiral downward. Having lived an exciting life as a hostess at the Camellia House of the swanky Drake Hotel in Chicago, she ended up isolated in a sterile suburb with no access to a car. After my birth and then my brother’s she suffered from paranoia. This was intertwined with her sense that my father no longer loved her, which was true. In a desperate attempt to keep his affection, she agreed to undergo a lobotomy at the hands of Walter Freeman, the same doctor who lobotomized Rosemary Kennedy. Now the real decline began and as a young child observing this, I was very scared. She became obsessed about my bowel movements and at a performance of the movie “Show Boat” she fell apart in a flood of tears before my eyes. I was so frightened that I would be sucked into this world. She became psychotic, hearing God and seeing crosses in the sky, and had to be institutionalized.

Living with mental illness is obviously hell for both the patient and his or her family and friends. But hell as it is, that does not have to be the end of the story. It was not the end of the story for either myself or my mother. Rather than further isolation, as in Styron’s case, it was surrounding ourselves with the right people that made all the difference. For me, I had friends and family who picked me up and made sure I got psychiatric care. Taking medication of course helped, but it is talk therapy in conjunction with the medication that has been so powerful. There were no such medications available in my mother’s time, but ironically she found a psychiatrist at the mental institution to which she was committed in the midst of the cornfields of Iowa who believed that she could make it outside the institution. His determined faith and the positive environment at the institution, so unlike the stereotypical image we have, did indeed allow her to leave, never to return. Although the lobotomy had taken away her “sparkle,” she was able to work and lead a normal life. The hell of mental illness can be overcome.