Some years ago, I had major depression explained to me in terms of rivers trickling down a hillside. The rivers are feelings. Your brain is the hill. Wherever those rivers run, they’ll dig furrows over the years, and become so entrenched that rerouting them is difficult. When you’re depressed, those your river-thoughts dig horrible trenches, black and deep, and the longer it runs, the deeper it cuts. Therapy means more than taking pills to improve the water quality; it also means learning to fill in the old trenches and dig new ones. The work is difficult. It’s dirty. It never ends.

I spent a lot of time writing as a child. I hit upon feverish obsession in elementary school, drafting lengthy stories about the things that interested me. When I was twelve, I wrote a 105,000-word epic fantasy tome that was slightly worse than Eragon, narrowly, and realized this would be my life. I had plans. I’d have published novels by the time I was eighteen, like my idol Amelia Atwater-Rhodes, and never need another job. My life would exist in the space between myself and the blinking cursor.

Writing remained a retreat through my teenage years. I moved from high fantasy to horror to science fiction, then urban fantasy when Anita Blake started raising zombies in my brain. My second original novel–and most of the next sixty-plus novels–would remain urban fantasy, and the first of them were written when I was in high school. I wrote and rewrote those books, painfully aware they didn’t yet meet standards. I relentlessly hunted agents. I joined critique groups to pick apart my style and learned what it feels like to bleed over fiction.

Sometimes I didn’t go to school because I wanted to write. At school, I was lonely. I felt like a lazy fool because I couldn’t track deadlines, organize my binders, backpack, or locker, and I made as much effort to survive as it took to be a straight-C student. Writing at home was different. I sat in a dark room with my heels up on a desk, just me and a glowing CRT monitor, and I wrote stories about tough women who killed evil.

I don’t think I was ever actually diagnosed with depression. The word floated around because my mother and sibling were diagnosed with it, so I knew what it looked like, and eventually I went into doctors’ appointments, informed them I had depression, and requested a prescription. They assented. If I wanted a dose change, I told them and got it. My depression was self-managed for years.

My survival through that time is impressive, looking back. I had a total failure of executive dysfunction and seldom got off the couch. Cleaning was a non-starter. Yet I always had clothes and bus fare, I kept a job, and I never had a major breakdown at work.

I must have written my first dozen published novels at that job. I worked at an isolated desk on a computer room floor, and my job was primarily monitoring, so there was nothing to do unless something broke. As a lightly supervised young adult with vague job requirements, I wrote, and wrote, and wrote. I never saw sunlight. I worked weird shifts. I couldn’t keep friendships.

But I had the books.

Perception is reality to the mind. Without enough serotonin, the world is terrible, has always been terrible, and always will be terrible. With too much cortisol, we’re all going to die and it will definitely be sooner than we hope. With a boost of dopamine, we’re in love with life, eternally perfect, always happy.

For most people, these chemicals are stable enough to function with normal life. There are emotions, but you’re not consumed by them in perpetuity. When it rains, the rivers of your feelings will flow down the hillside, sometimes spilling into sadness or worry or joy. They’re always moving, though. Eventually it melds into the lake of your long-term memory.

For the depressed mind, more feelings means more rivers going down dark trenches. It means the water floods, trapped within the deepest holes.

You’re living in the bottom of that hole. You can drown in two inches of water. And people often do, if the trenches are deep enough or if it rains too much.

My waking hours are consumed by writing, even now. If not the act of writing, then planning my books. I’ve developed myriad ways to imitate a normal life while living in my fantasy world. I listen to playlists when I drive so I can daydream creative ways to murder innocents. I’ll talk about the plots with my dog on our walks. Every time I watch a movie, I’m thinking about how I’d improve on it, or how I could tell the same story except with demons.

When I go to bars for a few drinks, because I can’t stand being sober, I strike up conversations with people to get inspired for characters. I’m sexually harassed in reality and kill another man in my books. When I’m in the hospital, I make an inventory of sensations, smells, sounds. I get discharged and go home to write a character gravely wounded.

I dwell on it, I wallow. Even the brightest days can be shadowed by threat of infernal apocalypse at the back of my mind, reminding me I have more to write.

One time I wrote the death of a three-year-old while I was on vacation at a lagoon, gazing out at a perfect sunset. I had a three-year-old. I was pregnant. It hurt to write, like slipping razors over my tenderest skin, but I wrote it, wondering why all the while.

Somehow, writing doesn’t feel like an escape. It feels urgent. Like I *have* to be writing, or thinking about writing, all the time. If I don’t, then I have to live in reality. I have to be myself, in my body, in my brain, in this world.

Cognitive-behavioral therapy is a whole-life approach to treating depression, among other things. The idea is that you must get chemical support in the form of medications and then adjust your life to avoid deepening the trenches. You go to talk therapy. You learn to identify your emotions as you experience them: This is sadness, this is anger, this is fear. You desensitize to traumatic memories. Sometimes it means getting away from abusers, exercising more, or eating differently.

Ideally, the result is that medication gets you out of the trenches of ill mental health so they can fill in. The rain forms new, different rivers, following easier paths. You have learned to argue without yelling. You take a walk once a day so the sunlight can purify you. You sleep more, talk about your feelings more, and stop dwelling in darkness. After a while, the dark places just aren’t as dark. You get to see the sunlight whenever there’s a break in the rain.

I started taking antidepressants when my first son was a baby, eight years ago. I didn’t cry as much when left alone with him. That was good. I took them until my second pregnancy, then began again afterward. My medication remained managed by my general practitioner. One helpful GP changed my medication when I complained of low libido, and the experimental antidepressant threw me into wild panic attacks. I spent a week in a mental hospital.

Since then, my medication has been managed by a psychiatrist, and things have been generally more stable. I’m more functional, anyway. Sometimes I get out of my hole to play with the kids, drive to appointments, and go to the gym. I clean the house occasionally. I’m raising a puppy, which requires a daily commitment to wearing pants and going on walks. Though I was fired by my last therapist for being argumentative, I did do several years of therapy, and my communication has vastly improved along with my understanding of self.

Still, there are holes, and they are dark as ever. My eating disorder struggle reached a special level this year. I’m still seldom sober. I started using nicotine. My books are getting darker too. I’m trying to traditionally publish dark psychological suspense, with graphic depictions of abuse unlike any I’ve written before. And when I’m doing it, I feel that razor feeling again. The one that’s bad but good and irresistible. Perception is reality. It hurts right to write like this. But it also hurt right to starve myself, to bite my fingers until they bled, to drink until blacking out in public spaces.

I attribute some of this to the nonlinear path of managing a chronic illness. Diabetics can stay on top of their insulin and still have problems. I have major depression even if I’m on bupropion, escitalopram, and alprazolam to manage it.

Yet perception is reality. My reality remains between my body and the blinking cursor. When I write, I’m immersed in it, convinced on some primal level that these things are real. Old books feel like memories to me now, they’re so vivid, but faded. Some years of my life, I can only really remember what happened in my books. I’ve chosen to populate those memories with demons, hellfire, and death.

Will I remember this year by the rapes I’ve written? Or will I remember going to the gym two or three times a week, walking my dog, and building LEGO with my children? Am I filling trenches with medication while digging deeper with my writing?

I don’t know. I don’t know when I’ll find out, either. As I finish writing this, I’m already drifting to the problem I have to fix in my current manuscript, wondering how I can worsen my heroine’s life in a low-impact scene. There are wildfires in my head. I am filled with smoke. And I don’t know if I’ll ever quite find peace like this, or what life on the surface looks like if I do.