According to the Cleveland Clinic, one third of patients with a chronic illness experience symptoms of depression.

While that statistic is jarring in its magnitude, it's not really all that surprising. I talk a lot about what life is like with a chronic condition, but I rarely talk about the mental repercussions of my diagnosis. That's probably because depression, anxiety, and other mental health issues still pack a major stigma –– and because I tend to cope with the bad stuff in my life by cracking jokes about them. But considering that one third of the patients that may read this blog are also struggling with depression, it seems negligent of me to not address it.

I started going to therapy when I was nineteen. I had recently started having panic attacks several times a week and feeling too depressed to leave my apartment. I assumed it had something to do with the transition from high school to college, but it didn't take long for my therapist to pick up on the fact that my descent into depression coincided almost exactly with my diagnosis.

The idea that being diagnosed with Crohn's would have such a major effect on my mental health didn't make sense to me at first –– I was on medication and doing pretty well, physically. But the thing is, even when your symptoms are under control, the overarching idea of what chronic illness is can be a lot for anyone to handle. Being told a few days after turning eighteen that I was sick and I was never going to not be sick again, took a big toll.

The feeling of hearing that news is difficult to describe, but I once saw it fairly succintly covered by one of my favorite authors, Jeffrey Eugenides, in his book The Marriage Plot:

It seemed especially cruel then, three days later, in the hospital when the doctor came into the room to tell Leonard that he suffered from something that would never go away, something that could only be "managed," as if managing, for an eighteen-year-old looking out on life, could be any life at all.

I know now that I have been able to create a whole, good life in spite of my illness. But since a hallmark of depression is negative thinking, it's sometimes easy, when I'm going through a bout of depressed feelings, to forget about the good stuff. I focus instead on how unfair it all is. I focus on the limitations being sick has set upon my life. I think about how different things could've been. I think about how even though I'm fairly healthy right now that I know from personal experience that it can all be taken away tomorrow by a new flare. Having these thoughts can't be solved by just "being more positive." For people with depression, it's more complicated than that.

In 2016 I went through a year-long flare, much of which I chronicled here. Looking back, it feels like I missed a year of my life. I didn't get to date, or make new friends, or do any of the other things a 20-something should be doing. And while my disease is mostly managed right now, I know it could go back to that –– the steroids and the pain and the isolation –– at any time. Because that's how chronic illness works. It's peaks and valleys, but you can't necessarily know when a dip is on the horizon.

Depression works very similarly. Saying I have depression does not mean I am depressed at all times. Like my Crohn's flares, sometimes I feel perfectly fine. Sometimes I feel happy. Other times, the symptoms of depression crop up and I have to deal with them. The best thing that ever happened to me in relation to my mental health issues was accepting them –– I stopped fighting and denying them, stopped blaming myself, and started seeking help.

I've been on anti-depressants and anti-anxiety medication on and off over the course of my illness. I've been in therapy for most of that time. I've learned to better express to friends and family how they can help. I've started taking better care of my mind and body so that I'm better able to fight off negative thinking when it starts to take over.

What I'm getting at is that if you're physically sick, it's exceedingly normal to develop mental illness symptoms as well. You are not alone, and you are not to blame. But just because it's normal doesn't mean you can't treat it and try to create a life with more peaks and fewer valleys. Like any other symptoms of chronic illness, there are steps you can take. There are medications. There are therapists who specialize in talking about illness. There are support groups and friends to talk to and books to read and meditations to do. It all might sound a little hokey, but it really helps.

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If you're feeling depressed, you can find some awesome resources through the National Institute for Mental Health.