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Mara

Age at interview: 18
Age at diagnosis: 14
Brief Outline: Mara (age 18) was self-harming from a very young age and was diagnosed with depression and anxiety at age 14. Therapy and support from her father and friends helped in high school. In college she started taking medication and studying Buddhism.
Background: Mara is a student at a large university. She lives in a dorm room on campus. She is Vietnamese and White.

More about me...

Mara, now a freshman in college, was diagnosed at age 14 with depression and anxiety after an emergency room episode of self-harming. Her parents immediately sought help for her. Through high school Mara saw a variety of therapists. Mara said it was really interesting to get these different opinions because it led her to struggle to discover her “own personal philosophy”. Regular therapy, in particular for self-harm and anxiety, was “really, really helpful”, because at that age you feel like nobody, including parents, will listen to you about feelings of “isolation and desperation”. 

In addition to therapy, Mara values her great “support group”. Her dad, as her number one advocate, “was invaluable” because her, like a circle of her close friends, they were willing to say “I have no idea what, where this is coming from... but I really want to be here to support you through whatever you’re going through.” Since coming to college Mara has also been practicing Diamond Way Buddhism and has started to take anti-anxiety medication, which she says in conjunction with other forms of therapy, “has played an enormous role in helping me reteach myself how to cope without needing self-injury”.

Mara highlights three ways in which depression is a “weird dualism”. First, with regards to low self-esteem, “It’s been weird compensating between …feelings of worthlessness and then the inherent knowledge that you are valuable, you do mean something”. Second, she has “pendulated” between “having an emotional mind and a logical mind. The emotional mind wants you to isolate yourself, and [the] logical mind tells you by creating these relationships and maintaining them that you have a better chance. …Third, Mara notes the tension of perceiving depression as and integral part of you or something separate, “It’s a really dangerous road to go down when you say I, not only I have depression, …but I am depression”. She says the “first line of defense is to know where your self starts and where you stop, and where your depression is, because that way it’s not a part of you”.

Mara says depression is “totally a constant struggle” and that “it’s your job to fight it no matter how hard it is”. Taking control and striving for autonomy are critical. She notes, “Self-injury was about control”. But “if you can exercise and gain control over your body, that’s another amazing thing”. Academics, she says is another way to gain autonomy, “an awesome SAT and great grades, then nobody can tell you where your limitations are”.
 

Mara describes how self-harm was difficult for her parents to understand and a visit to the emergency room led to her getting professional help.

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Basically what happened was that they realized I had been self-harming from a very young age. So it was at that point that  when I was 14 years old that  I had an episode that required me to go to the emergency room and immediately following that they realized our daughter has a problem and they wanted me to start seeking help for it.  Partially because they were concerned and partially because they were so distraught, so I think that’s just kind of what instigated everything, it instigated sort of my experience with health care professionals. 
 

Mara asks “how much is me, and how much is depression?”

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I guess I like, I. Something I think about a lot if terms of depression is, and something I wonder, is, like, how much is me and how much is the depression. So how much of me is just my personality and things I learned and the things that I was conditioned to do or genetically inclined to do. How much of that is me and how much of that was influenced and conditioned by this disease. And I think just something that I sort of have to tell myself every day is just not to identify with depression, with anxiety, with self-injury, because I think that’s just that’s a really dangerous road to go down when you say I, not only I have depression or I have anxiety, but I am depression, I am anxiety. So, I think just something I would want to share is that I think people should remember to keep themselves separate because that’s your first line of defense is to know where you start, where yourself starts, and where you stop where the thing you care about stop and where your depression is, because that way if it’s not an integral part of you, it’s easier to fight. 
 

Depression fractured some family ties for Mara, but others survived.

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So it put a huge strain on the relationship with my mom which is totally regrettable, but in a lot of ways I think it was sort of my relationship with her that lead to a lot of the feelings that sort of fed into my, my depressive personality and my self-injury. And then on the other hand my dad has always been like, my number one advocate so it was really nice just having a lot of support from him and just having support from him as somebody who was willing to say, “I have no idea what, where this is coming from, I have no background in this I can’t comprehend it, but I really want to be here to support you through whatever you’re going through.” So that was invaluable to me. 
 

Once in college, the potential for building a career helped Mara deal with the loss of motivation she suffers when depressed.

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Where in high school, sort of like, depression and anxiety were just this cocktail that totally like ruins, it just ruins your motivation and makes it really hard to get out of bed and to want to stay up and, and to stay active. While in college it’s been easier to use these things as kind of like a, a motivator. So in some ways just kind of nice to be able to say like, “Yes, I know I have these tendencies to shut down. Yes, I know I want to hide away, but if I can fight through this and if I can suffer now, I am going to be able to reap the benefits later and I’m going to be stronger for it.” 
 

Mara talks about how therapy helped her not feel isolated or feel like she was burdening other people.

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So I think it was just really effective having somebody who could listen to you. Which sounds kind of obvious, but I think sort of the problem with being that age and having this, like a mental condition that promotes feelings of isolation and desperation is that you really feel like you have nobody to go to so that’s including parents, including a lot of friends, just that overwhelming feeling of being totally isolated. So having a professional that who is for the most part a stranger, who can’t really enter other parts of your life, I think is really nice. Just somebody who can sort of walk with you parallel, somebody who you can check in with weekly or like twice a week or once a month, pretty much just to give them like a blow by blow of the things you are concerned about and to get some perspective on things that you can’t normally with just talking with a friend who may or may not have similar problems with anxiety or depression or what have you, so [coughing]. Furthermore, in talking to a professional, you don’t really have to feel like you are burdening anyone, so there’s no, there’s no fear, or at least there wasn’t for me, of like bothering somebody with my problems who isn’t going to want to care or doesn’t have to care. 
 

Mara looks for relationships with people who can balance her subjective depressed feelings with a more objective view of reality.

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I had some really good friends and some people I could rely on really well who were always there to say, like I understand or not necessarily that they understood, but what they could say to me was , “I may not know exactly what you are feeling, but I want you to know objectively, here’s what’s going on. Objectively, you are a worthwhile person. Objectively, people care about you. And whatever subjective feelings you’re having right now, just know that those are totally not valid, that’s not reality.” So I think, yeah, it was just a mix of those two things, just valuing myself and knowing that I was valued by other people. Which can be really hard, I think, because if I hadn’t had that group of friends at that time, I think it would have been a lot more difficult to recognize.”
 

Mara works hard to enjoy things during good periods, but still finds herself wondering when depression will return.

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So yeah, I sort of had these ebbs and flows like throughout my childhood and I think a lot people can relate to that. Where there would be like, a bad few months and then a good few months, and then maybe a bad year and then a good couple weeks, but I think sort of what I spent a lot of those good periods in was just kind of like, this petrification like this this feeling like, yeah things are good now but I can’t really truly enjoy them because I’m still just waiting for the other foot to fall. So, since, since moving out and since having a lot better outlook on a lot of the things happening to me I’ve had a lot of an easier time enjoying things and enjoying people, the people that I’m around and building new relationships but it’s still kind of hard not falling back into the mentality of, well when is this all going to stop like, when is the movie going to end, when are the credits going to roll like, when do I have to come back and face reality. 
 
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Buddhism provided for Mara the resilience to persevere, despite anticipating that depression might persist for her entire life.

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A lot of what I have learned through, like these meditative practices and, and sort of like the central philosophy behind all of it is that, suffering is brought on by aversion or by desire. So if you, if you want something you’re not always going to be able to get them, and if you don’t want something you aren’t always going to be able to escape them [coughing], excuse me, so the idea is to get rid of aversion and to get rid of desire so you can be simply by yourself and not, not need material things not need relationships in order to be ok with yourself. So for me, sort of like bringing that back to a lot of, like my experiences with depression and anxiety was just the idea that, like well no I don’t think I will ever be able to escape like problems I’ve had with my mom or just like difficulties I’ve had making friends or like problems I’ve had in the past or that I will have in the future, but just accepting that these things are going to come and go. And it’s up to me, up to me as an individual or people as individuals to decide how they are going to feel about that and so you might say, well depression is a disease and you can’t, you can’t choose whether or not to have depression which is absolutely true, you are not going to be able to make those choices, but I think it’s your choice to empower yourself with the knowledge, “I have depression. I am going to feel a certain way about things and that is totally ok. But also understanding that you are very much like a mountain and these things that come and go and pass are kind of like clouds, you don’t change around them. 
 

Mara appreciates that people give her support even—and perhaps especially -- because they cannot understand what she is feeling.

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I had some really good friends and some people I could rely on really well who were always there to say, like I understand or not necessarily that they understood, but what they could say to me was , “I may not know exactly what you are feeling, but I want you to know objectively, here’s what’s going on. Objectively, you are a worthwhile person. Objectively, people care about you. And whatever subjective feelings you are having right now, just know that those are totally not valid, that’s not reality.” So I think, yeah, it was just a mix of those two things, just valuing myself and knowing I was valued by other people. Which can be really hard, I think, because if I hadn’t had that group of friends at that time, I think it would have been a lot more difficult to recognize. 

My dad has always been like, my number one advocate so it was really nice just having a lot of support from him and just having support from him as somebody who was willing to say, “I have no idea what, where this is coming from, I have no background in this I can’t comprehend it, but I really want to be here to support you through whatever you’re going through.” So that was invaluable to me. 
 

Mara cautions that her “story sounds familiar”, but “chances are you have no idea what I am feeling.”

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Yes, yeah, yeah that, that’s totally a common theme there, because I think in some ways I’ve always sort of felt, like you know, you’ll, you’ll be revealing something to a friend that you think is kind of getting closer and you disclose something and they go, “Oh, I totally get where you’re coming from.” And on the one hand it’s easy to see how they are trying to be supportive and trying to be there for you but on the other hand you want to go no you have no idea what I’m going through you, you live a completely different life and even though you think the story sounds familiar, chances are you have no idea what I am feeling. So I think, yeah it was just nice having people around me who could just say not necessarily that they thought they knew everything I was going through and that they knew all about me, but that they could say, “My experience is different than yours, but here I am, I want to help you I want to be emotionally present for you.” 
 
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Mara reflects on how she overcame her barriers to taking medications as a sign of weakness.

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… for so long I was really opposed to it. I felt like I should just go through it alone and it should be just me and I should fight it out and I can’t have this, this like, molecular crutch, you know, I can’t just take your drug and just use that to, to like, I don’t know, just yeah, I can’t describe it any better than as a crutch, because that would be a detriment to me and that must mean I’m weak, right. But as you know when push came to shove, I started thinking about medication as more and more of a viable option just because I heard more stories of people using it who weren’t weak people, who were people who were respectable, who weren’t people who were taking drugs just to, just to get out of something or just to get out of feeling because they weren’t actually up to fighting it. It was people who were brave enough to say I need, I need help, I need to take the medication and maybe this is an option I should try out. So I think just a couple of those stories of friends and family really inspired me to pursue that as something that I could consider for myself.
 
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Maya notes that only a few people see the pain behind her façade of an upbeat and adventurous person.

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You know what I mean, like very rarely do we show ourselves when we are struggling and so you have this false perception of everybody, purely at their best … 

And I know that I contribute to this a lot, because it is very rare. There are only probably three people, maybe more, but more or less three people who know when I’m genuinely upset. Because I can be totally fine seeming to everyone else, but these three people will be like, “Are you actually ok?” And I mean like, “Are you actually ok?” Not like, “Hey how are you doing?” Because my answer is going to be like, great let me tell you about this amazing adventure I went on and this incredible person I met and this amazing project they’re working on. But they’ll be like, “Hey." They'll check in and be like, "Hey you, really, how are you?" 

... Most of them can't see it unless I disclose.
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