THIRTY YEARS AGO, the bookshelf in my Chicago apartment held practically every book I’d ever owned; all the novels I’d studied in college; my childhood copies of Little Women and Black Beauty, and The Handmaid’s Tale, personally signed by Margaret Atwood.

When I first started my English doctoral program at the University of Chicago, I had lovingly arranged all of them alphabetically on a set of cinder block shelves. Years after my sister, Mary Michael, died from leukemia when she was 16 and I was 20, books were precious to me, a predictable and safe retreat.  I could expand my understanding of the world without having to leave the downy nest of my bed. At the start of the semester, I’d eagerly lugged even more bags of books home from the campus bookstore and set them in piles according to course. 

At first, my school workload felt manageable. But as the quarter progressed, I started to fall behind. By midterm, I realized that I’d never come close to denting those piles of books, and the thought filled me with dread. Where reading had always been my solace, it was now, for reasons I didn’t understand, my tormentor. My brain couldn’t focus on the sentences and paragraphs; letters felt like they were sliding off the page.

There were so many words. And I couldn’t catch them as they fell.

Shortly after midterms, I flew to Boston to visit my boyfriend.

When I fell into his arms at the airport, he was visibly shocked at how loosely my jeans hung on my hips. While I’d noticed I’d lost a little weight, when we got to his house, the scale showed I was down 20 pounds.

I told him I’d been studying so hard that I must have forgotten to eat. But hanging out in the kitchen later with his roommates, I could also hear there was something off about the way I was talking. My responses sounded like they were on a time delay. 

Later, when I looked in the mirror, I was shocked to discover how grey and dull my skin was and that my normally curly hair had lost its spring. I also couldn’t relax my shoulders, which were perpetually hunched. I was 25, but I had the physical and emotional vitality of dead grass. I was both exhausted and sapped and twitchy and anxious. When I woke up, which was probably 20 times a night, my body no longer knew how to ease itself back to sleep. 

After boarding my return flight to Chicago, I buckled myself in and looked up at the sky through the rainstreaked window. Since my sister had died, my fear of flying had switched from anxious to petrified. I pressed the call button simply to inform the flight attendant I was afraid. I was overcome by how alone I felt, and how terrified I was to go back to Chicago. 

After a few minutes, the man sitting next to me had to fold up his paper to allow me to get to the aisle, where I apologized as I brushed past the flight attendant, who tried to talk me out of abruptly disembarking because it would delay the flight finding my checked luggage. 

“I’m sorry,” I said. “But I just can’t.” 

I was heading to the baggage claim when I saw my boyfriend standing in the corridor, his hands in his pockets. He’d been waiting until the plane took off. 

“I had a feeling this might happen,” he said.

That my boyfriend had worried I wouldn’t be able to handle a two-hour flight should have been a warning to both of us that I was not OK. But the truth was, we had no idea that my brain was so sick. 

Back in Chicago again, I was sitting on my peach futon couch when I picked up the latest copy of Vanity Fair. It was mid-December and my apartment was so cold that the linoleum floor tiles squeaked when I stepped on them. I was behind on my assignments and struggling. I couldn’t get through even a single paragraph.

As I flipped the magazine pages, I saw an essay by William Styron. It was called “Darkness Visible,” and was about his personal battle with mental illness.

For a few moments, my brain absorbed Styron’s words:

“In truth many of the artifacts of my house had become potential devices for my own destruction. The attic rafters (and an outside maple or two) a means to hang myself, the garage a place to inhale carbon monoxide, the bathtub a vessel to receive the flow from my opened arteries. The kitchen knives in their drawers had but one purpose for me.” 

His descriptions seemed terrifyingly close to whatever was happening to me. I’d gotten to a place where I couldn’t look at my chef’s knife without imagining its blade carving a red line the length of my wrist. I’d stored the knife in the back of the kitchen drawer because even the sight of its sharpened edge felt like a cannon exploding in my chest.

I called my mom and told her that while I would finish the quarter, I was dropping out of graduate school and moving home.

“Mom, something’s really wrong with me,” I said. Then I asked her to find me a therapist.

The next day, I drove my station wagon home to Minneapolis, through a blizzard that lasted the length of Wisconsin. I was soon living in my mom and stepfather’s basement.

I spent every morning under the covers, listening to the B-52s, their relentlessly happy melodies a reminder of the person I used to be, a person who would dance on beds, on tables, on any surface that would hold me.

A therapist who had worked with my mom after my sister died referred me to another therapist, who I started seeing three times a week. I measured my days by those appointments, telling myself that once I got through them, I could have dinner and go back to the basement and my music.

At our first session, my therapist took her seat in an overstuffed chair across from a too-soft couch that folded up around me when I sat down. I informed her that I didn’t plan on staying in town; as soon as I felt better, I was moving back to New York. 

She stopped taking notes and looked up. 

“You’ll be able to move back to New York, if you want to,” she assured me. “But have you ever considered the possibility that if you can live here and be happy, you will be able to be happy anywhere?”

She told me she had considerable experience with “clinical depression,” and she could tell from my appearance—was it the shoulders? the dead eyes?—that I was dangerously depressed, along with all the other warning signs; weight loss, sleeplessness, thoughts of suicide.

“But I’m not suicidal,” I insisted. “I’m too afraid of dying to kill myself.”

“I’m not saying you have made a plan,” she said. “But you’re having fantasies about knives, which can be the mind’s way of imagining a scenario where you don’t feel so awful.” 

She then mentioned that there was a new drug that had recently come on the market. It was called Prozac, and unlike the old-school medications, it helped lift depression without debilitating side effects. It was, she insisted, a true breakthrough. She went on to explain how not being treated for depression is like being diabetic and not taking insulin.

“But I’m not going to take medication,” I insisted. “I’m not that bad.” 

A month later, I was on my way to another therapy appointment. There had been a snowstorm earlier in the week; the snowbanks on the wider streets were at least four feet tall.  

I was taking a right turn on a well-traveled parkway when a passing car slammed into the front of mine. I knew immediately that the accident was my fault. I was too distracted, too unsettled to notice that the car didn’t have a stop sign.

The driver was shockingly kind.

“Things happen” he said, holding up his hands. 

My insistence that things weren’t that bad evaporated the moment I slammed into that sedan. I was 30 minutes late to my therapy appointment. Once I settled onto the couch, I trembled so violently that my therapist handed me a blanket and instructed me to hold it tight around me, like a self-hug. 

“I think it’s time to consider Prozac,” she said.

This time, I agreed. I understood I needed more than just talk therapy or lavender oil or a full spectrum lightbulb popped into a desk lamp. I was desperate for science to rebalance my brain chemistry.

Eight days after I started Prozac, my sleep switched from a jangled and caffeinated trance to something that, if not exactly restorative, at least resembled the lights-out, REM slumber I associated with going to bed. My days still revolved around therapy, but I no longer faced the nights with dread.

Midway through week four of my new drug regimen— I now marked days from the time I started taking Prozac— I found myself thinking, “It’s so beautiful out today.” There had probably been 30 days with the same exact conditions that winter, but the only difference was that now I could see it.

I took Prozac for three years and did both talk therapy and psychoanalysis for almost two decades. All these years later, it’s reassuring to know this combination worked for me. I have not suffered a major depressive episode since that awful winter, but if that ever changes, I know where to find the help I need.