I was 20 years old and in my second year at the University of Washington when I stumbled into a rut.

It was summer. I was the only one left in an apartment I’d rented with three other guys that school year. Everybody else had gone home, but I was taking classes and became something of a recluse. I stopped cooking, and I didn’t really go out, either. My most frequent meal was 2% milk poured over Frosted Mini- Wheats. I also ate bagels with no-fat cream cheese. Obviously very health conscious, I shopped almost exclusively at the 7-Eleven that was at the bottom of the hill.

Shades drawn and lights off, I could go a full day in the dark without leaving the apartment, playing Sega Genesis alone or perhaps getting fixated on marathons of MTV’s The Real World or maybe Law & Order, which I came to believe was playing on at least one of the various cable channels every hour of the day. At one point, I took a part-time job going door-to-door, soliciting donations for an environmental organization. I thought this would force me to socialize. I quit after two days. I dropped one of the history classes I was taking.

I never considered talking to a doctor, though. My problems, as I saw them, related to laziness, a lack of discipline, and feeling sorry for myself, which was true to a certain extent. It just wasn’t the whole story.

I am the one of every four Americans with a diagnosable mental-health condition, but I was in my 30s before I really considered this possibility. Being diagnosed with a depressive disorder was more a first step than a destination, though, and the fact that it took me so long to realize I should talk to someone is one of the reasons that I’m so willing to talk about my mental health now. Well, that and the fact that being open about my own experience helps me as much as it does anyone else. The only thing I struggle with is finding the right verb.

Saying, “I am depressed,” isn’t accurate because right now I feel pretty good. Saying, “I have depression,” isn’t much better because it sounds like I have a pet or perhaps an uncooperative appendage. Depression is more like a tendency my brain has. A predisposition that I should be aware of and, more important, guard against. Feeling sad or withdrawn is part of life. Experiencing this for weeks on end can signal an underlying issue. At least it does for me and the 17.3 million Americans who are estimated to have experienced at least one sustained depressive episode. That’s 7% of the adults in this country.

In my case, I believe some of this is genetic, a result of the brain chemistry I was born with. My Mom experienced depression. I think the specific details of my life have played a role, too. My father died when I was 13, and as a teenager, I had a difficult relationship with my stepfather.

But for me, understanding the reason why I feel depressed is not nearly as important as recognizing and accepting the fact that I do have this tendency. It’s a pattern I can trace back to my late teens and early 20s when I would feel an intense sadness that didn’t always have an identifiable cause. A good example of this is the time my Mom visited me while I was in college. We sat in the old Caffe D’Arte near Pike Place Market, and I was moved to tears because I felt my life wasn’t going how I wanted. Specifically, I was upset I had stopped playing baseball after I was 15 years old. This was silly for any number of reasons from the fact I was never that good to begin with, but more important, there was nothing stopping me from playing again.

Yet that’s exactly the kind of thing that would initiate a psychological tailspin, and the fact that my sadness was disproportionate to the situation only made me feel more inadequate. I felt like I was fatally flawed, so sensitive that I wasn’t able to handle the sharp corners that are inevitable when you live in this world. That’s one of the things that makes depression so tricky for me, this tendency to spur actions that exacerbate my sadness.

When I was 24 and living in Connecticut, where I worked at ESPN, I felt so bad, I spent one weekend repeatedly calling the phone number of my college girlfriend even though I knew she was on vacation in Hawaii at the time. I called at least 20 times. She had Caller ID, which was a relatively new feature then, and I didn’t consider this at all when I kept dialing her number. I still talk to her from time to time, but I’ve never asked if her phone told her just how many times I called that weekend she was out of town, because I don’t want to extinguish the possibility she doesn’t know.

As I approached my 30s, insomnia became a symptom as well as an accelerant in my depressive episodes. Everything escalated when I stopped sleeping. I went past being disappointed in myself to being angry with myself. Furious. At one point, I raised my own fist over my head and rapped own my skull. Hard. Fortunately, that’s as close as I got to trying to injure myself, but I felt desperate enough that I can understand how people reach that point.

I began talking to a therapist the year I turned 30. I was formally diagnosed with a depressive disorder a few years after that. In 2008, my primary-care physician prescribed Citalopram, a selective-seratonin reuptake inhibitor that is also called Celexa. Seratonin is a neurotransmitter, which is a fancy way of saying it’s a chemical messenger that helps carry signals between brain nerve cells, which are called neurons. Among antidepressants, it’s relatively mild. An SSRI blocks serotonin from being reabsorbed into the neurons, meaning it increases the serotonin available to transmit signals. In 2018, my doctor added 150 milligrams of Bupropion, which is also known as Wellbutrin.

The one mistake I think people make in discussing mental health is to characterize a diagnosis or the decision to take medication as some sort of finish line. For me, it was much closer to a starting point. It was only when I understood what was happening that I could really accept it and then address it. There was no single thing that changed everything for me. No “aha!” moment. It has taken steady work in a process that is not linear.

Shades drawn and lights off, I could go full day in the dark without leaving the apartment.

The biggest thing I’ve learned during the past 15 years is that my first inclination when I feel depressed is to do things that accentuate that feeling, like flipping off the lights and pulling down the shades so I can watch television in the dark. I’m better served by opening up those windows and airing the place out by talking about what I’m feeling with my therapists (I’ve now had a total of five of them), my wife or even my coworkers. I’ve cried in the office of two different supervisors, and while I wouldn’t say that I’m proud of this fact, I’m not at all embarrassed, either. Sharing who I am and what I am feeling helps give me a foothold to climb out of a pit that I’m otherwise liable to wallow in.

I’m 48 years old now and I feel better about myself than I ever have. I believe I’m always going to be prone to depression. It’s just a part of who I am. That doesn’t mean I am always going to be depressed, though, and the best defense is to stay open and honest instead of suffering in silence.

If you’re feeling alone, depressed or facing a problem you can’t solve, reach out to someone. I’ve been a patient at Sound Health. For those who need immediate help, 988 is the national suicide and crisis lifeline.