Lately, I’ve been noticing the return of one of my most distressing depression symptoms: thoughts about self-harm. When I first started harming myself, I was so ashamed that I couldn’t talk about it at all. When asked, I’d shut down and say nothing for fear of crying uncontrollably. I have the same struggle when it comes to suicidal ideation; I feel such overwhelming shame that just saying the words out loud has been a gradual process. I was recently talking to my (very patient) nurse practitioner, who reminded me that the first time we talked about my suicidal thoughts it took me about ten minutes to get the words out, and I was shaking like a leaf the whole time.

It’s only recently that I’ve really been working on seeing these things – self-harm and suicidal thoughts – for what they are: symptoms of a larger issue. They’re indicators that my depression has worsened. There should be no judgments about willpower or self-control. They’re symptoms that should be taken seriously, but they’re nothing more or less – just symptoms.

While I know this intellectually, when those old thoughts come rushing back, so do the remnants of guilt and shame that I’ve worked to eliminate. It eats at me – the thoughts themselves and the judgments I hold against them. That’s how it always is; whether it’s a trickle or a flood, the thoughts eventually erode my determination not to give in to self-harm. It’s a battle to hold out until the thoughts pass, and sometimes I make it, but sometimes I don’t. The good news is, it does get easier with time and practice. If you relapse it can feel like you’re back at square one, but you’re not. If you need a little encouragement today, keep going. Keep working to treat yourself with kindness. You’ve got this.