While mental health challenges affect people from every demographic, cultural factors, economic factors, and access to mental health care often play a large role in the burden these challenges put on individuals and communities.

Rural places in particular, face significant mental health care shortages, even in spite of efforts like the recent expansion of the U.S. mental health hotline. These shortages only exacerbate problems like the increased risk of suicide among aging farmers, and the greater instance of rural LGBTQ adults dealing with depression, anxiety, and fewer treatment options.

Against this backdrop, rural West Virginia author Kathleen M. Jacobs shares about her own struggle with depression.

My earliest memory of deep depression was an episode that came without warning, without any specific incident, and with a sense that something was happening to me. Something that I could not define, but was certain that if I simply talked to myself and found a way to reason with, it would move along, much like a very dark cloud after a storm. 

I, of course, was wrong. And once I found the courage to tell to my physician about the episode, he explained: “This is not something you can simply talk yourself out of, Kathy.” His tone was not condescending. It was a declaration without a shred of doubt. And I believed him. As time passed and more episodes found me (although I tried very hard to hide from their clutches) that declaration made all the difference.

Sometimes I still wonder at my naiveté at the time, and at the naiveté of my community. In my experience, statements that serve no purpose in restoring one’s health, while well-meaning, can do just the opposite. “Mind over matter.” “Just shrug it off and move on.” “Don’t think about it.” “Reading a good book will help.” “Remind yourself that it could be much worse.” “Oh, it’s just a moment; it will pass.” “Do something to take your mind off of your problems.” After these words are repeated, they often become yet another hurdle that we, those who suffer from depression, must jump.  And this additional jumping becomes so effortful that we find ourselves withdrawing to an even greater degree in order to avoid hearing these sorts of, likely, well-meant words.