Editor’s note: This is the first in an 8-part series of weekly feature stories written in conjunction with the “Inside Out” community campaign to normalize mental illness.
Jessica Ekholm has gotten really good at masking her depression.
Even on days when her thoughts are dark, her demeanor is bright. Friendly, engaging and often bursting with laughter on the outside, what’s going on inside, she says, is a totally different story.
“I feel like there’s a black hole inside of me,” she describes of being depressed. On good days, that hole is a nice, safe distance away from her, but on bad days, she’s right on the edge of falling into it, “holding onto that hole with one finger.”
“That is how I live,” she says. “Almost on a daily basis.”
Diagnosed with depression 16 years ago, at the age of 21, Ekholm has had time to perfect the art of appearing cheerful even when she’s anything but. She wears a mask in public as a coping mechanism, she says. It allows her to function and get through the daily routines of life, but not without taking a toll.
“Every day is just robotic, it’s just going through the motions,” she says. “And it’s exhausting.”
For Ekholm, depression wears many faces: “It’s not just sadness. I do not sit at home and cry all the time.”
She still has moments of genuine happiness, satisfaction with life and peace of mind. And she’s never had thoughts of suicide or harming herself in any way.
“I’m very blessed,” she says of that. “That’s very rare.”
Instead, depression, for her, causes destructive thoughts of hopelessness and of being unworthy. It leads her to disengage from everything around her, and to disassociate herself from other people, “so the majority of people do not know that I have depression. I’ve learned how to hide it well.”
“People always comment on how happy and vivacious I seem, but they don’t see me at home, when I’m barely functional from wearing that mask all day,” she says. “I just want to curl up on the couch and go to sleep.”
Although Ekholm conceals the symptoms of her depression, she does not treat it like a dirty secret. She’s been very vocal about her struggles, with family, friends and even in public. Three years ago, she spearheaded Stomp That Stigma, a charity walk held at Peoples Park in Detroit Lakes.
Held every May, during Mental Health Month, the walk helps raise awareness of mental health and serves as a fundraiser for families struggling with medical or funeral expenses related to mental illness. Informational booths are set up at the park during the walk, and a remembrance ceremony is held in honor of lives lost to suicide. The event’s motto is, “Together we can make a difference.”
“I want people to know they’re not alone,” says Ekholm of her desire to speak out and raise awareness of mental illness. “The biggest thing I say is, ‘It’s okay to not be okay,’ because when you know you’re not okay is when you can get the help you need. And I want people to know that it doesn’t matter if there’s a stigma or not - when you have what you have, you have it. And when you’re able to recognize that you need help, that’s when you can reach out and your healing will begin.”
Raised in the Frazee/Vergas area, Ekholm graduated from Detroit Lakes High School in 1999. She married fairly young and later divorced after having two children, a daughter and son who are now 12 and 9 years old. Looking back, Ekholm says she “always had symptoms of depression but never really realized it.”
She had trouble holding down jobs, and struggled to cope with day-to-day life. She didn’t know “something was not right” until someone very close to her - her mother - recognized her troubles and insisted she go see her doctor.
Ekholm says her mom had to drag her to her first appointment “kicking and screaming,” but today, she’s so glad she did. Being diagnosed with depression “was an eye-opening thing for me,” she says, adding, “I was at a point where I was tired of feeling like I was.”
Even so, she admits that she resisted treatment at first. She went to therapy, and she tried different medications, “but I never gave myself the opportunity to really get into anything to get myself better.”
It took her four years to find and accept a prescription that worked right for her, and then to figure out the right dosage. Even after that, she still struggled with her symptoms. She “hid away” and “slept a lot,” she says. She didn’t want to be around people, and “didn’t want to get out of bed.”
She’s never had a particular trigger for her depression. Instead, “it’s just something I deal with every day,” she says. “It’s a big misconception that bad things will make you go in a hole. Sometimes you can have the best stuff happening to you and you still fall into that hole, regardless.”
Through the years, Ekholm has been through a slew of different therapists, and tried “so many different medications,” she says. “I’ve tried essential oils, I’ve tried tanning lights, I’ve tried using different paint colors in my home...”
Pretty much any possible form of treatment that’s ever been suggested for depression, she’s tried. And while some things have helped, to varying degrees, it wasn’t until very recently that she really started to see “a light at the end of the tunnel” thanks to Cognitive Behavioral Therapy, or CBT.
Ekholm started CBT about six months ago, and she says it’s helping her in a way she’s never experienced before. This type of psychotherapy “is about retraining the brain, retraining your thought processes,” she explains, and “it’s really amazing.”
Through CBT, Ekholm is learning how to ask herself pivotal questions before falling into that “black hole.” She’s able to keep things in perspective by asking things like, “How will this affect me in one week, or one month, or one year?” or “What would I tell someone else who’s going through this?” It’s teaching her to look at things from a different angle, and reminding her that “things aren’t as bad as you think,” she says.
She’s come to understand that, while there are situations in life that can’t be controlled, what she can control is herself: “We try so hard to control everything around us,” she says. “The only thing we can control is how we handle that situation, and how we approach it from our own standpoint.”
While each person responds to different therapies in their own ways, Ekholm says CBT has been groundbreaking for her. So has finding God again in recent years; her faith has become an integral part of her life, healing process and general wellness. She’s also striven to surround herself with positivity and positive people, as much as possible, and is focusing on love: “I know and feel the love that I have for people around me, and I know the love that I feel for my children. That’s the biggest thing.”
Ekholm feels fortunate to be in a good place today, overall, but she still has days when she just wants to be left alone, and still has trouble getting out of bed in the mornings. She constantly has the TV or music on in the background, she says, because “I don’t like silence - that’s when my brain can really dive.” She still wears a mask every time she leaves the house.
“My biggest challenge is everyday functioning, trying to wrap my brain around life in general,” she says. “Just getting up in the morning is the hardest thing for me in a day.”
The first “Inside Out” video, featuring Jessica Ekholm speaking about her experience with depression, is available to watch here: http://beckercountyenergize.com/inside-out-a-step-inside-mental-illness/ .THE BASICS OF DEPRESSION
What is it?
In the “Inside Out” video about depression, Melissa Cook, an outpatient therapist at Lakeland Mental Health Center in Detroit Lakes, calls depression “a major medical illness.” It’s a mood disorder often associated with sadness, but it goes beyond the regular everyday ups and downs of life to the point where it starts to affect a person’s everyday behavior and ability to function.
How common is it?
Cook says depression is “one of the most common illnesses” that they see at Lakeland. Even if it’s not the “main presenting symptom,” it often goes along with other mental illnesses. According to Cook, one in six people will suffer from depression at some point in their lives.
Who does it affect?
Anyone at any time, but people are at a greater risk when going through a major life change such as losing a loved one, starting a family, becoming an adult, or experiencing loss of functionality after a medical issue.
What are the signs and symptoms?
Isolation and trouble interacting with people. Missed work, school or important social functions. Difficulty sleeping, and eating either more or less than usual. In older adults, depression can look a lot like dementia, resulting in forgetfulness and anger. In young kids, it may lead to excessive irritability, crying and tantrums. In teens, it can be mistaken for “normal” teenage behavior such as rebellion, rule breaking, tardiness from school and crying.
How is it treated?
Usually through a mix of talk therapy and medication, through treatments are individualized based on a patient’s needs and wants. If a patient is not comfortable with medication, “that’s definitely okay,” says Cook in the video.
WHAT TO SAY - AND NOT SAY - TO SOMEONE WHO MIGHT BE DEPRESSED
DO be supportive. Be there for the person, in a caring and non judgemental way. Make sure they know they’re not alone, that they’re loved, and that mental illness is common and nothing to be ashamed of. Say things like, “I’ve noticed you haven’t been yourself lately - is everything okay?,” “I’m here for you,” “It’s okay to feel this way,” “You matter to me,” “Is there anything I can do to help?,” “I’m not going anywhere,” and “I care.”
DON’T be afraid to speak up. If you suspect someone is in need of help, gently encourage them to seek it. Don’t say things like, “Suck it up,” “Pull yourself up by your bootstraps,” “Just smile,” or “Try to think better thoughts.” These kinds of statements are unhelpful and make people feel judged, as they suggest that the person has control over their depression, which is a common misconception.
*Suggestions compiled from mental health experts featured in the “Inside Out” videos and from online mental health sources, as well as advice from Jessica Ekholm
- Becker County and White Earth Reservation 24-Hour Mental Health Crisis Line: 218-850-4357
- Minnesota Crisis Text Line: Text MN to #741741
- Veterans Crisis Line: 1-800-273-8255 (or text #838255)
- Essentia Health St. Mary’s Behavioral Health: 218-844-2347
- Sanford Clinic Behavioral Health: 1-218-846-2000
- Lakeland Mental Health Center: 218-847-1676
- Stellher Counseling Services: 218-444-2845
- The Village: 1-800-627-8220
- White Earth Mental Health: 218-983-6325 or 218-983-4703
- Willow Tree, mental health crisis stabilization services for adults: 218-844-1733
- A Place to Belong, recreational and social events, peer support, meals, computer access, free laundry facilities and community service opportunities for adults with diagnosed mental illnesses: 218-739-0797.
- Lakes Crisis and Resource Center, mental health services for victims of domestic violence: 218-847-8572, or 218-847-7446 for the 24-hour Crisis Hotline
- Bridgeway Behavioral Health Services, Fergus Falls: 218-736-8208
- Prairie St. John’s, Fargo, N.D.: 701-476-7216
- Red River Behavioral Health System, Grand Forks, N.D.: 701-772-2500
*Visit beckercountyenergize.com for even more mental health resourcesMORE ABOUT THE 'INSIDE OUT' CAMPAIGN
"Inside Out: A Step Inside Mental Illness" is a Detroit Lakes area project to raise awareness of mental illness and erase the stigmas surrounding it. A community partnership between local media and regional healthcare and crisis organizations, the campaign consists of a series of online videos, newspaper articles and radio discussions that shed light on some common mental health disorders, putting local faces to those disorders. Topics covered include depression, PTSD, anxiety, ADHD, suicide and others.
Videos are being released once a week over the next eight weeks, and are available to watch free on Becker County Energize's website, beckercountyenergize.com. There will also be a program airing each week on lakestv3.com. Newspaper articles are being published in the Wednesday print editions of the Detroit Lakes Tribune over the next eight weeks, as well as on this website, www.dl-online.com. Participating radio stations include Leighton Broadcasting's local stations, Wave 104.1 FM, KDLM 1340 AM and 93.1 FM, and KRCQ 102.3 FM.