Jaquira Díaz on Addressing Mental Illness During COVID-19

Several years ago, when I was in my mid-20s, after suffering from major depressive disorder and anxiety for most of my life, I found myself at the emergency room during an episode of substance-induced psychosis. My father and stepmother found me, at the very beginning of the episode, having paranoid delusions. Someone had tried to poison me and now they were coming, I told them. “Do not answer the door.”

Somehow, I listened when they said I needed to see a doctor. “We’ll be with you the whole time,” my father said. At the hospital, after checking my vitals and asking me to describe what was wrong, the triage nurse talked to my father. He explained my history with depression, my mother’s schizophrenia. I was given an emergency bed.

A psychiatrist—a tall, middle-aged blind man—approached with his guide dog. He asked questions while my father and stepmother watched, worried, nervous. “When was the last time you slept? Do you ever feel disconnected from yourself, or from reality? Do you hear voices?”

“I’m not crazy,” I insisted. I was afraid I was going to be hospitalized, or medicated against my will, which had happened to my mother many times.

The doctor reassured me. “Everyone here wants the best for you. Right now, we’re just trying to understand.” I glared at him, then at my father, who looked miserable, tears welling. My stepmother took my hand, and there was such kindness in her eyes that in that moment she seemed like an angel.

And suddenly it clicked. Something happened in my brain, like a fog had lifted, and I could see clearly: my stepmother was an angel. I took in all my surroundings. The hospital bed, the curtain half open, my parents waiting. The angel was there to help me cross over. I had died. They had been keeping this from me.

“Am I alive?” I asked my parents. “Or did I die?”

They both burst into tears and wrapped their arms around me while I asked again and again, “Am I alive? Please tell me the truth. Am I alive?” I felt the heat of them on my body, their tears on my skin, and I doubted any of it was real.

I pulled away, and didn’t like what I saw on their faces. “I’m not crazy,” I said again. I remembered my mother, who’d spent so much time in mental hospitals, psychiatric wards, her whole life cycling between being overmedicated, under-medicated, ignored, treated like a hysterical woman who couldn’t care for herself. How many times had she told me, “All these doctors, and for what? They don’t ever listen to me.”

There was movement on the other side of the curtain, nurses calling out to one another, someone wheeling a cart down the hallway. And then, out of the corner of my eye, the psychiatrist, his guide dog at his side, and another fog lifted. He was no doctor. He was a demon, come to take me to hell, along with his hellhound.

I started screaming.

More nurses burst through the curtain. Someone took my wrists. The psychiatrist, the nurses, everyone stopped speaking to me, and spoke only to my father. “Her heart is racing,” someone explained. “Dangerously high. She could have a heart attack.”

“Do it,” my father said. He left the room as they held me down.

My stepmom pulled back the curtain. It was time now. There was a needle, then an IV. The demon and his hellhound stood at the edge of the bed.

Above me, the overhead lights were bright, so bright.

I started Ordinary Girls, my first book, shortly after that first episode of psychosis—in October 2007. I was in treatment, getting better, and working was helping me find a way back to myself, even though I was writing about surviving sexual violence, about my mother’s mental illness and about my own struggles with depression and suicidal ideation. I couldn’t really get my head around what I was doing—I was just trying to make sense of my life. I was trying to figure out how to keep living.

More than a decade later, when the book was released, I was happy for the first time. I was still struggling with anxiety and depression, but I had never been this happy. I was engaged to the love of my life, and we shared homes in Miami Beach and Montreal. I was doing what I loved, writing and teaching. I was in the middle of my book tour, which had started as a small 10-city tour, and grew into a several-months-long affair with over 40 readings, speaking engagements and lectures all over the country. Then overnight, at the start of the pandemic, everything stopped.

I was struggling with almost every aspect of my life.

We didn’t know it yet, but my fiancé and I would be separated for five months. I was in Miami, and because of the COVID-19 travel bans instituted by the Trump Administration, they were forced to travel back home to the U.K. One day I was sharing my life and work with my partner, spending time with family and friends, talking to my mother every day, traveling three times a week to talk about work I loved, planning our wedding. And then, suddenly, I was living alone, separated from my partner, from my family, from my friends. All of my remaining book-tour events were canceled, so I lost most of my income for the year. We had to cancel our wedding. My partner’s interview with U.S. Immigration was postponed again and again, and then finally canceled—they had to remain in the U.K. until the travel bans were lifted. And then my mother got sick, spending months in the ICU in a South Miami hospital after a terrible year of recurrent pneumonia. The doctors advised us to make plans, to say our goodbyes.

Like so many other women have over the past year, I was struggling with almost every aspect of my life. The recession caused by the COVID-19 pandemic is disproportionately affecting women, and while women in the U.S. appear to be impacted most, this is a global problem: according to the McKinsey Global Institute, during the pandemic, women have lost their jobs at 1.8 times the rate of men. A January 2021 report by the National Women’s Law Center has found that in the U.S., women’s labor-force participation rate is 57%, on par with the rate in 1988. Approximately 40% of women over 20 have been without work for six months or longer, with white women’s unemployment rate at 5.1%, while Asian women saw a rate of 7.9%, Black women saw a rate of 8.5%, and Latinas saw a rate of 8.8%. And women who were forced to leave their jobs to care for their children—who are now at home because of COVID-19 school closures—are not officially counted as “unemployed.”

A study by CARE, a nonprofit that fights global poverty, found that the pandemic has caused a crisis in women’s mental health, and that accessing the quality health care services they need has been significantly harder during this time. After months in isolation, I started to experience that firsthand: I didn’t leave my apartment for days, weeks. Time became meaningless. I stopped sleeping, stopped eating, stopped reading and writing, stopped doing everything and anything I loved. It wasn’t so much that I chose to stop, but that I just couldn’t, even though I tried. I’d try melatonin one night, Benadryl the next. I’d doze off for two, three hours, and then wake in despair. I called friends, desperate for sleep, or feeling absolutely exhausted with life, or convinced that I was having a heart attack, or that we were all going to die. I didn’t hug another person for a month, then two, three, four, five. When I finally slept, after swallowing my last four sleeping pills, I didn’t wake for a day and a half.

The day after winning an award for my book, I called a suicide-prevention hotline.

There is a history of mental illness on both sides of my family. We have all been in and out of therapy at some point, on and off medication. Five of my mother’s six siblings suffer from depression or bipolar disorder. My maternal grandmother, like my mother, spent her life battling schizophrenia and depression, and threatening to end her life. Ten years ago, she died by suicide. When I got the news of her death, I was both surprised and not surprised at all.

Being alone during a pandemic, just me and my thoughts in that apartment, I started to feel numb. I couldn’t remember feeling joy, even though months before I had been celebrating my work, had been planning a life, had been able to pick up a collection of poetry, read a single poem and feel a sense of connection with the world, something meaningful and artful and complex. Now the pandemic had me questioning whether any part of my world had any meaning at all, if there was any point to all of this. I was convinced I’d never see my partner again, I’d never see my family again, that my mother would die in that hospital, alone, without me there to hold her hand. How could I keep going when I didn’t have a reason?

I didn’t leave my apartment for days, weeks. Time became meaningless.

The truth was that I didn’t want to die. The truth was that as soon as my partner left, as soon as the work and the planning and the traveling stopped, when there were no more parties or family and friends, as soon as I was alone, I recognized what I’d been doing my whole life. I’d spent my 20s and early 30s avoiding the problems. Even though I’d had periods of happiness, even though I’d been productive and high-functioning, I had somehow managed all that without dealing with any of my mental illness. I hadn’t taken care of myself—I’d spent 15 years avoiding therapy, starting and abandoning it as soon as it got hard. And now, the isolation was forcing me to see how I needed to face all the ways I’d let my illness get out of control when I knew what I had to do and was fully capable of taking it on. Finally, when I couldn’t take any more sleepless nights, I made an appointment with a therapist.

I arrived in the U.K. in early August, after months of weekly psychotherapy. I was finally able to read, and write. I was sleeping without medication. I had committed to getting better, and was doing the work. I quarantined for two weeks before moving in with my partner. At the end of August, we got married, in a small, private ceremony in their mother’s living room.

I never stopped thinking about how fortunate I am, how privileged. I grew up poor, and that meant that as a teenager, when I first started showing symptoms of major depressive disorder, my family couldn’t afford treatment. It was never an option. During the pandemic, when so many people have lost their jobs, their homes, their health insurance, I’ve been lucky: even though I lost most of my income, I’ve still been able to work from home. I don’t have children to care for. I can still afford weekly therapy. I was able to pay for an international flight, leave the U.S. for six, seven, eight months at a time. Most women are not this privileged.

Living in the U.K., and watching the U.S. from abroad, even temporarily, has given me new perspective. I’m grateful for every day, for my health, for my family and friends, for my spouse. I’m always conscious of how fortunate I am, and I can finally say I am truly happy, the happiest I have ever been. I try to remember that I may not always be this happy, that depression tries to convince me that there’s no point. But there is. I’ve learned that for me, there is a way to keep making art, to keep living: I prioritize my mental health, I stay focused on the things that feel meaningful and purposeful. And sometimes I ask myself, “Am I alive?” And the answer is always, “Yes. I’m alive.” And I know it’s exactly how I want to be.

Díaz is the author of Ordinary Girls

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