This article was written for Suicide Prevention Month and contains themes of suicide, suicidal ideation, mental disorders and eating disorders. If you are experiencing a mental health crisis, you are not alone. CCPHS provides a 24/7 hotline for distressed members of the UMass community.

Today is my 20th birthday. Usually, a 20th birthday is overshadowed by the fun of a 21st birthday, but making it to 20 is important to me, because it was never a guarantee.  In high school, I thought I would graduate college and work aimlessly for a few years before ending it all. In freshman year, it became apparent that I may not even survive to graduation. This past summer, I thought it was going to end.

I always thought about what would happen after I died. What would my family say? What would be in my obituary? The guilt over imposing a financial and emotional toll on my family has been always enough to keep me from actively taking steps to commit suicide. But suicide is not always actively taking your life; it is also giving up trying to live with mental illness.

Depression can act like a chronic disease, slowly tearing apart the body until it’s no longer recognizable. In the fall of my sophomore year, no medication would work to mitigate the effects of my increasingly worse depression. What used to be melancholy became a hypomanic-like state. I was sleeping 17 hours and staying awake for 36 hours. My personality and sense of reality were dissolving before my eyes as I struggled to make it to Christmas break.

I did survive though. I made it to Christmas break and then through spring semester. I balanced recovering from fall’s madness, classes and the side effects of my new medications. I finally felt like I had some control over my body and could move on from this mess. I came out of the semester with a little bit of hope that things could get better, something I hadn’t felt since entering the University of Massachusetts.

Summer was worse than I could have ever expected. I started to eat less and less. Despite the full fridge and pantry in my one-bedroom Amherst apartment, I ate less than 1000 calories a day. My weight dwindled to a scarily lean 140 pounds as my bodily deterioration and worsening mental health intertwined to create a Lovecraftian monster. I remember first realizing how bad it had gotten after a 4th of July event; I arrived home and almost collapsed in my kitchen.

This became my new normal as I went through the summer. I would stumble around after getting up from my low blood sugar. When the summer class I was taking ended in mid-July, I became couchbound. No one was in town to check on or even visit me. When I went to an eating disorder specialist at the University Health Services, they told me without a hint of empathy that it was just depression and that I was just looking for another reason. I became hopeless and utterly lonely. If I starved to death or had a bad fall, I likely wouldn’t be found for a couple weeks.

I kept fighting to survive because in spite of the typical depictions of depression, I wanted to live. I wanted to be happy, I wanted to graduate and fall in love and have all the friends I could have.

At the same time, there was a seed of doubt- a thought that this cycle of hope and sadness would continue and that it would be better to just wrap it up now. That even if I recovered, I would still be lonely and end up in the same place I started.

The cycle was finally broken though.

My appetite recovered because of a medication dosage issue – a fixable issue that was almost tossed aside by the specialist. The new medication I started at the beginning of the summer was starting to work. I started to feel a quiet peace that led to a genuine joy that I had never felt in my life. The urge to smile, to enjoy the present, to be excited about the future was something I had never experienced until now.

As I start to move on from this chapter of my life, I’m reflecting on where I am now. It’s still messy and imperfect as I mend the relationships I trashed and neglected. The stress of coming into a semester where the goal is not to make it to the next, but to do well and push myself to new heights is also a new sensation. No matter how this year goes, a thought rings through my mind with such clarity.

“I am alive. I am alive.”

Dylan Nguyen can be reached at [email protected] and followed on Twitter @dnd_photo_.