What a large number of factors constitute a single human being! How very many layers we operate on, and how very many influences we receive from our minds, our bodies, our histories, our families, our cities, our souls and our lunches! I came to feel that my depression was probably some ever-shifting assortment of all those factors, and probably also included some stuff I couldn't name or claim. So I faced the fight at every level. I bought all those embarrassingly titled self-help books (always being certain to wrap up the books in the latest issue of Hustler, so that strangers wouldn't know what I was really reading). I commenced to getting professional help with a therapist who was as kind as she was insightful. I prayed liked a novice nun. I stopped eating meat (for a short time, anyway) after someone told me that I was "eating the fear of the animal at the moment of its death." Some spacey new age massage therapist told me I should wear orange-colored panties, to rebalance my sexual chakras, and, brother—I actually did it. I drank enough of that damn Saint-John's-wort tea to cheer up whole a Russian gulag, to no noticeable effect. I exercised. I exposed myself to the uplifting arts and carefully protected myself from sad movies, books and songs (if anyone even mentioned the words Leonard and Cohen in the same sentence, I would have to leave the room).

I tried so hard to fight the endless sobbing. I remember asking myself one night, while I was curled up in the same old corner of my same old couch in tears yet again over the same old repetition of sorrowful thoughts, "Is there anything about this scene you can change, Liz?" And all I could think to do was stand up, while still sobbing, and try to balance on one foot in the middle of my living room. Just to prove that—while I couldn't stop the tears or change my dismal interior dialogue—I was not yet totally out of control: at least I could cry hysterically while balanced on one foot. Hey, it was a start.

I crossed the street to walk in the sunshine. I leaned on my support network, cherishing my family and cultivating my most enlightening friendships. And when those officious women's magazines kept telling me that my low self-esteem wasn’t helping depression matters at all, I got myself a pretty haircut, bought some fancy makeup and a nice dress. (When a friend complimented my new look, all I could say, grimly, was, "Operation Self-Esteem—Day Fucking One.")

The last thing I tried, after about two years of fighting this sorrow, was medication. If I may impose my opinions here, I think it should always be the last thing you try. For me, the decision to go the route of "Vitamin P" happened after a night when I'd sat on the floor of my bedroom for many hours, trying very hard to talk myself out of cutting into my arm with a kitchen knife. I won the argument against the knife that night, but barely. I had some other good ideas around that time—about how jumping off a building or blowing my brains out with a gun might stop the suffering. But something about spending a night with a knife in my hand did it.

The next morning I called my friend Susan as the sun came up, begged her to help me. I don't think a woman in the whole history of my family had ever done that before, had ever sat down in the middle of the road like that and said, in the middle of her life, "I cannot walk another step further—somebody has to help me." It wouldn't have served those women to have stopped walking. Nobody would have, or could have, helped them. The only thing that would've happened was that they and their families would have starved. I couldn't stop thinking about those women.