On high-pressure campuses like Penn, there is still great shame and misconception surrounding depression and suicide. The death of Madison Holleran, a 19-year-old freshman, was one of a group of student suicides that devastated the Penn community in 2014. A year later, Holleran’s family recently released her suicide notes to the public. Along with starting a foundation in their daughter’s name, Holleran’s parents hope that their story might help other young people in crisis, especially those transitioning to college.

When interviewed by New Jersey publication The Record, Holleran’s father Jim said, “The thing I am still shocked about is that every 13 or 14 seconds in the United States, someone will take their own life. I can’t fathom that. Madison was the happiest kid, you know, when she was happy. And if that person would understand what they are doing to their family and their friends and their extended friends, they would not choose suicide if they really understood that they would be gone forever.”

Unfortunately, the problem precisely is this two-sided misunderstanding. While loved ones try to make sense of the death, suicide victims and depressed individuals often cannot understand the effect on their family, or ultimately, feel that their loved ones would be better off. In her letter to her family, Holleran apologized, leaving her jewelry and other possessions to them and telling them repeatedly that she loved them.

Many of the sentiments I have heard from my own family and friends are hypercritical. “I don’t understand how anyone could be selfish enough to take their own life” is one of the most common statements I hear. Coming from communities like Penn, students who take their own lives are often described by those close to them as smart, kind and talented, with close friendships. Media outlets sensationalize deaths like Holleran’s, wondering where a student who was also attractive — as if this alone should account for a young woman’s happiness — could go wrong. How, it is argued, could someone not only fail to consider those around them, but even have depression considering how fortunate their circumstances are?

This only adds to the misunderstanding of depression and other mental illnesses. It implies that not only does a depressed person have a certain profile, but unless they are surrounded by profound hardship, they are not justified in being depressed. Like many other misconceptions of mental health, the view of the selfish, privileged person takes emphasis away from the illness and places a burdening responsibility on the depressed person.

While it is easy to say depression is an illness, it is hard to appreciate just what that means. Clinical depression is the result of a combination of environmental and biological factors and does not suddenly emerge overnight. Young women are more than twice as likely to become depressed as young men. Some cases, according to the National Institute of Mental Health, are accompanied by psychosis, which causes delusions and false beliefs. A person with depression also has significant differences in brain functioning than a non-depressed person. Mirror neurons, which help people understand the perspectives and intentions of others, have weakened connections in depressed individuals. Areas of the brain that control functions like action planning, memory and the reward pathway are also affected. It is no surprise then, that a person with suicidal thoughts may not only falsely underestimate their importance to others or the true consequences of suicide, but may not be able to consider another’s perspective more strongly than their own.

The real selfishness regarding suicides is expecting a person to live in misery for someone else, rather than helping them to get to a place where they can live happily for themselves. We do not give people suffering from illness enough credit for having the strength to endure just as long as they do, often merely for the sake of others.

I am reminded, even after my own medical leave, that powerful assumptions about mental health persist in our culture and pervade the space of the Penn community. We must recognize that not only can anyone suffer from depression, but the feelings and symptoms that go along with the illness are justified and valid. We all have the responsibility to become more aware of what mental illness means to intervene when others are struggling, without judgment.

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