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I pause to gaze out the window at our vibrant garden, where alyssum overflows the limestone rock border. Over the Spring and Summer I have watched its hues change from yellow and red to lavender and mauve. With each change, I have marveled: I do not remember seeing that last year. And each time I have thought, I am so glad to be here to see it. My toddler climbs onto my lap, pretending to be a puppy, we nuzzle and hug. I reflect, absolutely nothing in the world feels as perfect as a toddler's hug. A cacophony of playful laughter fills the room as my three children enact a comedic drama. And I think, how could this have sounded like noise last year?

A year ago, I was contemplating ways to end my life that would cause the least collateral damage to my children and loved ones. This was clearly an oxymoron; suicide is an inherently hurtful act. But it is one borne of desperation and hopelessness, and that is an accurate description of my state of mind at that time. Depression and suicidal thoughts are not new to me. In the sixth grade, I recall bursting into racking sobs for no explicable reason. The first time I contemplated ending my life and my pain was in eighth grade.

The source of my distress is tragically common. Incest, emotional abuse and neglect all contributed to my history. They also compounded the challenge of overcoming these scars. If I had not had children, I might not be alive today. For their sakes I dragged myself into a walk-in clinic and confessed my distress. This was my one last shot. I left the doctor's office with a one-month 50-mg/day prescription for Zoloft (sertraline) in my hand. With swollen eyes and reddened lips, I handed the slip of paper to the pharmacist, then walked around the mall numb, frightened and ashamed. I debated whether to pick up the prescription. I deeply resisted the idea of pharmaceutical treatment for depression. I had observed my mother taking one pill after another, with various and sundry side effects, to no permanent avail. Yet I had tried alternative therapy, had tried "pulling myself up by the bootstraps," with negligible success. I decided to give this medicinal approach a four-week trial and only in conjunction with therapy.

Two weeks later, I was feeling a little better, though not consistently, but had still not been able to see a psychiatrist. Four weeks later, I was slipping rapidly and still had not seen the psychiatrist. My doctor renewed my prescription at 100-mg/day and provided interim counseling. Once again, I experienced a gradual improvement, then a plateau, then a decline. On the eve of my first appointment with the psychiatrist, I experienced a bizarre constriction of my throat shortly after swallowing my capsule. I interpreted the sensation as the pill being stuck in my throat, so did not mention it to the doctor. Only when it occurred several times over the next week and physical explanations had been ruled out, did I realize that this was a psychosomatic manifestation of my illness. It was an eloquent expression of reluctance to use medication and my fear of speaking out about the roots of my despair.

Having been in therapy before (without medication), I knew that things would get worse before they got better. I was not prepared for how much worse. Even with the help of Zoloft, twice-weekly psychiatric appointments and loving, supportive friends and husband, I sank deeper. I began to be explicitly self-abusive, inflicting pain on my body. I lost weight. I became sexually unresponsive. I hid in my closet at night. Suicide was still only two paces behind me, beckoning, tempting. It was all I could do to decide, each day, to stay alive. Yet, after only two more months of combined drug treatment and psychotherapy, I was feeling much better. I had even ended some relationships that had been causing a lot of strife.

I felt stable and ready to wean myself off the medication while continuing therapy. From 150mg of Zoloft per day, I reduced it to 100mg, then 50mg. It did not take long for me to realize what a significant role the Zoloft was playing in my progress. Within two weeks, I was distraught and hopeless. Around this time I met several other people who, it turned out, were also taking one or another of the SSRIs for depression. My husband and I joked that we knew more people on Prozac (our generic term) than we did smokers! We seriously considered whether this trend was not our generation's version of the alcohol, cigarettes and Valium that our parents had depended on. This was perhaps part of my reluctance. I did not wish to see my illness as part of a fad. Nor did I like to think that something which I had struggled with for decades could be cured with one, two or three pills a day. I could not accept what I felt was a crutch or a patchwork solution.

Reading the bestseller Listening to Prozac by Dr. Peter Kramer gave me some valuable concrete information. It exposed some of the myths surrounding this new genre of drugs. It also addressed the history of pharmaceuticals and the management of psychiatric disorders. The latter information helped me understand why my mother had encountered such impediments in her own abortive healing process, trying everything from Valium to electro-convulsive shock therapy and hysterectomy.

Gradually I came to understand that my particular problem had both a neurochemical and an environmental aspect. I therefore made it my priority to do all that I could to ameliorate my environment. I stopped apologizing for my inability to forgive those who had abused me. I began to talk and to write about my experiences. And I accepted that, for now, I needed Zoloft as surely as any diabetic needed insulin. My progress, as with any chronic condition, has been neither smooth nor rapid, but it has been steadily uphill. I have been taking 300mg of Zoloft per day for the past four months, with no troublesome side effects and no plateau or relapse. I cannot believe how dramatically my world has changed in 12 months. A year ago, my world was tinted tan and gray, my body a hideous cage from which I sought release. Since then I have found the freedom which was at the heart of my search. I am free of despair, free of the constant companion of self-hatred.

Today, far from looking at the world through rose-colored glasses, I feel that a haze has lifted on a new day. I revel in its beauty. The blossoms and buds in the patch of sunshine outside my window may be no more abundant this year than last; my children are certainly no quieter or compliant than they were before. Yet my perceptions of these things are altogether different. As my toddler runs her tiny car up my arm and over my shoulder, I know I am profoundly glad to be here.