It would be impossible to convey how many weeks it has taken me to write this article… the wash of anxiety every time I contemplate it; the bubbling in my tummy as I strategize how I will start, where I will start and what I will say.

Let’s start here: That sentence you just read? I’ve rewritten it three times. I took out the words “terror” and “shame” because I don’t want to sound dramatic. I decided against “trembling,” “nauseous” and “dreading” because I don’t want to seem like a weakling. The truth is my tummy isn’t bubbling. It is in knots. Because it’s easy to write about sex, relationships and reproductive health. I don’t have any baggage about what’s between my legs. Just the 500-ton tire iron I carry in my head. And the words I’m always so ashamed to say out loud.

*Deep breath* I suffer from clinical depression. The bad kind. The “can’t get out of your bed for days except to pee and nibble at stale crackers so your stomach doesn’t eat itself” kind. The “don’t answer calls, texts, smoke signals, knocks on the door, messages from Jesus, Beyonce or Maya Angelou” kind. The “don’t brush your teeth or shower till you have to go to therapy” kind (therapy is once a week, so you do the math). The “spend months weighing the most considerate way to commit suicide so you don’t leave the person who finds your body with a lifetime of nightmares” kind.

The kind black people don’t really talk about. Even now, when we say we’ve broken the silence around mental illness.

I’ve realized that we discuss self-care:

     Go to the spa so that the daily wear and tear of being a black woman doesn’t make you lose your mind.
     Go to church and hear the Word when you’re sick and tired of being sick and tired.
     Get your girls together, light candles, drink wine and lift each other up.
     Do yoga, eat well, get enough sleep, process historical trauma, yada yada yada.

But, somehow, we rarely have an honest dialogue about Clinical Depression, Major Depressive Disorder and the illnesses that make it into the DSM-V. We don’t create the spaces where people can share their truth and we can all acknowledge that sometimes life breaks your brain. And no matter how many Thursdays you spend telling a well-meaning woman with an LCSW about your complicated yet joyful childhood, or how many mornings you shovel a handful of pills into your mouth, your emotions don’t do what you tell them to, your thoughts are thick with darkness and every step you take is like trying to swim in molasses.

Yet, according to the CDC, there are about a million black women with major depression in America. For those who deal with abuse, trauma and PTSD there’s a higher incidence. For those who deal with chronic pain and health issues there’s a higher incidence. And the truth is it is impossible to talk about reproductive health as if it’s separate from mental health; as if the ability to know your body, accept and embrace it, explore your sexuality, make your own reproductive decisions and advocate for your rights doesn’t hinge on being able to function without a cloud of despair surrounding you.

But we try to.

We act as if serious mental illness is a spilt drink which will evaporate if we just ignore it. We overlook major depression because the world tries to kill black women and then tells us how inspirational we are for being strong enough to withstand the assassination attempts. And we buy into it. We don’t have time to be broken; black girl magic doesn’t color-coordinate with being pitiful. A fabulous twist-out can’t carry sadness in it, melanin and melancholy don’t live on the same block. Shit needs to get done.

So we do it.

We don’t receive the tools to recognize a brain when it’s breaking. We just tell ourselves we’re in our feelings, even as shit gets heavier and heavier. Nobody tells us that sadness is tripping off a curb; depression is falling off a cliff. Until there are too many of us at the bottom of the ravine.

So I’m typing this article, between sobs. Dreading the moment when you read it and whoever you pictured me as wilts, into some weaker, pitiable person.

But I have no choice but to write these words. I owe it to all the women who walk among us in silence, backs bent under the heft of stuff they are too scared to reveal…

The sistas whose libidos are so low from the blanket of grief they are wrapped in that their relationships are suffering and their chests are tight with fear…

The ones whose sex drives are suppressed by the antidepressants they are hoping will shake the blanket off — and who now have to reconcile the functionality the drugs are supposed to provide, with the anxiety over what havoc the chemicals might cause…

I write for the sistas who can barely make it to work or pack a lunch bag but who’ve told themselves that what they don’t do for their man another woman will — and who open their legs, burrow somewhere inside themselves and go through the motions because they can’t afford to lose one more thing…

And for the sistas who have every bit of sex they can, and drink desire like a drug, because being touched is the only thing that fights the voice telling them there is nothing to live for…

This is for the sistas who can’t find any way to love their bellies, thighs, stretch marks and saggy boobs right now because they themselves are flattened by pain…

For the sistas who haven’t been on top of their reproductive health because every ounce of their energy is used up by breathing in and out…

Hold on, sis. I see you. I feel you. I am you. The dark is deepest before the dawn.

F.N. is an internationally recognized author of fiction and non-fiction. She alternates between Accra and Washington, DC.