You can have lunch or dinner with a person many times and never suspect they have a parasite in their digestive tract.

Outwardly, they might seem normal – they have an appetite, they eat, they enjoy the taste. They might even seem better than normal – they might be a good chef, or a voracious eater without weight problems, or have a healthy diet.

You look at their outsides, and you assume – understandably – that their insides work like yours do. That they convert the food into energy and nutrition.

They don’t – at least, nowhere near enough of it. The tapeworm eats it. They go home on an empty stomach.

Sometimes, they’ve eaten enough that it takes the tapeworm a while to work through all of it. For a moment, it might feel to them that the tapeworm isn’t there – they might feel like they get to enjoy life as though they didn’t have it.

But it’s still there, and sooner or later it catches up to them. Sooner or later, when they’re in the middle of their impersonation of a healthy person, their fuel tank will be empty when a healthy person’s would be full, and they’ll crash.

You think you can relate – you’ve been hungry too, you tell them; you know what that’s like. In a sense, you’re right: you both know what it’s like to be hungry. Maybe you once went a very longer time without eating – maybe longer than they ever had – maybe you’ve been hungrier than they had ever felt. You think of how you got out of it, and you try to lead them down that same path.

But you can’t.

Not because you don’t know what it’s like to suffer from hunger, but because the hunger isn’t the real problem.

When you eat, it nourishes you. When you were hungry, eventually enough nourishment got you through it. You could feed yourself.

When they eat, it only feeds the tapeworm. It’s not enough.

Maybe you’ve been hungrier than they’ve ever been; maybe other people have it worse; maybe their hardships are nothing compared to those others – after all, they may be hungry, but at least they can feed it. That’s all true. But it doesn’t help feed them, and it doesn’t lessen the hunger. Despite all outward appearances, they aren’t hungry because they will themselves to be hungry; they’re hungry because this thing is eating for them.

You care for them. It confuses you that eating doesn’t help their hunger, and maybe that complicates your relationship with them, but you still want to help. OK, you say, if there’s this drain on them, we just need to make sure they eat enough that the tapeworm is fed and they still get enough nourishment for themselves.

It doesn’t work like that.

First off, they can’t keep that pace up forever – no-one can, in fact (though believe me, we fucking try) – sometimes they just miss a meal, or don’t get their vitamins, or whatever. It happens. But where a normal person’s fuel tank is full enough, and more readily re-filled if not – theirs isn’t.

But worse than that – the tapeworm is never fed.

It has no quota. It has no appetite. It is never sated; it is only hungry.

And when it doesn’t eat their food, it eats them.

It drains their muscles, it thins their attention, it takes the color from the world they see and the melody from the sounds they hear, and it blurs their thoughts. They just don’t have the energy to do the things that a normal person so easily does.

They’re not blind – they see and know what’s happening to them. But being aware of the effects of malnutrition doesn’t make them go away. They shred their throat screaming at this parasite, at this condition, at this circumstance – but no-one comes. They didn’t actually scream out loud; they only screamed in their head, and so no-one else heard them, no-one felt that poisonous anger and frustration but themselves.

Later, they tell you how they felt so weak and powerless and hungry, and you – caring for them – ask them, “Why didn’t you tell me? Why didn’t you ask for help?” And they just look back at you helplessly, without an answer.

And each time that happens, a piece of your desire to help them – no matter how much you love them or how well-intentioned or how patient you are – transforms. It becomes a little piece of helplessness in yourself (“Why can’t I help them?”), or resentment (“Why don’t they let me help them?”), or alienation (“What’s wrong with them?”).

It’s not your fault that you feel these things – it’s natural, and reasonable. It doesn’t help them, but you can’t stop it anyway. You’re trying to help them, you want to help them, but you can’t see the tapeworm – even if you know it’s there, even if they’ve told you or a doctor’s shown you. Each time you try to help and you encounter obstacles, the only thing you can see is them. What’s fighting you isn’t something external that’s pulling their strings like a puppet, strings you can cut – it’s a part of them. This thing on the inside taints your picture of them from the outside, like a leaky pipe gradually discoloring the wall around it. It’s frustrating.

They know that. They’ve seen your facial expressions on their loved ones their whole lives. And they have a sinking feeling that eventually, like a candle running out of wax, your desire to help them will burn out – leaving just a wisp, a memory of something bright, escaping a puddle of formless, unpleasant feelings.

And then they’ll be alone again.

The tapeworm inside of them will whisper, “See – even if I weren’t here, you’d still be alone.”

Except it’s been with them so long that it sounds like them. As time goes on, it gets harder and harder to tell if it’s the tapeworm talking, or if it’s themselves.

And that starts to drain their motivation and energy to try to help themselves even when they’re not hungry – and the line between their condition and them blurs more.

All the excrement that this parasite produces after stealing their food, all this shame and guilt and weakness and resentment and despair, all this poison that should be getting excreted, should be getting dumped out into the world, should be the parasite’s own problem to deal with…all of it builds up in them instead. They own it, because no-one else can. They bear the fault for shortcomings they didn’t bring upon themselves, that they feel powerless to correct.

They look to others for help or inspiration, but it’s hard to tell if other people have the same thing inside that they do, for all the reasons I mentioned at the beginning. They hear about people “overcoming” it or being X years “free” from it, but they can’t be sure what it is the other person had – they can’t even be sure what their own parasite looks like. (As a result, no matter how many people share these experiences, any individual person with one still has this gnawing sense that it might just be them, alone, who is this un-fixable.)

The best they can do is draw a wide outline around the parts of their life that they think the tapeworm has impacted. They tell you, that’s the shape of it – that’s the size of it – as far as they can tell.

And it’s hard for you to believe them. You think about the times you ate with them, and they cooked up a storm and enjoyed the meal, and it seems incongruous – you can’t reconcile their description of such a massive all-consuming condition with the little moments of outward happiness and function you shared with them.

Everything I’m describing builds up over their whole life, from the moment the parasite takes root – maybe some people can trace it to a specific event, this one thing that poisoned them; others can only say that it’s been there since far before they ever knew it.

Those people stumble through life with all the experiences I described, except without the understanding of what sort of thing is happening. Like the people looking at them from the outside, the only thing they can find to blame is themselves.

The tapeworm complicates other things, too (I know I have a whole family of problems in the dark corners of myself) – for example, if they have a vitamin D deficiency, the tapeworm makes it harder to treat, because the tapeworm eats the treatment for that, too.

They can try to poison the tapeworm with substance abuse or other self-destructive behaviors – many do – but they cannot kill it before killing themselves in the process.

As much as the tapeworm shouldn’t be there, as much as it’s an aberration, as much as it’s something to be corrected, it is still a fact about them – they still must feed it.

Depression is that thing they must feed. It is that toxic, inseparable part of their systems. It stops them from metabolizing healthy life experiences like you do.

I wish I could tell you how they fight it; I wish I could tell you how to overcome it; I wish I could describe the progress I’ve made in my own life fighting depression and its allies – in reproducible steps, in a form that will make it past your tapeworm – but I know how hard it is to get you what you need past that thing inside you.

And I know it’s not your fault.

I know I can tell you, with sincerity, that there are certain things you should do – things like seeing a doctor, working through it, being open to any treatment options they suggest, throwing out any counterproductive misconceptions you might have had about psychotherapy or doctors or medication; things like telling your loved ones about some of these experiences even though it seems pointless to; things like teaching your loved ones how to fight you to feed yourself – because when you are too weak and scared and alone and tired to try to invite other people into your dark pit to help you out, they will have to fight you.

I can’t tell you what the end of that road looks like. I have confidence – much more so than I had earlier in life – that this sort of road (though not necessarily this exact one) is a productive one to living with, and despite, depression.

And I wish anyone going through similar experiences the best of luck and strength. We can outlive these parasites. We can’t kill them or remove them from our lives entirely, but they still need us to feed them – and with the right help, support, and treatment, we can try to sculpt the impact that they have on our lives to something ever smaller, blunter, more harmless.

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Categories: Miscellany

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