I’ve talked about writing this article for several years, but the timing never seemed quite right. It’s rather heavy for a blog about gift baskets, and yet such an important topic that ignoring it seems the wrong thing to do. And then, as you will understand after reading, there is the fear of opening myself up to criticism and disapproval. All these factors have conspired against my doing this.  But the time has come.

I have both a chronic illness (Crohn’s disease) and clinical depression. In my universe, they are separate beasts that I struggle with on a daily basis to control. My friends and family are supportive and loving, but had trouble understanding what depression felt like until I came up with the Gorilla concept. to help my father, who also had clinical depression, convey his emotional state to his medical teams.

Depression is an ape on your back. Every day presents a different ape to deal with. The goal in living with depression is to have a spider monkey. Spider monkeys are tiny little fellows. They cling pretty tightly, and can certainly get in the way, but hey, you can manage a spider monkey. You can put a leash on it, you can walk around with it on your shoulder and it might require some attention, but you can breathe, you can think, and for a while, you might even forget it is there. A spider monkey isn’t perfect, but it’s absolutely reasonable.

Some days you have a monkey on your back. This guy is bigger than the spider monkey. He is probably still controllable, but he’s certainly more of a problem. He is going to steal your food, so you won’t eat much. He is going to distract you so you can’t focus on what’s in front of you, and he’s going to trip you up, but you can probably work around him with some extra effort.

Orangutans are harder. They are big, heavy and have really long arms that reach around and cause trouble. They push away things that give you joy, make it hard for other people to get near you, weigh you down. They will literally cause you physical pain and block your ability to see the path to relief. If you live with depression, you develop the strength to carry around an orangutan, but you are aware of its presence 100 percent of the time. It impacts the way you eat, sleep, play, work, and interact with friends and family. Having an orangutan on your back is a huge, heavy weight to bear.

Then there is the gorilla. Imagine how hard it would be to get out of bed with a gorilla on your back. Think about how difficult it would be to get dressed, to brush your teeth, to go to work and do your job with the crushing weight of a gorilla on your back. Imagine the pain — both physical and emotional — that the gorilla is going to cause. Try to breathe or eat or think; the effort is exhausting.

Now, live with your primate of the day when no one else knows it is there. They can’t see the monkey, orangutan or gorilla, and you can’t make them believe it’s there. They want you to shake it off, ignore it, think about something else. They haven’t lived with a monkey on their backs, and they cannot begin to understand how overwhelming life is with a monkey.

Those of us suffering clinical depression are given tools to help control and tame our beasts  — medications, therapy, exercise  — but some days those are not enough. If we aren’t using all the available tools, finding the strength and energy to pick them up is sometimes more than we can do, because simply being is an exercise in emotional and physical endurance.

So, how do you help someone like me  live with a monkey on his or her back?

One: Don’t be judgmental. Trust me, no one wants to live like this. No one would choose to deal with this. It might look like we are not doing what we need to or that we are wallowing in the pain. But from where we sit, we don’t see any way out. We are too busy just trying to breathe.

Two: Respect it. While you may never be able to fully empathize, respect that this is a very real pain, in every sense of the word. We know that what we are feeling may not be logical, may not be reality, but that doesn’t change how it feels  — and it feels lousy.

Three: Offer the help you can. Be a friend, show the love. Don’t walk away or get angry  — that just feeds the monkey. Ask (gently) if we have taken our meds, help us make a doctor’s appointment, come by and just spend time, even if we can’t tell you we want you to. Listen to us, let us cry and encourage us to not check out from the world. And know that sometimes we are doing all the things we are supposed to be doing … and yet King Kong is moving in. It is just like that sometimes.

Finally, watch for cries for help. I am blessed; my family and friends know that when I have gorillas, I need support. And thanks to this analogy, I am able to tell them how I feel with just a few words, instead of trying to explain how the day is going. I have a monkey, I have an orangutan, I have a gorilla.

The gorillas are real.