A young woman has brought attention to the invisibility of depression - by getting a tattoo which sends out two opposing messages depending on how you look at it.
The tattoo on her leg appears to say "I'm fine" when read by someone looking at her, but reveals its true secret to its wearer when she looks down at it, reading "Save me" instead.
Bekah Miles, a 21-year-old US student who has struggled with depression for some years, got the inking on her leg to start a conversation about mental health and give voice to her experience.
She said in a Facebook post which has been shared more than 200,000 times that the topic was very difficult to talk about.
"So today, I got this tattoo. I feel that my leg was the best place for the meaning behind it. When everyone else sees it, they see 'I’m fine', but from my viewpoint, it reads 'save me’.
"To me, it means that others see this person that seems okay, but, in reality, is not okay at all. It reminds me that people who may appear happy, may be at battle with themselves."
Ms Miles was especially concerned that mental illness was not being taken seriously enough - in the same week as Iain Duncan Smith, UK minister for work and pensions, said depressed people should "get into work".
In the full letter she said:
"Mental illness is serious, but so shamed in our society. We care so much for our physical health, but hardly a thing about our mental state. And that is seriously messed up."
Her list of how depression feels especially moved readers and received a huge number of responses from strangers who commended her brave stance.
"Depression is the nights I begin to cry because I feel so overwhelmed, even though everything is going right.
"Depression is the 50 pounds I carry in my chest at all times.
"Depression is the need to constantly be distracted (being on social media, playing video games, watching movies or shows, or working all the time) because I can’t trust myself with my thoughts for longer than 3 minutes.
"Depression is the friendships that have suffered because of my inability to function."
Quotes on depression
Quotes on depression
1/14 Alistair Campbell
Alistair Campbell: "One day, we will look back and wonder how on earth we used to believe that depression was a lifestyle choice, only to be debated and taken seriously when an A List film star took his life, and the world filled with people saying how shocked and saddened they were. "
2/14 On living with depression
Stephen Fry: "Depression is as real as the weather…it’s all about a kind of mental umbrella. 'Hey-ho, it’s raining inside: it isn’t my fault and there’s nothing I can do about it, but sit it out. But the sun may well come out tomorrow and when it does, I shall take full advantage.'"
3/14 On living with depression
Ernest Hemingway: "The world breaks everyone, and afterward, some are strong at the broken places." (He also said "happiness in intelligent people is the rarest thing I know")
4/14 On living with depression
Jonathan Davis: "A lot of people don't realize that depression is an illness. I don't wish it on anyone, but if they would know how it feels, I swear they would think twice before they just shrug it."
5/14 On passing judgement on depression
Geoffrey Boycott: "Until you've had depression I don't think you're qualified to talk about it."
6/14 Jack Dee
Jack Dee: "I have had issues with depression all my life, and it's probably true to say there was a tendency towards it even when I was very young, during my schooldays. There was often - and this is quite common with comics - a sense of not feeling as if I belonged anywhere."
7/14 On living with depression
Jason Manford: "The world needs you even if you don't think it does. I promise, we need you here, now."
8/14 Author Jeanette Winterson
Art saved me; it got me through my depression and self-loathing, back to a place of innocence.
9/14 On life and depression
Agatha Christie: "I like living. I have sometimes been wildly, despairingly, acutely miserable, racked with sorrow, but through it all I still know that just to be alive is a grand thing."
10/14 On living with depression
Albert Camus: "In the midst of winter, I finally learned that there was in me an invincible summer."
11/14 On dealing with low mood
Dolly Parton "The way I see it, if you want the rainbow, you gotta put up with the rain."
12/14 If you're feeling depressed right now..
Annabel Giles: "If you’re depressed right now, then let's remember that we only have to do today, that's all. Nothing more. We can do just a day, can't we? And don’t forget, we haven't always been like this. The good days will come back. We've just go to do as much as we can, when we can."
13/14 Helen Keller on looking for the positive
Helen Keller: “When one door of happiness closes, another opens; but often we look so long at the closed door that we do not see the one which has been opened for us.”
14/14 On it happening to all of us
Mariella Frostrup: "Only those with skin as thick as elephant hide can hope to sail through their teens unscathed by self-doubt and bouts of depression."
Her story has gone viral and made it into national and international news, as well as been shared by well-known people such as US actress Zooey Deschanel.
Ms Miles has reacted with disbelief at the coverage of her clever and moving tattoo.
"I never expected it to go beyond my friends and family [...] I am completely and utterly in awe of how far this has travelled.
"This is exactly what I wanted - to reach out to people and let them know they are not alone. Clearly, 24,000 people and counting and they are not alone. Please keep sharing and spreading the awareness."Reuse content