Dylan, forty-two, female, says “I never thought I would amount to anything, that is why I was always more concerned about how other people were doing. My mom and my brother always told me to not worry about them, but that is all I could think about. I never liked school. I dropped out of college, so I thought I could never make something of myself. Then, I got this wonderful job and they really supported me and I felt really great until they had budget cuts and I was laid-off. So, even though I had that really good experience for ten years, now I feel like a failure, just like I did when I was a kid and I saw all my friends going off to Harvard and Yale, and I could barely get through my basic algebra class. Sometimes, I just want to check out of this world, I feel so bad.” I hear this after knowing Dylan for ten years. I never knew she felt this bad about her life until this moment, so I am astonished by her sudden openness. I knew she struggled in school and I knew she flourished at her job, but I did not understand how she threaded those experiences together. I did not know that all of her high school friends were academically successful, making her feel like she was doomed to failure. As I see kids in my practice, see how academic struggles can tragically lead to low self-esteem, thereby leading to life-long feelings of depression which come and go, depending on life circumstances. “I had no idea you felt this way, but I am glad you are sharing your feelings with me. It takes a lot of courage to say what you are saying because you have kept it inside for so long.” I say, trying to appreciate what a momentous occasion this is. “No one wants to hear how I am feeling. No one, I mean except you, of course.” Dylan quickly corrects herself as she tells me how her loved ones would only become anxious and upset, rather than understanding if she were to talk about how she really felt about herself. “It is hard if you have these feelings which you surmise would make others uncomfortable.” I say, understanding that passive suicidal feelings are really hard to talk about since most people respond with judgment rather than empathy. “I feel better” Dylan says, not to reassure me, but with palpable relief for expressing these feelings. “It seems like you feel better for telling me, but at the same time, it still must be hard to have those feelings,” I say. “You got that right,” she says with a smile of recognition. “Good luck with your job search,” I say, as we wind up our time together. “Thanks. It is really hard out there, but I am not giving up,” she says, with what seems like new-found determination and energy.