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As often as Kanye West talks about the state of his mental health, one would think that we’d be having a national conversation on mental health–kind of like the way we had a wave of conversations about domestic violence in the wake of the Chris Brown-Rihanna incident. Yet, in the four years since Kanye began talking openly about the depression related to the death of his mother and the dissolution of his romantic relationship with longtime paramour Alexis Phifer, the conversations have continued to be one-sided.

A search for “Kanye West and Depression” brings up surprisingly few articles and discussions. There’s a sterile AP article describing his initial comments, Cord Jefferson advising Kanye to go to a therapist on The Root, an MTV news article on his path to recovery, and Tom Breihan in the Village Voice distilling 808′s and Heartbreak down to “emo bellyaching” and a “album-length tantrum at his ex.” While Bassey Ikpi later argued to have some compassion for Kanye, it was one small plea in a sea of indifference and condemnation.

After four years of being open about pain and vulnerability, I’m starting to wonder if society will ever really hear him.

“ Depression is humiliating. It turns intelligent, kind people into zombies who can’t wash a dish or change their socks. It affects the ability to think clearly, to feel anything, to ascribe value to your children, your lifelong passions, your relative good fortune. It scoops out your normal healthy ability to cope with bad days and bad news, and replaces it with an unrecognizable sludge that finds no pleasure, no delight, no point in anything outside of bed. You alienate your friends because you can’t comport yourself socially, you risk your job because you can’t concentrate, you live in moderate squalor because you have no energy to stand up, let alone take out the garbage. You become pathetic and you know it. And you have no capacity to stop the downward plunge. You have no perspective, no emotional reserves, no faith that it will get better. So you feel guilty and ashamed of your inability to deal with life like a regular human, which exacerbates the depression and the isolation. If you’ve never been depressed, thank your lucky stars and back off the folks who take a pill so they can make eye contact with the grocery store cashier. No one on earth would choose the nightmare of depression over an averagely turbulent normal life.

It’s not an incapacity to cope with day to day living in the modern world. It’s an incapacity to function. At all. If you and your loved ones have been spared, every blessing to you. If depression has taken root in you or your loved ones, every blessing to you, too. No one chooses it. No one deserves it. It runs in families, it ruins families. You cannot imagine what it takes to feign normalcy, to show up to work, to make a dentist appointment, to pay bills, to walk your dog, to return library books on time, to keep enough toilet paper on hand, when you are exerting most of your capacity on trying not to kill yourself. Depression is real. Just because you’ve never had it doesn’t make it imaginary. Compassion is also real. And a depressed person may cling desperately to it until they are out of the woods and they may remember your compassion for the rest of their lives as a force greater than their depression. Have a heart. Judge not lest ye be judged.