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Anyone who has suffered from depression or another mental illness knows that the struggle is rarely obvious to outsiders, making it difficult for them to truly understand what dealing with the illness is like. Now, a 20-year-old college student has opened up discussion online about the subtlety of depression by posting her new tattoo in a Facebook post that has now gone viral.

On Aug. 24, Bekah Miles, a student at George Fox University in Newberg, Oregon, posted photos of her new body ink in a Facebook post.

(Dear mom and dad, please don’t kill me over this permanent choice. I want you to hear me out.)Today, I am coming out…

Posted by Bekah Miles on Sunday, August 23, 2015

The tattoo itself is an ambigram – a series of symbols that appear to spell out a word or phrase when viewed one way, but spell out something completely different when viewed from another angle. In Miles’ case, her leg tattoo initially appears to spell out “I’m Fine,” but when looked at upside-down, also spells out “Save Me.”

“To me, it means that others see this person that seems OK, but, in reality, is not OK at all,” Miles explained. “It reminds me that people who may appear happy, may be at battle with themselves.”

In the post, Miles revealed that she was diagnosed with depression last year, but in addition to her illness, she also struggles with the stigma that goes along with her diagnosis.

“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,” she wrote. “Mental illness is not a choice and will likely hit everyone at some point in their life. If it’s such a huge issue, why aren’t we having this conversation about it?”

Well, it seems that Miles has started quite a conversation. The post quickly went viral and at press time, her Facebook post has been shared nearly 300,000 times with more than 32,000 comments, and it has clearly struck a chord with people around the world.

“Thank you so much for your bravery,” wrote Facebook user Wendy Nicole. “I absolutely love your tattoo and relate so much to your words. It’s so hard to be honest about depression/mental illness, and you have done so in such a real and beautiful way.”

Miles concluded her post with a quote from the late legendary comedian Robin Williams, who himself suffered from depression: “I think the saddest people always try their hardest to make people happy because they know what it’s like to feel absolutely worthless and they don’t want anyone else to feel like that.” On Aug. 28, only a few days after her initial posting, Miles took to Facebook again to thank everyone for their support and for opening up a dialogue.

I think that it is time for me to make another status about my viral post. I never expected it to go beyond my friends…

Posted by Bekah Miles on Friday, August 28, 2015

Miles isn’t the first person to use ambigrams to depict the duality of depression. A 2013 ad campaign from the suicide prevention organization Samaritans of Singapore featured similarly positive and negative phrases.

Samaritans of Singapore Samaritans of Singapore

It’s time we started talking openly about our mental health. Join the conversation on Bell Let’s Talk Day, January 27, and help end the stigma around mental illness. For every text message sent and mobile or long-distance call made by Bell Canada and Bell Aliant customers, Bell will donate five cents to Canadian mental health programs. The same goes for anyone sending a tweet using #BellLetsTalk or sharing the Bell Let’s Talk image on Facebook. But talking about it is just the first step: Visit letstalk.bell.ca for more ways you can effect change and build awareness around mental health.

WATCH: More true confessions from people struggling with depression: