An estimated 16.1 million Americans struggle with depression, according to the Anxiety and Depression Association of America. Few of those want to admit it. Fewer still want to talk about it.

Trying to explain the anguish and hopelessness inside you to those who have never battled mental illness is like a woman trying to explain the pain of childbirth to a man.

Sometimes people sense those overwhelming feelings of sadness, especially if you seem gloomy or unusually slow or uninterested in much of anything. But for many, such obvious signs are buried behind much more subtle symptoms. Some overeat. Some don’t eat at all. Many lose sleep. Others are always tired and sleep too much. More recently, psychologists have begun recognizing rage, anger, and irritability as symptoms of depression–especially in men, but also in women.

Trying to explain the anguish and hopelessness inside you to those who have never battled mental illness is like a woman trying to explain the pain of childbirth to a man.

Worse still, many turn to alcohol, drugs, work, and other addictions to bury their depression, anxiety, ADHD, or other mental disorders. When addictions cease to smother the pain, suicide becomes the last resort to make it all go away.

Depression and the American rock and metal scene

Among the most famous is Nirvana legend Kurt Cobain. A chronic drug and alcohol user since age 13, in 1986, he started using heroine. By 1990, recreation became addiction. Unlike softer drugs, repeated heroin use changes the brain’s structure and physiology, creating imbalances that are not easily reversed. Cobain’s brain became dependent on the drug, then developed a tolerance that made it almost impossible to ever deliver enough of the drug into his body to stay happy and alert. Eventually, overcome with mental, physical, and chemical depression, he shot himself.

Cobain is hardly alone among rockers and metalheads. Soundgarden and Audioslave frontman Chris Cornell struggled with depression most of his life until hanging himself in a Detroit hotel room at age 52.

Linkin Park’s Chester Bennington hung himself only months after Cornell, on what would have been Cornell’s 53rd birthday. Stone Temple Pilot’s Scott Weiland battled substance abuse for much of his career and a year and a half before Cornell died after overdosing on cocaine, ethanol, and methylenedioxyamphetamine (MDA).

At the core of these singers’ struggles, as a psychologist once taught me, are feelings of hopelessness. Little brings you happiness. Nothing seems to change. You feel trapped, perhaps useless, unwanted, unloved–even if you are adored by millions.

What causes us to feel hopeless?

Exactly what causes those feelings depends on the individual, but for many, myself included, we feel as though we are running from our pasts, from memories we long ago repressed, from demons we thought we exorcised on a therapist’s couch.

Some, like Cobain, have a family history of depression, suicide, and substance abuse, likely indicating an underlying physiological problem with the brain. For others, like Weiland, are simply unable to cope with terrible traumas and unprocessed memories of rape or abuse. Others still suffer from both.

Many have no idea most depressed people are in so much pain– even singers, musicians, writers, and artists whose lyrics, music, themes, and styles can be dramatic, morose, and hint at, if not signal mental anguish. Often, nobody knows until it’s too late. Our culture needs to change that.

Finding inspiration in those who have struggled

The past several months, I was inspired, though not surprised, to find these themes not just pop up, but humbly honored at rock and metal concerts. Dexter Holland of Offspring paid tribute to friends he lost. From Ashes to New dedicated multiple songs to Chester Bennington, citing him as a major influence and calling him a friend. Breaking Benjamin similarly called out struggles with suicide and depression. Five Finger Death Punch discussed substance abuse. Their lead vocalist, Ivan Moody, shared his own struggles and recent decision to stay sober.

Disturbed truly went out of their way, airing the numbers for mental health hotlines as they paid tribute to all that rock and metal have lost over the past few years to suicide or substance abuse as they played their ballad “A Reason to Fight.” While some have been critical of the track, calling it too much of a departure from Disturbed’s iconic twenty-first-century metal sound, I love the song. Hearing it live with candles and a supportive audience that clearly had many battling their own beasts inside.

Depression: You should talk about it. With the help of friends, family, therapy, medications, support groups, and hotlines, you can win the battle. I am proof of that.

In Disturbed’s words:

Don't let it take your soul, 
Look at me, take control
We're going to fight this war
This is nothing worth dying for

Are you ready to begin
This is a battle that we are gonna win