Cheslie Kryst had the attributes and accomplishments that any of us could imagine for a complete and fulfilling life.

She was stunningly beautiful and became our Miss USA. She was a standout collegiate athlete, academically exceptional with a master’s degree in business and a doctorate of law.

She later passed the bar to practice in both North Carolina and South Carolina. She also was widely loved, respected and a television star earning two Emmy nominations.

But after 30 years of life, she stood at the edge of her apartment building and jumped to her death.

How could this extraordinary young lady even entertain such a tragic decision? There were no warning signs, no concerning behavior. There were no indications of drug use, trauma, emotional loss or illness.

Tragically, this is the nature of mental agony. It is invisible. The sufferer secretly endures as best they can, for as long as they can. Until at some point, the mental anguish is so unrelenting that they lose the strength to coexist with it.

There are well-intentioned slogans that encourage reaching out for help when at this stage of suicidal progression. But the fact remains that those suffering from mental anguish are experts at keeping their affliction secret. Society does not yet know how to respond to a person announcing they are suffering from depression; let alone employers or others that depend on their contributions.

Unfortunately, many still see depression as a temporary mood change rather than a physical brain disease.

Now there are several classifications for depression. Not all are life threatening. However, there is a condition that is unique called Persistent Depressive Disorder; or dysthymia. Difficult to treat, it is a debilitating malady that affects 1.3% of U.S. adults according to the National Institute of Mental Health. That is over 3 million people.

While the clinical definition of PDD is a condition lasting more than two years, many endure a lifetime of living with the disorder.

And herein lies the danger. Faced with a permanent condition combined with a need to eternally conceal their sufferings, there comes a point where many simply give up.

Common Shared Emotion

Not all experience the same symptoms. Nonetheless, there is a common shared emotion similar to the grief from losing a loved one. But there is no originating event like a death from where your mind can heal toward closure. Instead, you are left in limbo with a grieving experience that has no cause, origin or end.

This is where fatigue sets in and becomes the prelude to suicidal ideations. It is a lethal thought process when combined with feeling trapped in a secret mental agony. Normal life activities become monumental tasks. You become emotionally and psychologically depleted. Ultimately you find yourself just longing for a quiet dark place. This is the ledge and abyss of suicide.

Normal life activities become monumental tasks.

Think of it this way: While many are able to survive tragedies, almost no one can endure sustained torture. Dysthymia is the sustained torture of the mind.

While scientific efforts are ongoing, a cure for dysthymia is far from being available. Until then, societal compassion is the best start to bringing sufferers out from hiding. Secrecy is the biggest barrier to even starting to think treatment.

Secondly, a treatment that can prevent the sufferer from ever reaching exhaustive collapse is tantamount. A nasal spray called Esketamine shows promise for such fast action. But it is still under FDA evaluation and must be administered in a hospital setting. It is not yet something you can reach for in your hour of need.

Zuranolone however is a medication that may be just that. In clinical trials, it has shown positive relief for some within hours. But it too is still within the confines of FDA approval protocols.

Transcranial magnetic stimulation is FDA approved and shown to be effective for many who do not respond well to SSRI medications. It is non-invasive and generally well tolerated.

And while talk therapy has shown promise, it is not widely sought by those with PDD. The dysthymic instinct to hide symptoms can be so strong that it becomes a barrier to coming out of hiding.

Rather, support groups of those who also suffer from PDD can be restorative. Members can provide non-judgmental support and be a lifeline during a crisis.

Lastly, loved ones have the most impossible task; trying to identify something they cannot see. They have the closest view to someone with a smile but living a secret torture. By chance, if even a fleeting sign of despair behind a seemingly happy face is detected, a gentle persistent probing can be lifesaving.

But as I’ve said repeatedly: Coming out of hiding is the crucial first step.