Later in the comic, in a section simply titled in cursive script (that personal touch made it all the more real) "today I'm going to die", McDiarmid really gets at that sense of relief, almost a kind of lightness when one's mind snaps from the pain of depression to the decision to kill oneself. McDiarmid depicts Elena dressing nicely, putting on earrings, etc and only pauses when she saw a thoughtful gift from her boyfriend. She overdoses, passes out, and instead of embracing that oblivion, imagines that there are dark hands all over her body, squeezing and obliterating her. It's a stark, two page-spread where this happens, with everything on the pages being black except for her form. The hands are almost like tendrils, slowly insinuating their way through her being, until she forces herself awake and calls for help, telling her housemate that she overdosed.
The nature of that help and the experiences depicted are genuinely overwhelming and frightening for her, and that comes through on the page. She has her wrists restrained because she had been yanking out her IVs and panics when she wakes up. She loses control of her voice for a while. The world in general is disorienting and she has no sense of time. The comic also depicts her friends and their feelings of helplessness, especially when Elena is moved to the ICU and they are unable to see her. When McDiarmid fast-forwards to life in the psychiatric ward, there's little sense of comfort--only routine. The concern of the workers feels forced and syrupy instead of actually therapeutic, like when one woman who starts talking about the voices she started hearing again and then being shut down by the worker, and that same worker putting words in Elena's mouth in a manipulative fashion. There's a notable difference between her actions and those of the psychiatrist who sees her, he talks to her with respect and just talks openly saying, "Because you are not your diagnosis". She engages Elena in things that she loves, like mathematics, and we see new branches and trees behind her outside, framing her discussion and representing growth.
However, it's one thing to get better enough to get out of the hospital, and it's quite another to make the readjustment to outside, daily life. The final scene of issue four shows her isolating from her loved ones again and avoiding the studies that she actually loves. McDiarmid here gets at the idea that the progression of mental health and illness is not a linear process. Progress can be halted and halting and regression can be common without therapy, medication and support. That support is especially important, especially given the sense of "exhaling" among loved ones after she comes out of the hospital, with the idea that she's "cured". The cure is a multi-faceted process, and McDiarmid really gets at the idea that simply working one's way back from the bring of suicide is not the same as being freed from depression and the things that trigger it and make it worse. There's one more chapter to go, and I'll be curious to see how McDiarmid resolves the narrative now that past and future have caught up with each other.