The mutations and surges brought by the COVID-19 pandemic has sent waves of mental agony in an unprecedented global scale, made worse with the continued varying alert levels of community quarantines and anxiety creeping throughout mankind. Entering the second year, psychiatric issues skyrocketed exponentially within each and every country, as each person grapples to survive everyday living with the lurking fear of contracting the dreadful virus.

Living with a mentally modest society where psychiatric issues are still a taboo, seeking expert care maintains daunting due to added fear of societal judgement and possible ostracization. This led to a poor and grim psychiatric health care system in the Philippines. Being part of the allied medical team, I am one with the people advocating to correct the stereotypical reaction of the common society – to stop the negative response but become a responsive and supportive society.

In observance of the National Mental Health Day last October 10, I would like to share a portion of my life that is affected by Depression, and how I am coping.

Disclaimer: this article is shared based from my personal account of the illness and I am not an expert about this. Should you have any symptoms, it is highly recommended to see a Psychiatric professional. 

PERSONAL JOURNEY WITH DEPRESSION

Entering the medical warfare during its heights and varying surges took toll also on my mental health. There are two main stressors during my training; One is the stress of industry adjustment and second is the stress to hit the ground running to keep up with my experienced senior nurses. Thirteen years in corporate world took large swathes of clinical knowledge and leveled flat my nursing skills – there is humongous stuff to get on with and thank God was able to surpass it. Huge mistakes that I did also was a huge factor. It was a huge mistake to linger much on my past mistakes and not forgiving myself. Each and every fault during duty will make me to punish myself in different ways, like sulking and isolating myself for quite a while. These actions led me spiraling down to depression.

WHAT IS DEPRESSION?

It is more than prolonged loneliness and sadness from the what the general public perceive. It is more than think that this person is just weak and cannot handle different issues in life. It is more than prolonged crying and social isolation. For me, depression feels like an internal vacuum or an emptiness inside my system that continues to suck away each and every piece of energy. It is not easily identifiable that a person suffers from depression until such time it progresses and gravely affects the daily routine. Depression also includes feelings and thoughts of being inadequate and useless. There is always that lingering guilt that affects thought and relationship processes, added with changes of patterns in sleep and appetite. I tend to sleep more and eat more from what I have experienced. Also, wanting to stay longer inside my room and isolate from the family. One thing that I noticed lately was that it is hard for me to generate a genuine laugh. Mobile games were my greatest accompany and quickly leveling up my account was the accomplishment I recognize gladly that time. Gladly, I do not have any substance abuse, had a bottle of brandy just beside still sealed for many months. There is this persistent lack of energy to do things that are productive. All I thought that it was just merely physical exhaustion from a seven-day arduous duty inside an isolation ward.

DENIAL PHASE

It took months before I acknowledge the signs. Just focusing on how to survive the 7 day duty then retreat to my bed after and recuperate. It became a cycle where productivity highly dwindled. At work I was doing more than bare minimum and continued to lose focus. There is agitation and ease on losing temper. The increase in appetite continued that led to weight gain. I thought I was doing well. All I believe is that I am just plain tired.

SUICIDAL ATTEMPT

It was on a month of July, a Monday night after waiting for results of our exit swab when I attempted to take my life. Never had I imagined trying to squeeze my body through a high ventilation window and throw myself from the 10th floor where I was. My shoulders did not fit with only my head hanging outside cloaked by cold wind and cooing from distant pigeons. From then on, I just returned to the bed and stared blankly from the view with no thoughts running on my head, just plain viewing the roofs and the beautiful mountainscape.

ENDURING THE INTERNAL VACUUM

For many months, I did not recognize of me doing much lesser meaningful activities. It was a routine of , shower, dinner, hit the sack, wake up and repeat, while at work. At home, wake up, eat, bathroom routine, hit the sack again, use gadgets for hours, do the laundry prior returning to work and that is it. No meaningful socialization ad no productive activities. I just plainly believe that I am just still tired. Everything seems heavy. Everything is mediocre and insipid. There are occasions of brain fog and it certainly sways my cognitive function. It decreased my reaction time, logical and critical thinking, also, quick wit. It was difficult to retrieve the right words. Working inside the isolation ward became somehow on autopilot mode. It was just getting by the 12 hour duty – to plainly survive it, and duty hours slowly became dreadful for me. It was from seemingly gliding or jumping with excitement to dragging my feet. There is also short term memory loss, I tend to forgot what is verbally instructed, so always, having a pen and paper beside me is helpful.

What is difficult also is the zero creative energy. I am not able to produce creative and insightful contents during my down moments. It is so hard to produce any prolific output. It is just plainly staring at my monitor with no words leaching out from my head. There was no internal drive, I was so blank for a very long time. It was also harder to have a genuine laugh. Being with happy colleagues and having fun and joke time during break, there are many occasions that I just fake a laugh to get by. But when one legit laugh burst out, it made me feel good.

SEEKING EXPERT HELP

During my post employment clearance process, I was able to speak with my Chief Nurse and she offered to connect me to a psychiatrist, Dr. Romy Enriquez. On the same day too, I had my first consult with him via telemedicine and found it certainly helpful. Seeing a psychiatrist does not mean you are already crazy or insane. These experts will help you realign your head and will help you get up.

And how is it consulting to a psychiatrist? It is same seeing an Internist or any other medical doctors. However, psychiatrist would dig down on other aspects of your life like relationships, and understand you better. They would assess every aspect of your life. They would let you speak and spill until such time they got an understanding of your history. Afterwards, they would prescribe, not just medications, but action plans, both long and short term, that you need to accomplish. After the first session with Dr. Enriquez gave me an internal boost and saw that there is hope from all of this.

ROAD TO RECOVERY

After understanding what I have to undertake after check up with Dr. Enriquez, a little spark of meaning came into light and clear path leading away from depression unveiled. Dr. Romy advise to resume my previous activities – biking, content creation, photography and if feasible, travel or hike. Hence, this article as first steps to recovery. He advised also not to stay longer in my bedroom but to interact more to people, lessen the isolation. Another is to have a dose of sunlight. This helps on release of Serotonin, a neurotransmitter that regulates appetite, mood, emotion and digestion.

Also, I started opening up to handful trusted people only. I chose people whom I knew are not judgmental. You know who you are, and I am thankful for your time and effort to listen.

STOP BEING JUDGMENTAL

Avoid these phrases if you know someone is depressed or coping from depression:

1. “You are just weak”
2. “You are becoming insane”
3. You just lack prayer”
4. “You are just sad or lonely, just cry it out and you will be better”
5. “You lack prayer”

Those are few sample declaratives that would just make depressed spiral down more. I veer away also to hyper religious people. They are packed with verbatim verses and most often than that are judgmental, based from my first hand experience. They would force feed you on what they unilaterally believe without even further understanding deeply the depressed person. Treating a mental disorder entails a collaborative plethora of effective regimen. Yes, offering a prayer really helps, but judging a person with the “kasi hindi sya..” sentences will not help.

END TOXIC POSITIVITY

We never knew that these common statements or cliches are actually not helping to striving mentally challenged people:

1. “Just stay positive” or “Think positive only”
2. “Everything happens for a certain reason”
3. “There are more worse problems than yours”
4. In vernacular, “Laban lang”

They are never helpful and do not foster to the healing of the depressed person. It causes more shame and inflicts additional guilt, which we need to avoid much to a coping one. Also, you failed to acknowledge what the person is undergoing hence, the person would tend to isolate more and would hold more on spilling their thoughts or feelings. Our goal is to make the depressed person spill out its negative thoughts and provide compassionate support.

AVOID THE “WHY?”

Depressed persons do not know the exact reasons why the fell in such state. Asking the why question would further trigger the negative thoughts and emotions. No one wants to be depressed and getting out of this box entails genuine and lasting support from oneself and from trusted ones. If you want to dig deeper, rephrase your communication style and ditch the “why” at the start.

FINAL WORDS AND ACKNOWLEDGEMENT

I am thankful that I found support on the last day of my employment. The helping words of my head nurse and coordinating help of my chief nurse led to my expert help. It is as if a clear pathway was laid in front of me. Nothing but gratitude fills my heart.