Depression was a stranger and anxiety was an old enemy

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I had read about depression. I have lost friends to it. But it was not something that I thought would happen to me. And many people around me thought the same thing.

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I thought, it’s not something that happens to a happy girl who hates being sad, not to the grade school kid who called herself an eternal optimist, not to a person who shuns drama, not to a writer who likes turning problems into punchlines. I was so ignorant. And I was so, so wrong.

I had read Allie Brosh’s Hyperbole and a Half two years before and had enjoyed it immensely. Later on, I found out that her comics about depression had been lauded by experts as some of the best contemporary depiction of the condition. But I had read those chapters with a sense of detachment. I just couldn’t relate. Truth be told, I could relate more to the young Allie in The God of Cake. (Because damn it, who hasn’t felt like eating an entire cake? Especially if it’s mocha or really moist chocolate cake with good frosting. Or that Jollibee cake from Aggy’s.)

But in the midst of trying to understand what was happening to me, I reread Adventures In Depression and Depression Part Two and realized with alarm that this time, I could see myself in the strips. That fear-proof exoskeleton, not giving a fuck, the inability to connect, the difficulty of interacting with people and just feeling absolutely nothing? That was exactly what I was going through.

I googled like mad, found BuzzFeed’s 21 Comics That Capture The Frustrations of Depression and saw myself in most of the panels.

In the weeks before my diagnosis, when I started telling a few friends about what I was experiencing, I usually sent them these links to read.

Depression comes in different forms for different people. The sadness part for me didn’t last very long. What was more terrifying was just being completely numb and empty. I wanted to feel things but couldn’t.

“I couldn’t access my emotions,” I kept saying during those weeks. I imagined my feelings hiding inside a mouse hole like the ones from those Tom and Jerry cartoons. I would reach in, because I knew they were there, but they’re always just beyond my grasp,  no matter how hard I tried. Eventually, trying became boring. Exhausting. So I stopped.

When I went to Dr. D for the first time and I started rattling off my symptoms, I had no idea that was acing the DSM-5 test for depression.

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th Edition or DSM-5 is used by psychiatrists as a classification and diagnostic tool. It was only last week that I leafed through Tita Arlene’s copy and found out that to be diagnosed with a major depressive disorder or clinical depression, you should have five or more symptoms during the same two-week period. Under the criteria are nine symptoms and, without realizing it, I had told Dr. D that I had eight of them. Eight out of nine. For over two weeks.

“No thoughts of suicide naman, anak? Aggressive or passive?” Dr. D. asked gently.

“What do you mean by passive?” I asked. And without waiting for her to reply, I continued. “I’m not going to do anything to hurt myself but in those first weeks I went from “Oh my god, if they ever find a way to make human beings immortal, I’m definitely going for it, I want to live forever” to “If I die tomorrow, okay lang. Okay na.”

(But don’t panic, people. I am back to wanting to live forever. Except I don’t want to have to drink blood or find a sparkly fake teenage vampire for it to happen.)

I was less surprised when Dr. D also diagnosed me with an anxiety disorder.

Clinical depression was a nasty surprise, an unwelcome stranger. But anxiety? Anxiety was an old enemy. Anxiety and I go way, way back.

When I was nine, after my grandma’s mother and my grandpa’s father died within a week of each other, I developed an unhealthy obsession with death.

I remember being in bed, sandwiched between my parents and making them promise that we would all die together.

I feared that every time my mother left the house, she would die. And so every time she would go out, I would freak out and cry.

That went on for a while and it got so bad that my parents sat me down for a serious talk. And that led to this hilarious exchange with my father The Hulk:

The Hulk: “Ganyan ka rin ba kay Papa or kay Mama lang?” (“Do you feel that way about Papa too or just Mama?”)
Pam: “Kay Mama lang.” (“Just Mama.”)

I wasn’t trying be an asshole, I swear. I was just being an honest kid.

The talk didn’t stop my fears. At night, as she slept, I would look closely to see if my mother’s blanket was moving up and down—a sure sign that she was breathing. When I wasn’t satisfied by her blanket’s minuscule movements, I would carefully place my hand an inch away from her nose to feel her warm breath. But because I have always been clumsy, I often ended up accidentally poking her nose. My mother would wake up and scold me for playing with her face while she slept. I didn’t correct her, I never told her I was just checking if she was still alive because I wasn’t sure which one she’d think was worse.

I didn’t just worry about my mother’s death, I worried about my own too. The tiniest cuts would have me bawling and asking my grandma hysterically, “Am I dying?” I dreaded evenings because evenings meant sleeping and sleeping meant there was a possibility that I wouldn’t wake up. And so on many nights, I would refuse to sleep. I would hide books under my pillow and spend the entire night reading. It was tricky sometimes because I still slept in the same room as my parents and I knew I’d get a good spanking if I got caught staying up all night.

I don’t know how but I outgrew the tantrums and I learned not to fear sleep.

But when I got older and started having relationships, my anxiety reared its ugly head again. This time, I kept worrying that my boyfriends would die. I always had the same scenario in my head. I was always sure they were going to wreck their car on their way home from my house. But I never told them about my fears. I worried that they’d think I was weird.

The weirdness didn’t stop there. After the Rizal Day bombings in Manila and a horrific flight (and you know it’s a really bad one when you talk to the pilot—a supposedly experienced one—after you land and he tells you “I thought I was about to meet my creator”), my nerves were frayed. In 2003, I had my first panic attack and my anxiety levels were so high that I stopped commuting and I avoided work trips for a few months. My friends started calling me Panic Attack Pammy.

Even now, every time I’d board a flight, I’d think, “This plane is going to crash.” And the odd thing is, I really love flying and I especially love long flights. But the thought of doom is always there, buried in the back of my head.

About two years before my diagnosis, I developed an almost constant feeling of dread. Something bad is going to happen, something really bad, I would often think. The feeling would last for weeks, disappear for a bit and return, disappear and return.

And naturally, I tried to explain it away. “This is probably just one of my personality quirks. I’m just a worrier. Maybe I’m paranoid because I’ve been watching too many episodes of Dateline. Yeah. I really should stop watching Dateline.”

In December 2015, depression the stranger and anxiety the old enemy came together and turned my life upside down.

But I am back on my feet. And I am stronger than ever. And I continue to fight. Because it will take so much more than a shitty mental disorder to take me down.

 

 

 

The World’s Worst Pee-er

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My shrink ordered a urinalysis on top of the blood test so one Wednesday, before heading off to work, I got ready to go to the hospital I’ve been going to so frequently I should probably get parking discount. Or at least a lollipop.

Mistake #1: I peed before leaving the house.

Mistake #2: I took a swig of water before leaving my room, thinking, “That should be enough to fill a cup.” Clearly, I know nothing about biology. Or anatomy. Or medicine. Or science. Whatever.

I got to the lab area, grabbed a number and waited to be called. Soon, a guy was handing me a clear cup with a white cover and said, “Ma’am, catch the sample mid-stream.”

It was a very clinical way of saying, “You’re gonna get pee all over your hand, bitch.” I cringed.

And so off I went to the little toilet in the corner, the same one I went to before getting blood drawn.

I was lugging a big tote with me and the idea of having my heavy bag on my shoulder and trying to catch my pee mid-stream sounded like a recipe for disaster. And there was no hook for my bag. I briefly considered setting my bag down on the dirty floor (No!) until I spotted the door knob and tried to forget the millions of germs that probably populate it. (Hello, it’s a door knob used by people who just peed on their hands and the hand soap is outside the door. I repeat, the hand soap is outside the door. What is this hospital thinking?)

This should be a breeze, I thought. I’ve never been a shy pee-er. I can pee while talking to people.

I squatted and got ready to be the MVP of mid-stream catching. Except there was no stream. What came out was barely a trickle. In fact, to call it a trickle is an insult to all trickles that ever trickled.

I mentally kicked myself for peeing and not drinking enough water before leaving the house.

It was hopeless. Nothing was going to come out. I tossed what little droplets I managed to catch back into the toilet and washed the cup and my hands. Then, I made a quick exit, wondering if I should explain to the lab people that I couldn’t pee. I didn’t. Instead, I went to the cafeteria and bought the biggest bottle of water I could find and drank it like I had been stuck in the desert for a month.

“Hmm, I wonder how long it will take for this water to turn into pee? Maybe five minutes?” I wondered like the idiot that I am. Clearly, biology/anatomy/medicine/science isn’t one of my strong suits.

Luckily there was a little bookstore in front of the cafeteria. It wasn’t really a bookstore, it was just a table piled with books, but, I thought, it should provide enough distraction until I feel the urge to pee.

It didn’t.

I soon realized that my body isn’t a chute, that whatever I put in inside me isn’t just going to come out the other end instantly. I was in for a bit of a wait. And because I hadn’t eaten lunch, I walked to Pancake House. I ordered a taco and a big glass of iced tea because, I don’t know if it happens to you, but whenever I drink iced tea, I couldn’t stop peeing. I ate my taco, drank my iced tea and I also drank a glass of water for good measure. Then, I waited for Jesus to turn my water and iced tea into pee while doodling in my diary. I was so full of liquid I felt like I was sloshing every time I moved.

About fifteen minutes later, I was bored. Enough time has passed, I said to myself. I walked back to the lab area and got ready to impress them with my peeing skills.

Before returning to the hookless toilet, I asked one of the lab people, “Excuse me, how much sample do you need?”

“Fill at least half the cup,” I was told.

“Shit,” I said. Then I walked into the toilet. I hung my bag on the door knob again, pulled my pants down and squatted.

Yes! I was peeing! But it stopped as soon as it started. I had only filled a tenth of the cup.

I pulled up my pants with my clean hand.

God damn it, Pam, pee! I told myself.

Shwshwshwshwshw. I made that stupid sound people make to torture their friends whose bladders are bursting. I said sorry to Mother Earth and let the water run. Hearing running water makes people want to pee, right?

I pulled down my pants again, squatted, peed a little more and then pulled them up again.

Still not enough urine. I sighed, shwshwshwshwshwed, let the water run and pulled down my pants for what felt like the nth time. Another trickle came out, this time a real one.

I repeated this process three or four times. Sigh. Pull up pants. Shwshwshw. Water. Pull down pants Squat. Pee. Sigh. Pull up pants. Shwshwshw. Water. Pull down pants. Squat. Pee.

I pulled down and pulled up my pants so many times in such a small amount of time that I felt like the employee of the month at the world’s busiest brothel.

I was going to have to wait some more. Should I go out again? But where would I hang out with my cup of disappointing pee? I decided to stay put. And to help pass time, I washed my hands and decided to apply lip gloss. Don’t ask why. It just made perfect sense at the time.

Pee, damn it! I told myself again. I pulled my pants down (this should be the last time, I said) and willed every ounce of pee that I could out of me.

I inspected the cup. It was almost half full. That will do, I told myself. That will have to fucking do, I told the hospital. But only in my head.

I covered the cup, rinsed it, exited the toilet and washed my hands vigorously. As I was washing my hands, a guy walked into the toilet with an empty cup. If this jerk finishes peeing before I’m done washing my hands, I am going to be really pissed. But he didn’t. Instead, he spent so much time hocking loogies that I wanted to knock on the door and say, “Dude, what are you doing? They need your urine, not your phlegm.”

The hocking sounds wouldn’t stop and I shuddered in disgust as I walked away. Yes, me. The girl whose hand was covered with pee just minutes ago. What a hypocrite.

I had covered my cup of pee with tissue because, while I can write paragraphs and paragraphs about it, apparently I am too modest to let people see my urine. I placed my sad cup in the specimen box. I’m sure it felt inferior to the cups brimming with pee, clearly left there by the world’s peeing champions.

I walked out of the hospital, got in the car and went to the office where, as soon as I arrived, I peed the pee I had been waiting for, a glorious stream that could have filled ten cups and made any lab technician proud.

I wish there was Tinder for shrinks

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On my way to my first shrink session

The first step is recognizing that you need to see a psychiatrist.

In some cases, the first step may be finally being convinced by the people around you that you need to see a psychiatrist.

When I started telling my story, some people expressed surprise at my willingness to seek professional help.

“Who told you to go to a doctor?” I was asked several times.

“No one,” I would reply. “I felt like I had to.”

When I read about people who have been suffering from depression for two or three or more years without getting help, my heart breaks. How do they survive? I was just two weeks in and I couldn’t stand it.

The second step is finding a psychiatrist you can go to.

I wish I could tell you that that’s easy but I soon found myself wishing there was Tinder for shrinks. Or Grindr. (Because the truth is, as strange as this sounds, I have more Grindr than Tinder experience. My Tinder experience is limited to reading articles about it and my Singaporean tour guide showing me her creepy matches. I’ve had hands-on experience with Grindr though. I sometimes like to grab my friends’ phones to choose hot guys for them to talk to. Sometimes I send the hot guys emojis on their behalf. And then I stop when they start screaming at me.)

I began my search for a shrink on Facebook. I wasn’t ready to tell people about what I was going through yet but one of the many good things about being a journalist is people always assume you’re doing research. (Which can also be a bad thing. But not in this case.)

Can anyone recommend a great (not just good) psychiatrist?

Posted by Pam Pastor on Monday, November 30, 2015

My Facebook friends started sending me names of psychiatrists and psychologists they knew. When some of them asked why I was looking for one, my replies were shady.

“For a friend,” I told one, feeling guilty for lying. But I wasn’t ready to be open yet.

I looked up “best psychiatrists in the Philippines.” I searched for “psychiatrists in Manila.” And I started jotting names down.

I noticed that some names kept appearing over and over again. I put those who were recommended by multiple people on top of my list. One name in particular stood out because she had been recommended by both strangers and people I knew.

The next day, I called her clinic, eager to make an appointment.

“New patient?” her secretary asked.

“Yes,” I said. I could hear her flipping through pages of what I guessed was the doctor’s appointment book.

“Her earliest slot available is on January 6, 2 p.m.,” she said.

January 6? That was over a month away! I didn’t think I could make it through an entire month without knowing what was wrong with me. But I booked the appointment anyway.

Some people have compared trying to find the right psychiatrist to dating. You shouldn’t expect to find your match on the first try. And so I kept looking.

The second psychiatrist on my list was also highly recommended. And to my surprise, when I called her clinic, I was told by the person who answered, “She books her own appointments. This is her cell number.”

A psychiatrist who books her own appointments and gives out her cell number? I was intrigued.

I texted to ask if I could book an appointment. She replied on Monday morning, telling me to call her in an hour.

The first time I heard her voice, I instantly liked her. Even over the phone, she was very comforting. She was apologetic when she told me that her schedule that week was full.

“Is it an emergency, anak?” she asked.

“No naman, Doc,” I said.

And so we set my appointment for the following week. December 16. Nine days before Christmas.

***

“Oh no, I think I’m going to cry.”

It was my first session with my psychiatrist Dr. D, otherwise known as The Best Shrink In The World.

In the week before our appointment, I started wondering if what I was going through was a fluke. It had been over three weeks since that strange night in LA. I still wasn’t myself but I thought I was on the road to feeling better. It helped that I heard good news after good news from friends—Ruthie was pregnant! Giff was dating someone we liked!

But two days before I was set to see Dr. D, I woke up having a panic attack. It felt like someone was sitting on my chest, my heart was beating so fast and I couldn’t breathe. I sobbed quietly, trying to remember the breathing exercises Tita Marie taught me over a decade before. It was a while before I calmed down. And when I did, the darkness was back and I had shut down again.

The morning of the appointment was just as bad. There was no anxiety attack but I couldn’t sleep. I kept waking up every thirty minutes and eventually, I got so frustrated that I started to cry. Trying to sleep was pointless so I got up and headed to the bathroom.

Later, I wrote in my journal: “You know you have reached a new low when you’re crying while you’re showering and your dog is watching you and Hotline Bling is playing in the background.”

In front of Dr. D, the tears were threatening to come out again.

She pushed a box of tissues towards me. “It’s okay to cry,” she said, her voice soft and her eyes kind.

I grabbed a tissue and started talking, my voice cracking. “I’ve always been a happy person but a few weeks ago…”

My tears stopped almost as quickly as they started.

In late November, I began using my phone to keep a list of the changes I noticed in myself. But that afternoon, in front of Dr. D, I didn’t need to bring it out. I could rattle them off because they were all still happening.

“I have no appetite and when I am able to force myself to eat, I usually stop eating in the middle of my meal. I’m always tired. I have lost interest in the things I used to like. I was obsessed with nail polish but I did not paint my nails for fourteen days. I feel guilty about amassing so many material things. I don’t want to go out. I have a constant feeling of doom. I feel numb, empty and hollow. Like I just don’t care about anything. I’ve lost my enthusiasm. I can’t cry. When I start, it’s like a faucet that someone switches off instantly. The tears just stop. I can’t recognize myself. I forget things. I can’t concentrate. I don’t know how to communicate.”

Dr. D described what I was going through as a major depressive episode. And because there was no trigger and I couldn’t identify a reason for feeling the way I feel, she suspected that my condition was genetic and caused by a chemical imbalance in my brain.

Dr. D diagnosed me with clinical depression and anxiety disorder. But to rule out other underlying conditions that might be causing depressive symptoms, she ordered a thorough blood test and a urinalysis.

The following week, I was back with my test results and they were all clear (well, except for my cholesterol level which was slightly—only slightly—high). My thyroid was functioning properly so we couldn’t blame it for my symptoms. It was official: I was clinically depressed.

She prescribed an antidepressant and anti-anxiety medication, explaining how they worked. “The effects wouldn’t be instant. You will start feeling them in two weeks and they should take full effect after eight weeks.”

And because it was just days before Christmas, that meant I was going to go through the holidays still feeling all the strange things I was feeling.

Dr. D reached out and squeezed my arm gently. “I’m so sorry, anak. I feel for you. The timing is unfortunate.”

She told me to text or call her anytime I needed her which I appreciated.

Our sessions have light moments too. Dr. D often talks about my clothes and how much she likes them. The first time we met, she said, “I’m happy to see you taking good care of yourself. Some depressed people start neglecting personal hygiene.”

“Oh no no no,” I said. “I’m still bathing every day.”

And the following week, after a long wait outside, when I walked into her office, she said, “You smell so good even after sitting in humidity! You made my office smell so good!”

“Yes, Doc, I’m still showering regularly,” I said, smiling.

I liked Dr. D so much that after just one visit, I knew I wasn’t going to the other doctor anymore.

I guess this is the mental health equivalent of marrying your high school sweetheart. I got lucky. I didn’t even need Tinder for shrinks. I found The Best Shrink In The World on my first try.

Dancing with depression

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New Year’s Day 2016.

Lunch had just ended and we were in Lola Charit’s living room, surrounded by relatives who were all talking about my father’s problematic heart valve.

I nudged Powie and whispered, “I kinda wanna tell them.”

He nodded once, encouragingly.

I spoke, my voice loud and clear, like it sometimes has to be in order to be heard in our family. “Guys, speaking of medical problems, I have one!” I said, almost cheerfully, as if I was announcing that I bought a new TV.

“What?”

“I was diagnosed with clinical depression and anxiety disorder.”

***

In hindsight, there were signs that I ignored.

In the months before my diagnosis, my PMS had transformed from just a day or two of irritability or sensitivity (and sometimes neither of the two) to lengthier, darker periods of gloom. I chalked it up to hormones, to getting older. “Maybe I’m approaching menopause?” I thought a few times, which is laughable since the red fairy and I will keep meeting for about two more decades before she says goodbye.

And then there was the bigger sign.

The day after the launch of my second book “Planet Panic,” I woke up feeling… nothing. It was so different from the way I felt after “Paper Cuts” came out—I was elated for days. This time, even though I had a lot of fun at the event, the next day, I felt no joy.

“Shouldn’t I be happy? Why don’t I feel happy?” I asked myself. But I told no one and I tried to explain it away. “Maybe I’m just tired. Yeah, I’m probably just tired.”

Besides, I didn’t have time to think too much about how I was feeling. I had a trip to the U.S. I needed to prepare for.

***

I spent a few extra days in the States because I didn’t want to worry about being rerouted when Manila was declared a no-fly zone during the APEC summit.

I met up with friends and relatives but I was alone most of the time, having adventures around Los Angeles, finding stories to write about. It had been an amazing week—I interviewed Lucky Blue Smith and Sean O’Pry about their Penshoppe campaigns, I had a blast seeing Lala, Chloe and Tito Ringgo, I loved hanging out with Tita Becky, I had dinner with Edzel, I had Chipotle twice (way essential), I somehow (magically) ended up at the Mockingjay premiere, I watched a taping of 2 Broke Girls, I went to Rainn Wilson’s book launch. Thanks to Uber as my wingman, I had finally fallen in love with LA.

It was almost time to go home and I had one last adventure planned. I went to the Grammy Museum to listen to Conan O’Brien and Peter Guralnick talk about Sam Phillips.

I wasn’t there for Sam Phillips or Peter Guralnick. I was just there to stare at Conan who had been my strange celebrity crush for many years.

And so it was a big surprise that when I walked out of the museum, my delight at spending a good couple of hours watching Conan play with his hair and my excitement at seeing his assistant Sona suddenly disappeared, only to be replaced by something I had never felt before.

“Have a good night,” the museum’s security guard had said to me.

“You too!” I had called out to him happily.

But the minute I stepped onto the sidewalk, I felt like I had been sucker punched.

This is the way I have explained it to friends: It was like my insides had been scraped out, leaving me hollow and empty. I felt like a human Jack O’Lantern.

I was supposed to head back to Tito Boy and Tita Becky’s house so I could start packing but my body refused.

“I need to walk this off,” I thought. And so I did. I walked block after block in Downtown LA but did not feel better.

“Walking isn’t making a difference. I think I need a drink,” I thought. I whipped out my phone, looked up bars on Google Maps and started walking towards Hank’s. I entered the dark dive bar, grabbed a seat and told the bartender, who looked like an older version of Kristen Stewart, “Can I get a beer please?”

“Sure, hon, but I will need to see an ID.”

I looked at the sign on the wall: “If you look under 25, be prepared to show ID.”

“Lady, I am 35,” I wanted to argue but I had no strength. I dug around in my bag for my passport and waited as she squinted at it.

Soon, a cold beer was in front of me and I drank in silence.

Kristen Stewart Sr. made small talk with every single customer in the bar, asking them about the basketball game, teasing them about the sports teams they rooted for, talking about how much she fucking loves Abba, but to me, she said nothing except ask, “Do you want another one?”

It was like she could see the dark haze around me and knew that even her edgy zeal couldn’t penetrate it.

I was draining my second bottle of beer when my phone went off. “You on your way back?” Tita Becky texted. It was time to go.

I arrived at their place to discover that Tito Boy had cooked a beautiful plate of Chilean sea bass for me. It was absolutely delicious and I ate every last bit of it. I didn’t know it then but that was going to be my last full meal for a while.

I spent the rest of the night packing and watching videos of Jennifer Lawrence on YouTube, finding comfort in the fact that I could still laugh.

The next morning, I watched a clip of Adele surprising her impersonators and I started crying at the airport. I spent the almost-fourteen-hour flight from LA to Korea just sleeping. Then I landed in Manila feeling like an alien who had been plucked from my home planet and dropped somewhere really really strange.

***

I was in my head for days, trying to understand the odd feeling that just wouldn’t go away. On the outside, I pretended everything was normal. I was working, I was productive, I was interviewing people, I was meeting deadlines, I was replying to messages and comments on Facebook and Instagram. But on the inside, I was everything but. Outside of work, I couldn’t relate to the people around me. I was constantly exhausted. I was barely eating. I spent nights crashing on the carpet and watching stand-up comics on YouTube. I slept too much. I remember being in a mall to meet with Jill and Giff for dinner and when they told me they were going to be an hour late, I felt completely helpless, like I wanted to go home. And when they finally arrived, I didn’t know how to talk to them. I was an alien, an alien pretending to be Pam. I felt like the person that I was had left, leaving her empty shell still standing.

I was maybe more quiet than usual but I thought I had been doing a good job at hiding the strangeness. But after about ten days, Jill asked, “Is everything okay?”

And after days of silence, I finally spoke. “No, I’m not okay. I think I’m depressed. I need to see someone about it.”