My plan was to fight. If my psychiatrist tried to prescribe medication, I would put my foot down and say, “Nope. No no no no no. No, doc, no way in hell am I taking any pills. There has to be another solution.”
I was worried they would mess with my already messy head and make me incapable of writing.
But all my resolve melted when Dr. D explained what the medicines can do for me. I didn’t even argue.
(This doesn’t mean though that I think you should automatically start taking meds if you’re depressed. That will be up to you and your doctor to decide together. Aunt Marie says, “As long as you’re with a very good psychiatrist, you should be able to question any medication you’re taking and be informed.” And please please please never self-medicate.)
“I just want to make sure they won’t affect my work,” I told Dr. D.
She prescribed an antidepressant and an anti-anxiety pill. She wouldn’t warn me about the side effects, she said. And she asked me not to Google them. I guess she didn’t want me to wait for or imagine any side effects. Instead, she wanted me to observe how I would respond to the medication for a week so I could report it to her.
After our session, I dropped by the drug store on my way to the office and I joined the world of medicated depressives.
Days later, I wrote this in my journal:
During the day, after I finally force myself to eat something, anything (me, the girl who spent one high school summer regularly scarfing down four Pancake House tacos and eventually returning to school so suddenly plump that I earned the nickname Lobo because yes, I had ballooned), I free a capsule from its foil packet prison and pop it into my mouth.
Four hours later, I will feel a wave of nausea, a desire to throw up and my throat threatening to close—sometimes one by one, most times all at once—but these can all be remedied with one piece of gum or candy. Another three hours later, I will feel really sleepy, groggy sometimes. When I am outside, I fight it. I yawn, I shift, I struggle to stay alert. When I am indoors, I give in, curling up into a ball or collapsing on the floor, the carpet, the bean bag, the nearest stretch of surface that will take me.
At night, I split an already tiny pill into four with my thumbnail, popping a sliver into my mouth. It is so small that water is unnecessary but I drink anyway. Then I let my head hit the pillow and wait for sleep to take me away. And I wake up the next day and do it all over again.
This is my new life. This is how you fight the sad.
Initially, those were the side effects I experienced: nausea, dry mouth, drowsiness, exhaustion, loss of appetite (not that I had much of an appetite to begin with). And because I couldn’t look them up online, Tatin became my side effect guardian.
“Tats, my mouth is really really dry. Is this normal?”
Days later, more side effects.
Bruising all over my body, restlessness (I often found myself tapping-tapping-tapping my foot impatiently—something I didn’t do before), a tendency to become off-balance even while doing simple things like trying to put on my shoes and—this is too much information but fuck it, we’re being honest here—constipation.
When I returned to Dr. D and I rattled off my side effects, she said, while taking notes, “Mild side effects. Okay, good, let’s continue with the medication.”
On the first week that I started taking meds, two of my stories came out on the newspaper’s front page, erasing my fears that the drugs would affect my work.
And Dr. D was right, my side effects were mild compared to others I have since read online. There’s one in particular that I would like to discuss but will not because my grandparents know about this blog: the inability to achieve orgasm. (Let’s not give them a reason to seek therapy.)
After several weeks, my side effects have disappeared one by one. Only one has remained: drowsiness. (I blame it more on my anti-anxiety pill than the antidepressant.)
During our first session, Dr. D explained that the antidepressant would only start to take effect two weeks after I began taking them. Full efficacy happens after eight weeks, she said.
I thought that meant I would stop taking the meds after eight weeks but I misunderstood. I just found out two weeks ago that I will have to continue taking my medication for at least ten months before we find out if I will need a lower dose for maintenance for the rest of my life.
“I’m kind of relieved,” I told Dr. D. “If you told me we were stopping the medication today, I would have told you I wasn’t ready.”
My mother doesn’t like the idea of me taking medicines for depression. “Ayoko nyan. Sabi they’re too strong,” she said. I have patiently tried to explain to her that the meds have been helping me and that I feel a lot more stable than I was in December.
In fact, I feel really lucky that it’s like I hit the antidepressant jackpot on the first try—that’s not the case for everyone.
Some people even think my medication has added benefits.
“Is your antidepressant good for the skin? You’re glowing,” some people have said.
It’s funny when people think your depressed self looks better than your normal self.
The only drawback? The medication isn’t cheap. But I will gladly shell out for it over and over again if it means never feeling like that hollow robot version of me again. Aunt Marie wrote, “The medication costs are absolutely ridiculous but necessary.” She added, making me feel like crying, “If ever you can’t do your medication at the dose you need because you don’t have the money, please let me know and I will send you money. There is no reason you can’t have a great life if you’ve got your health under control.”
Dr. D realizes that the medicines are expensive too and on my last visit, she said, “I wanted to tell you about a new drug. It’s a lot cheaper than Cymbalta.”
“Will the side effects be the same?” I asked.
“We don’t know yet, it’s new.”
“No thanks, doc. I’ll stick with the old one.”
I like a good bargain, but not when it comes to my brain.
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?
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.