Depressed once again

My depressive episodes are back. My antidepressant is back. And me? I feel like I'm back to zero.

I really thought (and believed!) that I was already getting better. My former psychiatrist thought so too, and that was why I've been off my antidepressant since January. I'm still taking my antipsychotic (Quetiapine) and anti-epileptic (Lamotrigine) on 300mg and 150mg doses, respectively, to help stabilize my mood. For six months, I believed I was getting better. But yesterday, I broke down.

It's because of my insecurities. Yesterday, during my therapy session, I was doing great. I was sharing with her what I wrote on my thought journal in the past three weeks. I was talking about my anxiety triggers. Everything was fine. But when we came across my entry about something that triggered my feelings of being insecure, I cried, and we dwelt on that during the rest of the session.

My psychiatrist wanted to make sure if I'm taking the right combination of meds. I stopped taking my antidepressant at 10mg. She was thinking that if we push my antidepressant a bit more---if I'd take 15mg instead of 10mg---I might get better. It might work. "I know it's an added cost," she said. "But let's try it."

Of course, I agreed. I am under her care, and she knows what's best for me. I asked her, though, if what I really have is bipolar disorder. My psychiatrist told me that my former psych (a good friend of hers) had his reasons for giving me that diagnosis. But now, she wants to make sure that I'm taking the right combination of meds. She wants to see if I would respond better to a higher dosage of antidepressant combined with my two other medicines.

I'll see her again in two weeks. Meanwhile, I'll keep writing on my thought journal and take my medicines as prescribed. Thank God for medicine samples; I have enough antidepressant tablets to last me for two weeks.

Anxiety and my thought journal

My depressive episodes are no longer that frequent. But it's anxiety that plagues me now. My mind is racing most of the time, as if it's flipping through pages of a book very quickly. Sometimes, my thoughts shift so fast I can't quite keep up. This is why I now have the habit of listing everything down. It's an expanded to do list, which includes not only my tasks at work but also personal ones like buying bread, milk, and toiletries at the supermarket; buying my medicines; getting rid of clutter in my cubicle; and organizing some things, among others. I even list down websites to visit when I have free time so I won't forget them.

I've been to three CBT (Cognitive Behavioral Therapy) sessions, and so far, I think I'm doing fine. My depression index score has decreased significantly from 16 to 4 (a score of 15 and above indicates depression) after one and a half month. I don't feel so insecure anymore (although I still feel insecure at times, but no longer as frequent as before). 

My third session last July, I think, is the start of the therapy proper. My last two sessions had been all about establishing the context in which all my personal issues stem from. On my third session two weeks ago, my psychiatrist started discussing with me how different people react to different situations, because different people see things differently. We ended the session on this note, and she gave me my first homework: to create an automatic thought journal where in I would write about a situation, my mood during that situation, and what I was feeling before that situation. This is the format I will follow in writing my entries. 

I've been expecting this kind of homework, because during my first session, when I told my psychiatrist that I maintain a personal journal, she said I would have one in therapy, but there would be a specific format. I bring my therapy journal everywhere (I gave my personal journal a break in the meantime). I write even the smallest of things that changed my mood, like how a girl took my seat during lunch and how a Facebook post affected me, among others. I write almost anywhere, even inside a movie theater while the show has not yet started. 

My entries, so far, have been all about anxiety attacks---how worried I am over some things, how I easily got irritated over something that set me off, and how I feel there are swords dangling above my head whenever I want certain things done during situations I have no control over. But I guess, anxiety can also be managed. I just have to be equipped with the right coping skills. Hence the importance of these therapy sessions. 

A letter to Taylor Swift

Dear Taylor,

I don't want to say that we are never, ever getting back together. I really don't. I want to remain one of your most avid fans. I've always defended you from people I know who don't like you. When these people say that your songs are all about your exes, or that they're just catchy but not that great, I tell them that your songs, of course, tell your stories and speak of your own experiences. Because isn't it the magic of any creative output--to tell our stories through something beautiful, like a work of art?

I don't feel this way because of the Hiddleswift that so swiftly happened. I'm not even counting the whole Kim K-Kanye brouhaha into the equation. I feel this way because of what you have become. Gone are the days when the Taylor that we know is someone relatable and approachable. Gone are the days when the Taylor that we know is the Taylor who leaves an encouraging message on a fan's Instagram account because that said fan was bullied in school. Gone are the days when the Taylor that we know is the Taylor who bakes cookies for her beloved fans when she invited them to an exclusive listening preview of her 1989 album that (at that time) was yet to be released. Gone are the days when the Taylor that we know is the Taylor who makes a surprise appearance at a fan's wedding to make that said fan happy on her wedding day. Gone are the days when the Taylor (oh, the sweet Taylor) that we know makes jams and makes embroidered gifts to Ed Sheeran.

Because all of these--as recent articles, opinion pieces, and online comments have pointed out--are part of a grand PR stunt that you orchestrated very well. And as a fan, it saddens me, because when I first heard your songs (Love Story, White Horse, You Belong With Me), I felt that you could relate to us, your fans (and we, your fans, could relate to you). I've had my own time spent in Loserdom when I was an adolescent. I've had my fair share of experiences of not being well-liked, of not being cool in the Ms. Popular/Cheerleader kind of way (which was a big deal when you're a teenager, or when you're simply surrounded by mean girls in school). When I first heard your songs, I felt that we were in the same boat, and you were out there telling our stories and standing for us who were (or still are) in Loserdom.

And your songs about your exes? They were all about heartbreak, and haven't we all had our hearts broken at some point in our lives? For us, your fans (or at least for me), that was another reason to like you even more.

So I followed your career, supporting all your albums--from Fearless to Speak Now to Red to 1989. I saw how you transitioned from being this sweet, country singer to a bombshell pop star. And that, perhaps, was when it all started to go wrong. Or maybe that's just how I felt (or should I say, feel right now).

You've pretty much achieved almost everything--Grammy Awards, a roster of A-list stars whom you have dated, a swanky New York apartment, a #squadgoals circle of friends, among others. And why wouldn't you have them? You deserved all of those, I told myself, because you worked so hard in writing those songs that we pretty much gravitated towards you and made you famous.

So upon the realization that all of these have "PR Stunt" stamped on them, I feel like you've played us all along. You exploited our experiences of being in Loserdom, of having our hearts broken, of having been rejected at school, and a host of other unpleasant experiences. You taught us that "haters gonna hate", so we were like, yeah let's "shake it off!" You taught us that the one on the bleachers, the one who wears sneakers, the one who wears T-shirts will eventually win over the girl who's cheer captain, the girl who wears high heels, the girl who doesn't get a special someone's humor like we do. Now, where is the girl who taught us all of these? Oh, maybe chillin' out in her New York apartment in the company of her squad of white girls who are stars themselves or supermodels.

And then, you become defensive whenever shade is thrown at you. Well, we can't reach you anymore. Do you even know how tickets to your concerts cost? Girls are literally running to get their hands on your tickets, even getting angry at a dad who's buying a ticket for her daughter because it's taking him a bit long to choose a seat (as what my sister witnessed during the selling of tickets for your Red concert).

So, is there still a Taylor with a soul beneath all the fame, the wealth, the enviable list of "friends", and the swanky New York apartment? Is there still a Taylor who's authentic and sincere? And, to borrow our very own Ms. Pia Wurtzbach's words, is there still a Taylor who's confidently beautiful (and talented) with a heart?

I'm hoping you won't get out of style though, what with all your (alleged but seemingly true) pretentiousness. Otherwise, we might have to shake you off for good.


From,
A fan

Lost stars

It has been a year and three months since I started seeing a psychiatrist. It has been eight months since I started sharing my experiences in dealing with bipolar disorder here in my blog. And in those eight months, several friends have messaged me on Facebook--some to offer support, and some to ask about my experiences in seeking help.

I appreciate all of those. When friends message me to ask questions, I welcome them. If I were to be asked to describe dealing with mental illness, I would have to say that it is not a gray cloud with a silver lining. It is what it is: difficult, exhausting, and expensive. A psychiatrist's professional fee is a four-digit figure, and don't make me start talking about the cost of medicines prescribed. Sometimes, I ask myself: Are the means to help me get better also make me feel worse because of the high levels of anxiety brought about by the cost of these means? Yes, I've asked for financial assistance from one of my aunts, and I couldn't be more thankful. However, there's not a silver lining to see when you see the amount (or the absence of it) left in your bank account every month.

Will this make me stop taking my meds? No. I will (and I do) take my meds as prescribed. I often compare my current self with my pre-treatment self, and I see the difference. Maybe it's not a big difference, but still, it counts. I don't regret seeking treatment, even if I have to move mountains to be able to pay for everything.

Whenever friends message me on Facebook because they feel they have similar concerns, I can't help but ask the universe (quoting the song "Lost Stars"): "Are we all lost stars trying to light up the dark?" Maybe we are. We are one another's candle. We perfectly understand each other because we are going through the same things ourselves. We may not find a silver lining, but we can always light a candle so we can make our way through the dark.

Just like Audrey

My chick lit streak hasn't ended yet. Or should I say, my Sophie Kinsella streak hasn't ended yet. I've mentioned before that "serious" writers may frown at my choice of books, but what the heck. I've been dealing with depressive episodes and bouts of anxiety that all I want is to be entertained. I want to laugh. I want to free my mind from all the stress, even if it's just temporary.

Anyway, I've finished Sophie Kinsella's Shopaholic series up to Mini Shopaholic. Those books were hilarious. Then, I tried reading another chick lit novel by another writer, but I didn't like it that much, so I went back to Sophie Kinsella and read Undomestic Goddess and Can You Keep a Secret?. These books were hilarious too that I found myself laughing while reading.

Now, I'm reading Sophie Kinsella's Finding Audrey. When I saw the synopsis, I knew this book was something I could appreciate not just because it's funny. Finding Audrey is a young adult novel about Audrey, a 14-year-old girl who has Generalized Anxiety Disorder, Social Anxiety Disorder, and depressive episodes. As a person struggling with mental illness, this is something I can relate to.

Audrey wears dark sunglasses even when indoors or even when it's raining and she's outside. She finds it hard to make eye contact with people (even with her family), let alone talk to them. Talking to a stranger (even if it's her brother's best pal) gives her panic attacks. Her psychiatrist gives her projects to help her overcome her anxiety. I haven't finished reading the book. But the chapter where I'm at tells how Audrey is filming activities in her house and interviewing people so she could practice communicating with them without making eye contact. That's the project her psychiatrist asked her to do.

I can definitely relate to Audrey's panic attacks. Encountering (or sometimes, even merely thinking of) certain people sends my brain into panic, as if all my brain cells and nerves have been fired up. My fight-or-flight response is immediately activated, and my brain automatically chooses flight. And by flight, I mean breaking down into a catastrophic flood of tears despite religiously taking my mood stabilizers (a combination of anti-psychotic and anti-epileptic medicines).

This is how I panic, just like Audrey. I don't wear dark sunglasses, but now I wish I do, not because I can't make eye contact. I want to cover my eyes so people won't see me at the verge of tears. I want to cover my eyes so I have time to make a mad dash to the bathroom before I break down. And at times, I want to cover my eyes so people won't see the fury in my eyes when they piss me off.

I think I also need to do a project to overcome all my issues, just like Audrey. Maybe this is where I can channel my creativity and make something good out of my situation.

What feeling small feels like

It has been a month since I last wrote here. And in those weeks, a lot has happened. Or maybe not a lot. Just... significant.

I've been to a couple of Cognitive Behavioral Therapy (CBT) with my new psychiatrist, Dr. Evelyn Gapuz. She's a kind and caring doctor and not intimidating (well, I think she should not be intimidating. Hehe). Over those sessions, I've once again told my story--my childhood and adolescent experiences up to the time when I was diagnosed with depression and anxiety. which morphed into a more accurate diagnosis of bipolar disorder.

I can't talk about all these experiences without shedding a tear or two. Okay, without crying. Even if it has been years (heck, decades!) since those unpleasant experiences, they still resonate as though they just happened yesterday. And I can still remember them, small details and all.

On my second session, I was asked to answer a form called depression index (I forgot the exact name of the form). Each item consists of four statements that describes a range of emotions and situations, from mild to extreme. It's something like this: I feel happy and good about myself; I feel bad at times; I often feel terrible; I feel like a train wreck all the time. Something like that. And then, I am tasked to tick the box that closely resonated with my experience over the past two weeks.

I didn't know if I was to answer it casually, without thinking about each item too much, just like those psychological or personality tests we answer in school. There was no time limit though, so I took my time answering each item, reflecting carefully on what I had been feeling for the past two weeks. When I gave Dr. Gapuz my form, I thought she would study it already and give me her assessment. But she didn't. Maybe I would here of her assessment on my next session.

The one thing that she picked up from my narration of experiences is how insecure I am of other people. In every stage of my life, there's always one person I'm insecure of. Some people might find this surprising because I was never the shy type. When I was a student, I was active in class recitations. I used to volunteer for certain tasks. I used to lead prayers, was a reader whenever there's a holy mass. Even in college, I share my opinions and comments with rest of the class.

But deep inside, I feel so small. An orgmate of mine in college once asked my why I underestimate myself. Maybe it's because of my fear of getting frustrated with myself. I never aimed to be the best (if by some sort of miracle I become the best at something, then,well, great!) because I was scared of failing. "If you can't be the best, be a little better than the rest." This quote was my mantra. I just want to be a little better than the rest. It's okay if I'm the bridesmaid, never the bride. It's okay if I'm second, or third, or whatever.

And yet, when I see people (classmates, batchmates, even friends) who seem to have it all, I feel small. I feel unaccomplished--that my vocabulary is not wide enough; that my singing voice is problematic; that I'm not really good at playing musical instruments; that my diction is horrible; that I'm not smart enough to comprehend a certain theory that everyone else understands; and so on. I often ask the universe, "Why do some people have it all? And why do some of us don't have much (and I don't mean money)?"

"You shouldn't compare yourself with others," says everyone on earth. Yes, I agree, but it's easier said than done. Especially when you've felt small practically all your life. Especially when you've been bullied in school. Especially when you've experienced teachers discouraging you and putting you down instead of giving moral support. Especially when you've experienced being hated by everyone in class (or at least, the "queen bees") that you don't want to go to school anymore and your grades have suffered. Who would emerge all bright and shining from those experiences?

Based on everything that I've told her, Dr. Gapuz has come to the conclusion that I am insecure of others over these two things: talents and intelligence. That feeling of not being good enough because, well, somebody else does it so effortlessly well. And then, my time was up--this will be discussed on my next session (which I only have a tentative schedule of because Dr. Gapuz will be gone for a month for further studies abroad).

Dr. Gapuz's conclusion made me look at myself in a different light. Talents and intelligence--I'm not lacking on those departments (people have said). I don't know what to make of this, actually. But I think it's good that we've established the things that make me so insecure. And I need to "fix" this; otherwise, I won't be able to advance in life.

So that's it for now. I'm still taking the same dosage of meds (300mg of Quetiapine, 150mg of Lamotrigine). So far, this dosage has been making me stable. I haven't had full-blown, catastrophic depressive episodes lately. Or maybe this is just temporary. That was last month. I don't know about next week. Or tomorrow. Anyway, maybe I should have only the present to think about.

Relapse

It is what happens when I've imprisoned my triggers and negative thoughts in a box, only to escape when I thought I've finally succeeded. It is what happens when I've already pushed these triggers away, only to come back with a vengeance and haunt me again.

Relapse.

I've been religiously taking my medicines, not skipping even a single dose. I've been going to my psychiatrist regularly, even if it means it's another P3,000 slashed from my bank account (it was P2,000 before, but it was with another psychiatrist who doesn't do CBT). Whenever I think about the cost, I realize that had I not been diagnosed with bipolar disorder, I would've had a substantial five-digit amount in my bank account--enough for me to have money to put in a sound investment. But how useless it would be if I am not healthy both in body and mind. It has been a year since I started seeing a psychiatrist and so far, I've managed to get by. Every month, I'm in the red financially, but I get by.

Dealing with bipolar disorder has cost me a lot of money, that's why when I relapse, I become so frustrated. It's like all my efforts have been wasted. Then, I would try again to put my triggers in a box, only for them to haunt me again after a couple of weeks of respite. And the cycle continues.

Twitter has been helpful in helping me deal with bipolar disorder. People from all over the world who are also battling different forms of mental illness follow me, and I follow them, too. Once in a while, we all tweet using a specific hashtag, like #EndTheStigma and #WhatYouDontSee. It's like we are all part of a community, even if we are oceans and continents apart.

A girl I follow on Twitter tweeted a quote from Alex Elle this morning. It is this: "I am thankful for my struggle because without it, I wouldn't have stumbled across my strength." This puts our struggles in another perspective, to remind us that we are stronger than we think we are. That we have the power over our illness even if we often feel that our illness overpowers us. That we are the captains of our respective ships, and we can stay afloat even if huge waves continue to knock us over.