Suicidal in Singapore

At my lowest low in March 2016, I found myself hanging out with KTV hookers from the hood in a police station, and discussing the life-saving grace of Jesus with a 60-something kleptomaniac in a cell. With a short detour to the IMH, handcuffed and rolling around in a wheelchair, listening to the police officers’ stories about ‘funny suicides’ (wtf, really?), that night made for quite the field trip. Thanks to my acting skills I managed to convince the psychiatrist I was “just feeling sad”, would seek help from the private mental health system, and got discharged the same day.

Thank god attempted suicide has been decriminalised in Singapore.

TO TELL YOU THE TRUTH, I WASN’T ACTUALLY READY TO DIE, I JUST WANTED TO LEAVE.

The idea of suicide was a respite from the mental anguish I was going through day in, day out – it was the one act that I could actually have control over. The idea was very comforting indeed.

At that point in 2016, the depression had gotten so debilitating that I found it difficult to compose a simple email at work. In social situations, I found myself unable to comprehend day to day discussions on business and politics, I found myself simply not giving a fuck (and I felt bad about it). I felt stupid. When I listened to music, I couldn’t enjoy it at all. I felt so numb to everything that I was experiencing, that it just didn’t feel like living. 

On top of that, anxiety kicked in: 

• “If I can’t even write an email, I won’t be able to keep my job. How am I going to achieve anything in life? I can’t be a failure when all my peers are doing so well.” 

• “If I’m unable to understand what they’re talking about, what value do I bring to the table? Nothing!”

• “If I can’t even enjoy music, and I supposedly love it, then who am I?”

• “I’m so privileged to have a roof over my head, food on the table, and a decent job – I have no right to feel this way.”

And then came the existential crisis – I couldn’t find any answers at the time – and the suicide ideation. And then the attempt (the one thing I’m glad I failed at!).

It was a really difficult time, and I am very grateful that I am still here today – very much alive and kicking. 

It’s been 3 years and 7 months since my last episode of major depression. In that time, I’ve made incremental yet major changes to my way of living, and have learned to proactively manage my mental health. 

With World Mental Health Day happening on the 10th of October, it’s given me the impetus to share my recovery journey: from feeling resolute about leaving this world, to learning how to live life as fully and meaningfully as possible. 

I hope that through sharing my story and learnings, I will be able to help someone, somewhere, somehow.

Some Context & Challenges

I’d been experiencing major depression yearly since 2013. Prior to that, a few minor existential crises at 11, 15, and 17 years old (I just noticed those were the years leading up to major examinations).

In therapy, I figured that the condition was triggered by a combination of life events, lifestyle, and genetics: the stress of post-uni adulting (rent, bills), moving homes multiple times (and not feeling at home anywhere really), loneliness, the death of a close friend, late nights from DJing, and my family’s history of mental illness. So I learnt that I already had a predisposition to depression and the lot, and such events simply acted as a catalyst to surface the condition.

With the onset of depression, the situation was always exacerbated by Expectations (hello anxiety). The expectation to succeed, to be smart, to look good, to be better, to be happy, to think positive… the list goes on. Whose expectations? Admittedly, as I realised later on, mostly my own – with some help from the conditioning of my Raffles education (I need to be a Daughter of a Better Age!), and the ever-optimistic mantras and success stories shared on my social media news feeds.

Living in a society where there is generally a poor understanding of mental health, getting the right help at the right time was always a tough one. Reaching out to friends, family, and anyone willing to listen oftentimes led me to interesting advice and strange places when my cries for help weren’t simply being shrugged off. Most commonly I’d receive well-meaning advice to “just sleep it off” or “focus on the good things” – but that didn’t quite do the trick. My call to the SOS hotline was received by a lady who couldn’t wrap her head around the fact that I was facing an existential crisis and not something more tangible, like a boyfriend or financial issue. At one point I found myself at a Malay bomoh’s house, where we had a Q&A with lime slices floating in a bowl of water. I’m happy to see that there’s been a much bigger push to educate the public on mental health, but it’s only the beginning.

Awareness aside, getting to Acceptance posed a significant challenge for me. Mental illness is invisible, and typically does not manifest itself in the form of physical pain, making it all the more difficult to accept that it was something that I needed to attend to medically. It was only when one of my best friends Pang told me, “Remember, the brain is an organ, and it can get sick too.” that I started accepting my condition, and opening up to the idea of getting professional medical help. It took me years to get there, and I’m all the better for it.

In finding my way to proactively manage my mental health, I’ve learned to work with the context and constraints to the best of my ability. As painful as it was, and as clichéd as it sounds, it was worthwhile to plough through the challenges. Along the way, I’ve had a surprising amount of help and support, and have come away with stronger relationships and a much deeper understanding of myself. There is light at the end of the tunnel.

How I Went From Leaving to Living

I’ll break my recovery journey down into three sequential phases: 

• Phase 1: Survive

• Phase 2: Live

• Phase 3: Thrive

Different tactics worked at different times in my recovery journey. There are times I’ve had to take a step back and focus on basic strategies worked when my aim was to simply “survive”, and there are times I find myself being able to push forward towards “thriving”. Most of the time I’m contented to simply Live. 

In this post, I’ll be sharing about my journey through Phase 1. We’ll save the next two for another time (there’s so much to say!).

What you’ll find below is what has worked for me, given my personality and inclinations. Hopefully you’ll find something helpful amongst the lot!

Phase 1: Survive

This was me, for the most part of 2016. It was about pulling myself out of the darkness, getting myself more or less functioning again. With the lessons and tactics below, I managed to survive debilitating depression, and become a somewhat productive human being again.

HIT THE RESET BUTTON. 

After the jail/IMH excursion, I decided to leave my job and stop DJing. I pretty much exited the current game I was playing and forced myself to start again. It was a pretty drastic move – these weren’t the easiest decisions, given that I’d tied my identity so closely to what I do… However the pressure to perform and pretend that everything was ok was so debilitating, it was better to leave at the time. Being freed up from both day and night responsibilities, I had the headspace to focus on getting better. 

REMEMBER, IT’S ALL ABOUT TAKING BABY STEPS.

The initial days were a struggle; most of the time I’d be curled up in bed wishing the cloud of depression would simply go away. But it doesn’t work that way. My friend Pang reminded me time and again that recovery is about “baby steps” – working towards small wins, and going back to basics. One doesn’t recover from mental illness overnight, just as a broken foot doesn’t heal in a day. It was then I started resetting my goals to more simple, achievable ones: waking up by 9am (instead of 12pm), taking a shower before noon, making it to my therapy and psychiatric appointments, going for yoga, taking my meds.

GET ENOUGH SLEEP.

I read a saying somewhere that “depressed” means one needs “deep rest”. Kinda lame, but there’s an element of truth in it. Sleep and mental health are closely connected. I won’t explain the science behind it, but I’ve personally found that getting enough sleep each night greatly affects the quality of my mental state the next day. I do my best to get 7-8 hours of sleep these days, and back then I’d allow myself up to 9.5 hours. More than that, however, was a sign that I was probably hiding from the world due to depression and anxiety – my body doesn’t actually need to spend 11 hours in bed.

MOVE.

It’s been found that exercise helps fight depression. Taking walks (especially in nature) and going for yoga classes have become part of my weekly routine. Sometimes I go for the occasional run or HIIT class to get the extra boost in endorphins. Dancing to a great DJ set or at a concert also gets the energy levels up. During the initial recovery phase, I signed up for a gym membership and some PT sessions so that I’d feel obliged to attend classes and work out. Since then, I’ve figured that it’s not quite for me – I prefer yoga and being out in the open.

EAT WHAT’S GOOD FOR YOU.

There’s a connection between the brain and gut, and the medical world is getting real excited about the possibilities to treat mental illness through the digestive system. There’s also talk about “nutritional psychiatry”. While I’ve yet to find a definitive, prescriptive diet for depression, there are certain rules I live by: 

• More: nutrient-rich veggies (spinach, broccoli, and kale top my list), omega-3 fatty acids (salmon, tuna), antioxidants (berries, dark chocolate)

• Less: Sugar (this means less desserts), red meat

• Eliminate: Alcohol and coffee

You can learn more about “antidepressant food” here; and the gut-brain connection here.

KEEP TRACK OF YOUR DAILY ACTIVITIES.

If I really wanted to get better, I needed to keep myself accountable. At the end of each day, I kept track of the number of hours I slept the night before, what I ate that day (it was easy to indulge in chocolate cake when I felt down), whether or not I exercised (and how much), the amount of money I spent (I was on a budget since I wasn’t working), whether or not I took my meds. To make sure I don’t forget, I’d set timed notifications to remind myself to stay on track.

I’ve used a variety of apps to keep track of these things, but I’ve managed to keep it simple and focus my main tracking activity to just two apps: eMoods and Expense. I also have Eve to keep track of my periods (those generally affect my moods), and for a few months I used MyFitnessPal to track what I ate and how much I exercised. Tracking these things gave me a greater sense of control over my daily well-being, and it gave me the data points to review my moods and behaviour in retrospect during therapy sessions.

GET HELP FROM LOVED ONE(S).

I was really lucky to get the support of my mum and dad post-attempt. It was hard to get the necessary help initially during prior depressive episodes, and understandably so – they found it hard to comprehend the invisible challenge I was grappling with. 

However, having their help both emotionally and financially helped me in my recovery by leaps and bounds. My mum flew in from New Zealand to be by my side and to make sure I was eating properly and doing my laundry, and my dad checked in on me regularly despite his hectic schedule. Mum found a psychiatrist and accompanied me to the initial visits, and both parents lightened the financial burden of medical treatment, therapy, and rent while I wasn’t working. I wasn’t able to express it at the time, but I’m really eternally grateful for their love and support in helping me get through those dark times.

I am very blessed to have a few good friends who stuck around and supported my journey proactively. Simply spending time with me, taking walks, going for yoga together, having a meal, helping me with errands, providing a non-judgmental space to talk things through was comforting and encouraging. Thank you Pang, Josh, Chinks, Dee Jee, Sherry, Weiyuan, and Jin for the kindness and compassion you’ve shown me. Your friendship means a lot to me.

GET PROFESSIONAL MEDICAL HELP.

This was a really hard one. It took me 4 rounds of major/minor depression since 2014 before I came to terms with the fact that I needed to be on medication regularly (in case you haven’t figured out already, I actually have bipolar II – unfortunately it’s lifelong). It took 2 years to get the right combination of medication — in between, I experienced side effects from weight gain to sleepiness to rashes, and made multiple trips to the psychiatrist. After many rounds of tweaking and testing, I now know what works, what doesn’t, and when to make changes to the mix, to keep my moods in a state of equilibrium.

The effects of being on and off medication are noticeable. It takes about 2 to 6 weeks to kick in, and the period up to that gets a bit tricky as your body is figuring out how to deal with the new input. Mood swings, tiredness, nausea can happen. If the side effects persist, it means that the medicine isn’t working — there’s always an alternative to try. There’s so much more I can say here, but that’s for another time. In short, it’s worth giving medication a shot, especially in severe cases of depression and any other form of mental illness. Once it starts affecting your day-to-day life, it’s time to seek help from a professional. 

SEE A THERAPIST.

Just like how I had some resistance in seeing a psychiatrist, the idea of seeing a therapist took me a while to come round to. After all, what good is talking to a therapist when I can just talk to my friends and family? Why should I pay to speak with someone? Wrong, wrong, wrong approach. Before I go on further, I have to point out that it is absolutely necessary to find a therapist that you feel resonates with you — you’ll have to approach it like dating. In order to find out, you’d go for one or two sessions, then it’s either a clear yes or no (and if it’s a no, find someone else).

I managed to find a therapist that I felt comfortable with at my second try. During our weekly sessions, and subsequently monthly sessions, we managed to unpack a lot of the triggers and factors that have brought about the negative feelings of depression and anxiety. We managed to get pretty deep, and I learned a lot about myself. With that insight, I managed to accept and let go of quite a lot of unhappiness and stress I’d been feeling. Today, even though I’m in a much better space, I still go for therapy once every 4 to 6 weeks, and am reaping the benefits of the sessions on a daily basis.

GET BACK TO BASICS.

As I started to feel better about 3 months in, I knew that I wasn’t ready to jump straight in to a full-time role. Instead of taking on a job, I decided that it was a good time to become a student again, so I signed up for General Assembly’s Web Development course. It was an area I’ve always wanted to explore further, and it was a full-time course which meant I’d be kept busy from 9am to 5pm, 5 days a week (at minimum) for 10 weeks. The initial month was difficult, and the self-critic was actively at work – my depressed brain was still in sleep mode. The next month, however, with my healthier habits in place and treatment at work, I started feeling much more engaged, and managed to create a web app or two. I made some new friends too. Thanks mum for sponsoring this!

Being a student forces you to be humble and open-minded. The act of learning something new means that you have to start from the basics, be patient, and build your understanding from the ground up. Beyond applying this principle to web development, I applied it to my own recovery journey. Learning how to code reinforced the idea of having to take baby steps, and to approach the process of reclaiming ‘life’ one step at a time. The individual function needs to work in order to run the entire programme.

And so, I started Living again.

This part of the journey took me 8 months to get through – and that was only the beginning. They say that getting started is the hardest, and I found that to be true. There were days I felt like giving up altogether; especially on days where I had brain fog, or when I missed a workout (the depressed/anxious voice is a harsh one). But there were also beautiful days where I was able to enjoy the moment, work on a problem productively, and dance along to the music I love.

If you’re experiencing some form of mental illness, or just a tinge of anxiety or depression, and all that I’ve just written was consumed in a blur — just take away this key message: Keep going, it will get better.

Thank you for reading this far. It means a lot to me, and I hope it’s helped you in some way too.

Special thanks goes out to Jin and Gemma for helping me proof-read the article, and encouraging me along the way.

This piece is dedicated to Kaleni and Tyler. Bipolar depression is no easy challenge, and both of you put up a good fight. Rest in peace – we miss you.

 

In 2020, Sabrina cofounded Calm Collective Asia, an online community for good mental health, where she’s breaking the stigma of mental health in Asia by building a space to share practical and actionable strategies through free virtual talks and normalising the conversation on mental health.