It started with panic attacks in the middle of the night. I’d wake up with palpitations, and worried about every single thing–from minute details, such as the commute going to work, to something huge, like whether or not I’m equipped for my job. I was constantly in a deep dark hole.
I felt like the walls were closing in around me. I wanted to sleep all the time (Later on, I learned that this is called hypersomnia, one of the symptoms of depression, where a person sleeps excessively). I could not get out of bed, could not get out of the house. I stopped going out with friends. If I had something scheduled, I’d have a panic attack and then bail on them.
My bed became my best friend. Every morning, my anxiety attacks made me feel so nauseated that I wanted to throw up. I could not make a decision to save my life. In fact, the night before I decided to seek professional help, I was rooted to the spot outside of church, paralyzed. I could not decide whether to go to Katipunan for dinner or just go home. Both choices made me feel like I was choking.
People didn’t have to tell me to snap out of it, or that it was just mind over matter because I was already telling myself that. And yet, I just couldn’t–for the life of me–pull myself out of the darkness. This was unusual for me because I’d always considered myself a strong woman. I’d weathered so many storms. We left the country I called home, left all my friends, left all that I knew. Then, two months after arriving in the Philippines, my mom died. I got up, lived life. Three years later, I got kicked out of school, but I bounced back, getting good grades at my new school. By the end of those four years, I had two job options barely out of college.
A year into working, I watched my grandmother die right in front of me. We thought we were going to be homeless. I went through a very traumatic breakup. Still, I got through it standing strong. So in 2007, when I started having anxiety attacks, and feeling like every day was doomsday, I couldn’t understand why I could not just "snap out of it."
I’d gone through worse, I rationalized. Standing paralyzed in front of the church was my breaking point. I had to get help, otherwise I felt like I would die. No exaggeration. I truly felt like I was getting buried alive. It is a feeling I would not wish on my worst enemy. You feel helpless. Alone. You keep groping around for that happy switch, but you can’t seem to find it. It’s like that dream where you’re trying to run away from someone as fast as you can, but no matter how fast you run, you’re still in the same place.
My dad was very supportive, but many others could not understand what I was going through. They though that it was "mind over matter." If I just tried hard enough, I could get past this "negativity."
"Just think positive."
"Kaya mo yan."
"Snap out of it."
Those are the worst things you could ever say to someone who is clinically depressed. It makes them feel even more useless. It magnifies what they’re already feeling–that they’re not good enough because they can’t "help themselves." Clinical depression is an actual illness, just as you can’t tell someone with cancer to will her cancer cells to disappear, or someone with coronary heart disease to unclog their arteries. There are many other kinds of depression under the term clinical depression–unipolar, bipolar, and postpartum, to name a few. What I had was unipolar depression, which is also called major depression.
Unipolar depression is when someone is in a persistent depressive state, unlike bipolar depression, where the patient "has mood episodes that range from extremes of high energy with an up mood to low depressive periods."
The day after I was paralyzed with fear outside my church, I had another panic attack and couldn’t report for work. My dad took me to St. Luke’s in Quezon City to see a neurologist, who then referred me to a psychiatrist. He said she was usually booked and that I needed to make an appointment, which made me panic even more because I knew I couldn’t wait any longer. I had to get treated, stat! But God had my back because it turned out she had an available slot right that moment. And I found out later on that her treatment plan suited my needs exactly–using medication, psychological therapy and spiritual guidance. I’m not sure if other psychiatrists use the same methods, but God is a very important part of my life and I wanted Him to be the center of my healing process.
Dr. Monina Garduño-Cruz, Head of Section of Psychiatry, International Institute for Neurosciences at St. Luke’s Medical Center Quezon City, explained to me that "the most widely accepted explanation for what happens when someone becomes depressed is the decrease in serotonin secretion of the brain." According to WebMD, "an imbalance in serotonin levels may influence mood in a way that leads to depression."
"There are low levels of certain neurotransmitters, most commonly serotonin, but scientists are finding (a connection to) dopamine and norepinephrine. But it’s not just about the chemicals. There are so many things happening in the brain that can’t be explained yet. More of the circuitry. Certain areas of the brain that are not functioning very well when a person is depressed but they cannot fully explain this mechanism very clearly yet."
Can someone be treated for depression? Specifically for unipolar or major depression, Dr. Garduño-Cruz shares, "Treatment is time limited. At least nine months to a year of taking medications. Completely, the symptoms can remit or disappear. A person can go back to his/her previous level of functioning." Can it be cured forever? She warns, "Once you have a history of depression you will always be more vulnerable than someone who has never had depression. So it can recur." But there are ways to prevent it via psychological therapy, changing the way you think and cope, acquiring more effective stress management strategies, and rooting oneself in their spirituality.
Dealing with someone who is clinically diagnosed with depression can be tricky for most people. Dr. Garduño-Cruz gives tips: "Be aware that persons who are depressed are more sensitive. So be sensitive also with how you deal with them. Be careful of what you say because they tend to be more pessimistic, they see things more negatively so even if you don’t mean anything negative, it may be taken in a negative way. Do encourage the person to seek (professional) help because it may be something that has to be treated. Be there for support, provide emotional support. Don’t minimize what the person is feeling. Don’t minimize the problem or the stressor.
And very important–if they talk about suicidal thoughts or wish to die, make sure that you secure the person’s safety. Be there for the person, mobilize support system. Assign a relative or a friend to be with the person 24/7 and convince them to get help. Also, secure the environment and remove access to method (of suicide)."
After seven years of battling depression, I am now in remission. What took me so long? Every time I felt like I was feeling better, I’d go off the meds, when it was precisely the anti-depressants that was helping me feel better. I think this is a common problem amongst people who have depression. They think they’re cured and prematurely stop taking medicine, when in fact, the medicine is just starting to work. Similar to anti-biotics, I needed to take the full course of the medical treatment in order to truly be healed.
I am blessed that my support system was receptive to the concept of clinical depression, in a society where I felt that it wasn’t widely accepted yet. I feel like things are a lot different now, compared to 2007. More people have come to have a better understanding of depression, acknowledging that it isn’t just "mind over matter." But I feel that it’s important to keep bringing awareness about clinical depression until every single person truly understands that recognizing it as a real illness, and thus getting treated for it, can spell life and death for the person going through depression.