Queue Numbers May Not Be Called in Sequence
Trigger warning for mentions of death and domestic violence, depression, and anxiety attacks.
Words by Dominic Nah. Illustration by Valerie Yeo.
04/2018 | Psychotherapy Centre, Institute of Mental Health (IMH)
Sinking into one of the smooth PVC covered armchairs outside Consultation Room 1 now.
9:15AM: I’m fifteen minutes early today. That’s rare. Thankfully, my brother woke me up. Otherwise, I would have missed this first session of my sixth attempt at counselling/therapy in nine years.
***
06/2010 | Counselling Room, Victoria Junior College
Ms L, my JC school counsellor is telling me about bananas, dark chocolate and the 4-7-8 breathing technique. I remember she said ‘high-functioning’ at some point. I cannot bring myself to tell her about the terrible secret I was made to bear by my father earlier this month, in my A Level year.
***
01/2015 | University of Warwick, Coventry, UK
It has been about 3 meltdowns in 2 weeks. I had no mood for Christmas or the New Year. Enough is enough, I need help.
Visited the Mental Health Wellbeing Drop-In clinic at the University House. People have been saying that I need to get help. Okay. If I just got off my arse somehow and sought help, I would be rewarded with the help I needed and things would get better.
I emerged from the Drop-In Clinic none the wiser (I had already read about all this exercise, eat better, sleep regularly, breathing technique stuff thanks to Google Search Results). Now I felt more guilty for being unable to follow through with these self-care activities.
At least they referred me to University Counselling services. It was free and well-reviewed on the website by students past and present. Maybe it would help. I met this tall, blonde English woman with a voice so polite, it felt condescending. The way she listened, it was as if she was performing the act of listening. All I took away from that session was the feeling that she was judging me to be the stereotypical stressed-out, over-achieving Asian student.
Five days after that counselling session, my father (whom I hadn’t spoken to in 2 years after falling out) died suddenly of a heart attack in Singapore. He would leave a lot of unfinished business behind.
***
11/2011 | Clinic B, IMH
It has been about 3 meltdowns in a month, including one in camp. After a referral from Sengkang Polyclinic, I’m here now for the first time at IMH. I did not want to be referred from the in-camp Medical Officer at Paya Lebar Air Base.
I meet the psychiatrist first. We talk about anger issues. We talk about low moods. We never speak of diagnosis.
Later that month, I met Dr H, who would be my psychologist for the next 14 months. I got time-off from camp duty to go for therapy. She says that in absence of a diagnosis, our therapy will be exploratory in nature. She seemed nice. But I just wanted her to think well of me and make her feel as if she was helping me.
I also felt shy in front of her.
All of this, I never said to her over the course of 2012.
***
07/2015 | Counselling Room, Centre for Promoting Alternatives to Violence (PAVE)
Ms T. is my family’s case counsellor at PAVE in Ang Mo Kio. Now that my father is dead, the goal of family counselling and intervention is different because the main source of the threat and danger is no longer around. She seemed nice. But I just wanted her to think well of me and make her feel as if she was helping me.
I also felt shy in front of her.
All of this I never said to her over the course of the 6 sessions in 2015.
***
02/2013 | Sayang Wellness Centre, IMH
Dr. H needs to close my case as she is leaving IMH. She tells me I have duly attended thirty-seven sessions over the past year and thanks me for sharing so much. I think to myself that I actually held a lot back over the last 14 months.
I don’t say that. I still have no diagnosis. I don’t know if anything is wrong with me or am I just making it all up? I suspect it is because I told them I am a MOE overseas scholar and they do not want me to have a mental health medical record. I don’t know how to confirm this.
***
07/2016 | University of Warwick Health Centre, Coventry, UK
I just had another meltdown right after my graduation the other day. I managed to get First-Class Honours but I hated the fact that I did well. I believed that I didn’t deserve it. A person like me should not get good results like this. I did not put in hard work like I wanted to. I just gamed the assessments strategically. My first aunt and best friend watched me in disbelief as I lost my mind at the university bus interchange, threw down my certificate and stormed off.
Now I am at the Health Centre, after my mother’s pleas on the phone to do something to help myself; she is already feeling so helpless and disappointed that I am “still like that”. I walk in to the doctor’s office and ask about mood stabilisers. He asks me if I have had low moods for more than 2 weeks. I say yes. He prescribes me a 1-month dosage of 20mg fluoxetine (Prozac). We never speak of diagnosis.
I look at the box of Prozac, thinking, what am I supposed to do with this? Can I take it with no diagnosis? Will it help? Should I rely on medicine? What’s happening?
That day, I decide to switch off anger as an emotion. I decide that I would never be angry again.
***
05/2017 | University of Warwick Health Centre, Coventry, UK
I am still at Warwick - I convinced MOE to sponsor a 4th year to complete my Masters. I am really privileged. My one goal for my Masters year was to get emotionally stable before coming home. By May of 2017, I slid into one of my worst depressive pits.
I went to the Health Centre with one, single mission: get diagnosed with depression. I went in and asked the doctor straight up “How does one go about getting a diagnosis of depression?” I had never been this straightforward. I always believed that the psychiatrists and psychologists would tease it out of me. If they did not say anything, then surely nothing was wrong and I was making it all up: after all, they are the professionals and they don’t sense it from me so I must be pretending.
I got diagnosed, finally, after 7 years of suspecting something was wrong with me.
Later that day, I wrote an e-mail to my scholarship officer to disclose that I had been diagnosed with depression.
***
07/2017 | Clinic B, IMH
I bring the diagnosis home and check myself back into IMH via a polyclinic referral. By a stroke of luck, someone cancelled an appointment, so instead of waiting for 4-6 weeks, I was referred within 1 week. I tell them I have been here before. They recommend Group Therapy to me. I take up the offer.
Meanwhile, MOE sends me for a psychiatric review at Raffles Medical Group to ascertain whether I am fit to return to work. At this point, I have moved home to complete my Masters’ dissertation due in September. That had not been going well either too but somehow I have pulled through, with my bursts of momentum that never last long.
***
08/2017 | Ministry of Education HQ, Buona Vista
I was called in for a meeting and offered 6 months of no-pay leave to rest and recuperate. It was a surprise. I took it up. At the time of writing (18 April 2018), I have still not yet returned to work even after attending a second psychiatric review. The stress and uncertainty of unemployment has been a strain on my mother.
***
10/2017 | Mood Disorders Clinic, IMH
The 8 sessions of the Psych Up! Group Therapy programme have ended. I have submitted an incomplete dissertation five days late even after a 4-week extension. During Group Therapy, I realised I had the tendency to get in my way of finishing anything, sometimes even simple daily functioning activities, let alone entire dissertations and essays. But it ended too soon. We made promises to reconvene but it has been 6 months and, still, no word.
Meanwhile, my dosage of fluoxetine goes up to 40mg. I start to get very excitable and irritable.
***
11/2017 | Clinic B, IMH
I spoke to a friend who told me about Bipolar Type 2. I recognized a bit of myself in the description of hypomania.
Elsewhere, instead of angry outbursts, I have taken to overeating. I am about 10 kg heavier than my normal weight during the routine weigh-in at my next psychiatric appointment. I set my mind on telling him that I think it is Bipolar Type 2. After so many attempts at seeking help on my own, I concluded that if I didn’t speak up for myself, nothing would change.
We have a conversation about the bipolar spectrum. He gives me a prognosis of Cyclothymic Disorder. My medication changes to include Sodium Valproate and anti-depressants are lowered. He confirms this 4 weeks later in December as a diagnosis after I complete for him a daily mood chart. 4 weeks later in January, I disregard my medication altogether.
***
04/2018 | Psychotherapy Centre, IMH
Does medication help? I have no idea. I also stopped recording my daily mood chart. I find it so artificial that I can fake the numbers to create a story I want to tell the psychiatrist, and that he will believe it.
I have little to no work available. I make mistakes doing ad-hoc and part-time work because I cannot concentrate. A couple of theatre projects keep me going. I decide to return to therapy upon encouragement of close friends: I can’t just give up on professional help, even though I am tired of trying.
I’m fifteen minutes early. I am worried this is all not going to help; I have been losing faith in the ability of professional help to help me cope. I feel like I have been slipping through the cracks.
I speak to Dr. J. I tell her that I feel like I am doomed to repeat my cycles of ups and downs, which really disrupt my daily life, relationships and potentially work in future. Will I ever get better?
This time, because the diagnosis is much more accurate, when she covers the symptoms I feel like I can finally safely address the dark parts of myself I have kept silent from everyone, including myself, and I leave the room with a rare sigh of relief.
The trouble is, my next therapy session is 5 weeks later. It seems like even when I take steps to seek help, I can no longer expect a linear sequence of recovery. I’ll just keep collecting queue numbers to wait then. I tell myself at least I’ve showed up and played my part, and nobody can blame me for not trying.
