Bipolar Disorder by Helen M. Farrell

This is a brilliant TED-ED talk that explains in simple graphics what bipolar disorder is in 6 minutes.

Well worth a watch and do share it with your friends!


Book Review: OCD and the True Story of a Life Lost in Thought

I was browsing in Popular Bookstore when I chanced across David Adam’s The Man Who Couldn’t Stop: OCD and the True Story of a Life Lost in Thought. It looked intriguing and I was just about to buy it before remembering a promise I made to a friend that I would check out the library before buying books (I have stacks of unread books at home).


Lo and behold, our extensive National Library stocked the book and I promptly borrowed it and finished it within a week.


The book is part memoir, part investigative research on Obsessive-Compulsive Disorder. You’d have probably heard of people describe themselves as having OCD but the truth of the matter is, it is not just a behavioural quirk, it is a very serious mental health issue that has proven to be very debilitating for the people involved.


I must admit, as I read the first half of the book, I got rather worried and slightly depressed because it seemed like I have some of the traits described by the author. Ever since I was a child, I have always avoided stepping on cracks while walking on the pavement. If I did step on a crack, I would have to step on a crack on the other foot to “balance” things out.


This is illogical and somewhat weird, which is probably why I’ve never told anyone about it. You can understand my concern as I read this book. However, I reasoned, as this did not seem to impair my life that much (some diagnosed spend up to 4 hours a day bathing to get rid of dirt), I figured I was alright.


What was very interesting was the last third of the book where the author outlined a wide variety of treatment methods. He first talked about the group therapy he attended in UK. The therapist employed elements of Cognitive-Behavoiral Therapy which had positive effects on the author. In addition, we learn about the effectiveness of exposure therapy and extinction decay. On top of that, he shares about how medicine seems to be able to control the condition and even touched on the touchy subject of lobotomy. Fascinating stuff.


The author seemed to have gotten better after several rounds of group therapy and the conclusion was pretty hopeful.


I’m sharing this book review because I would like to raise awareness of OCD. Depression and anxiety seems to have gotten much better press lately but sufferers of OCD is usually made fun of and the topic is treated with much levity because of how it’s manifested.


It’s not funny at all.


I would encourage everyone to get a copy of this book to find out more about OCD and if they spot symptoms in a loved one, to encourage their family member or friend to visit a psychiatrist to seek treatment. Click here to get it on Amazon, Book Depository or even Popular Bookstore if you’re living in Singapore.






My last day in therapy

So the psychologist that I’ve been seeing at Khoo Teck Puat Hospital officially released me from therapy today. I guess that’s something to cheer about. We’d been discussing this a couple weeks before but I didn’t realise that this would be the last session until we discussed it when we met earlier.


I went to get a referral to see her in the beginning because I felt that my bipolar meds weren’t working, especially when I had an episode (both depression and mania). But subsequent chats with my psychiatrist convinced me that they did work. Nonetheless, I’ve learnt several helpful things with my psychologist:


It ended on a good note and she gave me an “Open Date Appointment” which meant that I could go visit her anytime within the next one year.


When I first started seeing my psychologist last year in August, I knew it would be helpful, but I did not expect to be completely blown away by the level of care and attention I’ve been given.


I would definitely encourage anyone in distress over their mental health to seek help with a psychiatrist and/or a psychologist and if money is an issue, get a referral from your polyclinic like I did.


And I’ll definitely recommend KTPH.

Talking about anxiety and depression on YouTube

I’ve been following YouTube star charlieissocoollike since a year or two back after chancing on some of his videos while randomly surfing YouTube.


I subscribed because he struck me as a sort of witty dude who had an English accent to boot (I dig English accents).


But then he disappeared from YouTube.


Until now.


He posted a video detailing his experiences with anxiety and depression 3 weeks ago because “on YouTube there is only a certain kind of bumming out you’re allowed it seems”.


“And for a long time I sort of felt that those we sort of things that I was. I was just an anxious person. I was just a bit of a depressed person sometimes.”


“But I also kind feel like I wasn’t comfortable admitting that I had any real problems, you know? I honestly thought I was just being a bit whiny?”


“It’s not that I’m depressed, I’m just lazy. It’s not that I’m anxious, I’m just a bit scared and need to man up and deal with it.”


This was exactly how I felt when I was first diagnosed and I’m glad that he’s come out to talk honestly about dealing with anxiety and depression. With 2.4 million subscribers on YouTube, he has a tremendous opportunity to spread the word and reduce the stigma still attached to mental illness in this modern day and age.


He admitted that when he first started sharing on Twitter about it, he thought he’d be helping people. But instead, he received an overwhelming amount of support and encouragement that he’s not gotten in a long time.


I believe that everyone has a story to share and every single one of them has the potential to bring change to someone’s life. Admitting you have a diagnosis of mental illness is like owning it and sharing one’s story brings hope to another who might otherwise be closeted in shame and fear.


So check out his video and I hope you’ll share it with someone today!

A cure for insomnia (Part 3) – Sleep with me podcast

It was 2:42 am and I was still awake, lying in bed scrolling Facebook after I was done with Instagram and Snapchat.


It was then that I chanced upon this article by The New Yorker that heaped praises on the Sleep with me podcast hosted by Drew Ackerman.


“No harm trying,” thought I, and promptly downloaded it.


The first 10 minutes were advertising by the founder and host but it was pretty calming and the slow drawl was surprisingly soothing.


When he started the podcast proper, I was prepared for a long and meandering story. In the beginning, I followed his introduction pretty closely, alert and interested in what he had to say.


The next thing I knew, it was 10 in the morning.


Wow. I was pretty impressed with this. Maybe I’ll try this the next time I can’t sleep.


You can download the Sleep With Me podcast here and also check out A cure for insomnia (Part 1) and A cure for insomnia (Part 2).


Hope it helps you to sleep!

Interview with a suicide survivor

Hey guys, I recently did an email interview with my really awesome friend, Tan Meiling, who is a survivor of multiple suicide attempts. She has kindly allowed me to share her story so as to help those out there who need to hear this.


There are Christian elements that might not apply to all my readers out there, but I think it’s still very helpful in many areas. Read and be encouraged!

1) Tell us a bit about yourself.

Well, I’m now 28, working as a freelance writer/editor/tutor/trainer. I was trained as an English teacher, but decided to take a step of faith this year and pursue my dream of writing and editing.


2) At what age did you start thinking about suicide?

Around age 13. I’d just moved back to the States from Singapore, and was having a tough time fitting in at my new school and re-adjusting to American culture. I was also dealing with a lot of repressed negative emotions because I was badly bullied for an extended period of time in Singapore, just before I moved to the States.


3) What was/were the trigger(s)?

It was likely the slow build-up of all the emotions I was grappling with: anxiety about my new school and adjusting to a new culture, the loneliness of not having any friends, the anger and powerlessness I felt at being bullied for such a prolonged period of time, and the increasing isolation I felt because my family wasn’t able to support/understand me emotionally.


Eventually, everything just became too much, and I attempted suicide for the first time. I can’t even remember now what my first suicide attempt was. Between the age of 13 and 19, I think I tried to kill myself six times.


These attempts mostly involved trying to overdose on whatever pills I could find, though once I tried jumping in front of a train, and another time I tried jumping off the ninth story of a building. Oh, and one time I also ate 1kg of rat poison.


4) What treatment(s) methods did you/your family try?
After everything became overwhelming for me, I broke down and confessed to my mom that I’d been thinking about suicide. She sent me for an evaluation by a psychiatrist, who diagnosed me with major depressive disorder with suicidal tendencies. They promptly put me on various medications (I can’t remember which ones now) and started sending me for therapy.


In the next few years after that, they changed my medication half a dozen times, increased the dosage of each medication to see if it would help, and switched therapists and therapy styles and psychiatrists just as many times.


By the age of 14, I think I was taking like four or five different pills every night for depression, anxiety, insomnia, and so on. Of course, the number of pills I had access to didn’t help the suicide attempts, so I think eventually they decided to give me fewer pills and instead have me refill the prescriptions more often. That way, I wouldn’t down all of my medication at one go.


5) Tell us about the very last suicide attempt and what prompted that?

My last suicide attempt was the 1kg of rat poison along with about 10 grams of Paracetamol (Panadol). It tasted quite nasty — I had to put the rat poison in my breakfast cereal just to get it down my throat, and to this day I still don’t like the taste of Panadol.


What prompted it was an extreme feeling of abandonment and loneliness. There was this huge void in my heart that I kept trying to fill; I felt like no one understood me, and I believed that those who were supposed to be there for me were never around or didn’t have the ability to truly protect and care for me.


The recurring thought in my head was, “I am alone. I always have to fend for myself, and no one will ever truly know me nor love me.” It was therefore not a big leap for me to start thinking, “I am a mistake. I wasn’t meant to be here in this world. I am not important to anyone. My existence is an error.” So I acted on those beliefs and tried to correct the mistake.


6) How do you cope with depressive thoughts these days?

By being in relationship with God and learning to love myself the way that He loves me. If I find myself sinking into a place of hopelessness, I try and get reconnected to what the God of hope is saying to me. I allow Him to love on me even in my darkest times…and when I can’t do that, the friends He’s placed in my life help Him to remind me how much I am loved.


Practically speaking, I structure my life so that I filter out distractions, choosing to focus on His heart for me above what all the other voices are telling me. For instance, I choose my closest friends carefully and over a long period of time; for me to consider them a close friend, they have to consistently demonstrate that they value the whole of me (and not just the part of me that lives up to certain expectations)…because God values the whole of me.


In turn, I do the same for them, and my close friends and I have such a strong bond that I know I’m always going to be there for them just as they will be there for me. I also live my life and order my priorities based on what He tells me, and I can see day after day how He cares for me even in the little things.


But honestly, even though I now feel a lot more healed and whole than I did a decade ago, there’s still a small voice inside me that wonders if I am really significant to God. Does He really think I am that special? Does He really consider me His precious, beloved daughter? Does He really know and care for the desires of my heart?


This small, nagging voice may always be there until after I meet my Father face-to-face. “Then we shall know fully, even as we are fully known,” after all. But instead of focusing on that small voice, I’m choosing to maintain an awareness of my Father’s heart for me instead. That way, no matter what adverse circumstances come my way, I am more aware of His heart for me than I am of that little voice that tries to steer me off course.


7) What would you like to let friends and family members know about someone who has suicide ideation?

If your loved one is struggling with suicide ideation, don’t jump to conclusions. Don’t rush to fix them. And definitely don’t tell them that the solution is to “rejoice always” or “count it all joy when you meet trials of various kinds.” Validate their feelings, however extreme or drastic they may seem to be.


Be present with them in the moment. Sometimes that means simply embracing them and crying with them.


Other times it means listening to them pour out their hearts, not trying to hand out quick fixes so you can move on. Seek to understand their hearts, and seek to love them well. (By the way, if you think you’re loving them well but they don’t feel loved by you, it may be an indication to re-evaluate what you’re doing.)


That suicide ideation is a mere symptom; the real problem lies deeper within. For me, it was an overwhelming sense of being unloved, unsupported, and alone. There were many lies I believed about myself because of the things I went through, and it took time and a lot of love to unearth those beliefs and replace them with the truth.


For others, it may be that they’ve just lost their jobs, and they’d tied their whole lives to their careers. They’ll need time and a lot of support to regain their footing and develop a new, more secure sense of themselves that is not tied to something external.


Be patient with your loved one, and always endeavor to listen and understand what their hearts are actually saying. (The words that are coming out of their mouths are a good indication of what their hearts are feeling, but words can’t tell you the whole story.)


Lastly, if you have a relationship with God, find out what our loving heavenly Father thinks about them! It will change the way you relate to them. It will change you. And in time, it will change how they see themselves too.

Interview with someone with an anxiety disorder

This is an email interview I conducted with Justina, my friend who has an anxiety disorder. 
1) Tell us a bit about yourself. 
Hi, I’m in my late 20s. My hobbies are reading and playing videogames. I have worked full time since graduating from polytechnic and consider myself very fortunate that I have never needed to be warded. 

2. How did you realise you suffer from anxiety?

I have been timid, shy, a worrier and socially anxious since childhood. So much so that I and everyone just presumed it’s my personality.

I managed to get full-time jobs as a graphic designer and web developer that are all quite “back-end” in nature. However I joined the civil service, and for the first time in my working life, I had to regularly answer my phone, go to meetings, talk at meetings and socialise with colleagues at staff events.

I had a lot of trouble. My colleagues realised that “small” things such as speaking up at a meeting made me extremely nervous, and that my face would go pale with anticipatory anxiety at the prospect of a meeting. They also noticed my anxiety over making phone calls or picking up the phone. One day, they confronted me in the lift and I tried playing everything off as “just shyness and introversion.” 

“That’s not introversion, it’s something more” one of them replied, and I knew he was correct, because my introverted colleagues were quiet, but NOT anxious about everything like I was.

I ended up googling “anxious in social situations” and as I read the criteria for Social Anxiety Disorder, it made a great deal of sense. Still, I wanted to be sure so I wrote down a list of situations in which I had anxiety, and how it impaired me socially and at work. It was quite a long list.
3. How did you decide to see a psychiatrist for it? Do you go to a public hospital or private clinic? Why?

While I suspected I had social anxiety, and because I realised I needed to heal it in order to perform “acceptably” at work, I was afraid to see a psychiatrist. I did a lot of googling and hoped that brief counseiing would be enough.

I looked at polyclinics and at that time, NHG Polyclinics had a “health and mind” clinic where a family doctor would assess you for mild depression and mild anxiety. I made an appointment.

I saw a family doctor and brought in my list of symptoms. He questioned me, and gave me a diagnosis of “Generalised Anxiety Disorder. He also sent me to the in-house psychologist for “a few sessions” of counselling. I saw the counselling psychologist for 4 sessions spread out over several months. I was extremely visibly anxious in all my sessions and despite rehearsing the relaxation techniques learned in counselling, taking up exercise and working through a Cognitive Behavioural Thearpy (CBT) self-help book that I found on my own, the psychologist deemed I was worsening and that I also fit criteria for Social Anxiety Disorder.

He said I needed psychotherapy and likely medication so he sent me back to the family doctor for a referral to a hospital psychiatrist with a confirmed diagnosis of “Generalised Anxiety Disorder” and a provisional diagnosis of “Anxiety Disorder – Not Otherwise Specified” (although they strongly suspected Social Anxiety Disorder).
4. How did you start seeing a psychotherapist? Is it in a public or private setting?

Now I go to a public hospital, due to the polyclinic referral. The psychiatrist assessed me as having Social Anxiety Disorder and referred me to the clinical psychology department. That’s how I started seeing a psychotherapist. I also started medication, but only after some reluctance, after a staff event where people noted my hands shaking. 
5. What do you usually do in your sessions with your therapist?

I had CBT with a clinical psychologist for a year. With CBT and the relaxation techniques I learned from counselling and self help, my functioning at work improved really well. However, I still struggle in my personal life because of emotional issues.
So she referred me to her colleague who does ACT (which focuses on Accepting your emotions), mindfulness, and schema therapy.
My current therapist and I work together on mindfulness and grounding exercises. I find mindfulness very good for calming me down when I am anxious.
Currently, my therapist blends ACT and schema therapy.
6. You have an app you use to manage your anxiety. What is it called and how does it work?

I use 2 apps, both recommended by a friend. They are “Stop, Breathe and Think” (free) and “Calm” (free and paid version). They are both guided meditation apps where you can choose different meditation tracks. 

SBT has a “emotion check in” so you can select how you feel and it will then suggest several guided meditations for you. 

Calm is sorted by effects that you want – eg improve focus, sleep better, reduce anxiety. Calm also allows you to select from several background “scenes” which play different ambient sounds and music such as rain falling on leaves or waves on a beach.
7. What other coping strategies do you have?

I use a lot of mindfulness and cognitive strategies learned from CBT and ACT as well as relaxation exercises.
8. How does anxiety affect you at work and at social situations?

At work, I am much better now — I am now able to do things I have never dreamed of, such as lunching with colleagues as a group or with one or two others. I am far less anxious in work meetings and staff events, and have received comments that I’m “a lot less shy” now, as though I had a “personality change”. I believe that it’s really the “real me”, no longer hampered by crippling anxiety.
Socially, I am still working on it. I am able to hide my anxiety much better, but socialising is a lot more complex and scary than working for me. I work in IT as a project manager, where introversion is common, talking is task-focused, and there is little pressure to be chatty and outgoing.
9. What would you like to say to people who suffer from anxiety?

I would encourage people with anxiety to seek professional help if self-help is not working for you. Very often, people think “everyone has anxiety in social situations” or “everyone worries” but if it is impairing your life, it is good to seek help. 
Other conditions such as PTSD, OCD, agoraphobia etc are also treatable even if you have comorbid diagnoses which complicate things. 
Stories in the ebooks by IMH and the books by Club Heal, and stories from other peers will show you that you are not alone.
10. Do you take medication for anxiety? Why or why not?

I do take medication. For example, I am on a low dose atypical antipsychotic which augments my antidepressant and reduces my racing thoughts. My brain is literally “quieter” and so it is easier to implement coping strategies such as mindfulness.
My antidepressant boosts my mood, as depression is common when you have anxiety disorders.
I am also on a low dose of a benzodiazepine to be taken shortly before high stress situations at work such as a meeting with senior management.
I feel that medication is one leg of the chair which supports me, and the coping skills I have learned being another leg. Lifestyle such as a good diet with enough sleep etc is another leg.

I plan to reduce and stop medication if possible, but am okay if I can’t as long-standing anxiety (more than 2 decades before treatment for me!) may be chronic and may reoccur over the lifespan.