To be a nurse is a noble job, but there are not many good opportunities for practicing nurses in the Philippines, and because of this, I had to leave the country, work overseas, and bear being away from my family.
My anxiety and depression started when I left for Saudi in 2010 to work as an ICU nurse. The symptoms of my disorders started to surface eight months after I arrived in Saudi. I began to notice a sudden change in my sleeping habits. There came a time when I couldn’t sleep; I would go back to work with no sleep, which made me have to take naps at work. I was aware of the repercussions, but sometimes I took extra medications from the ICU to get myself to sleep better. I also started getting palpitations, cold sweat, and nausea; these symptoms persisted. I could not sleep; on rare occasions where I could, sleep was shallow, because anxious thoughts about my family occupied my mind. At that time, I wasn’t aware of the prevalence of mental illnesses. I recognize my feelings of sadness, I do, but I was still able to withstand it by distracting myself through physical activities such as playing basketball.
Congenital heart disease and anxiety
One day, I ended up knocking on the door of my flatmate to ask for help, hyperventilating and aware of impending unconsciousness. I asked him to bring me to the ER. Luckily, the nurse on duty in the ER was my roommate then, who was like a brother to me. They ran an ECG reading where they discovered a congenital heart disease, a right bundle branch block. I was admitted to our own unit in the ICU. Every day, my co-workers would take turns to monitor and check on me. I was hospitalized for three days. However, each time I lacked sleep, I still experienced palpitations and felt like I was about to faint. At that time, I was already experiencing panic attacks, only I didn’t recognize them as such. I would experience the symptoms often when I was on duty: palpitations and lightheadedness. My co-workers told me to fight it because if I let it grow worse, I would be forced to go home. This aggravated my anxiety further. What was distressing about it was that I felt alone, desperate for help, but the people who could have helped at the time failed to consider the state of my mental health just as my physical health.
Time went by and I tried hard to fight the symptoms I’ve experienced. I still took extra medications from my unit just so I could sleep. Not being able to take medications left me to have panic attacks four times a week. I needed to exercise to combat the symptoms. My duty was from 3 PM to 11 PM, and whenever my roommate and I were on the same shift, I would invite him to play basketball with me at around 2 AM in the morning, hours after our shift was over, just to tire myself out and help me get to sleep. There were even times we got yelled at, “Brother, it’s time to sleep! It’s 2 AM! Why are you still playing basketball?”
Going back home
I have worked there for just eight months even though my contract was for three years. An old man I met in Saudi told me, “As much as you can, give your time to your family, especially your children.” This led me to decide going back to the Philippines. I relied on exercise to relieve myself from the panic attacks. Sometimes I would ride a bike on the way to my brother’s home; sometimes, I’d just roam with no particular direction. But from time to time, I’d be too tired and worn out of overthinking and all the pressure, and this often triggered another attack.
One of the ways I combat my panic attack is challenging my thoughts about what was the worst thing that could happen. Whenever I hyperventilate, the feeling was like having SVT (Supraventricular tachycardia) whereas my heart rate would go up to 170 to 180 beats per minute. Still, I would still challenge that. I would run really fast and thought that if I fainted here, there would be people who would see me and likely bring me to the hospital. Or if I die then, they could bring my corpse to the morgue. That was when I realized my anxiety couldn’t get the best of me. I challenged even the worst panic attacks that I had.
Nevertheless, I’m glad that my family and friends didn’t give up on me. What’s disappointing about the Philippines now is the stigma that entailed getting diagnosed with anxiety or depression–they’d already had a misconception of you as someone crazy. One instance was when I rode a jeepney and had an untimely panic attack. I asked a fellow passenger, “Manong, can you accompany me to walk just until the hospital? I don’t think I can walk there alone.” He replied with a sharp “Are you crazy?” With his disdain and my anxiety, I decided to just run towards the hospital.
Changes at home
When I was already working in Manila, my wife didn’t understand what I was going through right away. She ended up pressuring me, asking me what my plan was. Sadly, in the Philippines, nurses are underpaid and I already had a child to support.
I didn’t like the changes in myself when I came home. I was irritable. From the time I woke up, I didn’t want people to talk to me. My son didn’t want to come near me; he didn’t recognize me. I felt like my family did not understand my struggle. I felt so much pressure; I frequently had fits of anger at night.
My family decided to have me consult a psychiatrist. It was then that I was diagnosed with generalized anxiety disorder, panic disorder, and depression. I was prescribed with different medications. The medications I took always left me drowsy, so I wasn’t able to exercise. I would play basketball in the morning and would fall asleep once I sit down to rest. My peers would wake me up when the game is finished. When I come home, I would sleep again. I would just wake up to eat, and sleep again afterward. My mom said that the effects of the medications on me were not normal. We came back to the psychiatrist and my mom noted the significant difference in my sleeping pattern and activity: “He is not able to do the things he usually does. He couldn’t even take care of his son because he’s always falling asleep.” The psychiatrist just answered that this was my body’s way of making up for all the sleep I could not get during my stay in Saudi.
My mom suggested that we find another doctor, but during that time, I was already some improvement and my panic attacks lessened. I thought I could handle myself so I opted to stop taking my medications and did not go back to my psychiatrist for check-ups. However, my irritability persisted, especially when dealing with my family. It got to a point where, one time when I fought with my father, I hit and broke the cabinet at home.
I already had thoughts of suicide before, but I never entertained them. However, they became worse when arguments with my wife got more frequent; I felt too pressured. I almost jumped from the rooftop at home one time, fortunately, I was saved by my brother-in-law as he hugged me and told me, “Don’t do this, let talk about it.” There was also an instance that I intentionally tried to have myself run over by a jeepney, which only ended with me getting cursed and yelled at by the driver.
New job as a supervisor
I was still battling my panic attacks even as I worked as a nurse in Manila. I was beating myself up to go abroad. Fortunately, I was offered a job opportunity in another hospital as a supervisor in their eye center. I took the chance without knowing what a supervisory role would entail.
I am a nurse and I’m used to having our performance measured by the quality of our service to our patients. Isn’t it such a nice feeling when you get a commendation from a patient? I was shocked when I started working at the new hospital. The vice president was an industrial engineer, and my performance was measured based on the revenue of the eye center, even as I repeatedly explained to him that, as a nurse, the focus should be on the quality of the service of the unit given to the patients.
Once, I was doing a procedure on a patient when the vice president had me called to a meeting. I told him that I would go soon as I finish the procedure, but he wasn’t willing to wait so I had no choice but to leave the patient, only to have them tell me in dismay: “Don’t be like that. You didn’t even finish the procedure.”
Due to the expectations entailing the responsibilities I had, I grew harder on myself. The symptoms resurfaced. Yet again, my sleeping habits changed and I couldn’t sleep. I was offered a job opportunity abroad, but then I was also about to have my second child. I was perplexed and the stress piled up until the symptoms peaked and I was met by a new problem; signs of depersonalization began to appear–like an RPG game, I felt as if I was a third person observing myself. I was attending to a patient when my boss asked for me. I told him I’d follow soon as I was finished attending to the patient. Not that long after, the voice on the pager called for me. I felt my ears heat up. Out of irritation and anger, I got myself water. Suddenly, I felt like I was in the third person, detached from myself. I tried to ignore what was happening and instead went up to my boss, telling him that I didn’t like being paged when I was with a patient because I felt embarrassed for it. He didn’t respond so I went back out and calmed myself down. I felt like I couldn’t handle it anymore and brought myself to the ER. My boss, either oblivious or inconsiderate, still called for me over the pager even when I was already in the ER. I was in a depersonalized state until I was given an anxiolytic and fell asleep. Soon as I woke up, I was feeling normal again. That was the white flag that made me realize that I needed help and couldn’t deal with my problems on my own.
I was at work when I felt like I was about to have a panic attack. I went out and caught myself asking, “Why not find a psychiatrist here?” Immediately after, I checked the doctor’s directory and had myself scheduled for an appointment. I asked my new psychiatrist whether he thought it’d best for me to resign from my job. He noted that it seemed likely that the cause of my anxiety was my boss. He advised, “You can let it go since there’s another opportunity waiting for you. But while waiting for opportunities, you can apply for other jobs.” At that time, I was weighing on an opportunity to go to the UK to work. Even when I felt anxious about earning to meet my family’s needs, I thought my parents could help support me in the meantime. I let go of my job, and luckily, was offered a new job.
I am regularly getting therapy now from my psychiatrist, as well as taking medications. So far, my panic attacks haven’t relapsed. Now I am able to function well as a father, husband, brother, and son. I will be seeing my psychiatrist again after three months, and have had my dose already decreased–a definite sign of improvement. I was prescribed an anxiolytic to be taken as necessary as I was about to have my third baby.
However, what many people don’t understand is that we also need help from a professional. Neurotypical people wouldn’t easily understand your condition. That’s why there are lots of cases of alcoholism and suicide because those are their ways of coping, of handling their illnesses–and it makes me sad. I learned from my neuropsychiatrist that anxiety and depression are like diabetes. With diabetes, you lacked insulin; with anxiety and depression, you lacked serotonin. This is why clinically depressed individuals are given SSRI antidepressants, to recycle serotonin. That’s what people don’t understand, and have to understand: that mental health problems are valid concerns that require appropriate medicinal procedures.
Causes of my condition
I believe the main cause of my condition is due to overthinking and the feeling of being too pressured. Stress caused by the thought that I already have three children, and we all know that life is hard in the Philippines. It happens when I think about my problems too much.
I could say that I also already had a predisposition to developing a mental illness. Growing up, I had an inferiority complex and low self-esteem. When I was in elementary school, I was frequently bullied. I remember hoping that each time I went to school, I wouldn’t be bullied. And honestly, my parents also both have anxiety. I believe my mom has undiagnosed anxiety. My father also had anxiety but had only been treated by a GP (general practitioner).
Biggest factors toward recovery
The biggest factors toward my recovery are my friends and family. When I was depressed, some of my close friends were also unemployed. I would just text them and they would come here and talk. Other factors would be playing basketball, sports, and exercise. Then coming home, I would be welcomed by my family and we would eat dinner together. Every day, I am grateful for that.
When you’re depressed, you truly feel alone. I almost gave up on myself, but my support system was strong enough to lift me back up. One of the biggest factors of my recovery is my wife. Despite the trying times that often led to arguments, she was always there for me. Occasionally, whenever I wasn’t in the mood to talk, she would just hug me. My brother had also been a big help. I look up to him and ask for advice whenever I have a problem, and his words always influence me toward better choices.
I think I will withdraw my medication before 2018. But like what I am telling my doctor, if I have to take this medicine for the rest of my life to fulfill my roles, I am willing to do it. What is 50 pesos a day spent on medications if that significantly improves my quality of life? Anxiety attacks can make you miss out on happy moments with your loved ones. You’ll be there fighting against yourself. Isn’t that sad?
My advice to others who are having the same problem is to seek professional help. However, finding the right doctor medications would be hit-and-miss. If you don’t like your doctor, find another one which is more compatible with you. Find someone who is passionate about helping you, someone who will treat you like their family and would respond with care and compassion when you open up about your problems. But we shouldn’t rely solely on medications. You also need support from friends and family. It also helps not to dwell on the past too much and focus more on the present. If you feel like you are alone, you can reach out; there are people willing to listen. I know it’s hard, but talking to another person is the first step in recovery.
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