Grey is the colour of depression

I learnt how to be a mental health patient in 2012.

My twins were born at the end of 2011. I was frantically trying to pull myself together to be a parent to my new babies. I did not know that my body would respond to the creation and birth of these 2 new human beings in this way.

Now I know.

I also know now that depression is not the same as being sad. It is an all-pervasive feeling of hopelessness. I am not colour-blind, but things around me started to look washed out, as though they were images from old faded photo prints. Everything had a grey-yellow tinge to it. I did not enjoy my babies. They became a giant never-ending checklist of chores for me to get through each day, and for the foreseeable future. I could not see my way out of the conveyor belt of drudgery in front of me. There was a constant feeling of being on a hamster wheel, only I was not an energetic racing rodent, but a hollow-eyed listless creature placing one foot at a time on a skinny wobbly rung in front of me, trudging along ceaselessly. I certainly could not feel the joy of having two healthy, happy babies. I slept but woke feeling unrested. I kept hearing babies’ crying, even though they were not. I was mechanically going through the motions of parenting. I was numb.

On the surface, it looked like I was well-resourced. My in-laws did their best to help. My husband took 3 months off work to be at home. There was another lady around to assist in a house-keeping role. In fact, I started feeling guilty for my inability to appreciate all the good people around me. Then I started feeling guilty that one twin would successfully breastfeed, and the other twin flatly refused. So, I fed one and pumped for the other. Eventually, it all got too much, and I gave up breastfeeding completely after a month. Another thing to feel guilty about.

One evening, I sat down at the dining table with my husband and told him,” I can see why people end their lives if they feel as bad as I do now.”

He looked at me sharply. I swear I could almost hear the gears switching in his head. In a moment, he had gone from being a husband and father, to a psychiatrist in consultation with a new patient.

He pulled some strings and got me to see my GP and a psychiatrist.  All I could do at these appointments was cry and express my guilt for feeling bad despite having as much support as I did. It is interesting that even my husband, who is a trained mental health professional, was unable to recognize that I was deteriorating before his eyes until I made that fateful statement. On hindsight, he thought I was showing signs of psychomotor retardation and was becoming thought-disordered.

Within another 2 days, I got admitted into a private psychiatric hospital with severe postnatal depression.

It is not easy being a patient. You lose all sense of self-control. Your routine is no longer your own. You must conform to another set of rules. You cannot leave whenever you want. You eat what is there. You eat at set times whether you are hungry or not. Your doctor pops in at random times. You worry about what other patients are like. You wonder if you are being secretly judged for your condition. You worry about the mental health label you will eventually be given. You worry about your family at home. You wonder if you will ever get better. You get given medication which are essentially chemicals with side effects, even though they are meant to help you. You worry about the future.

My personal belongings were searched (albeit respectfully) by ward staff for items that could be a potential self-harm implement. I had to line up at a medication counter along with all the other patients to get my medications, swallow it in front of the dispensing staff member so they could be sure that the pills had been taken. A torchlight was shone onto my bed at regular intervals throughout the night to ensure I had not absconded. I spent the first 2 days crying without stopping. I felt so guilty about being away from my babies yet could not bear the thought of seeing them. I ended up being heavily sedated.

Gradually I settled into a routine. The hospital became a place of refuge, the white walls, bland scenery, sparse white bedlinen, basic chest of drawers and clothes cupboard, and most importantly, the quiet. There were other hospitalized mothers, but they had their babies with them in the mother-baby unit. I did not have my babies with me, so I chose to stay in the general ward as I did not think I could cope with the sounds of crying babies. Cue more guilty feelings. I could always tell who had been started on mirtazapine, as we would be the ones queueing impatiently outside the common dining room, waiting to eat, and we would return for seconds and even thirds. I put on 20kg after 6 months of being on that drug. Slowly, the echo of crying babies started to fade from my mind.

I became so comfortable in there that I was reluctant to return home for a visit even when I was granted leave. When I did go home to see my babies, I would always be impatient to get back to my quiet bland room in the hospital. So strange.

I left hospital after about 4 weeks as an inpatient. I was better, but not completely. It took me about a year to fully return to my normal active self. It also took me some months to grow that deep bond with my children that I did not have when they were first born, but I am thankful to say it did grow. I have never managed to shed the weight that I gained while using that particular anti-depressant, but I now accept that this is my new self.

All this happened about 8 years ago, and I am much better now. Over the years, I tried to wean myself off medication several times. But each time I started feeling unwell again, so I have given up. If all it takes is 40 milligrams of fluoxetine daily lifelong to keep me mentally well and coping with life, it is a small trade-off I am prepared to accept. It has also taught me a lot about respect and compassion for my patients.

Now I have a newfound healthy respect for people who work in mental health care. Through much self-contemplation, I have also learnt to be kind to myself. 

These days, I am a senior clinician in a public hospital. I see first-hand how the daily grind of health care work and all sorts of multi-directional pressures can ruin a perfectly well person. I am now very careful with my work-life boundaries. I do not attend every single scheduled meeting unless it is relevant to my interests. I do not read emails which seem to serve no purpose. I no longer stress (as much) about issues which are beyond my sphere of influence. In my down time, I sew, cook, read, paint and play my cello, all solitary activities which suit an introvert like me. I actively strive for slow mindful living, if anything to appreciate my ability to feel again, not like the numbness of depression when I was sick. And I think all these measures have made me a better clinician and person overall.

I have never been embarrassed about my mental health diagnosis. It is quite clear that mental health concerns know no boundaries, so I think the more people talk about it and acknowledge it, the better it is for us all, particularly health professionals.

After all, we are not machines. We have thoughts and emotions, and that makes us human.

• Text and artwork by Dr Leslie Gan.