gwyn’s mental health logs, #1

in this series: #0.5 | #1 | #2

A psychologist told me last week that I have signs of major depressive disorder (“clinical depression”). I wasn’t surprised.

The following is a record of my experience seeking help for my mental health and the observations I’ve made along the way – both as a recipient of services and as an advocate. You might find it helpful if you’re curious about mental health or its (challenging) landscape in Singapore. Or you might see a part of yourself reflected herein.

Counsellors, Psychiatrists, and Psychologists

I’ve been putting off getting therapy for years. The thought that maybe I should get help first occurred during my senior undergraduate days. I noticed cyclical episodes where I would nosedive mentally and emotionally after busy periods in the semester. But it was easy to ignore because it wasn’t hampering my academic performance (yet), and I was juggling too many commitments to care. And it was easy to rationalise as part and parcel of living in a hypercompetitive environment – I figured everyone felt the same way, and if they could cope with it, so could I.

But I could only live like that for so long.

I began seeing a counsellor in 2021 at my university’s counselling centre. I used a playful tone when I wrote about it then, but in hindsight, the visits were a sign that my mental health was deteriorating. My first counsellor left “to take a break” for her mental health after three meetings, and I’ve been with my current one since. The counselling helped me manage my emotions following major stressors better, but it’s been less effective at ameliorating the root problem. Suffice it to say that it is unrealistic to expect a university counselling centre to have the resources to cope with issues of greater severity, regardless of how well-intentioned it might be¹.

Later I would be referred to the university psychiatrist, who prescribed me antidepressants to regulate my moods. The best way to describe their effect on me is that I become stupefied. Everything is dulled – my senses, mood, and cognition. She said I would improve if I committed to taking them regularly, but I never managed to do so.

In mid-2022, I zeroed in on a private therapy clinic after encountering their advertisements. I emailed them, going as far as to use a burner email address to maintain anonymity and avoid commitment. That vague reluctance at the back of my mind was justified when they told me their costs were $200/h (but I could receive a “reduced rate of $150” for being a student).

I did not reply.

When I did reply to that email to reinitiate contact with them recently (yes, a year after), however, the new clinic admin (yes, a whole new person) informed me that they were unable to offer me the reduced rate as previously agreed… even though my status as a student remained unchanged. If I wanted the reduced rate, I would have to provide details of my “financial situation” and my family’s.

I was enraged at this turn of events.

Now I acknowledge from a business perspective (à la my partner’s rational, non-depressed response when I started venting to him) that changing your company policy in a year is perfectly legitimate. Very well. What gutted me was how blatantly the event made it evident that money was their primary consideration. I felt compelled to interpret it that way.

Minor segway here onto the complex relationship between therapy and money that I feel is acknowledged occasionally by leaders but only ever dealt with superficially. I wholeheartedly agree that becoming a clinical practitioner is a considerable investment that warrants a high dollar-per-hour return. I would also like to be paid handsomely for my work². But the fact is that $200 (or even $150) an hour is something most people cannot afford, much less students. Not to mention comprehensive treatment plans can be 16 sessions on top of add-ons like assessment packages (I was quoted $2000+). Those are unimaginable numbers.

Clinical psychology speaks of the therapeutic alliance – the partnership between the client and the therapist – as a central element in treatment success. Whatever potential alliances I could have had with this clinic’s therapists were ruptured before they had begun.

And so they lost a client before they had one.

Anger overcoming my inertia, I searched for an alternative and found one through a friend who had sought treatment earlier. This new place’s rates were far more reasonable ($40/h) – perhaps because they were not a private clinic³. I quickly filled in the intake form, reporting what I believe to be concerning scores on well-being and productivity, and waited. They contacted me in a few weeks to schedule an intake interview.

And that brings us back to the beginning.

Sign(s) of the Times

During the interview, I had a ball of a time facing the psychologist over Zoom. Who doesn’t love talking about themselves, especially to a non-judgmental and curious listener? At the end of it all, the psychologist shared his observation kindly, if slightly nervously. I had “signs of major depressive disorder”, with a smattering of anxiety to boot⁴.

My first reaction was to laugh as if he had made an inside joke. After all, there could have been no other outcome.

I felt oddly liberated after. I continued with my day reinvigorated, getting things done and at peace with myself. (It didn’t last.)

At least I can move forward now. I’ve been stuck in place for too long; it’s time to get going.

Meta

I hesitated before posting this. For all I know, this could be a career-ending move… not that it’s begun. But we can leave the stigma expositions for another time.

I wrote that this post might be helpful to some people, but it ultimately doesn’t matter if it is or isn’t. It’s for me and should always have been; this post deserves to exist in its own right, as I do, without the necessity of acknowledgement by others as a reason to be. And so it shall.

It’s good to be here.

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Footnotes

¹ The same goes for peer-helping programmes.

² Though as a mental health advocate, I am not (paid at all), and neither are my peers.

³ More deets when I feel like it’s the right time to share about them. Or not. See how.

⁴ His observation is not an official diagnosis because he’s not a psychiatrist. For all intents and purposes, my condition only allegedly exists.