[Two Pronged] Living abroad, feeling alone, looking for help

 Rappler’s Life and Style section runs an advice column by couple Jeremy Baer and clinical psychologist Dr Margarita Holmes.

Jeremy has a master’s degree in law from Oxford University. A banker of 37 years who worked in 3 continents, he has been training with Dr Holmes for the last 10 years as co-lecturer and, occasionally, as co-therapist, especially with clients whose financial concerns intrude into their daily lives

Together, they have written two books: Love Triangles: Understanding the Macho-Mistress Mentality and Imported Love: Filipino-Foreign Liaisons. 

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Dear Dr. Holmes and Mr. Baer:

Being Filipino, I know the word “depression” brings about drama. I’ve been denying myself help for almost two years now. Because maybe it’s all my imagination or my stupidity. Maybe I’m exaggerating or wrong. I don’t know. All I know this is not me, and that I need help.

I moved out of my parents’ to be with my husband abroad after marriage. I admit I am a baby at home – a “señorita.” It’s not that I am unhappy with my married life. It’s just hard adjusting (it’s not my strong suit). I am deeply attached to my family.

My husband is a great man, giving me all the understanding and love he can. He gives me whatever I need and want. But living too far away from the Philippines, in a foreign land I do not consider home, not enjoying the food, being homesick every second and not seeing my parents are the main reasons why I am sad.

I get so sad over nothing; super angry over little things. I can’t sleep properly. Have lost weight and even some hair. I don’t have a goal. I am an anxious person; I love that about me. I can plan ahead of time – months, even years. However, this anxiety got amplified. I can’t take it anymore.

I sometimes stay awake 48 hours simply because I can’t stop thinking. I argue with my mom over petty things and then cry over it. I probably live the “life” but I am unhappy.

I’m introverted and dislike meeting new people. There was even a point when I asked – what’s the meaning of my life. Don’t get me wrong, I’m not suicidal nor having suicidal thoughts.

Still, I know something’s not right. Please help.

 Ellie

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Dear Ellie,

When one’s co-columnist is the author of the first book published in the Philippines on depression, it is wise to tread cautiously when addressing the subject.

You have of course spent a lot of time considering the nature of your problem and it seems you have concluded that depression is probably the correct explanation. At this point, therefore, it is worth reviewing the basics.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health care professionals in the United States and elsewhere, including the Philippines. DSM V has the current definition of clinical depression.

Self-diagnosis is however not always the wisest course and so you should seriously consider therapy with a mental health professional, either where you live now or back home, who will be able to assess your situation and prescribe you medication if required.

Best of luck,

JAF Baer

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Dear Ellie:

Thank you very much for your letter.  

Mr Baer is correct that self diagnosis is not the wisest course. In my opinion, what is even less wise is for a clinical  psychologist to diagnose you based on one letter. Happily, I am writing as a columnist and not as a professional mental health practitioner so sharing my opinion (albeit backed up by years of clinical experience and research) is ok.

I agree with Mr Baer that you seem to be clinically depressed.

However, in addition I feel you might consider your being bipolar. You know the symptoms of depression you have so I do not need to share them with you. However, let me pick out other descriptions you shared that hint that you may have bipolar disorder; and I quote: “I get …super angry over little things. I can’t sleep properly… I sometimes stay awake 48 hours simply because I can’t stop thinking. I argue with my mom over petty things and then cry over it. “

One thing that stands out among what I call your bipolar symptoms is not being able to sleep. Many psychiatrists (and psychologists) consider sleep difficulties one of the most common reasons a manic symptom is triggered. Most people are aware that an over enthusiastic, over expansive response is a sign of hypomania but few are aware that the anger you describe is also a symptom.

Finally, should you want to know more about bipolar disorder, in addition to what you can pick up from DSM 5, you might wish to take a look at the 3 #AskMargie videos on Rappler: 

• https://www.rappler.com/video/askmargie/55314-bipolar-disorder-part-1
• https://www.rappler.com/video/askmargie/55821-bipolar-disorder-part-2
• https://www.rappler.com/video/askmargie/56377-bipolar-disorder-part-3

My dear Ellie, forgive me for bombarding you with information before responding emotionally to your plight. I guess I am merely projecting since this is what I would prefer.

In my opinion, an anguished person would welcome knowing the truth and thus being more able to discern if the person they were talking to was simply saying things to make them feel better. 

Also, knowing the facts might make many people more comfortable about dealing with their emotions.

Facts like—there are many reasons people get depressed and your situation (alone in a strange country with no old friends and family to whom you can confide—despite having a loving husband with you) could certainly contribute to anyone’s feelings of isolation (and depression). You need not blame yourself and this will become clearer as you read more and more about your disorder and see a professional about your situation.

If you find out that you, indeed, have bipolar disorder, there is even less reason for feeling guilty!

Bipolar disorder has been proven to have many biological and genetic links which thus proves that this is not something you brought upon yourself. True, bipolar disorder is considered one of the two most virulent (and most difficult) mental disorders to have, but the sooner you know you have it (if, indeed you have it) the better you can manage it. As John Mcmanamy, author of several books on living with bipolar disorder, knowledge is not only a preference, it is a necessity.

Please write us again as you go through the labyrinth of learning to thrive (and not just survive) in a country where you have yet to discover friends, family, job, hobby and meaning in your life that goes beyond yourself.

You are a courageous and perceptive woman and it would be an honor for me to go through this journey with you, if only for a while.

All the best,

MG Holmes

– Rappler.com

Need advice from our Two Pronged duo? Email twopronged@rappler.com with subject heading TWO PRONGED. Unfortunately, the volume of correspondence precludes a personal response.