CONTENT WARNING: suicide, and very strong opinions on the value of lives.
F2022
2022 is probably the most disorienting year of my life thus far. I spent the whole year trying to make sense of things, and failing. I was diagnosed with depression in the latter half of the year, and then very fortunately was given time off by my employer for an extended period. I am better now, at least on most days, and have gone back to work.
I want to write these experiences down because I learned a lot during this ordeal. I think the past me would have benefited from a post like this; I wish I had known to take insomnia much more seriously, and I was lucky to later learn to gauge the severity of my symptoms and when and how to escalate.
I am no expert, and the process I went through was quite a mess. I hope you read with empathy. My case is likely not going to be applicable to most, and I understand some of the words used and quoted might be triggering to some. As the content warning suggested, please stop reading now if this is a sensitive topic to you.
I have had enough good faith arguments with friends to know that many of them strongly believe that some of the principles for survival that I follow rigorously are unhealthy. I plan on continuing to have these discussions with my friends and therapist, because I do want to get to a better place, and am open to being convinced.
But past experiences shape us into who we are today. My ways of surviving are deeply ingrained; to change them, I would have to try creating new, more wholesome and less treacherous experiences.
Moving back to Taiwan
One of the first things I did after moving back to Taiwan was find a therapist, mostly for the family issues that I have been avoiding by doing all I could to stay off this island, but also for the burnout I experienced from my previous job.
I was extremely lucky to have found a therapist through a referral, someone I immediately clicked with. I’d describe our sessions as very productive. There is always an agenda, and always a debrief. I make notes during the sessions, I am very good at executing solutions, and things were getting resolved. At one point I even thought I was really the happiest I could be. Not all the problems were gone, but I could see that many things are “solvable”; much like software development, you just need enough code.
One issue existed from the get-go though—I am pretty guarded, and I was the one setting the agenda, instead of being led by my therapist. I thought I knew best. I made decisions on what problems were worthy to talk about and what weren’t. I treated the sessions like work meetings, which I’d avoid if possible, and I only book a session when absolutely necessary, with specific items to discuss.
From my therapist’s point of view, it was a matter of “when Mu-An is ready, she will tell me,” which I definitely appreciated. Earlier this year I opened up to her about new topics, which I led with “seems stupid to talk about this, but…” She paused and took some time to make sure I was aware that by delving into this new topic, it showed I have grown a lot, and that I was ready to take on more. But like many, I strive to present an outward image of being productive, hyper independent, functional, and efficient. There are definitely many things I deem unworthy of the billable hours.
Insomnia
I cofounded a company in 2011 and acted as a one-person engineering, product, design, and ops team. I always treated it as a side project, and I learned a lot by having to do everything. By 2021, it had grown to a company with 40 employees, and became the largest crowdfunding platform in Taiwan. It long grew past what I originally signed up for. I never intended to work on it full time, and it had been stressing me out ever since the business picked up significantly a couple years ago. Because friendships were involved, changing the arrangement took energy I didn’t have. Last year, with time, space, and therapy, I finally made the decision to hire a CTO to build a team and then stepped away from operations completely.
Around this time I thought I should be my most stress-free self. I intentionally stayed unemployed, I didn’t have to worry about money, didn’t have commitments, and had close to no responsibilities other than taking care of myself. But for unknown reasons, I started experiencing chronic insomnia. I wasn’t able to sleep for more than 5 hours, and never really felt rested. The insomnia was something I deemed unrelated to mental health (I couldn’t be more wrong) so I did not tell my therapist, but I did talk to her about still not feeling relaxed.
I tried a lot of things. I exercised regularly, did cognitive behavior therapy for sleeping, tried getting more sun, had all sorts of supplements, took sleeping pills, tried weed (where it’s legal), and attempted to exhaust myself to the point that I would pass out on my bed. Despite all these efforts, I still would always wake up after a choppy 4 hours of sleep, wide awake, feeling unrested, exhausted, and unable to fall back to sleep.
At the end of 2021, I decided to continue on with life. I bought an apartment, and got a job. The insomnia worked well with the new job’s setting since I was up every day at 4 or 5am and could catch up with US folks some.
Soon after, I gave up trying to sleep better, and I started to do more, as how my normal self would have, after a long vacation. I operated as if I was at 100%. I worked, led projects; I exercised, squash and weight trainings; I fulfilled all my responsibilities, and then some. I was doing open source, learning Swift, studying Japanese, expanding my social circles, and taking care of my family, all with severely deficient rest.
I felt my attention span declining, and almost everyone who saw me in real life around that time commented on how I was visibly exhausted. How rude of them.
I figure at some point, life must find a way, since I couldn’t.
“It’s time to revisit the idea of suicide.”
A couple months later (18 months after the insomnia started), my mind sort of just… gave up. It might be worthwhile to note that my body didn’t.
I woke up one day and there was one thought on my mind, and I could not get rid of it: “I’m exhausted, I have no energy to go on. It’s time to revisit the idea of suicide. Baby Mu-An chose difficult and painful methods. Being twice her age now, surely I am smarter, wiser, more experienced, more resourceful, and can come up with something better and easier.”
I had attempted suicide twice before, but in completely different contexts; contexts that drove me to leave and try my best to stay away from Taiwan. After the second attempt I concluded suicide was something I am not competent enough to execute, therefore I simply crossed this option off the list of potential solutions. Given that I can’t die, at least not on my own terms, I should try to live well, which involves a lot of rules and guidelines for survival that I regarded as completely necessary for my own protection, yet were thought by friends to be unhealthy.
In the following days, committing suicide became my only thought every waking minute. I was still working. I tried my best to distract myself, I exercised even more, I started baking, I met with friends whenever possible, and forced myself to say yes to all social events. Though I am an introvert through and through, I filled my time with people’s presence so my mind couldn’t idle and spiral. It was exhausting pretending everything was fine, and the harder I tried to repress the thought, the more prominent it got.
My manager knew I’d been going through “some stuff” at this point, and one day I laid it out to him, and just said I don’t think I should be working now. At that stage, I was desperate enough to just quit and let my life come to a halt, but was talked down by a friend. My manager said that I should 100% prioritize my mental health, and I went on leave soon after.
Now a timely recommendation came through from a friend–a neurology clinic that was renowned for treating insomnia. I went and got diagnosed with severe anxiety even though I really didn’t feel that way (#NotADoctor), and I got prescribed benzodiazepine. Getting treated for insomnia seemed reasonable to me, since my urge to end my life was due to exhaustion. I simply didn’t have the energy to live anymore. Imagine a device with a drained battery, that can’t shut down, but still processing at 100%, overheating.
I got loaded with benzodiazepine, 4 times a day. I did feel slightly more rested in the morning, but was still only getting a choppy 4-hours of sleep. Worse, I was barely able to function in the day time due to the side effects—dizziness, unsteadiness, not being able to concentrate. I broke a few glasses and mugs in this period. I swapped to enamel cups and got anti-slip slippers.
I told my therapist about the suicidal thoughts, which caught her off guard, since I had never mentioned anything of the sort and I seemed generally functional and capable. She demanded that we switch from the initial ad-hoc scheduling (every 2-3 months) to 2 times a week.
Around this time I started to reach out to even more friends, but my inner self thought it was utterly pathetic to need to talk to other humans on a daily basis (one of the “unhealthy” survival principles of mine). This need added fuel the fire that is the root of my suicidal thoughts—life is unbearable now because of my incompetency in resting, in being self-sufficient, in being independent, in being not a burden to others.
I went back to the neurologist every week, and the doctor’s solution to my unchanged situation was to up the dosage repeatedly. He reassured me that I would eventually get used to the pills and the side effects would subside. They didn’t.
In the next few weeks, even typing on a phone became too difficult of a task for me.
Being overwhelmed by the thoughts of killing myself, I contacted a lawyer to set up a will. On a day which I deemed to be close to “the day,” I called up my dad. I know he cares and might blame himself. He came to my apartment immediately.
In a traditional East Asian parent fashion, he couldn’t understand why I was going to therapy to begin with; none of my family members understood it. I was the successful one, I had it all together. He commented that maybe I was just bored (mind you, around this time I was still working on open source projects that excite me a lot). He also suggested that perhaps I needed a purpose in life, needed an answer to the meaning of life, given I am the only atheist in my very Christian family.
All his responses were expected. I shrugged and let him hang out for the day since that’d ease his mind. I told him about my situation for his benefit, so that it wouldn’t come as a surprise, and to give him an opportunity to “do something” to prevent what would come.
However, as it may be obvious to you by now, I later realized that I irrationally didn’t really want to die, at least not that badly.
How…disappointing.
“Why won’t you just jump off of a bridge?”
You see, I am a nihilist. I don’t think taking one’s own life is bad. I recognize the insurmountable pain is completely subjective. I think the act of suicide is brave. I regard it selfish for people to say “You should continue to suffer for my sake. I’d be sad. People’d be sad.” I believe in the right to die. I believe the pain right here, right now, in my mind, is just as real and excruciating even if it may or can go away in the future. The future holds no weight for my present state of consciousness. Life has no meaning, and sure, we get to create our own meaning, but why bother? In a world that is so hostile, we should be able to just not live.
I was extremely lucky that everyone I reached out to, without fail, made time to talk to me. They offered a lot of different perspectives, and some know me so well, including my nihilistic nature, that they trusted their blunt and piercing questions would force me to re-examine my perspectives instead of push me towards the edge. I was not sad, I was not seeking consolation nor attention. I was trying to make sense.
One day, I sat in a park after squash, facetiming with a friend in New York, when he asked: “why wouldn’t you just jump off of a bridge though?” …Good point, why?
Against all my beliefs, I fought back the suicidal thoughts as soon as they got here. I instinctively push back on the thought of “how nice would it be to just stop?” every time it pops up. I could not explain it, except perhaps this is my Survival Instinct at work?
Again, “how disappointing!” I thought to myself.
Changing course
Thanks to the American pharmaceutical culture, many friends knew more about the pills I was taking than I did, and they suggested that I should at the very least get a second opinion. But contradicting someone with a medical degree when I know nothing feels odd, so I reached out to my therapist. It turned out she’d been hoping that I would ask. She did not volunteer advice because she feared contradicting another professional and how I wanted to seek help (in this case, choosing to treat insomnia instead of depression) might create further anxiety for me.
She referred me to a psychiatrist, who turned out to be a godsend. He saw the previous prescription and changed it all. He explained to me why the previous combination of pills led me to feel a certain way. Then he explained the new treatment to me: what SSRI is, what my diagnosis is (other types of non-recurring depressive episodes as opposed to major/clinical depression) and the differences, what each pill is for, what are addictive and what are optional. He agreed the chronic insomnia is likely the root cause for the suicidal thoughts, which were essentially a symptom of chemical imbalances caused by being sleep deprived for an extended period of time.
This might sound too good to be true, but as soon as I switched to the new prescription, everything got better. Granted, I was still exhausted throughout the day, but I was able to essentially sleep any time anywhere. I vividly remember how on the first day I was still filling my time with human presence, and in front of a fish market, I told my friend that I was so close to just laying on the asphalt to sleep that I needed to call a taxi home immediately.
In the following days I just slept. Day and night. I have never felt so tired yet so relieved.
On the 4th day I woke up, surprisingly, full of energy. And the suicidal thoughts were just gone. The pills work so well that I immediately started to feel a dependency on the them, which created a new anxiety for me.
I went back to the psychiatrist for my recurring appointments, and just like my approach to therapy, each time with a list of questions that he patiently answered, including the pill dependency, the withdrawal affects, and if/when the end of this would be.
“There’s not a requirement for you to live the depth of your own internal despair.”
I definitely had a case of depression imposter syndrome. “Am I depressed enough to deserve people’s time and attention?” “I don’t want to act like a total mess, but should I act out my internal despair so it wouldn’t seem like I am faking it to get out of responsibilities?”
During a one-on-one, my manager calmly reassured me that no one was questioning my needs, and I did not need to put my heart on the table to justify anything. And similarly, a friend told me that he took my call for help seriously not because of how depressed or not I seemed, but how desperately and relentlessly I was seeking help.
Between seeing my therapist more frequently and the new treatment, I slowly made peace with needing people and asking for help, some of the time. And the suicidal thoughts went away once I was sleeping better.
However, now I can feel the energy and mood difference when I don’t get a good night’s sleep, or when I forget to take the pills the night before. The thoughts and depression come creeping back like clockwork. And at times, I experience dissociation, which I never have before. My psychiatrist introduced the term to me after I told him about this weird out-of-body feeling.
I was told it’d take time. Something to do with neurons, receptors, et cetera. But I am indeed better now. Slowly and surely, getting back onto the orbit.
“Aren’t you glad you didn’t manage to commit suicide two weeks ago?”
After I got on the new prescription and stopped having suicidal thoughts constantly, a friend asked if I was glad that I didn’t manage to kill myself impulsively, because they were extremely relieved to see that I was feeling better. I responded, “honestly, no.” I was not, and I am still not glad. Not in particular. My view on life has not changed. I still believe the pain was very real, I still believe it would not have made a difference whether I had left you all two months ago or I stayed alive for another 50 years.
I grew up on the receiving end of suicidal words and messages, even though most of them were meant for emotional blackmailing. As someone who had tried and failed, I tend to either call their bluff or take their ideas seriously and analyse their plans with them.
My biggest takeaway from this experience is that nothing can make me feel worse than being depressed, and this has changed how I prioritize a lot of things.
I feel extremely privileged to have the resources to get all the help I needed to unstick myself, but many who are clinically depressed aren’t in my position, and I can only imagine their despair. I hope they can stop suffering, whatever way that seems viable.
As for myself, I am glad I am no longer in that constant state of despair, and I now prioritize my mental health over essentially anything else; perhaps mainly my own expectation of how accomplished and capable I should be.
Morbid as it might seem, I do still believe that when one feels such levels of desparation, suicide remains totally reasonable.
“Your friends sound great.”
Many, many, many thanks to my lovely, intelligent, empathetic friends. I can’t name all of you, but you know who you are. Everyone who’s jumped on a call with me, kept me company, picked up my calls, responded to my texts, sent me texts out of nowhere, gave me quests, invited me to hang out, randomly dropped by my apartment, set up recurring calls with me, strongly encouraged me to fly out of the country to see your lovely faces, randomly checked in on me, told me to watch a documentary about suicide, a standup comedy about depression, rudely pointed out that I didn’t want to die, and even more rudely pointed out that with a lot of work I might one day find life to be preferable to death. The nerves on some of you!
I wrote this post because I learned a lot in the last couple of months, and I thought it might be helpful to share it. I have a mountain of work to do on myself, and a whole list of topics to read up on; especially given that I have found out my instincts would prevent me from taking my own life. I know it is a feature, not a bug; regardless, this feature is a nuisance more than anything.
I have to admit I was quite clueless about depression before this, aside from what’s portrayed in the media, and I still am. My case of depression is definitely not a universal one, just one of the many ways it could manifest, but hopefully some of this will be useful to someone out there.
I wish you all a peaceful mind.
P.S. Many thanks to Domenic, Garen, Hidde, Jessica, Rob B, and Rob H for reading my draft and giving me feedback and the confidence to publish this post.
Addendum, January 23, 2023:
The woman who cries wolf
A month has passed by since publishing this post. Many friends who offered support have sort of… dispersed, which makes sense. I am “better” now. However I also found myself slowly creeping back into the habit of “I should not bother people with my problems”, especially not with the same old ones. It is now a personal failure of mine that I am incapable of getting through the same obstacles with ease.
I still have good days and bad days, and some bad days are crippling.
I want to stress how extremely difficult it was and still is to reach out and ask for help. As someone who lives alone and work remotely, there’s really little to no social contact I get unless I go out of my way to seek them, which is terrifying.
Something I left out in the original post was that I had tried to read a book a friend wrote about his journey through depression. I broke down crying at the preface, written by his loving sister also business partner who saw firsthand how he went from a happy person to a depressed mess. No one would have known what I was going through if I had not simply… told them.
So this is a message to myself as well as to whoever struggling alone too. Perhaps you’ve experienced this as well—sitting on the floor of your apartment holding your knees tightly together, trying to hold back tears, and wishing that you can just stop feeling, whichever way possible. Unfortunately, the only way out of this is reaching out, owning and facing the vulnerability, and seeking professional help, with whatever that’s left in the tank, even if just the fumes.
I wish you strength.