S'pore woman with bipolar disorder opens up about struggling with mental health for over 30 years

PERSPECTIVE: In 2005, Mahita Vas was diagnosed with Type 1 bipolar disorder after more than 20 years of struggling with mood swings and suicidal ideation.

Here, we reproduce excerpts from her book A Good Day to Die: Inside a suicidal mind, in which she shares about how coping with suicidal thoughts has been an ongoing process since her diagnosis, despite taking medication and being financially secure.

Vas also shares about the importance of her family and close friends in supporting her, and how, in this process, she has also found more reasons to stay alive.

Published by Marshall Cavendish, you can get a copy of her book here.

By Mahita Vas

I understand why people think suicide is selfish; suicide leaves friends and families bereft, sometimes blaming themselves, wondering what they could have done to prevent such a violent and untimely death.

But suicide is not always thoughtless, considering how some people plan and execute their passing. They would very likely have thought about the ones left behind.

Yet, 800,000 people worldwide commit suicide every year – that is one person every 40 seconds. According to the World Health Organisation (WHO), there is reason to believe that for every adult who died by suicide, there may have been more than 20 others who had attempted suicide.

There are no indicative figures of how many individuals have seriously considered suicide but did not get to the point of attempting it, or had held back at the last minute.

I was one of the 20 others who had attempted suicide – just once. I have also been the non-statistic that had contemplated suicide but did not attempt it.

I was fortunate and I knew it

I started my working life as a stewardess with Singapore Airlines. After six years, I entered the advertising industry which included five years at Ogilvy & Mather – one of the world’s leading agencies – followed by five years in corporate marketing at Four Seasons Hotels and Resorts.

The privilege of working at the world’s finest organisations was a source of pride for me. I was fortunate and I knew it. On top of that, I was financially secure, by virtue of being married to my husband who was a pilot with Singapore Airlines.

I was living a charmed life. Yet, all that time, I had spent too many days feeling an urge to end my life.

For someone like me – with a mental health condition like bipolar disorder – whether medicated or not, I can find myself wanting to die simply because, at a given time, I find myself unable to cope. The source of such hopelessness can be difficult to identify.

Before my diagnosis, I did not understand why I felt suicidal

Thinking back to the times before my diagnosis, when I had seriously considered suicide, and thought back to the chain of events or things that had led me to attempt suicide, I do not remember feeling particularly depressed.

It was usually because I felt overwhelmed, helpless, and unable to change my situation. My sense of helplessness or self-loathing had been brought on by one, or a combination, of a number of factors, for example, feeling the complete loss of control over my emotions, especially after ranting like a lunatic at my children at the slightest fault, which, in turn, left me feeling incapable of being a good parent.

On such days, I would be convinced that my children deserved a better mother, and my husband needed a better wife. Interwoven with such convictions would be the belief that death had to be more attractive than life.

I could never understand why I felt this way in the first place, seeing how comfortable my life was, but whenever I got this close to the edge, the feeling was always real, and the urge was always strong. It never occurred to me to question these feelings, because they did not last long – anything from about five minutes to two days.

I would try to calm myself by reading or watching something on television, but it would be hard to focus. Occasionally, the urge lasted for longer than a day, and that was when I would start planning my suicide – when I would die and how I would kill myself.

Then, within minutes, or hours, I would drop my plan, admonishing myself for over-reacting, and being dramatic.

Distractions have helped, though – like when a family member or friend says or does something which brings me a blast of immense joy; when I look out of my balcony and see two hornbills flitting from tree to tree as if playing a game; or being forced to go out to commit to a lunch appointment with a close friend.

Being in the presence of my family and a few close friends has helped to hold me back from attempting another suicide. The thought of them having to cope with my sudden and unexpected death, especially for my husband and children, who would have to pick up the pieces of life without a wife and a mother, has been enough to make me resolve to stay alive.

Until the next time, and the next, and again and again, the cycle would always repeat itself. I swing from merely thinking about suicide and sometimes planning it, to finding a reason to live.

Trying to maintain stability

On suicidal days, I try as much as possible to focus on the consequences of my suicide to stay alive. Sometimes my mind can only process my own desperation, shutting out all reason. And then, I stop thinking about suicide, and decide to stay alive, telling myself to never go to that dark place again.

Yet, inevitably, I do.

Sometimes weeks later, sometimes months later. During the “circuit breaker” period of the coronavirus pandemic, it was mere weeks in between. That’s when I saw my doctor more often, who then added anti-psychotics to my medication regime.

Some people try to kill themselves and fail, while others succeed. Newspapers and television shows are never short of stories about people who killed themselves. It never crossed my mind that it was not normal to want to die. Especially when I had so much to live for.

In the last 15 years since my diagnosis, I have done whatever I thought I needed to do to maintain stability in my mind. Being diligent about medication was my first step. While I had a tight and reliable circle of family and friends, I have also learnt to rely on myself to eliminate sources of stress and anxiety.

This is not always easy, especially as there are situations I cannot foresee, or worse, situations that I cannot control.

In the early months of my diagnosis, when I would sometimes see a counsellor, I had learnt the concept of boundaries. I was taught to know my limits and to set the emotional equivalent of a “no trespassing” sign for the protection of my mental health, which, for me, also meant self-preservation.

I have never asked for, nor ever expected, preferential treatment or dispensations for my condition. If anyone had to compromise, it was me. As a result, I learnt that boundaries were essential for my survival.

Some years were more stable than others

From around 2009 until 2013, I experienced more frequent and longer periods of stability than in the years before that. I counted my episodes in terms of months and years. Typically, I would see my doctor every two months, and often, have nothing significant to report.

He would prescribe the usual dosage of lithium, which was 800mg at that time, and arrange to see me in another two months. In that next appointment, I would report an incident or two, which made me manic or depressive.

At those appointments, I told my doctor that I self-medicated with the anti-psychotics he prescribed for me to take as needed, which was maybe once or twice every two months.

Then, in 2014, and for the next six years, I spent more time mulling over suicide than I had in all the years before. In 2013, five years since I had switched from various drugs to lithium, I felt more stable than I could remember.

A year earlier, I had returned to Singapore after spending two years in Bali, where I had owned and managed a Bed and Breakfast. My first book, Praying to the Goddess of Mercy: A Memoir of Mood Swings, was published soon after my return. It received good reviews and much publicity, resulting in excellent sales.

I was happy and I felt what it was like to be well and truly alive. I had not experienced an episode in months. I was by then a patient at the Institute of Mental Health and had finally found a doctor that, for the first time, I trusted completely.

Starting in March 2020, I saw my doctor as often as once a month. Never had I felt more suicidal, more frequently, than I had been in the months between March and August.

It was during this time that I came to understand how little it took for me to be contented, and at the same time, how easily I was given to anguish.

The little things in life

Being on medication for bipolar disorder simply means that I am being treated for a mental illness. It does not mean that I am cured, or will ever be cured.

There is currently no cure for mental illness, and until a cure is found, if ever, I must continue to take my medication daily.

No matter how diligent I am about taking my mood stabilisers, there have been, and will continue to be, lapses in my moods. On most days, I feel normal, or as close to what “normal” is supposed to mean – I am neither restless, short-tempered or energetic, nor am I listless and sad.

But there are still days when I wake up feeling fine, ready for another predictable, uneventful day. And someone says something, or does something, and it triggers a reaction, one that comes quickly and unexpectedly. This usually happens when something does not go according to plan and I do not feel equipped to handle the situation.

It is almost always the little things that set me off, rarely ever the big and the obvious. Which is what makes it so hard for people to understand.

How can something so inconsequential lead to suicide? Especially for someone who seems to have it all – a husband, children, and friends who are all kind and loyal, a beautiful home, and a comfortable life?

Because that “small thing” makes itself big in a troubled mind, causing unbearable anguish. But just as it is the little things that can set me off on a downward spiral, it is equally these little things that can lift my spirits and give me yet another reason to stay alive.

Helplines

If you or someone you know are in mental distress, here are some hotlines you can call to seek help, advice, or just have a listening ear:

National Care Hotline: 1800-202-6868

Samaritans of Singapore 24-hour Hotline: 1800-221-4444

Singapore Association for Mental Health: 1800-283-7019

Institute of Mental Health: 6389-2222 (24 hours)

Tinkle Friend: 1800-274-4788 (for primary school-aged children)

AWARE Women's Helpline: 1800-777-555 (10am - 6pm, Monday to Friday)

Left image via Lina Trochez/Unsplash, right photo courtesy of Mahita Vas