Image Credit: Gulf News

While most teenagers think fashion, friends and fun, Caitlin Alana Medenilla was having suicidal thoughts. She was on the cusp of her teenage years when voices began stirring in her mind.

“I had suicidal thoughts when I was just 12. I had a lot of pressure in school. I wanted to be on the top achievers list, so whenever I got low grades, I would think of suicide. Even at that age, I started cutting my wrists.” To make matters worse, echoing taunts also filled her head. “I also heard voices. Sometimes I would hear them say, ‘cut yourself’, ‘kill yourself’, ‘you’re worthless’ or just say my name over and over… I thought it was normal, so I didn’t tell people. I thought maybe it’s something that was a part of me, literally like ghosts speaking to me,” she said.

By the time she was 14, Caitlin started experiencing periods of extreme hyperactivity. “At times I was very hyperactive. I would joke, run around, play with stuff, even roughhouse with my friends, and then there were times when I would get depressed, not talk to anybody, cry a lot and self-harm,” she said. These symptoms were the onset of the mental condition, bipolar disorder, which is characterised by alternating periods of severe depression and mania.

Mental illnesses often emerge during adolescence as the brain’s structure changes and body’s hormones shift. According to the US National Institute of Mental Health (NIMH), bipolar disorder may be as common among youth as among adults: “One percent of adolescents ages 14 to 18 were found to have met criteria for bipolar disorder in their lifetime.”

For years, Caitlin struggled with her mental issues on her own. “I tried hiding it from my family. I didn’t want them to worry about me, especially my mother.”

Caitlin, now 18, has moved back to the Philippines, but her mother continues to work in the UAE. Both her mother and sister were clueless about her condition, and she never spoke up about it. “I didn’t want my mother to worry about me too much. She’s already stressed with work and homesickness. I don’t want to add any more stress. Same with my sister. She was in her first year of medical school, and was just starting to cope with the stress of academics. I didn’t want to burden her with my problems.”

Putting up a cheery front and keeping her problems to herself from age 12, it wasn’t until Caitlin was 16 that a particular incident compelled her to seek help. “I had a panic attack. A really, really bad panic attack,” she said. According to her, she had “a fear of men” as a consequence of growing up with an abusive father who left the family when she was only four years old. During the incident, a few boys from school wanted to approach her, which triggered her anxiety. “I panicked. I screamed, punched people, and kicked anyone who wanted to calm me down. I screamed for three straight hours.”

Days later, Caitlin sought out a psychiatrist, without the knowledge of her mother. She was eventually diagnosed with Bipolar I Disorder and prescribed medication, which her sister helped raise money to pay for. After two months, however, the funds were beginning to run out, so the sisters had no choice but to tell their mother. “I told her, ‘Mum, there’s something wrong with me. It’s just something that needs to be treated.’ Since my sister was a medical student, she explained the medical aspect of it. I would say the personal things, and my sister would give the scientific explanation.”

According to the World Health Organization (WHO), bipolar disorder affects 60 million people around the world. Typically, those affected experience manic and depressive episodes, with duration and frequency varying by disorder type and individual. In simpler terms, a person with bipolar disorder experiences extreme mood swings, from intense highs to severe lows, which affect an individual’s ability to function. Manic episodes involve elevated moods, rapid speech, over-activity and lack of sleep, while depressive episodes may encompass suicidal thoughts. Medication such as antipsychotics and antidepressants help stabilise a patient’s mood.

Attention to mental illnesses around the world is still quite low. The WHO cites that 76 per cent to 85 per cent of people with mental disorders receive no treatment for their conditions in low- and middle-income countries, while the rate is 35 per cent to 50 per cent for high-income countries. Ignorance and stigma can also detract those with disorders from getting help. In Caitlin’s experience: “At first, I would tell my classmates about my condition, but one of them said, ‘You went to the psychiatrist? Isn’t that for crazy people?’. Over time I became more selective about who I opened up to.”

Diagnosis and drugs were just the beginning of Caitlin’s confrontation with her disorder. Psychiatric medicine has a ‘wait and see’ approach, since every patient reacts differently to each drug, and doses may need to be adjusted throughout treatment. Caitlin experienced a range of allergic reactions to her medicine, including a rare outbreak of Stevens-Johnson syndrome, a life-threatening skin condition that causes rashes and blisters all over the body. “I looked like I had second-degree burns. I spent a week in the hospital, but it took my body two months to get back to normal. It wasn’t just my appearance. The medication ruined my tongue and taste buds. too. I couldn’t taste anything for more than two months.”

Despite medication, Caitlin still faces challenges that she must overcome by sheer strength of will: “There are times that I get depressed, even when I’m on medication. I don’t want to get up or talk to people. But then I tell myself, ‘No, you have to do it. You have friends and family. It will be okay.’”

There has been progress. For one, she has not self-harmed in a year.

With time and maturity, Caitlin has managed to handle her condition with grace. She is in college and studies communications. “I’ve accepted who I am, and I’ve found people who accept me for who I am. What I realised in my journey is that although I have support from friends and family, I still need to help myself. No amount of medication can get you better if you don’t want to get better.

“Those with mental illness need to be strong. Society is a monster, and it will eat you up if you let it. If you can treat a wound, you can also treat your mental state. If you’re feeling suicidal or sad, talk to your friends and seek help. Nobody’s going to help you if you don’t ask.”


A mother’s perspective

Caitlin’s mother, Nenette Medenilla, has spent nearly a decade away from her children. Currently working as an executive secretary in Dubai, the single mother had a difficult time accepting her daughter’s diagnosis. “At first, I couldn’t accept it. I was in denial. I only had an awakening when I had a friend who suffered a breakdown within two months of moving to Dubai. That’s when I thought, we have to face this.”

The 43-year-old was quick to learn about bipolar disorder to be aware of her daughter’s condition. “It helped that my eldest has a background in medicine, so she explained that bipolar disorder was just like a physical illness. I also did my research, read up about it online and watched support videos on YouTube,” she told Gulf News.

Even with Caitlin receiving treatment, Nenette’s motherly concerns were never far: “I was always thinking about her future, and it was devastating me. I really thought she wouldn’t be able to pursue her dreams.” To add to her worry, she has to monitor her daughter’s struggle from thousands of miles away, getting updates via video chat. “Day and night I check on them, but it’s hard to be apart. Caitlin and her sister came to Dubai for vacation, and the doctor said she seemed more relaxed being around me.”

Over the years, Nenette has traced her daughter’s development, and her confidence in Caitlin has grown: “I feel more comfortable. I still worry that she might hurt herself when facing pressure. But she can cope. I know she can do it.”