Vacations I want to go on.

For the past two vacations I have had, going back to work was so bad I suffered a relapse of my depression. Thankfully I'm much better but still having residual symptoms at the moment.

I probably shouldn't go on such fantastic holidays such as a three week road trip in the Western United States or going to see the Formula One Singapore Grand Prix, with concerts by Robbie Williams, John Legend and Jennifer Lopez. Despite all this, my mind wanders to what trips I want to go in the future. Currently I'm planning going to back to the UK between March and May to see my younger brother and his family, with a quick detour to Wales.

Yet there is always another part of me think about other ideas about where I can go on holiday...

1. Edinburgh Festival Fringe
Having turned my back on movies and started enjoying British comedy more, the Edinburgh Festival Fringe has more appeal for me. I want to see shows my comedians I watch on TV or listen on the radio. I want to see the next big thing in comedy and the best place is the biggest arts festival in the world. It would also give me a chance of visiting Scotland.

2. Melbourne International Comedy Festival
Like the Edinburgh Festival Fringe, the Melbourne International Comedy Festival is another arts festival I want to go to because it's a hotbed of comedy talent. I was planning to go in March 2015 to coincide with the ICC Cricket World Cup final. I had already researched the attractions I wanted to go to, including the National Sports Museum, the Melbourne Aquarium, the Melbourne Zoo and the Royal Botanic Garden. However having spent a gazillion dollars on my last two dalliances, I've postponed going to Melbourne to a later date.

3. Scandinavia trip
I was planning this trip recently, mainly because I have never been to Scandinavia and I wanted to see most of it in one go. The simple trip would be Oslo - Stockholm - Copenhagen but I have an extended version here. I wanted this to be a road trip but having looked at the exorbitant prices of car rentals, it would be most likely done by train instead.

4. Eastern Europe
Due to troubles in the Balkans and the recent infighting in Ukraine, the only places which have any appeal to me in Easter Europe are Budapest, Krakow and Prague. Budapest and Prague have reputations of being beautiful cities and Krakow is most famous for the Nazi concentration camp. I remember going to the Dachau concentration camp in 2003 and it was horrifying and eye-opening at the same time.

5. Eastern USA road trip
Returning to the theme of the road trip, I had ideas of this way back in 2005. The main cities would be Boston, New York City, Philadelphia and Washington D.C. but anything could have been tagged to that.

6. Caribbean cruise
Another idea I had ages ago. Even though I can't swim, I would love to lounge around and go to exotic locations. I even did the research and found that it would be very expensive to go alone. It would be best if I could go with my significant other on this one.

7. The Pan American Highway
Probably the ultimate road trip for me. I don't want to transverse the whole of the American continent; only the Central American portion between Mexico and Panama. Again I need the time, money and logistics for this. The main worry for me is the car - do I rent one and return it at the end, if it is possible, or buy a car at the beginning and sell it at the end.

You can get the general theme of my fantasy vacations: either comedy festivals or trips cramming as many places in one time.

A vicious cycle

It's happening again. Every so often, I have "episodes. The duration between these episodes vary, from every two months back in my final university years to several months in recent times. Most of the times these episodes are not very intense and after a night's sleep, I "reset" myself and it is like nothing has happened. However this episode has been very severe, so severe in fact that I had to take a day off last Friday.

What am I talking about? The vicious cycle of my depression. The symptoms during the episodes are the same. I dread the oncoming day when I wake up with all the problems that I will encounter. I have difficulty getting up in the morning and lay there in bed, willing myself to start the day. When I get to work, the situation is no better. Throughout the whole day I just want to get to the end, rushing through my consultations as quickly as possible and saying "Yes" to almost every request and every question from my patients. After my work day has ended, there is still job-related tasks I need to do and I try to hide away from the responsibility.

Those are just my behavioural symptoms. Then there are the psychiatric symptoms of pervasive low mood. I laugh at jokes and watch TV shows / listen to radio comedy programmes with amusement but my baseline is always sadness. I completely feel drained all the time and always use weekend afternoons to nap - not a good use of my free time.  What hampers me most is the poor motivation and abysmal concentration. I have difficulty initiating tasks and maintaining focus is a chore. Even with programmes I like, playing them only results in pausing them after a few minutes. All of these psychiatric symptoms are surrounded by the baseline feeling of hopeless about my future, something I'll go into detail much later.

During intense depressive episodes, I get the biological symptoms. There is the chest ache and difficulty breathing but the somatic complaint I most commonly feel is the muscle ache in my arms. When I have the aching sensation in my biceps, I know I have a severe form of depression hanging over me. My appetite is the same, which I'm grateful for. I had a similar depressive episode 10 years ago which made me binge eat and caused me to gain 10 kg in a few months, which I have never been able to shed since. On the flip side, I'm excessively sleeping with wanting to go to bed straight after I had my dinner and evening shower at 21:30. Nobody of adult age goes to bed at that hour.

So why has this come about? My mum reminded me why I have these severe depressive episodes, A piece of advice I have forgotten since my university days, attending my psychiatrist and clinical psychologist. I have a tipping point regarding my depression - go past this point and you have the sombre side of me. I get closer to the tipping point if I have stress. I can tolerate low levels of stress, yet the more stressful things happening to me at once, the closer to the tipping point I get.

Lately my tipping point has been breached. There is the underlying work dissatisfaction, the worry about my future, the resentment of myself for being single for the rest of my life, the annoyance of still living with my parents when I'm in my thirties and the list goes on. Recent events include not finishing my protocol for the audit I have to do in my clinic for my GP higher training, starting an online diploma course on dermatology (skin diseases for the uninitiated readers) and just coming back from an excellent weekend trip to Singapore watching the F1 Grand Prix. I really should stop going on holidays, or more exactly going fantastic holidays where I do something outrageous. When I come back from a vacation is always a downer. I know everybody suffers from this but for me, I don't think my brain can handle the situation well. I really should go on shitty holidays from now on, or not go on holiday at all.

Thankfully for the past few days, my mood has improved. I still feel grumpy when I go back to work but at least I can do my job (just).

I hate going through these episodes. I always wish this is the last episode but I always know that it will always lurk around the corner.