This is a list of resources available in various countries. "We hope these provide support for those who are experiencing, or know of others who are affected by, mental health challenges". OBW assumes no responsibility or liability for the professional ability or reputation of, or the quality of services provided by any mental health providers or resources. Inclusion on this list is in no way an endorsement by OBW.
PGR is dedicated to empowering youths to discuss struggles and mental health by growing a community who understands and disrupting social norms, so we can make support simple, real, human and sustainable.
Care Corner offers individual, couple and group counselling, with specialisation in children therapy, couple therapy, mental health and trauma recovery. Counselling and therapy sessions are conducted in-person, over the phone and online via Zoom.
The AWARE Women’s Helpline is run by women, for women. Trained volunteers and staff will be able to provide you with assistance about various concerns, offering empathy, support, information and encouragement. The Helpline is the gateway to all of AWARE’s services, with support in English, Mandarin, Malay and Tamil.
The Malaysian Mental Health Association (MMHA) is a non-profit voluntary organisation established to promote mental health awareness and public mental wellbeing.
The team consist of mental health professionals and interns who are working towards professional licensure. Through counselling, the organisation aspires to contribute to society through their own unique strengths, skills, and mental health training. It operates the Buddy Bear helpline as a safe space for children to share their worries and troubles.
Helpline: 1 800 18 2327, 6pm- 12am daily
Online: Facebook Messaging is available from 6pm-12am daily
Lifeline is a non-religious NGO working to assist individuals affected by social and psychological issues through emotional support and community-based preventive programs for more than 29 years.
Thrive Well is a social enterprise with a mission to expand trauma-informed community mental health services to individuals, communities and organisations, particularly the marginalised and high-needs communities, in a sustainable manner. .
Manas is a Delhi-based national civil society organisation working on the issues of mental health and gender justice for the past two decades. Their work entails embedding mental health within private and public institutions to create accessible and affordable mental health services for the most vulnerable.
Sangath is an NGO working in Goa and other Indian states. Sangath’s tele-counselling services offer free phone-based mental health support by a trained counsellor for anyone in need. Counselling is available in Hindi, English, Konkani, Marathi
Helpline: 01141198666, 10am to 6pm daily (toll free)
Kashmir Lifeline
Those in Srinagar or anywhere around the Kashmir Valley, Kashmir Lifeline offers an anonymous one-to-one conversation with a trained professional, free of charge.
The Philippine Mental Health Association, Inc. (PMHA) is a private non-profit organization that provides mental health services through education, advocacy, intervention and research.
L.I.S.A. is a 24/7 helpline to help people with mental health and addiction issues, self-harm, or suicidal tendencies.
Helpline: Bahasa Indonesia +62-811-3855-472 (Whatsapp)
English +62-811-3815-472 (Whatsapp)
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Mental Health Story 2020
This is a list of resources available in various countries. "We hope these provide support for those who are experiencing, or know of others who are affected by, mental health challenges".
As a suicide survivor, it is devastating when you lose a loved one or a friend to suicide. The feelings of grief and sadness can be overwhelming. But there is help and support that you can reach out to. Here are some organisations and support groups made up of people with similar experiences.
SOS offers counselling services for those who have experienced a loss due to suicide. It also has support groups for people who have undergone similar experiences.
Non-religious and multi-cultural, CBSS was started by bereaved mothers as an informal support network of parents who have experienced the loss of their loved ones.
Befrienders (KL) deals with suicide prevention and other related issues with the aim of improving emotional well-being. They also started the Healing Connections Suicide Survivors Support Group, which aims to be a safe environment for suicide survivors to share their struggles, find support in others who have similar experiences and learn healthy ways of coping with the loss.
Lifeline Malaysia offers counselling and support services in Mandarin.
Call: 016-7201495 / 011-31571495 (10am to 12pm, 2pm to 4pm, 6pm to 10pm on Mondays to Fridays; 2pm to 5pm on Saturdays) / 016-6131495 (8pm – 10pm daily)
Aasra offers professional and confidential care and support to those affected by suicide, including family members, as well as those with mental health issues.
This helpline caters to both English and Tagalog speakers with volunteers trained to help those going through grief, loss, suicide as well as other mental health challenges.
Being an advocate for suicide awareness in Indonesia, Into the Light does not offer any counselling services but their website offers useful information on suicide prevention and other resources in Bahasa Indonesia.
Developed by the Ministry of Health, Sehat Jiwa is an app and online platform that offers information on mental health and the nearest places that people can go to for help.
*Disclaimer: The above article is for informational purposes only. While Our Better World aims to provide information that is accurate and up-to-date, it is not a substitute for professional medical advice. For more information, please consult a mental healthcare professional.
While many of these helplines were established to support Indonesians’ mental health needs in the wake of COVID-19, people with or without coronavirus-related issues are able to call in and be referred for further counselling.
HealthNetCafe (general info for caregivers, including on mental health)
Step into the Shoes of a Caregiver Explore our first multi-plot interactive video, A Quiet Ripple, that shows what a mental health caregiver might experience - from dilemmas, to a need for support. The choices you make will impact how the story ends. Experience it to better understand the lives of caregivers.
A free 24/7 nationwide telephone counselling service offered by In Touch Community Services, a non-profit, non-governmental organisation that aims to improve mental health within communities. Services available in Tagalog and English.
A 24-7 national mental health helpline to aid patients, their relatives and others struggling with mental health problems. Services available in Hindi, Marathi, Gujarati and English.
A 24/7 helpline run by professionally trained volunteers to help patients and people struggling with mental health. Services available in English and Hindi.
A suicide prevention organisation that offers unconditional emotional support for people who are depressed, desperate or suicidal. Sneha offers callers confidentiality and the services are free, and available in Tamil and English.
You are just as important as your loved ones. Supporting someone with a mental illness is a responsibility that requires a lot of energy — physically, emotionally and mentally. If it gets too overwhelming, you risk developing caregiver burnout or a health condition yourself too.
It is important for people who are supporting others to look after themselves. Only when you take care of yourself can you be in a good position to help others.
We have compiled this resource using online materials shared by professional and expert groups (full list below). The resources on these pages are meant to be educational, and should not be taken as medical advice. If you suspect you have a mental health concern, seek help from professionals before taking any action.
Tips to prevent caregiver burnout
Health is wealth — Take care of your health by eating and sleeping well, and exercising regularly.
Make time for yourself — Take time off to do things you enjoy and recharge, and maintain social relations
It’s okay to feel frustrated, confused, guilty or stressed. Acknowledge that these are normal responses, and it is part of a journey that is beyond your control.
Be kind to yourself — Celebrate small victories and be proud of your efforts.
Divide and conquer — Ask for help with smaller chores like running errands or household chores
Don’t bottle up — Share how you feel with your loved one or join a support group. And it is okay to seek professional help such as a counsellor — if the stress gets overwhelming.
Self-care for caregivers of people with mental health issues
Singapore
Helplines
Caregiver Association Of Mentally Ill (CAMI) Provides support for caregivers taking care of loved ones with mental illness. Tel: 6782 9371 | Mon - Fri, 8.30am to 5.30pm
AWWA Centre for Caregivers Provides information, training and support for caregivers. Tel: 1800 299 2992 | Mon - Fri, 8.30am to 5.30pm
TOUCH Care Line Provides information and referral services for caregivers. Tel: 6804 6555 | Mon - Sat, 9am to 9pm
SAGE Helpline for Seniors Provides counselling with a focus on the psychological and social health of seniors and their caregivers Tel: 1800 555 5555 | Mon- Fri, 9am to 7pm | Sat, 9am to 1pm
The pain that you are experiencing can be overwhelming. Some days, it may even seem like it will not ever go away. It can be a struggle to get out from underneath this weight of despair and meaninglessness. But it does not have to be this way. No matter what you are going through now, there is hope.
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The following article contains information that may trigger strong emotions in some people. If you have suicidal thoughts or behaviours, please contact one of these organisations in your country here.
Suicidal thoughts can be daunting, confusing and isolating. Very often, having these thoughts are the result of experiencing more pain than you can cope with. It does not mean that you are weak or flawed in any way. Don’t let fear, shame or embarrassment prevent you from getting help. Some of the most successful and gifted people have also experienced the same feelings and thoughts as you have. Emotions are not permanent, they are changing all the time. How you feel today may be different from how you will feel tomorrow. You can take steps to improve your mental health.
Here are some techniques that you can use to deal with the feelings and thoughts of suicide and help you overcome the pain.
1. Leave the place of danger
The first and most important thing to do is to move away from the place or situation where you can potentially act on the suicidal thoughts. Make your home safe by asking someone you trust to remove the dangerous items (knives, ropes, etc) that you can use to harm yourself. Give your medication to someone who will pass them to you at the right time.
Go to a safe location like your home, a friend’s house, hospital, or places of worship where you can be calm and call someone.
2. Shift your focus with a distraction
When the thoughts of suicide are really intense, it can be hard to focus on anything else. But the destructive thoughts in your head are not who you are. Those are negative thoughts. You are more than that. You have the ability to choose what your mind focuses on.
Try to do something that can distract you from the negative thoughts. It can be watching your favourite happy movie, going for a run, holding ice cubes in your mouth or simply meeting a friend for coffee. Remember that negative thoughts will not persist for long and can go away.
3. Breathe
When we are caught in a stressful situation, our anxiety level goes up. The thoughts of suicide can come about because we are looking for relief from the pain that we are experiencing. There are simple breathing exercises that you can do on your own to calm yourself down and bring about a healthy emotional state.
Try releasing your stress with a breathing exercise called “Inflating the Balloon”.
Step 1
Get into a comfortable position, close your eyes.
Step 2
Breathe in through your nose and out through your mouth.
Step 3
As you breathe in, imagine that your abdomen is filling up with air like a balloon. As you exhale, imagine that the air is escaping the balloon slowly. With each release of breath, feel the tension leaving your body. Breathe at a pace that is comfortable for you. There is no need to force the air out; it simply escapes on its own, in its own time. With each deep, long breath, trying to imagine a balloon in your favourite colour rising higher and higher into the sky.
When we are stressed, our bodies tend to take quick, shallow breaths. Visualisation can help you to breathe deeply from your diaphragm and relax.
4. Stay away from alcohol and drugs
Certain substances like alcohol and drugs can diminish your judgment and ability for self-control. Avoid them as they may cause you to act on suicidal thoughts.
While taking certain illegal drugs are seen by some people as a way to escape from stress, it is only temporary and can potentially cause more problems, like getting into trouble with the law. Once the effects of these illicit substances wear off, you may feel worse. They can also add to the negative thoughts by causing paranoia and hallucination. The best way to cope with stress and thoughts of suicide is to seek professional help from trained professionals like therapists and counsellors.
5. Reach out to someone who cares
Sometimes when people are depressed or feeling overwhelmed, they may want to withdraw from others. Being alone when you have thoughts of suicide is not helpful. There are people who value and care about you. Call someone you trust and talk to them about what you are going through. It may feel awkward at first but it is important to reach out to keep yourself safe. This is an opportunity to bring in people who are concerned about you to be part of your journey of renewal and restoration. They may also have solutions that you may not have thought of. Therapists and counsellors can also help you to overcome self-defeating thoughts.
These organisations in your country want to support you during this challenging time.
This article has been prepared in collaboration with Samaritans of Singapore. For more information, please visit the following:
Befrienders is a non-religious, multi-ethnic non-profit organisation that offers free emotional support for those in distress, in despair and having suicidal thoughts through its 24/7 helpline.
In Touch provides 24/7, free and confidential support for those in crisis.
Call (landline): 8937603
Call (mobile phone):
09178001123/09228938944
(24 hours)
Tawag Paglaum – Centro Bisaya
Tawag Paglaum Centro Bisaya is a government-run service by the Department of Health and Vicente Sotto Memorial Medical Center to provide support for those with suicidal risks and those in need of emotional support.
Being an advocate for suicide awareness in Indonesia, Into the Light does not offer any counselling services. Its website does have useful information on suicide prevention and other resources in Bahasa Indonesia.
Developed by the Ministry of Health, Sehat Jiwa is an app and online platform that offers information on mental health and the nearest places that people can go to for help.
Psychological Services for Mental Health (Sejiwa)
This is a helpline to serve those who are experiencing mental issues and stress due to Covid. It is run by volunteers from Indonesia Psychology Association.
A multi-plot interactive story of a father’s journey in coping with the aftermath of his son’s failed suicide attempt.
This interactive video shows what a mental health caregiver might experience - from dilemmas, to a need for support. The choices you make will have an impact on how the story ends. Experience it to better understand the lives of caregivers.
Created in consultation with Caregivers Alliance Limited (Singapore) to fairly and sensitively reflect the lives of caregivers and those they care for, this interactive video aims to build empathy for caregivers by helping us understand the challenges they face, and how every action, as simple as it may be, could impact them and those they are caring for.
Learn more about mental health, caregiving, how you can better support yourself or those in need with practical tips in our facts and resources section.
This interactive video shows what a mental health caregiver might experience - from dilemmas, to a need for support. The choices you make will have an impact on how the story ends. Experience it to better understand the lives of caregivers.
An interactive story experience of a mental health caregiver.
Sharing Message
This interactive video depicts what a caregiver of a person with mental health issues might experience daily - moments of dilemma, anxiety, and most importantly the dire need for caregiver support.
The choices you make will have an impact on how the story ends and what happens to the caregiver. Immerse yourself in this experience to better understand the lives of mental health caregivers.
Don’t let these common misconceptions about caregiving stop you from getting the support you need.
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Are misguided beliefs and unrealistic expectations about what caregiving should be like stopping you from getting the support you need? The reality is often more positive.
Myth 1: Supporting someone with a mental health issue is the same as supporting someone with a physical health condition.
Mental illnesses tend to be less understood and perceived as illnesses, unlike physical health conditions. This often makes it harder to empathise with the person living with mental illness and their caregiver. As a result, caregivers may feel more isolated in their journey, while dealing with stigma from their wider community and among family and friends.
Caregivers to those with mental illness live with extreme behaviours - rituals associated with obsessive compulsive disorder, elevated moods and risky behaviour associated with bipolar disorder, long periods of withdrawal and self-harm ideation associated with depression, delusional thoughts associated with schizophrenia, and so on.
Navigating the care system can be challenging too, especially where proper expertise in the treatment and management of mental health conditions are lacking. These factors involved in caring for someone with a mental health issue make it all the more necessary for you to get support.
Myth 2: I am a caregiver only if…
… the person receiving care is a family member.
… the person receiving care is living with me.
… I am doing it full-time.
… I am a certain demographic (40-50 years old, female, single, etc.).
… I am trained or a professional.
In reality, caregivers come in all shapes and sizes. The care provided may be medical or non-medical in nature. It may be performed by a trained professional or an informal caregiver. Caregiving can be a full-time responsibility or an additional role for someone with existing obligations, and may be triggered overnight or develop over time. You could be a primary caregiver who provides most of the daily care, or a secondary caregiver who helps out the main carer. Without recognising yourself as a caregiver, you may not realise that you need support from others and risk your own well-being as well as your loved one’s. Use this self-assessment tool to find out if you are a caregiver.
Myth 3: I should only have positive thoughts about taking care of my loved one and my needs have to take a backseat.
As a caregiver, you may experience negative emotions but it is entirely okay to not be okay. It is natural to feel angry, resentful, frustrated, discouraged, scared, anxious, tired, and so on. What is unhealthy is not having an outlet for these negative emotions, be it sharing your feelings or taking some time off to clear your mind.
Taking care of yourself doesn’t mean ‘me first’, it means ‘me too’.
A common emotion caregivers experience is guilt. Feelings of guilt may stem from comparing yourself to other caregivers, from the lack of improvement in your loved one’s condition, from hiding his or her condition, from thinking it is your fault, from splitting your attention among other responsibilities, or from taking care of your own needs.
“I used to feel guilty about being 'the normal one' between my sister and I. But I eventually realised that none of this is my fault," says Nadia who cares for an older sister with borderline personality disorder. "You shouldn’t have to feel guilty for wanting to socialise with your friends, for having ambitions, for wanting a career, for having a job that allows you to travel and go to parties.”
Myth 4: I should be able to do everything on my own. If not, I’m not doing a good enough job.
Mental healthcare has evolved beyond the realm of medical institutions and professionals to harness community-based resources and social capital in providing holistic care - such as the informal care provided by the social ecosystem of family, friends, workplaces, schools and other groups in the immediate community. Because of the diversity of mental health experiences, strategies that work are going to be diverse too. The best care you can provide for your loved one could come from shared wisdom.
Associate Professor of Communication Dr Zachary White, reminds us in his caregiving blog, “Care isn’t reducible to something that we’re either good or bad at - attention, access, and willingness are the most profound requirements of care that all of us possess. Care doesn’t ask us to be extraordinary, but to be remarkably ordinary. To walk with someone in the midst of need. To listen. To reach out. To be available. To know that we are bound to one another not by competence, but by fragility.”
Myth 5: Getting support is too difficult.
The truth is, support is available - you just have to lean into it. Many caregivers often have generous or strong personalities, and may prefer not to or do not know how to ask for help. But not speaking up creates a deficit of support, where people remain unaware of the magnitude of the work of caregivers and therefore do not offer help. If you would like to reach out for support, try out some of these help-seeking attitudes and behaviours.
Beyond the people in your social network, there is a wealth of community resources that can support your caregiving of a loved one with mental illness:
Helplines
Peer support groups
Training courses, education and outreach workshops
In-home or facility-based care services
Respite care
Counselling
Financial assistance
Events, activities
Mobile apps, online resources (stories, blogs, expert advice)
Mental health non-profits, volunteer groups, social services
If you live in India, Indonesia, Malaysia, Philippines or Singapore, start by looking through this list of caregiver resources.
Want to know more? Here are the articles we referenced to compile this resource:
Step into the shoes of a caregiver Explore our first multi-plot interactive video, A Quiet Ripple, that shows what a mental health caregiver might experience - from dilemmas, to a need for support. The choices you make will impact how the story ends. Experience it to better understand the lives of caregivers.
I don’t want to bother others with my problems. They won’t understand anyway. ~ It’s just easier to do it myself than explaining to someone else what I need. ~ I should be able to take care of this on my own. I don’t need other people to help me. ~ No one else has stepped up. ~ No one can do as good a job or get it right. ~ I don’t trust other people, especially “strangers”, to take care of my loved one. ~ I’ll feel bad if I don’t do it. ~ People will think negatively if they find out. ~ I don’t know how or where to get help, or who and how to ask for it. ~ Getting outside help is expensive.
Sound familiar? These are some common reasons caregivers give for going it alone. Because of the seemingly infinite responsibilities caregivers find themselves saddled with, asking for and accepting help from others goes a long way in reducing caregiver stress and burnout. But for many, this is easier said than done. How do you not just care hard, but care smart? Here are some ways to marshall the goodwill of others.
1. Share your situation
If someone asks how you are doing, resist the instinct to reply with, ‘I’m fine, thanks.’ Instead, take it as an opportunity to share your situation and ask for help. Use ‘I’ statements to explain your predicament and steer the conversation towards a request.
For example, ‘I’ve been so tired from waking up multiple times every night to check on my son and talking to him into the wee hours, that I can’t concentrate while driving my daughter to school. Would you pick her up on the way when you send your kids to school, please?”
People are not mind-readers, no matter how close they are to you. So be honest and open about what is going on with you and the person you are caring for, as well as about what you need from them. If you are still unsure, try rehearsing what you will say or write it down on a piece of paper. All you might need is a listening ear and sharing your situation with an empathetic friend is exactly what the doctor would prescribe! If you would like someone to call you instead, set up a regular check-in for others to contact you.
2. Make the ask
Make a list of how others can help and keep it handy. You can categorise it by task type and regularity, so that it is clear. Assign names to tasks as well as timings and remarks, so you can coordinate assistance. Keep the list open as your caregiving situation evolves.
Find potential helpers. Look within family, friends, neighbours, groups and associations you belong to, as well as from your workplace. Ask how each person can and would like to help, and play up to their strengths and interests. Offer various options using your list above so people can choose what they would like to do.
Be specific. 'I would like to attend a weekly caregiver training on schizophrenia. Would you be able to accompany Dad at home for three hours every Wednesday night?' 'Can you recommend a reliable house cleaning service that is within my budget?' 'Would you mind covering my duties when I need to leave the office for home emergencies?' 'Can you text or call my sister every week to find out if there’s anything bothering her?' 'Can you pay for respite care once a month?'
Get creative. Someone located far away can still help with refilling prescriptions online and ordering groceries or food. If you know a fellow caregiver who’s supporting someone with a similar mental health issue, take turns watching both of them together so you’ll each have some free time.
Outsource. If finances permit, consider what can be outsourced to hired help, community services and professionals.
3. Say ‘yes’ and ‘thank you’
There is no need to be bashful about accepting help. When someone accepts or offers, say ‘Yes please, I would really appreciate it’ and let people feel good about helping you. Express your gratitude with a thank-you note (or e-mail or text) or a lunch treat.
4. Handling rejection
Be prepared for hesitance or refusal when asking for help. Try not to take it personally, as the person is turning down the task and not you. Consider that this may be a painful situation for them too or that they do not understand what you are going through — mental health issues are complex and people process differently. Instead, move on to alternatives. Plan for backup help as the assigned helper may be unavailable sometimes.
If the situation allows and you are comfortable doing so, you can try asking these follow-up questions:
Would you think about it?
Can I ask you again later?
What can you help me with?
Would you know someone who can?
What would make it easier to say ‘yes’?
To flip the old adage, caring can do with some sharing! When you allow others to care for you, a virtuous cycle is created for you to better care for others.
Want to know more? Here are the articles we referenced to compile this resource:
Step into the shoes of a caregiver Explore our first multi-plot interactive video, A Quiet Ripple, that shows what a mental health caregiver might experience - from dilemmas, to a need for support. The choices you make will impact how the story ends. Experience it to better understand the lives of caregivers.
While the term ‘self-care’ may conjure up images of massages, masks and manicures, self-care can look different for different people. It is essentially any activity you do for yourself that adds to your personal health and well-being. Sometimes, that can look like doing nothing (let’s not under-estimate the therapeutic benefits of staring into space with a hot cup of tea.)
Caregivers who set aside time to look after themselves are generally better able to handle the challenges of supporting someone with mental illness. Before caregiver stress turns into burnout, it is important to practise self-care to avoid a situation where you are too exhausted to properly care for your loved one.
SELF-CARE FOR CAREGIVERS
At the very core of self-care is maintaining your own physical and mental health. This means eating well, exercising regularly, getting enough sleep and seeing a physician when you’re ill. You can also cultivate good mental habits by practising meditation, honouring your emotions, appreciating yourself, setting boundaries and sharing your feelings.
Taking a break from caregiving is also beneficial. While you take a break, see if there are any respite care services available near you or ask a trusted person to look after your loved one for a while. Taking a short walk outside, watching cat videos, working on a hobby, chatting with a friend or drawing a warm bath can all be therapeutic. Try to schedule in regular ‘me-time’ every week, even if it’s just for half an hour, so that you can do things that bring you enjoyment. Occasionally pamper yourself by treating yourself to ice-cream, getting a haircut, wearing a new outfit, buying fresh flowers for the house - whatever lifts your spirits and makes you feel taken care of.
Finally, keep your relationships going. Caregiving can become lonely and it can often feel like no one else understands what you’re going through. But your closest friends and family are a deep well of emotional and practical support you can draw on, whether you need a ride to the hospital or just need to vent. Contact with your social circles doesn’t have to be frequent, as long as you do it; eating, doing a fun thing, texting, calling, liking a post, and replying to your DMs all count, and if you can’t find the time or energy to head out, consider letting them visit you at home.
MANAGING BURNOUT
If you are already experiencing symptoms of caregiver burnout, consider adding on the following strategies to prevent further burnout or to recover from it, re-energise yourself and find more balance in your life.
1. Practise acceptance and embrace your caregiver role.
When faced with the mental health diagnosis of a loved one, it is tempting to dwell on the senselessness and unfairness of the situation. While all thoughts and emotions are valid, try channeling your time and energy towards what can be changed or controlled and solving problems with clear answers instead. Despite any resentments or burdens that inevitably well up from time to time, you have made a conscious choice to provide care, so think about the positive reasons behind that choice. Maybe it’s to reciprocate the care your parents provided for you while growing up, maybe it’s because of your values or beliefs, maybe you want to be a good role model for your children, maybe it’s made you a stronger person or brought you closer to others. Focusing on these deep, meaningful motivations can help sustain you through bad days.
2. Take care of your own physical and mental health.
If self-care does not seem to be working, it is crucial to seek professional health services when your physical or mental health is negatively affected. Studies have shown that caregivers are more prone to chronic health problems such as high blood pressure, high cholesterol and pain - therefore, don’t skip your own medical appointments, health check-ups, medications or follow-ups. Mental health conditions such as anxiety, depression and addiction are also common in caregivers - speak to a counsellor or therapist, especially if you don’t seem able to manage your own emotions. Guilt, anger, loss and loneliness are often experienced by caregivers and can spiral into a mental health issue without proper attention.
3. Get support from the people around you, including at the workplace.
Start to reframe caregiving as a collaboration rather than a solo act. Form a caregiving team if support is available, so that you can delegate caregiving as well as non-caregiving tasks; prioritise and plan together so that everyone is aware of their individual roles and can establish routines. If you’re unsure how to broach the topic, here are some practical steps you can take to share your situation and ask for help here. If you know a caregiver, take the initiative to support them in these different ways. Respite care services may be available in-home or in the community for a low fee or may be provided free by social service agencies and volunteers; other everyday tasks such as cleaning, meal delivery and transportation can also be outsourced if affordable.
4. Seek networks and resources available in your own community.
Besides providing a safe space to share and encourage one another on a regular basis, caregiver support groups are a wonderful source of practical advice, tried-and-tested ‘lifehacks’, as well as reliable recommendations for anything from empathetic psychiatrists to useful training courses to stimulating day care programmes. Support groups have also gone online in recent years to make it convenient and accessible for caregivers, and are a great alternative if your loved one’s condition is uncommon or if your local area doesn’t have one. In addition to support groups, there are also helplines, non-profit organisations and community care facilities dedicated to looking after the needs of persons with mental illness and their caregivers that you can reach out to here. Where finances are concerned, talk to a social worker about available financial assistance schemes or grants that can help defray the costs of care.
Caregiver burnout is real but it is avoidable. As you take care of others, remember to look after yourself too.
Want to know more? Here are the articles we referenced to compile this resource:
Step into the shoes of a caregiver Explore our first multi-plot interactive video, A Quiet Ripple, that shows what a mental health caregiver might experience - from dilemmas, to a need for support. The choices you make will impact how the story ends. Experience it to better understand the lives of caregivers.
Caring for a loved one can be a rewarding experience, but it can easily become overwhelming as time passes with seemingly no end in sight. Supporting someone with mental illness is often a lifelong affair, so it is crucial that your caregiving remains effective and sustainable. And the key to this is taking good care of yourself.
CAREGIVER WELL-BEING
If caregiving is taking a physical, mental or emotional toll on you, you may be experiencing caregiver burnout. When you get to this point, the well-being of both yourself and the loved one you are caring for will be compromised, since you will on longer be able to provide optimal care for them due to your own exhaustion.
A more serious form of burnout called compassion fatigue may set in, where caregivers experience a weakened sense of empathy for those in their care and display uncharacteristic behaviours or attitudes. Characterised by indifference and insensitivity towards others, it can manifest in neglect or even worse, violence.
If you are caring for someone with mental illness, do spend a few minutes taking stock of your well-being.
COMMON CAUSES OF BURNOUT
Are you experiencing any of these common causes of caregiver burnout*?
Lack of support from others, or personal inability to ask others for help
Lack of appropriate caregiving skills and knowledge
Lack of personal time for yourself
Financial stress
Pressure, judgement or unsolicited advice from others
Excessive demands from the person you’re caring for and from other people in your life
Unrealistic expectations about the improvements your loved one will have due to your caregiving
Negative mindsets or misconceptions, for example, ‘I am being selfish if I put my needs first’, ‘If I don’t do it, no one will’, ‘There’s no way I can find 15 minutes to exercise’, ‘Nothing is going right’, ‘If I do this, I will get the love, attention and respect I deserve’, and so on.
COMMON SIGNS OF BURNOUT
Are you experiencing any of these common signs of caregiver burnout*?
Feeling constantly tired or low in energy, no matter how much rest you get
Falling ill more easily, taking a longer time to fully recover
Getting easily angry, irritated or impatient
Loss of interest in social activities or things you enjoy
Spending less time on yourself, including for personal grooming, meals, leisure, essential health services
Change in sleep patterns, appetite or weight
Feelings of hopelessness, helplessness, anxiety, depression or self-harm ideation
Inability to concentrate or perform familiar tasks, increased forgetfulness
Family members, friends and co-workers expressing concern about your well-being
Reliance on substances to cope, including medication
MANAGING BURNOUT
While the causes and signs above are not exhaustive and an expert diagnosis would be best, any combination or persistent experience may indicate that you are at risk of or already experiencing caregiver burnout. If so, it is time to pay more attention to your own well-being, take active steps towards managing it, or visit a medical professional.
Step into the shoes of a caregiver Explore our first multi-plot interactive video, A Quiet Ripple, that shows what a mental health caregiver might experience - from dilemmas, to a need for support. The choices you make will impact how the story ends. Experience it to better understand the lives of caregivers.
“When my older brother isn’t doing well, he has suicidal thoughts. On such days, we lock the balcony doors — a sign that someone needs to be home with him,” recounts Christine, who helps care for a sibling with bipolar disorder and social anxiety. She adds, “Caregiving takes up a lot of emotional energy.”
WHO IS A CAREGIVER?
A caregiver has taken on the overwhelming responsibility of looking after someone unable to care for themselves fully due to illness, disability or a mental health issue. Anyone can be a caregiver and it is likely that most of us will be at some point in our lives. But while we know we are helping, we seldom think of ourselves as caregivers.
Perhaps we see it as a natural and good thing to do for a loved one; perhaps we have not accepted a diagnosis; perhaps we fear the stigma of looking after someone with a mental illness; or perhaps we feel that our needs are unimportant.
In addition to managing moods, thoughts and behaviours, a caregiver to someone with mental health issues may experience trauma, stigma, family conflict, social isolation, and emotions deemed ‘unacceptable’, such as anger, resentment, shame and guilt.
IDENTIFYING AS CAREGIVERS
When we do not self-identify as caregivers and do not practice self-care or seek support when needed, we risk neglecting our own physical, mental and emotional well-being. This, in turn, affects our ability to care for our loved ones.
As the saying goes, ‘You cannot pour from an empty cup.’
The first step towards better caring for yourself and others is recognising your identity as a caregiver and the value of what you do.
Are you a caregiver? Take this short quiz to find out.
ARE YOU A CAREGIVER TO A PERSON WITH A MENTAL HEALTH CONDITION?
Do you help a friend or family member:
1. with everyday tasks, such as personal care, buying groceries, cooking or buying food, providing transportation, doing household chores ?
2. by arranging medical appointments, accompanying him or her during appointments or discussing with healthcare professionals to understand what needs to be done?
3. with monitoring medications at home or following up with therapy, counselling or rehabilitation?
4. to find out more about particular mental health conditions, treatment options or how best to interact with someone with a mental illness?
5. by providing companionship, or emotional or psychosocial attention and support?
6. as the designated ‘on-call’ person to handle a mental health episode or as part of a crisis plan in an emergency?
7. with finances, legal matters, communications needs, decision-making or other personal affairs?
8. by taking time off work or school, or to arrange for alternative assistance when you are unable to provide it?
Or, do you:
9. feel burdened by the additional responsibilities you’ve taken on to help a loved one?
10. spend so much time, energy and resources taking care of a loved one that you neglect yourself?
If you answered ‘Yes’ to at least half of the above questions, you are very likely a primary caregiver who provides direct care on a daily basis. Even if you had answered ‘Yes’ to a few of these questions, you may be a secondary caregiver who helps the main carer.
SELF-CARE FOR CAREGIVERS
To sustain your own caregiving, try out some of these self-care tips*:
Protect your physical health — Eat well, get sufficient sleep and exercise regularly. Practise relaxation techniques, such as meditation and deep breathing.
Practise good mental health habits — Identify as a caregiver and appreciate the value of what you do. Notice your feelings without judging yourself. Set realistic expectations. Celebrate victories!
Understand how stress affects you — Signs of stress include, headaches, low energy, loss of appetite, insomnia, a short temper and crying. Identify your signs and triggers, and be aware of how you cope. Look out for signs of caregiver burnout — do a quick self-assessment here.
Make time for yourself — Set personal boundaries and remove your caregiver hat every so often. Do things you enjoy, meet up with friends, rest and recharge! Even a mini-respite of 30 minutes can be healing.
Ask for help — And be open to accepting it. This can include delegating tasks, sharing your struggles, joining a support group or seeking professional help. Also consider getting trained to take better care of your loved one. There is a wealth of resources and networks available.
The better you care for yourself, the better you are in handling the challenges of supporting your loved ones.
Want to know more? Here are the articles we referenced to compile this resource:
Step into the shoes of a caregiver Explore our first multi-plot interactive video, A Quiet Ripple, that shows what a mental health caregiver might experience - from dilemmas, to a need for support. The choices you make will impact how the story ends. Experience it to better understand the lives of caregivers.
This guide is written to help people respond to those at risk of suicide. Each person is different and any support must take into account the person’s unique needs. It is important for members of the public to seek professional help when dealing with suicide ideation.
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Suicide is preventable. Studies have shown that parents and peers can be instrumental in helping those with suicide ideation. If you know someone who has thoughts of ending their life, here are some ways that you can help them:
1: Call for help if they are in immediate danger
When you find out that a person is in a dangerous situation or has already harmed themselves, do not try to handle the situation alone. You should call the emergency services like the police or ambulance immediately and stay with this person until help arrives.
2: Look out for warning signs
There are several behaviours to look out for when a person is comtemplating suicide.
Warning signs
- Talking about suicide like “I wish I was dead”, “I want to end the pain”, “They will miss me when I’m dead”, etc.
- Planning to attempt suicide by buying knives, ropes or accumulating pills in large amounts. They may also be researching ways to end their life.
- Isolating themselves from family and friends, preparing a will, giving away possessions and saying goodbye.
- Changes in mood: quieter than usual, marked mood swings, increased sense of hopelessness and emptiness, more agitated, increased anxiety and extreme sadness.
- Sleep disturbances where the person sleeps less or more than usual.
- Taking alcohol or drugs.
3: Ask and listen
The key to asking someone about their suicidal thoughts is to be direct. It may feel awkward at first but you do not have to feel bad about showing concern about their mental health. It is important to be sensitive to their struggles while discussing the issue directly without being judgmental (criticising or blaming them) or feel fearful of where the conversation will lead to. Studies have shown that asking about suicide does not lead to an increase in the risk of suicide2.
Do try to remain calm and in control as a way of reassuring the other person that the situation is not as bad as they think. Please do not feel compelled to provide any solution just yet or tell them how to feel (“Be grateful for what you have”, “You should be happy”). The best way to show empathy and support is to simply be by their side and listen. Most importantly, do not try to argue with them about their thoughts of suicide. Expressing thoughts of suicide may be someone’s way of telling others that they are overwhelmed by their situation or about the emotional struggle that they are going through. Let them know that you want to support them because you care about them and that they are not a burden at all.
4. Reach out for help
Suicidal ideation is a complex issue. Mental illnesses, economic issues, relationship problems and sickness are just some of the factors that can often lead people to consider ending their life as a way out. There are professional therapists, counsellors and social service organisations who are able to help. Do not feel like you have to provide all the solutions on your own. Encourage the person to seek help from the professionals. To make the first contact easier for the person, you can always offer to go with them.
You can involve other people in the person’s social circle to build up a trusted network of support for the person with suicidal ideation. This will enhance their social connectedness and reduce the sense of isolation that the person often feels. Knowing that people care about them and want to support them in their journey of restoration is a very powerful protective factor in preventing suicide.
5. Safety planning
Remove items, like knives, that a person with suicidal thoughts can use to harm themselves. Should they have medications to take, get their permission or work together with them to hold on to the medicine and give them the correct dosage at the right time. When someone is going through suicidal ideation, it can be a confusing time and they may not be able to think clearly. In these situations, having a list of people whom they can call will come in handy. You can work with the person to identify a list of trusted family members, friends and professional helplines, and make sure these people know what to do when they are contacted.
Do check in with them regularly to see how they have been coping.
6. Look after yourself
Being a supportive friend and caregiver can be challenging. While it is rewarding, it can also be stressful and sometimes, overwhelming too. It is important that you also take care of yourself physically and emotionally.
Here are three ways to avoid a burn-out:
- Build up your own support network. It is vital that you are supported when you are giving support too.
- Refresh yourself. Take breaks often to recharge. Pay attention to your own needs. Getting enough rest and eating well will help you to better care for others.
- Get others to help. There are other people and professionals who can be part of the restoration journey too.
This article has been prepared in collaboration with Samaritans of Singapore. For more information, please visit the following:
1.Biswas, Tuhin & Scott, James & Munir, Kerim & Renzaho, Andre & Rawal, Lal & Baxter, Janeen & Mamun, Abdullah. (2020). Global variation in the prevalence of suicidal ideation, anxiety and their correlates among adolescents: A population-based study of 82 countries. EClinicalMedicine. 24. 100395. 10.1016/j.eclinm.2020.100395.
3. Colucci, E., Kelly, C.M., Minas, H. et al. Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in the Philippines. Int J Ment Health Syst 4, 32 (2010). https://doi.org/10.1186/1752-4458-4-32
This guide is written to help people respond to those at risk of suicide. Each person is different and any support must take into account the person’s unique needs.
Over 700,000 die due to suicide every year, and many more are affected, whether as someone who is grappling with suicidal ideation, or as a loved one. Here’s what mental health professionals share about understanding suicide.
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Suicide is a serious public health problem, but it is often said to be preventable. We speak to three mental professionals on the issues surrounding suicide and how it is perceived, and how greater awareness and conversation can create safer spaces for all.
Dr Elaine Yeo and Dr Jacob Rajesh are Senior Clinical Psychologist and Senior Consultant Psychiatrist at Promises Healthcare respectively. Dr Jared Ng is Senior Consultant at the Institute of Mental Health (IMH).
Suicide: Triggers and Misconceptions
“Suicidal ideation refers to someone wanting to take their own life or thinking about doing so. In active suicidal ideation, the person keeps thinking about dying and even plans on how to [do so],” says Dr Rajesh Jacob. “Regarding passive suicidal ideation, the person wants to die, but doesn’t make a plan.”
Stressors can include loss of employment, undergoing separation or divorce, being diagnosed with a serious medical illness and bereavement. “People suffering from chronic medical illness with significant pain can also experience suicidal ideation,” Dr Rajesh said, adding: “The risk of completing suicide successfully increases with history of past suicidal attempts.”
Trauma — an emotional response to distressing events like abuse, loss of a loved one, and disasters — can also increase a person’s risk of suicide. Dr Elaine Yeo notes that trauma, especially when repeated, can “destroy a person’s ability to regulate their emotions, tolerate distress, and engage in problem-solving”.
“Without the ability to self-soothe and consider different options, a person who has experienced trauma is more likely to feel that they cannot cope in the face of distress, therefore viewing suicide as the only option and increasing their risk of developing suicidal ideation,” she says .
A common misconception is that only people with mental illnesses will take their lives, but Dr Ng stresses this is not true. “I think patients with mental illnesses are at higher risk because of certain symptoms. But we do see many cases that are not diagnosed with any mental illnesses, but because they are undergoing so much stress in their life,” he says.
From Ideation to Action: The Tipping Point
“People have suicidal ideation because they are in intense emotional pain and, in their helplessness and hopelessness, death and suicide feel like the only way to eliminate pain,” says Dr Yeo. “The tipping point comes when people believe they have tried and failed at every possible avenue to get rid of this pain, leading them to lose all hope.”
When suicidal ideation becomes “more intense, frequent and preoccupies the individual, then it is a worrying concern”, says Dr Rajesh. “Thinking and formulating a concrete plan about the means of committing suicide, doing last acts such as sorting out financial matters and writing suicide notes are also strong indicators.”
A person may also abandon their reasons for living and their future dreams. “For example, people who previously stayed alive so as not to hurt their family, at the pinnacle of hopelessness, may mistakenly believe that their death would take away burden and shame from their family, or that it would bring their family relief,” says Dr Yeo.
Cognitive Constriction: The “Tunnel Vision”
Cognitive constriction is a state of mind that affects people who are feeling suicidal. Dr Rajesh describes it as “black and white thinking, seeing things as all or nothing, good or bad.”
“The suicidal person is temporarily unable or unwilling to engage in effective problem solving behaviours, and may see his or her options in extreme, all or nothing terms,” he adds.
In cases of people with mental health conditions, their symptoms can exacerbate this state of mind. “For patients with depression, the core symptoms are things like low mood, feelings of guilt, a lot of negativity...So this becomes ‘a double whammy’. They already have stress, they have depression, and they don't see a way out of their stressors. So death becomes the next best thing,” says Dr Ng.
In these moments, a mental health professional may be needed. “You tend to self-isolate, because you don't want to cause any more problems to people around you. You don't feel that you can trust anyone. You don't have any friends...And that causes your world to shrink and becomes more and more difficult to get out of the rut.”
Talking to a psychiatrist, a mental health counsellor or psychologist is important to helping a person break out of that cycle, he says.
Preventable But Not Predictable
Suicide is preventable if the signs are observed early and help is sought or given by someone who notices. “When concerned, you can and should ask if a person is thinking of suicide,” stresses Dr Yeo.
The signs in a person can include worsening moods, growing isolation, loss of interest in hobbies, frequent mentions of wanting to end their lives, decrease in appetite and weight loss, and declining performance at school or work, says Dr Rajesh. “They may also do last acts such as writing up wills, settling their financial issues or giving away personal items and closing or transferring bank accounts to others.”
But Dr Ng also notes that people often forget that “suicide is not predictable”. People’s stress levels and personal circumstances change throughout their lives, and an intervention that works this month might not work the next.
“We know that these are the risk factors for suicide. But does it mean that someone who has all those risk factors will kill themselves in the next five years? No, it doesn't,” he adds.
Prevention can involve teaching caregivers how to notice certain warning signs, and equipping frontline workers like the police, civil defence and hotline responders on methods to intervene, and increasing facilities in communities and hospitals to cater for treatment, he suggests.
Stigma: Recognising and Fighting It
Creating a safe community for people to seek help requires society to be accepting and tackle prejudice against suicide and mental illness.
“First and foremost, suicide and mental illness is not a sign of weakness or a character flaw. Everyone responds to life stressors, trauma, and sources of distress in different ways, and it never helps to judge a person’s lived experience,” says Dr Yeo, adding that a person who attempts suicide may have spent weeks, months, or even years “fighting to eliminate their pain in other ways”.
“Second, suicide and mental illness is not a choice...many would rather be alive — many work to stay alive for the sake of others — but experience such intense emotional pain that it overwhelms their capacity to continue living,” she stresses.
The prejudice faced by people with mental health concerns can occur at the workplace, schools and even in healthcare institutions. Dr Ng notes that worldwide, patients with mental health conditions are discriminated against and “get less care, and get poorer quality of care”.
“When a patient presents to another hospital, and they look at the records, and they note that this person has got some kind of mental health diagnosis... certain impressions get formed in the person's mind,” he says, adding that there are efforts to address this in the medical community through training and sharing by IMH.
It is important that the people do not dismiss suicide as “an easy way out”, “attention seeking” or a “cry for help”. “If the public continues to believe such misconceptions about suicide, then people experiencing suicidal ideation may be ignored, dismissed, or shamed, instead of receiving the help they so need,” says Dr Yeo.
“When it comes to suicide, it is better to be cautious than sorry, given the many instances in which people have unfortunately attempted suicide and succeeded, because others did not take them seriously,” she adds.
When engaging someone who is contemplating suicide, “stay calm, do not panic, and listen without judgment,” Dr Yeo shares. Allowing them to share their pain can help the person feel connected, and “may give them the hope that they thought they have lost”.
Also, help the person identify protective factors in their lives that will give them hope, such as family, friends, and communities, as well as things to look forward to in the future.
“Having said that, please know your limits. It’s best to refer a person with suicidal ideation to a mental health professional by contacting a helpline or, if you truly fear for their safety, accompanying the person to the A&E of the nearest public hospital,” says Dr Yeo.
Speak to someone today. If you or you know someone who needs help, here’s a list of hotlines to organisations who can support you.
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Mental Health Story 2020
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What Mental Health Professionals Say About Suicide
Over 700,000 die due to suicide every year, and many more are affected, whether as someone who is grappling with suicidal ideation, or as a loved one. Here’s what mental health professionals share about understanding suicide.
Although no official numbers exist, it is estimated that there are millions of caregivers in Asia alone. Thus, it is quite possible that you know someone who is a caregiver or may become acquainted with one at some point in your life. Caregivers shoulder heavy daily responsibilities and often go it alone. Physical, mental and emotional burdens build up over time and can lead to caregiver stress and burnout. How can you meaningfully support a caregiver in your life?
FIRST STEPS TO SUPPORTING CAREGIVERS
While we share some general tips below, it is important to understand that every caregiver and their needs are different. So it always helps to check in with the caregiver to find out what it is they would truly like help with and to respond flexibly to their requests. Otherwise, the already-stressed caregiver may be put in a position where he or she is accommodating you rather than the other way around, no matter how well-intentioned you are. In order to make a genuine difference, thoughtfully tailor your efforts to the caregiver’s unique circumstances, personality and preferences.
TIPS ON HOW TO SUPPORT A CAREGIVER*
I’m an acquaintance or neighbour. What can I do?
You may not know the person well but would like to show care and concern. Here are some useful pointers:
Send a ‘no-response-needed’ text
This reaches out in a thoughtful, non-intrusive way and the caregiver does not feel obligated to give you a progress update or share their feelings if it isn’t a good time.
Offer practical help
Some examples can be picking up groceries, taking out trash, walking the dog, making an extra portion of food, or watching the kids. Practical help gifts caregivers with more free time.
Send a nice treat to show you care
It could be chocolates, a gift card, a funny book or a note to encourage a caregiver to press on.
Respect boundaries
Be mindful that your show of care does not place unnecessary demands or expectations on the caregiver.
Provide a listening ear
Listen more and avoid negative chatter or toxic positivity. Communicate in a sensitive and considerate way, and keep everything confidential.
I am a good friend or family member. How do I support?
Being in a caregiver’s inner social circle affords you opportunities to make a difference. Here are some ideas:
Share caregiving tasks
As a trusted person, you can help out with some caregiving duties. This includes, sitting with the person being cared for and being a companion, following up with treatments, or being a backup resource.
Share other tasks
If you have more intimate access, help with chores or with personal matters like insurance and taxes. Providing logistical and coordination support can be useful for the busy caregiver. Consider scheduling, organising, arranging for alternative help, and so on.
Provide emotional and psychosocial support
You may be in a position to initiate deeper conversations when the caregiver is ready. Or encourage self-care, include them in social activities, take a break and have fun with each other.
Support financially
Caring for someone with mental illness can drain one’s resources. In addition to cash gifts, consider gift vouchers, funding therapy sessions, taking care of the utilities bill or paying for the groceries.
Find information
Learn about the condition and find resources and contacts that will better equip the caregiver to support their loved one. This can range from health info brochures, support groups, helplines, training centres, alternative care services to professional help. Present the information in easy-to-digest ways.
I am an employer or co-worker. How can I help?
Having an understanding and supportive workplace reduces the pressure caregivers face. Here are some ways:
Offer flexible work arrangements or remote work options
Allow caregivers to work different hours or telecommute, for a better work-life balance.
Cover a caregiver’s duties
For when there are unexpected situations. Help advocate for them by managing co-workers’ reactions or concerns.
This raises awareness and provides mutual support through an isolating journey.
Create organisation-wide awareness
Host a lunchtime talk series inviting care providers, counsellors, mental health advocates, social service agencies and other experts to share on relevant topics. Also share information on in-house schemes and benefits for caregivers.
Evaluate how well your efforts are doing
It is important to review the policies, programmes and benefits for caregivers. Ask employees for feedback regularly and solicit new ideas to do better. Ask after their personal wellbeing too.
Want to know more? Here are the articles we referenced to compile this resource:
Step into the shoes of a caregiver Explore our first multi-plot interactive video, A Quiet Ripple, that shows what a mental health caregiver might experience - from dilemmas, to a need for support. The choices you make will impact how the story ends. Experience it to better understand the lives of caregivers.
Healing Hearts is a support group in Singapore dedicated to mothers who have lost their children to suicide, helping them.
Singaporean Elaine Lek, who lost her son, Zen, to suicide in 2018, needed a support group dedicated to mothers grieving the loss of children who took their lives. As none existed in Singapore, she encouraged her therapist Geraldine Tan to start an informal therapy group.
Through Healing Hearts, mothers have the “opportunity to come together to speak freely about the pain that they are going through,” says Geraldine. Relying only on word-of-mouth, about eight mothers are attending these free, monthly 90-minute sessions regularly.
The new coronavirus is an infectious respiratory illness that is transmitted from person to person like the regular flu, but with a relatively low fatality rate compared to SARS,MERS and H1N1.
Not much is known about COVID-19 at this point, which understandably causes fear and distress especially for us who have anxiety related conditions.
Amidst the panic-buying (a.k.a. toilet paper hoarding) and frequent handwashing, we think this is a good time to hit the pause button and remind ourselves that resilience and hope (even humour!) can be just as contagious.
We can rise above the chaos. Here are seven practical suggestions to empower ourselves:
1. Write down what you can and cannot control. Fear and anxiety are natural responses to the unknown. Journal your thoughts and see what are the things you can change and what are those you can’t. For example, we can’t confront every person who doesn’t cover their mouths when they cough or sneeze, but we can walk away from them and keep a safe distance.
2. Do not skip your medical appointments. Consult your doctor to see if your appointments can be rearranged; whether it’s possible to meet less frequently, or if there are other ways to have your sessions without meeting physically. Another way to minimise exposure each time you visit the hospital or clinic is to align your medical appointments on one day if possible, or have them less frequently according to your doctor’s advice.
3. Ask if your medication can be delivered instead of collected in person. Hospitals and polyclinics under Singhealth offers this option. Some hospitals like Khoo Teck Puat hospital have a Medibox which functions like a parcel delivery locker that allows you to collect your medication refills at your own time, so you need not wait at the hospital pharmacy with the crowd.
4. Limit your exposure to media and yes, that includes muting family chat groups that spread well-meaning but also fear-mongering fake news. Get your information from reputable sources, be updated once or twice a day, and then fill the rest of your day with other meaningful activities.
5. There are many of us who feel the need to wash our hands frequently which can trigger anxiety-driven compulsions and obsessive behaviour. If possible, we could use this as an opportunity to practise personal self-care in a mindful, compassionate way. Take a warm shower at the end of each day before bedtime. Be present in the moment and gently massage your fingers, joints as you wash your hands. Keeping clean and hygienic doesn’t have to be a chore. Other ways of caring for ourselves include having a balanced diet, some exercise and adequate sleep. Participate in relaxing activities like deep breathing or hobbies like gardening to boost our immunity.
6. Social distancing does not mean social isolation. Reach out and check in regularly with people you care about. Make that phone call, or even video calls using Facetime and Skype. Or send a text or whatsapp. Be part of social media community groups. There are also groups that screen livestream events on Youtube and social media platforms. Gaming communities, Reddit are also other social ways of connecting with others. So even though we may all be keeping physical social distance, we can still connect with one another online in virtual spaces.
7. There is online help such as counselling hotlines, chats, emails. We have a comprehensive directory here. Remember, you don’t have to go at this alone. Help is available.
As persons with mental health conditions, we are familiar with the battles in our minds. There aren’t any easy solutions, but we are much stronger than we realise. We have already overcome so much in our lives, and likewise, we shall also get through this, one day at a time. Rooting for us all!
Nicole K heads upThe Tapestry Project SG, an independent, not-for-profit online publication that champions mental health recovery through the power of first-person stories. This voluntary ground-up initiative is run by persons-in-recovery who share a passion for mental health awareness, education and empowerment. Their stories are written by, and for persons who are touched by the realities of mental health challenges.
What to say and do in different scenarios when you think someone has a mental health condition.
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It could be a classmate, an acquaintance at work, or just someone you’re sitting next to on the bus.
With one in seven in Singapore having experienced a mental disorder in their lifetime, chances are that someone you know is working through problems related to mental health.
Many struggle alone, isolated by the stigma surrounding mental disorders. But they don’t have to — we can help.
Here are some tips on what you can do when you encounter someone dealing with a mental health issue.
You are a secondary school student. One of your classmates is reacting strongly to people’s comments and flares up at the slightest provocation.
Watch and see:
Note your classmate’s behaviour
Is she unusually withdrawn?
Does she react strongly to what is said in conversations?
Find out more:
Visit the REACH for Students website or contact 6389 2000.
Talk:
Raise your concerns to your classmate. Let her know that you care about her and have observed a change in her behaviour recently.
Show her you are supportive and ready to lend a listening ear.
If she indicates that she would like to seek help, suggest that she sees a school counsellor or visit CHAT Hub for a free assessment, or contact 6493 6500.
Seek help:
Talk to a teacher and the school counsellor about the changes you observed in your classmate’s behaviour.
What to do — At home
A family member recently has been unusually withdrawn. He has stopped talking to the rest of the family. He keeps to himself and stays in his room. For the last few weeks, he has not been going out or participating in his usual activities.
Watch and see:
Note your family member’s behaviour
Does he react very strongly to what is said in conversations?
What does he do when he is in his room?
Are there any signs of self-hurting behaviour, such as unexplained bruises or cuts on his body?
Find out more:
Visit the Institute of Mental Health (IMH) website and navigate to Clinical Services > Common Conditions or contact 6389 2000
Talk:
Share your concerns with your family member about the recent changes in his behaviour that you have observed.
Let him know that you care about him, and express your support and readiness to lend a listening ear.
Suggest an activity that you enjoyed doing together previously, but may have recently stopped engaging in.
Seek help:
Raise your concerns with other family members, share opinions and see if they have any concerns or suggestions.
Check out resources offered by mental health agencies such as the Singapore Association for Mental Health’s (SAMH) website or contact 1800-283 7019
Your son has been playing computer games all day and all night. He played so much that he forgot to eat, and the playing has affected his school performance.
Watch and see:
Observe his behaviour
Is he losing interest in other activities and social relationships besides gaming?
Does he flare up at anyone who threatens his gaming habit?
Has he tried to stop gaming but failed?
Find out more:
Visit the National Addictions Management Service website and navigate to Helpseekers > Internet and Gaming or contact 6732 6837
Talk:
Tell your son that you are concerned about him, without nagging. Let him know that you care about him.
Understand what is compelling your son to play computer games. Is it a need for achievement, a social need or a need to escape from problems?
Seek help:
Speak to a school counsellor or contact TOUCH Cyber Wellness at 6273 5568 or email them at [email protected] for more information and assessment.
What to do — At work
Your co-worker is unusually talkative and seems to be on edge. She sent an email to all the staff in your organisation regarding a personal matter which was somewhat incoherent.
Watch and see:
Note your colleague’s behaviour
Is your colleague’s agitation keeping her from working normally?
Is her behaviour interrupting others?
Find out more:
Visit the IMH website and navigate to Clinical Services > Common Conditions or contact 6389 2000
Talk:
Have a private chat with her to see what is going on. Does she know that her behaviour of late is unusual?
Express your concerns and note specific incidents to provide a basis for discussion.
Seek help:
Raise your concerns with other colleagues or supervisor; share opinions and find out if they have any concerns or suggestions.
You may wish to contact Singapore Anglican Community Services (SACS) Employment Support Services at 6801 0490 or email to [email protected] to find out how to better support your colleague at work.
You are interviewing selected candidates for an executive position. One bright young man who has been selected reveals at the interview that he has a mental health condition.
Watch and see:
Assess his level of readiness and understanding of the job
What is his level of understanding of his condition?
What is his ability to identify his triggers and his coping skills and support resources?
Praise his openness and honesty with regards to his disclosure.
Engage him further to understand his awareness and ability to manage his condition.
Be clear and upfront with him on the job description, roles, expectations, working environment, and potential job stressors.
If the person is agreeable, provide the team with information that he has shared with you so the team will be able to make an informed decision on employment suitability.
Seek help:
Seek the advice of IMH Job Club and SACS Employment Support Services on how to support him in the workplace.
Mental health conditions can be treated with various forms of therapy. But sometimes, not knowing where to start can hold people back from getting help.
Understanding the types of treatment out there, as well as the roles of different mental health professionals, can help you find the right support, whether for yourself or someone you care about. Read on to find out more.
We have compiled this resource using online materials shared by professional and expert groups (full list below). The resources on these pages are meant to be educational, and should not be taken as medical advice. If you suspect you have a mental health concern, seek help from professionals before taking any action.
I want to seek help. Where do I start?
Awareness of your situation is the first step. It is okay to feel the way you do. You’re not alone in this battle and many others are experiencing the same struggles as you.
Look for support from people you trust and care for. Let them know how you feel, share with them your fears and anxieties, and how they can support you. Having someone who’ll listen without judgement will help you along your journey.
Find out more about your condition to better understand it.
Consider talking to your local or family doctor about your condition. They will be able to give you a brief assessment, and direct you to the right mental health services. Remember: asking for professional help does not mean you’re weak.
Surround yourself with like-minded people. Join a support group and and journey together with others who have the same condition as you. Having a supportive community provides a safe space for you to share your feelings and provides additional emotional support.
Follow up on your medical treatment to improve your condition. You will get there!
I suspect someone I know is going through something. What steps should I take?
It can be scary when someone you love is suffering from a mental illness, but don’t be ashamed of your loved one’s condition. Accepting it can help to ease their hidden feelings of guilt, shame and fear.
Just like any other health problem, someone diagnosed with mental illness needs extra love and support. Be open-minded, patient and non-judgemental.
Talk to them, and let them know you’re there for them. Be supportive by acknowledging their struggles and listening attentively. While doing so, check on what kind of help or resources they've tried.
If they haven’t already done so, encourage them to seek professional support. Remind them that there’s nothing wrong with seeking medical help.
If needed, offer to accompany them on medical appointments and treatments.
Continue to support them by being involved and helping with their medication, appointments and treatments.
Whom should I seek help from
Everyone's different. Treatment needs to be highly personalised to suit your condition, circumstances, needs and preferences. Some people may need help from only one particular type of health professional, while others may benefit from seeing various people for specific aspects of their treatment. Consider inquiring about your mental health professional’s qualifications and level of training.
Scenario
Whom to consult
I want to get medical help, but I don’t know who I should go to.
General Practitioner (GPs)
While your local doctors might not specialise in mental health, they’ll be able to do a brief assessment and refer you to the appropriate mental health professional.
I know my condition well, and I want someone to talk to about my difficulties.
Social Worker
Social workers can help to assess, treat and evaluate your situation. They often provide social and emotional support through methods such as counselling and care planning. They typically work in multidisciplinary teams alongside health and education professionals.
I know my condition well, and I want to receive formal therapy. I don’t necessarily want medication.
Psychologist
They will be able to provide you with an appropriate psychotherapy method specific to your situation, preferences and needs. Psychologists do not prescribe medication.
I know my condition well, and I want to get professional help along with medication.
Psychiatrist
Psychiatrists are doctors who have undergone further training to specialise in the assessment, diagnosis and treatment of mental health conditions. On top of assessments and medical tests, they can also prescribe medication.
What kind of help is out there?
Psychotherapy
Psychotherapy, also known as “talk therapy,” is when a person speaks with a trained therapist in a safe and confidential environment to explore and understand feelings and behaviours and gain coping skills.
During individual sessions, the conversation is often led by the therapist and can touch on topics such as past or current problems, experiences, thoughts, feelings or relationships experienced by the person, while the therapist helps make connections and provide insight.
Studies have found individual psychotherapy to be effective at improving symptoms in a wide array of mental illnesses, making it both a popular and versatile treatment. It can also be used for families, couples or groups.
Types of psychotherapy
Cognitive Behavioural Therapy (CBT)
Talk therapy that focuses on exploring relationships among a person’s thoughts, feelings and behaviours. This will help to provide answers to daily challenges, and develop constructive ways of thinking and produce healthier behaviours and beliefs.
CBT is used as a treatment for a wide variety of mental illnesses, including depression, anxiety disorders, bipolar disorder, eating disorders and schizophrenia.
Psychodynamic therapy
Talk therapy where the psychologist works to find the cause of the issue through recognition of patterns of behaviour and feelings that are rooted in past experiences.
Psychodynamic therapy is often useful for treating depression, anxiety disorders, borderline personality disorder, and other mental illnesses.
Hypnotherapy
Hypnotherapy is guided hypnosis, or a trance-like state of focus and concentration achieved with the help of a clinical hypnotherapist. In this state, the root cause for the depression is identified in the mind and resolved by the client together with the therapist.
Hypnotherapy can be used to treat anxiety, phobias, substance abuse and bad habits. It can also be used to help improve sleep, learning disorders, communication, and aid in pain management.
Dialectical Behaviour Therapy (DBT)
Talk therapy that focuses on problem solving and acceptance-based strategies. It also includes developing new skills like coping methods and mindfulness practices, so that the person has the power to improve unhealthy thoughts and behaviours.
It was originally developed to treat chronically suicidal individuals with borderline personality disorder.
Eye Movement Desensitisation and Reprocessing Therapy (EMDR)
EMDR seeks to replace negative emotional reactions to difficult memories with less-charged or positive reactions or beliefs. It uses a specific sequence of phases and bilateral stimulation, such as eye movements, to help the individual process unresolved memories from adverse experiences.
It is often used to treat post-traumatic stress disorder.
Animal-assisted therapy (AAT) What: AAT brings domesticated animals such as dogs and cats into the psychotherapy process. How it helps: AAT has been proven to reduce anxiety levels. When the relationship between the individual and the therapy animal grows, the person also experiences emotional recovery and positive psychological transformation. Suitable for: People who perceive hostility or disregard from other humans may respond well to the unconditional affection and attention of animals.
Art therapy What: The use of creative processes and mediums such as painting, sculpture, drama and movement to develop self-awareness and explore emotions. How it helps: Through treatment, a person can address unresolved emotional conflicts, improve social skills and raise self-esteem. Suitable for: People who find it hard to express themselves verbally may find art therapy useful
Music therapy What: Music therapy uses music to improve and maintain the physical, psychological, and social well-being of individuals. This includes listening to music, singing, and playing a musical instrument. How it helps: While not recommended as a standalone treatment, music therapy can help evoke positive emotions and stimulate reward centres in the brain, easing the symptoms of various mental health conditions. Suitable for: The diverse nature of music makes it helpful across a wide range of mental health concerns, including depression, anxiety and schizophrenia.
Dance movement therapy (DMT) What: DMT uses movement to help individuals achieve emotional, cognitive, physical and social integration. It can be done in groups or individually. How it helps: It promotes self-awareness, self-esteem, and provides a safe space for feelings to be expressed. Suitable for: DMT can be helpful for many mental health issues, such as eating disorders, depression and anxiety.
Want to know more? Here are the articles we referenced to compile this resource:
Mental health is a global concern, yet the level of support found in each country varies widely, and cultural factors sometimes come into play. Read on to find out which conditions are most prevalent in each country, and where their respective healthcare support systems stand.
We have compiled this resource using online materials shared by professional and expert groups (full list below). The resources on these pages are meant to be educational, and should not be taken as medical advice. If you suspect you have a mental health concern, seek help from professionals before taking any action.
Singapore
One in seven people in Singapore have experienced a mental health condition in their lifetime, according to a 2018 national survey. The top three mental health conditions in Singapore are major depressive disorder (one in 16 people), alcohol abuse (one in 24) and obsessive compulsive disorder (one in 28). It is estimated that about 18 per cent of Singapore’s youth live with depression.
Despite plenty of resources for mental health, Singapore has one of the lowest rates of psychiatrists and psychologists per 100,000 residents among similar high-income nations. Singapore has 2.8 psychiatrists for every 100,000 residents, compared to Australia’s ratio of 13.5 psychiatrists per 100,000 residents.
Malaysia
By 2020, mental health conditions are expected to be the second biggest health problem affecting Malaysians after heart diseases. A national survey by the Ministry of Health found that one in three Malaysian adults aged 16 years and above (29.2 per cent) have a mental health condition, nearly triple from 11.2 per cent in 2006. The states of Sabah, Kelantan, Kuala Lumpur and Sarawak have the highest prevalence of mental health conditions.
Amongst Malaysian youth aged 13 to 17, one in five have depression, two in five have anxiety and one in 10 has stress. An alarming 10.1 per cent of youths have also attempted to take their lives.
There are four psychiatric mental hospitals providing mental health and psychiatric services throughout Malaysia. There are 410 psychiatrists in the public and private sectors, or 1.27 psychiatrist for every 100,000 residents.
Philippines
In the Philippines, 3.3 million Filipinos live with depressive disorders, with suicides rates of 2.5 males and 1.7 females per 100,000 persons, according to the Department of Health. The World Health Organization (WHO) also reported over 2,000 cases of suicide from 2000 to 2012, most of which involved people aged 15 to 29 years old.
Among Filipino youth aged 13 to 17, 11.6 per cent have contemplated taking their lives and an alarming 16.8 per cent have attempted to do so.
There is a scarcity of mental health professionals in the Philippines, with only a little over 500 practicing psychiatrists. The ratio of 0.52 psychiatrists per 100,000 persons is lower than other countries with similar income levels such as Malaysia (1.27 per 100,000) and Indonesia (0.3 per 100,000). Furthermore, access to mental health services is not equally distributed across the country, as most psychiatrists work in for-profit or private sectors in larger urban cities such as Metro Manila.
On 21 June 2018, President Rodrigo Duterte signed the landmark Mental Health Act, the first mental health act legislation in the Philippines. It outlines a framework for the integration and implementation of optimal mental health care in the Philippines, and protects the rights of people with mental health conditions, their family members and industry professionals.
Indonesia
Nine million Indonesians, or 3.7 per cent of the population, suffer from depression. Every hour, someone in Indonesia takes his or her own life. This astonishing figure of 3.4 suicides per 100,000 people in Indonesia was reported by the World Population Review.
Sixteen million people (6 per cent) aged 15 and older have displayed symptoms of anxiety or depression, and about 400,000 people (1.72 per cent) live with more severe illnesses like psychosis. Of the latter, 57,000 people have reportedly experienced shackling before, according to a 2013 report by the Health Ministry.
Indonesia is the fourth most populous country in the world (around 270 million people) but has only around 800 psychiatrists (0.3 psychiatrist per 100,000), 450 psychologists and 48 mental health facilities.
Accessibility to such services is a problem. Nearly half of all psychiatrists work in Jakarta. Also, there are 34 provinces in Indonesia, but more than half of the 48 mental health facilities are located in just four provinces. Yogyakarta is the only city that has been successful in placing a psychologist in all of its 18 public health posts.
Pasung
In recent years, Indonesia has been under the international spotlight for pasung, the practice of confining and restraining people with mental health conditions as remedy.
More than 57,00 Indonesians with psychosocial illnesses have been chained or isolated in a confined space at least once in their lives. Despite the government outlawing pasung in 1977, families, traditional healers and institutions continue to shackle people with mental health conditions. This is a result of lack of understanding and education about mental health, as some still see pasung as a way to enforce safety and protection against “dangerous” behaviour.
Human Rights Watch released a report in 2016 which showed 18,000 Indonesians who demonstrated signs of a mental health problem still being locked up in institutions or living shackles. Since then, 5,200 individuals have reportedly been released. However, 28.1 per cent of people with mental health conditions were still found locked up or shackled in or around their houses in 2017.
India
In December 2017, India President Ram Nath Kovind warned of a potential “mental health epidemic” in India, with 10 per cent of its 1.3 billion-strong population having suffered from one or more mental health problems.
According to WHO, India accounted for nearly 15 per cent of the global mental, neurological and substance abuse disorder burden. A meta-analysis of community surveys estimate that the prevalence of depression and anxiety could be up to 33 per 1,000 persons.
In India, the treatment gap (the number of people with an illness who need treatment but do not get it) is 70 to 92 per cent, depending on the state. It is estimated that nearly one-third of patients who seek help from healthcare facilities could have symptoms related to depression. But poor awareness of mental health symptoms, social stigma, and lack of adequate resources and facilities stop people from getting the help they need.
There are only 5,000 psychiatrists in India, or 0.3 for every 100,000 persons, and less than 2,000 clinical psychologists (0.07 per 100,000). To compare, the ratio of psychiatrists in developed countries is 6.6 per 100,000 and the average number of mental hospitals globally is 0.04 per 100,000 persons, compared to 0.004 in India.
Also, mental health services are highly inaccessible and up to 40 per cent of patients must travel more than 10km to reach the first available service at the district headquarters.
References
Hassan, Mohd Faizul & Mohd Hassan, Naffisah & Kassim, Erne & Hamzah, Muhammad. (2018). Issues and Challenges of Mental Health in Malaysia. International Journal of Academic Research in Business and Social Sciences. 8. 10.6007/IJARBSS/v8-i12/5288.
Guan, N. C., Lee, T. C., Francis, B., & Yen, T. S. (2018). Psychiatrists in Malaysia: The Ratio and Distribution. Malaysian Journal of Psychiatry, 27(1).
Tolentino, Udgardo. (2004). The state of mental health in the Philippines. International Psychiatry. 1. 8-11. 10.1192/S1749367600006950.
Lally, J., Tully, J., & Samaniego, R. (2019). Mental health services in the Philippines. BJPsych international, 16(3), 62–64. doi:10.1192/bji.2018.34
Hartini, N., Fardana, N. A., Ariana, A. D., & Wardana, N. D. (2018). Stigma toward people with mental health problems in Indonesia. Psychology research and behavior management, 11, 535–541. doi:10.2147/PRBM.S175251
Want to know more? Here are the articles we referenced to compile this resource:
Some ways to tell if someone might have a mental health condition.
Does someone you know seem out-of-sorts? Speaking to someone you think could have a mental health problem takes guidance, patience, understanding and an open mind. Find out how to start a conversation, and what to say to show your support for a loved one, friend or colleague.
Stigma stops people with a mental illness from seeking help and getting better.
Asher Low, Co-founder of Singapore non-profit Limitless, suggests that combating stigma requires “education, understanding and opening our minds.” While psychologist Geraldine Tan adds that parents are often humiliated by their own families and the shame stops them from giving their children the support they need.
Get to know the various mental health conditions and how they affect people.
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Depression. Bipolar. Anxiety. You’ve probably heard these terms before, but how much do you know about these mental health conditions, and about how they affect people?
Understanding these conditions can help reduce fear and misunderstanding of mental illness, and empower everyone with the knowledge on how to care for their mental health, and that of their loved ones. Read on to find out more about some of the more common conditions.
We have compiled this resource using online materials shared by professional and expert groups (full list below). The resources on these pages are meant to be educational, and should not be taken as medical advice. If you suspect you have a mental health concern, seek help from professionals before taking any action.
Mental health conditions explained
Addiction
What: Addiction is when a person compulsively persists in certain behaviours regardless of the consequences. A person can be addicted to substances (drugs or alcohol) or activities (gambling, sex, the Internet). Over time, the frequency and intensity of the activity increases, and when the person stops, he or she experiences unpleasant feelings or emotions.
Symptoms: Impaired control, social problems such as being unable to concentrate in school or work because of the addiction, making excuses or lying in order to continue with activity, engaging in risky behaviour in order to continue with activity (such as borrowing large sums of money to gamble).
Treatment and help: Individual or group talk therapy, sometimes in combination with medication to control drug cravings, can help. Individuals dealing with substance abuse may also require detoxification and rehabilitation services.
What: Anxiety is a common emotion when dealing with daily stresses and problems. But when these emotions are persistent, excessive and irrational, and affect a person’s ability to function, anxiety becomes a disorder. There are different types of anxiety disorders, including phobias, panic and stress disorders, and obsessive compulsive disorder.
Symptoms: Apprehension, confusion, on edge, a sense of helplessness, repeated negative thoughts, muscle tension, palpitations and difficulty breathing
Treatment and help: Simple strategies, such as relaxation techniques and regular exercise, are effective in reducing anxiety and contributing to emotional well-being. Psychotherapy can help and is sometimes used together with medication to reduce and eliminate signs and symptoms.
Bipolar
What: Bipolar disorder, formerly referred to as manic depressive illness, is a mood disorder with two extremes: depressed (“low”) and manic (“high”). It varies in severity, and mild cases may appear ordinary for many years. Symptoms vary; a person may be predominantly depressed, or predominantly manic. In between episodes, a person is likely to be quite well and able to function.
Symptoms: When depressed, a person feels persistently sad, hopeless and lethargic, and may feel suicidal, among other symptoms. When manic, a person becomes overly elated, more irritable, requires less sleep, makes grand plans and may impulsively engage in potentially dangerous behaviour.
Treatment and help: Psychotherapy can help people who are more stable to help them with symptom recognition and management. Medication can be used to treat acute episodes and to help prevent a relapse. Psychosocial support is an important component of treatment.
Depression
What: Depression is a low mood that lasts for a long time, affecting everyday life. It is often triggered by a mix of genetic, psychological and environmental factors; studies show that the risk of becoming depressed can be increased by life events such as poverty, death of a loved one, physical illness or abuse. For some, the risk is also hereditary.
Symptoms: Persistent sadness, loss of interest in activities, loss of appetite, feelings of worthlessness, becoming easily agitated, among others
Treatment and help: Talk therapy with a trained counsellor or psychotherapist, exercise and support groups are among the options available. Antidepressants are also sometimes prescribed, but they should not be used for treating children, and should not be the first line of treatment for adolescents. All treatment should involve identifying stress factors and sources of support, and individuals should maintain social networks and activities.
Schizophrenia and other psychoses
What: Psychosis, including schizophrenia, is characterised by distortions in thinking, perception, emotions, language, sense of self and behaviour. During a psychotic episode, a person may experience hallucinations and delusions.
Symptoms: Perception-wise, a person may think other people are talking about him or her, or hear voices. The person may also feel sad and irritable, or that he or she is constantly being watched. Behaviour-wise, the person may have difficulty sleeping, talk to him or herself, and behave aggressively.
Treatment and help: Medication is the main form of treatment, as it can help with abnormal biochemical balances in the brain and relieve symptoms like hallucinations. Psychotherapy can help a person make sense of his or her illness and deal with the impact of the illness on their lives. Rehabilitation and counselling helps the person build social relationships and independent living skills.
Want to know more? Here are the articles we referenced to compile this resource: