COVID-19 has brought with it a mental health crisis like we’ve never seen before. The forced and unexpected shifts to our lifestyles play a big role in contributing to mental illness for those of us unable to roll with the punches as easily as others.
In response, the Ministry of Health and the Institute of Mental Health has convened the Covid-19 Mental Wellness Taskforce, to review the psycho-social impact of the Covid-19 pandemic on the population and take stock of the government’s attempt to address the impact so far.
Apparently Madam President was quite pleased with the effort herself.
In addition to destigmatisation so people are willing to seek help for issues they may face, an imminent need is for we, the citizens to be equipped to help one another. In fact, if we’re to be a community that successfully destigmatizes mental illness, there’s no better way than to be equipped to support those around us for when the need arises.
Here are some practical handles on how you can recognise and help a person in need.
1. Comparing or rationalising sufferings is unhelpful.
Amelia is fighting for her life in ICU. Carl, on the other hand, is “very sad” because he is alone in isolation. It’s tempting to conclude that Amelia has “got it worse”, and that Carl should just “deal with it”. But you cannot compare sufferings. Each suffering is unique. Comparing Amelia’s sufferings with Carl’s is comparing apples with oranges. They are both suffering and in deep agony.
Tip: It is not helpful to tell a sufferer to consider those worse off than themselves and be thankful. It just does not work that way. Instead, acknowledge what they are feeling. Grieve with them. Let them know that you are there for them. It can be that simple if you would commit to being available.
2. Don’t assume that you “understand”.
The more well-meaning of us may venture an empathetic, “I know how you feel”. But do you, really? Each sufferer’s journey is unique to them. Two individuals battling clinical anxiety may experience the manifestation of the illness very differently.
When Ben is anxious, his mind goes into over-drive. He thinks of a million and one things all at the same time. He becomes hyper-sensitive of his physical surroundings – the ticking of the clock is deafening, and the lights are blinding. Daphne on the other hand, experiences anxiety in a very different way. Her mind shuts down. She becomes completely unresponsive to her physical surroundings.
Telling a sufferer that you “know” how they feel is not only untrue and unhelpful, it makes them feel even more lonely because it reinforces their belief that nobody understands.
Tip: Acknowledge (and I mean, really acknowledge it to yourself as well), that you do not know what the sufferer is going through. Get them to share with you what they are going through. Encourage them to share their uncensored thoughts with you and assure them that you would not judge them or what they share. Often, comforters feel that they need to say something after a sufferer shares his thoughts. And it is precisely in the scrabble to think of something “helpful” to say that comforters tend to rub salt to the wound of sufferers by saying (what may be) the right things at the wrong time. Remember: Saying that right thing at the wrong time is counterproductive. Instead of rushing to speak words of comfort, sit in silence with the sufferer. If you MUST say something but do not know what to say, try saying no more than “I’m sorry to hear all this”.
Tip: Comforters sometimes try to share about their own sufferings to find common ground with the sufferer’s pain. As above, this is well-intentioned but ultimately unhelpful to many suffererers. Remember that everyone’s suffering is unique and even between 2 sufferers, their experiences with mental illness can be very different. The best thing you can do when with a sufferer, is to sit with them till they are ready to talk. And when they do, listen.
3. You cannot just “snap out” of a physical illness. It doesn’t work that way for mental illness either.
When I was going through my first bout of depression, my mother stormed into my room one morning and told me, “enough already! It’s been XX days. Pull yourself together and snap out of it. The world still goes on!”
It is true. The world still goes on regardless of my mental illness. What isn’t true though, is that a sufferer can choose to “snap out of it” with enough willpower. Have you tried telling a cancer patient to “snap out of it”? I doubt you have. That is because they physically are unable to.
The same goes for mental illness. One doesn’t simply “snap out” of mental illness. Instead, the suffer will undergo a recovery journey. I say “journey” because it usually is one. Of course, there are the wonderful stories of miraculous healing, and we rejoice with such ex-sufferers. But, for the majority of sufferers, recovery is a journey. It often feels like 2 steps back before we manage to take 3 steps forward. This is why it can be helpful for comforters to build mini-milestones of achievement for the sufferer. These milestones not only provide something concrete for the sufferer to work towards, but also serves as reminders of his achievements and progress.
Tip: Surviving a day can be overwhelming to the sufferer who is already struggling to even live past the hour. Breakdown the day into bite-size pieces for the sufferer. Encourage them to think in terms of hour by hour as opposed to day by day. If that is too overwhelming for the sufferer, encourage them to think in terms of minute by minute. Surviving an extra minute can be a great source of encouragement to a sufferer.
Tip: Work with the sufferer to come up with a daily routine. Having a routine brings a sense of certainty to a sufferer whose life seems to be going through a complete upheaval. Restore a sense of control to the sufferer’s life by building a timetable with him. Make the tasks manageable by breaking it down into small blocks of time. For example:
- 10.00am – Wake up and drop comforter a text.
- 10.15am- Brush teeth and wash face.
- 10.30am- Have 2 slices of bread with peanut butter for breakfast together with a cup of milo.
- 11.00am – Do a piece of work (specify the work that is to be carried out).
- 11.15am- Walk around the house continuously for 15 minutes.
Write out the timetable and place it in prominent areas of the sufferer’s living space. For example, on the bathroom mirror, above the bed, or at their desk, etc. This will come in handy for the next tip as well.
If the sufferer is unable to build a timetable with you, I would encourage you to build one for him and send each task across to him at each appointed time. This will take effort, but care takes effort. Sending the entire timetable to the sufferer may be overwhelming or may reinforce the sense of “uselessness” and lack of control.
As consistency gives the sufferer a sense of familiarity, try to build into the timetable a fixed task that occurs at the same time every day, i.e. walk by the beach daily from 5.00pm to 6.00pm
Importantly: Remember to encourage the sufferer at the completion of each task!
Tip: Make a list of coping techniques to help your friend pre-empt the sudden onset of an episode. When a sufferer “spirals” he may feel that he has been sucked into a dark vacuum. The sufferer may not be able to think clearly or think at all even. In times like these, it is useful for the sufferer to have a list of concrete things to do as he waits out the “attack”. The list may include things like:
- Call ___
- Send a text to ___
- Carry out deep breathing exercising. Breathe in for 10 counts, breathe out for 10 counts;
- Put on the “__” playlist, etc.
As above, write out this list of coping techniques and place it in prominent areas of the sufferer’s living space.
4. Remember medicine, diet and exercise
Comforters sometimes think that if mental illness is an illness of the mind, then the cure would be found by fixing the mind. Yes, having a change in mindset and thinking positive thoughts may be useful. However, it is important to ensure that the sufferer’s general physical health is well maintained as well. When the sufferer’s physical body is looked after, their healthy body provides their mind the support it needs to fight the mental disease.
Tip: Check-in regularly with the sufferer to ask about if they have been taking their medicine as prescribed, eating and exercising regularly.
Checking in with the sufferer should not be a mechanical duty. While the primary goal is to check-in with the sufferer to ensure that they are maintaining their general health, you should also use your check-ins as an opportunity to strike up a normal conversation with the sufferer.
Ask open-ended questions instead of closed-ended questions. For example, instead of “have you taken your breakfast?” ask “what did you have for breakfast?”. Open-ended questions push the sufferer beyond the binary of “yes” or “no”, and cause them to engage their minds in crafting answers to your questions. Even the little things like how we frame questions help.
5. Start a Village
Comforters sometimes take it upon themselves to solve the sufferings of the sufferer. Compassion is great, but they shouldn’t do it at their own expense. In many cases, it takes a village to help the sufferer stand again. This village may consist of the sufferer’s immediate family, the people they live with, their bosses and colleagues, their circle of friends, counsellor, therapist, and their doctor, etc.
Tip: Form a group of comforters to rally around the sufferer. Start a communication circle (like, a WhatsApp group) where comforters can update each other on the status of the sufferer. Benefits of having a community of comforters include:
- Helping comforters being kept in the loop. This includes closer supervision if the sufferer is a suicide risk;
- Allowing comforters to cover for each other. This minimises the risk of comforters’ burn out;
- Allowing comforters to share with each other tips on what the sufferer responds/does not respond to; and
- Serving as a source of mutual encouragement. Comforters can share and celebrate uplifting interactions with the sufferer or share about a hard day they had caring for the sufferer.
To end off, let me say to fellow sufferers: It may feel like you are alone. But the truth is, you are not alone. In moments when your feelings are overwhelming, hold on to what is true, even though you may not believe it in the moment.
Here is a useful list of resource groups that can help!
National Care Hotline: 1800-202-6868
Marital and parenting issues
– Community Psychology Hub’s Online Counselling platform
Violence or abuse
– Big Love Child Protection Specialist Centre (6445-0400)
– HEART @ Fei Yue Child Protection Specialist Centre (6819-9170)
– PAVE Integrated Services for Individual and Family Protection (6555-0390)
– Project StART (6476-1482)
– TRANS SAFE Centre (6449-9088)
– TOUCHline (Counselling) – (1800-377-2252)
– Counselling and Care Centre – (6536-6366)
– Eagles Mediation and Counselling Centre – 6788-8220)
– Wesley Methodist Church – (6837-9214)
– Shan You Counselling Centre – (6741-9293)
– Club Heal – (6899-3463)
If you would like to learn about mental illness and how you can be a part of the movement to destigmatize it in Singapore, check out Beyond the Label by the National Council of Social Services.