As part of Mental Health Awareness Week (MHAW) 2017, The Cinnamon Roll and Love, USP brings to you a two-part series on mental health services in Singapore. In this series, Love, USP interviews two service-users of mental health services to share their experiences on what it was like for them to seek professional help.
We hope that these interviews serve as a starting point to larger conversation about mental health as a whole here in USP. If you would like to find out more, the members of Love, USP are always available to point you to the right resources :).
If you need someone to talk to, you can always approach USP’s own support counsellor Ms. Ng Yun Sian (Email or call for an appointment – email@example.com, 65164076) or approach NUS Counselling & Psychological Services.
Our first interview highlights the experiences that Sam (pseudonym given) had with seeking formal help in the struggle with depression. Love, USP hopes that this interview will give a clearer picture of what seeking formal psychological help entails and the journey of recovery that people with depression can go through.
Love, USP: What kind of professional help did you seek?
Sam: I decided to tell my parents and brother explicitly that I wanted professional help in order to not compromise my A levels that year. I got a direct referral to a private psychiatrist through my brother, which isn’t the conventional way of getting diagnosed as people normally go to the polyclinic first to get a referral (which is cheaper and less immediate). Despite my initial reservations, after about 2 months of seeing my psychiatrist, I began to look for a psychologist to speed up the recovery process as I was told having therapy combined with medication was most effective.
Love, USP: Tell me more about your experience of seeking help? What was the process like and what did you do? What were your initial thoughts about seeking professional help before you started?
Sam: The first session was akin to a health check-up, the psychiatrist asked medical questions about eating/sleeping habits, mood trends, whether you’ve harmed yourself or contemplated suicide. Then I was officially diagnosed with depression, which made the whole situation feel real, like finally I had something that explained and validated what I was feeling. They assess the dosage of medication required based on the symptoms you’ve experienced or physical condition, like if you are sleeping too little or too much.
Most people tend to be afraid of the possible side effects of medication because they’re scared that it’ll impact their daily life by depriving them of sleep or provide them with further discomfort but actually my side effects were barely noticeable aside from some initial drowsiness.
The psychiatrist gauges your improvement while on medication based on what you tell them each session, which most people find it difficult to be emotionally honest in. However, I tried my best to really ask myself if the medication was helping me so I could give the psychiatrist accurate information about my condition to facilitate recovery.
“Technically, you can tell yourself to do these things but having a professional give you their opinion and guide you on how to do it is completely different…”
Love, USP: Do you think the professional help you sought has helped you? If yes, how and to what extent? If no, why?
Sam: For me, the medication certainly helped. It improved my physical condition by enabling me to gain weight (since I’d lost weight prior to seeking treatment) and helped me function better in daily life. Yet ultimately, it was the psychologist who helped me find a purpose in life – which personally, is very important. What many psychologists do is they find out the person’s value system before the mental illness and try to work from there to help them find their sense of purpose again.
At first when I started therapy I was extremely skeptical like most people who go for therapy, even though I voluntarily sought help. However, I figured since I could, I might as well make use of the opportunity to recover.
My depression was more like a constant low rather than the very intense kind, which got aggravated by a breakup and my studies in JC. Hence, my therapy started out slightly different as it was nearing my A-level examinations so my therapist suggested that I shouldn’t talk too much about heavy emotional stuff first, and instead focus more on coping.
He gave me numerous tips on things I should do to help me through this hard period like recording down emotions and rationalising emotions. Technically, you can tell yourself to do these things but having a professional give you their opinion and guide you on how to do it is completely different, so he really helped me learn proper coping strategies for my condition.
A lot of times during therapy my therapist would try to help me find out what the trigger was – whether the trigger was a real trigger based on something that happened before in order to find out what happened in your past, when the roots of your condition began forming, how you perceive yourself and when did things change. I remember he did this tree exercise with me (like a sort of timeline on what impacted me in my life) where the leaves were supposed to represent events in my life and decomposing leaves at the bottom were supposed to represent bad things that happened, which got me to share about my life and acknowledge the bad things without being in denial about them.
I think I was quite lucky in that my therapist suited me. Everyone has different needs and while the therapist is usually supposed to mould themselves to suit the client, it’s not possible to find the perfect fit with every client.
On the other hand, I was given the option as to whether my parent/guardian could accompany me into therapy, so I didn’t consent to my mum accompanying me in despite the pressure to do so because I felt it would affect my mental health further. She cares a lot, which isn’t a bad thing, but it means added mental pressure for someone like me because I’d be worrying more about her mental health than my own. I had to prioritize my own mental health at that point, so she’d wait outside while I had my therapy sessions alone. That arrangement was most ideal, because I knew someone was supporting me outside but they didn’t have to see the most terrible parts of my life, allowing me to be more vulnerable with my therapist who was there for me.
After the first few sessions I attended, I didn’t feel better and it felt like nothing had changed, which felt like a waste of money because therapy is expensive. The mental burden of making no progress is worse when you’re in therapy, thanks to the financial burden, because you might get better but can’t just stop attending since giving up halfway would impede the recovery process (unless the therapist is a bad fit).
During therapy sometimes I would question my own therapist (which was a good thing, since he said it meant I was thinking about my own recovery) so at the end of the session he would always ask if there was anything else I wanted to talk about. At times I didn’t know where things were going, because sometimes even when you talk about stuff that happened you still feel like there isn’t any tangible progress.
Progress was personally significant but also caused stress because of the people around me who knew I was going to therapy, since they’d want to know what kind of ‘progress’ I made. I don’t blame them for wanting to quantify progress because it makes life so much easier when you can, but it would just be inaccurate and inauthentic to ‘censor’ my recovery process that way. To them, if there were a graph to represent progress, it should be this steady upwards trajectory because I’m getting professional help, but in reality it goes up a bit then way back down, then inches up a little again, and slumps back down. Evidently, progress isn’t supposed to be constant or linear.
Eventually, you glimpse progress which feels like this tiny glimmer of light at the corner of your eye that you haven’t seen in so long. It’s ironic that even after you’re better you still have to cope with the fact that you don’t feel terrible all the time anymore and that you have more energy to pursue things you care about, but it’s a valid issue especially since it concerns living with and adapting to a very different state of functioning.
At the end, you realise that mental illness is not something you have to get rid of. I’m still on medication because I feel like the physical part is something that might never really go away for me.
“Be respectful to people who’re experiencing different problems from you even if you don’t understand it, don’t joke about it and don’t ostracise the person further.”
Even though I more or less figured out how to cope with it mentally, I sometimes feel like this state will always be there due to some kind of chemical imbalance. That’s that and I’m fine with living with it because currently, this is way better than what I’ve experienced before getting help.
Initially, I was worried about seeing depression as part of my identity since I’ve struggled with it for so long that things would feel empty without it. I realised afterwards that it’s perfectly fine as it has inevitably shaped who I am today. Without it, I wouldn’t be like this, I don’t know if ‘this’ is essentially a good or bad thing but I’m here now, and to disregard it is to disregard the past which I’m not willing to do.
Love, USP: If someone told you they were struggling with regards to mental health, what advice would you give them?
Sam: One, if they are not currently seeking treatment, of course, get treatment, that’d be the first few things I’d say. The thing is, I’ve known quite a few friends who are insistent on not seeking treatment and I realised you can’t just tell them to get treatment. In the past, people told me to get treatment but it didn’t happen until I decided to do it myself, so you have to want treatment to get it.
Two, this sounds so cliche but it’s true – realize that there are a lot more people who care about you than you think, even if the world is super bleak.
Most of all, please just get help. In my opinion, no one can help you but a professional. You can say “I have a wide support network of friends” or “I have my family” or “I have alcohol” which may seem like healthy coping mechanisms or outlets. But to put it in terms of an analogy, you don’t go to your friend if you have the flu. I would want someone to treat mental illness like it’s a physical illness, equally deserving of specialized treatment.
It shouldn’t be about pride since it’s simply something you need to settle and not be in denial about because it affects your life. It won’t help anyone if you burden yourself/the people around you so do what you gotta do to recover
Love, USP: Wouldn’t you think that they already feel like a burden to others and don’t want to seek help because of it?
Sam: I can say it now because I’m not in as dire a position as before, the reason I got help was because I didn’t want to be a burden to people I care about and because in the long run, mental health is just as important as physical health in determining quality of life.
To be honest even now, I don’t have a very strong argument for this because I do think the financial burden is still a big stumbling block in seeking help. There’s the first level which is stigma, then the next is the financial aspect which comes in so fast once you’ve decided to get help.
I think it’s good to seek out organisations if you’re unsure or unable to get therapy, because they usually give the right kind of advice you need (such as this organisation at Scape called CHAT). During my last therapy session, my therapist recommended CHAT to me which is usually for people who haven’t sought professional help yet and for them to get (legitimate) referrals from the counsellors there. That being said, if you can go straight to a medical professional then absolutely do that.
Love, USP: Do you have any hopes/wishes for USP as a community with respect to mental health?
Sam: I’m not even sure about how mental health is perceived in USP because no one just casually talks about it. I think most people would be open to talking about it, but what is more concerning is how people react when someone who hasn’t sought treatment is asking for implicit advice. People need to know how to react to those situations so they don’t aggravate the situation because that’s the point where the person is deciding whether or not to seek help. It would help if people around them would give proper advice, and not useless advice like “maybe you’re just sad and not depressed”.
Unfortunately, I told some people about what I was facing and that’s the kind of response I got, they’d say “I hope it isn’t depression” as if they were saying “I hope it isn’t cancer”. I knew they didn’t mean it, yet either way it sounds very backhanded and insensitive. They don’t know it comes off that way so we need more awareness on wanting to help someone but inadvertently doing it in the wrong way – so we can learn to be both effective and helpful to our friends.
Essentially we should try not to talk about mental health in a stigmatising way even if someone isn’t explicitly asking for help. Just encourage the person to seek help and don’t make mental health sound like some disease! It’s something people should get treatment for and not something people should desperately pray their friend doesn’t contract.
Of course it’s best if one doesn’t end up suffering from mental illness, but even if they end up having it, it shouldn’t be seen as their fault or as something one can pray away. Don’t immediately judge people when they come to you for advice, try to notice trends in their behaviour, and lastly don’t throw around random mental health terms casually like “oh i think you should go to IMH”.
Be respectful to people who’re experiencing different problems from you even if you don’t understand it, don’t joke about it and don’t ostracise the person further. Mental health is something invisible which makes people not believe it but it really does exist, so don’t assume it doesn’t exist just because you don’t see it manifesting obviously in your friends.