ASK DR. NG COLUMN
Is there a question weighing on your heart? Ask Dr. Ng…
Your Question:
Hi Dr. Ng, I’m a close relative of a family member whom I suspect has Depression. I would like to know:
What are the key symptoms to note about Depression?
As a relative, how do I help?
What’s the best method for those suffering from Depression to practice in order to overcome depression?
Worried Relative
Dr. Ng’s Answer:
Dear Worried Relative,
Thank you for your questions. Here are my responses:
1. A depressed person typically experiences prolonged feelings of sadness and hopelessness, loss of pleasure and interest, sleep and appetite problems, fatigue, feelings of excessive guilt and worthlessness and even suicidal thoughts or death wish.
There is gender and age differences to consider as well. Whilst it is socially more acceptable for women to express their sadness in tearfulness, men who are depressed may be more prone to substance abuse (eg. alcohol) or aggressive behaviors (eg. violence at home or in the workplace). Children who are depressed often get misdiagnosed as having ADHD (attention-deficit and hyperactive disorder), or labeled as “naughty”, due to behavioral problems at home or in school (eg., can’t focus in class, irritable, physical fights with peers). Some teenagers may also report constant boredom, become addicted to computer games or engage in self-harm behaviors, when they are depressed.
2. It can be painful and draining for families and friends to listen to and stay with a depressed person. Hence, the temptation is to either judge the person harshly or stay away. Actually, simple gestures of kindness, compassion and empathy would be therapeutic enough for anyone who is struggling emotionally.
Often people think that they need to do or say a lot. Actually, less is more. Speak less, listen more. Do less, be present more.
Often people who are depressed are stuck in a deep sense of helplessness and hopelessness.
Therefore, it is important to engage professional help (e.g, clinical psychologists, counselors,
psychiatrists) to assist the person. Even when the depressed person refuses to seek help, when other family members are willing to reach out for help, there is new movement in the family system and there’s a good chance that the depressed person would eventually come forward for help as well. Don’t wait for other people, act now for your own sake.
3. When people are depressed, they may appear as though they were self-absorbed. However, a depressed person is often least caring to themselves. Therefore, self-care is the priority for recovery. This would include:
a) Taking care of your body (eg. ensuring enough rest, balanced diet and regular exercise)
b) Taking care of your mind (eg. working with a therapist to process any grief or trauma in your life, paying attention to negative thoughts and practicing more helpful ways of thinking in stressful
situations)
c) Taking care of your soul (eg. carving out quiet time for self-reflection and self-renewal, engage with your God in spiritual dialog through prayers and meditation)
Last but not least, the best healing comes from a loving community. Thus, it is important to reach out to your trusted people for help and support. Even though you may feel like a “burden” to them for now, allow yourself to be loved by these people in your life. For one day, you will be, in turn, a blessing to them who have helped you, when you get better.
Best wishes,
Dr. Ng
ASK DR. NG COLUMN
Is there a question weighing on your heart? Ask Dr. Ng…
Your Question:
Hi Dr. Ng, I’m a close relative of a family member whom I suspect has Depression. I would like to know:
What are the key symptoms to note about Depression?
As a relative, how do I help?
What’s the best method for those suffering from Depression to practice in order to overcome depression?
Worried Relative
Dr. Ng’s Answer:
Dear Worried Relative,
Thank you for your questions. Here are my responses:
1. A depressed person typically experiences prolonged feelings of sadness and hopelessness, loss of pleasure and interest, sleep and appetite problems, fatigue, feelings of excessive guilt and worthlessness and even suicidal thoughts or death wish.
There is gender and age differences to consider as well. Whilst it is socially more acceptable for women to express their sadness in tearfulness, men who are depressed may be more prone to substance abuse (eg. alcohol) or aggressive behaviors (eg. violence at home or in the workplace). Children who are depressed often get misdiagnosed as having ADHD (attention-deficit and hyperactive disorder), or labeled as “naughty”, due to behavioral problems at home or in school (eg., can’t focus in class, irritable, physical fights with peers). Some teenagers may also report constant boredom, become addicted to computer games or engage in self-harm behaviors, when they are depressed.
2. It can be painful and draining for families and friends to listen to and stay with a depressed person. Hence, the temptation is to either judge the person harshly or stay away. Actually, simple gestures of kindness, compassion and empathy would be therapeutic enough for anyone who is struggling emotionally.
Often people think that they need to do or say a lot. Actually, less is more. Speak less, listen more. Do less, be present more.
Often people who are depressed are stuck in a deep sense of helplessness and hopelessness.
Therefore, it is important to engage professional help (e.g, clinical psychologists, counselors,
psychiatrists) to assist the person. Even when the depressed person refuses to seek help, when other family members are willing to reach out for help, there is new movement in the family system and there’s a good chance that the depressed person would eventually come forward for help as well. Don’t wait for other people, act now for your own sake.
3. When people are depressed, they may appear as though they were self-absorbed. However, a depressed person is often least caring to themselves. Therefore, self-care is the priority for recovery. This would include:
a) Taking care of your body (eg. ensuring enough rest, balanced diet and regular exercise)
b) Taking care of your mind (eg. working with a therapist to process any grief or trauma in your life, paying attention to negative thoughts and practicing more helpful ways of thinking in stressful
situations)
c) Taking care of your soul (eg. carving out quiet time for self-reflection and self-renewal, engage with your God in spiritual dialog through prayers and meditation)
Last but not least, the best healing comes from a loving community. Thus, it is important to reach out to your trusted people for help and support. Even though you may feel like a “burden” to them for now, allow yourself to be loved by these people in your life. For one day, you will be, in turn, a blessing to them who have helped you, when you get better.
Best wishes,
Dr. Ng
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This service is for non-emergency concerns relating to mental health, relationships, and/or professional development issues.
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USD 30 Per Response
7 Days To Respond
This service is for non-emergency concerns relating to mental health, relationships, and/or professional development issues.
Please provide as many details as possible so that Dr. Ng can tailor her response to your specific situation.
Dr. Ng’s answer will be posted on this website in a week’s time. All identifying information will be removed or disguised to protect your privacy and confidentiality.
Some Questions You May Be Thinking About…
Check out these archives Q&A
Psychologists and Psychiatrists are mental health professionals who have been trained to help people restore or improve their mental health.
The difference is psychiatrists typically use medication as primary treatment method with some talk therapy as secondary; whereas, psychologists typically use conversations as a therapeutic tool to help people understand themselves and create positive change to their thinking and behaviors. Some psychologists also use other creative methods like play, and expressive arts like art, music, dance and drama to help people express their inner experiences.
Talking with a mental health professional is different from talking with a regular friend or family member. A professional is trained to listen to anything you say with more objectivity (compared to a friend or family member), and without judgement, so you can feel safe enough to share anything that you may not necessarily want to share with a friend or family. At the very least, just being able to ventilate the sense of losses and emotional burden that you’ve been carrying inside you for some time can be very healing for most people. Next is intention – sharing with friends/family is often a mutual process whereby you take turns to unload; whereas the professional is focused on helping you find a solution that could relieve your current distress and improve your mental health.
Show your concern, but don’t overdo it. If you are overly anxious, your anxiety will only burden your friend or family member who’s probably already dealing with a lot. Because now they have to take care of your feelings, instead of focusing on their own.
Focus on building a SAFE and TRUSTING relationship with the person that you are concern about. This is the only way the person would be willing to open up and share with you what’s bothering them, and if they need help.
Suppose if you are really concern and want to convince this person to go seek professional help, you can use your authority (eg. if you are a parent, caregiver, or a teacher) if you think the person still have some respect for you, hence they would comply. A softer and more effective way is to create safety and trust first with the person you’re concern about, so that he/she is convinced that you only have their wellbeing in mind, hence they are more likely to go with you to seek professional help. Accompany them to see the professional, at least the first time, because often seeing a professional can be quite intimidating the first time if they don’t know what to expect.
If you have a family member who is adamant about not seeing a mental health professional and if you’re really concerned that they are deteriorating, go ahead and make the appointment and go see the professional yourself first! Family members have powerful influence on each other – so even if other people are unwilling to make changes, you can be the first to change your own thinking and behaviors, so that when you are happier and healthier, other people will start wanting positive change for themselves as well!
With the help of internet nowadays, people can access many information and resources, including readings or videos about diagnosis and treatment. You can also google for places or hotlines that offer free counselling services. Most private centers that offer mental health services have nice websites that you can visit and pick your choice of professionals.
In general, if someone is experiencing high level of anxiety and distress, or manifesting symptoms such as severe insomnia, manic mood, suicidal attempts, violent behaviors, hallucination and/or delusion, I would recommend to go see a psychiatrist first. Some medications can be helpful to stabilize the person quickly, so it reduces their risk of harming themselves or others. There are psychiatrists available in all major public hospitals, and some private hospitals.
On the other hand, if the person of concern is generally stable, and willing to talk to a mental health professional, then it would be good to engage the help of a professional psychotherapist – this can be a clinical psychologist, counsellor, family therapist or other therapists who use expressive art or play as their modality. Given that this pandemic has evoked many intense reactions in people, it is important to find a therapist who can empathize and normalize your experiences, rather than reinforce the sense of pathology or “disorder” that you are already feeling inside yourself. Most therapists in Malaysia are in private practice or private hospitals, usually with nice websites that you can easily access. Some are in public hospitals, usually with a long waiting list.
If you require financial aid, do ask the private center or the therapist if they offer sliding scale rate (usually according to household income), or a reduced rate for the B40 group.
It’s important to keep in mind that post-traumatic stress is really a NORMAL reaction to an abnormal situation. The pandemic has hit everyone in the world, quite unexpectedly and at a rapid rate. No one has enough time to process or prepare for it before the nationwide and global lockdown. And if you have been infected or your family members were infected, you probably have just gone through a physical and emotional battle. Recovering from the physical infection is just one level of healing; many who have been infected or their family members were stigmatized and lost their privacy through social media. It can be very painful to reconnect socially if you have been targeted or ostracized by your own community for being associated with COVID-19. This happens every day, globally. So if you were feeling traumatized, you are probably NORMAL.
There is also something called secondary traumatic stress, which is a common occupational hazard among the frontliners – this could be healthcare professionals, case workers or therapists who have been working long hours treating or witnessing and listening to people who have been traumatized by COVID-19. Many healthcare professionals have to separate with their own families and some may have even lost their fellow colleagues who were infected. The sense of trauma and grief may not hit so quickly during the acute survival phase, but as the crisis gradually eases, more physical and emotional symptoms may emerge, which are signs that it’s time to seek support and healing for yourselves.
Just as how we would deal with any traumatic experiences in our lives, we must first grieve. This means we will have to allow ourselves to feel bitter, sad, angry and fearful for as long as we need. Feelings come up so that they can be released. If we do not allow them to surface, then they would keep harassing us by becoming louder and louder, making us suicidal even, until and unless we pay attention to them.
It might be very scary to do this grief work by yourself. Look for a friend or mentor with good listening skills, or hire a professional psychotherapist who can help you process your grief and trauma in a deeper way, so you can begin to heal and experience post-traumatic growth.
Actually, change is the only constant or reality in life. If we were to keep looking backward to how things were before, we can never progress in life, which is constantly moving forward, whether we like it or not. Technology is changing. The way people do business or connect socially is also changing. Before the pandemic, certain people are considered hygiene freak or OCD, but now with the pandemic, most of us are more or less OCD! If you have young children or elderly people at home, and if you’re concerned about infecting them, you would be hypersensitive or obsessive-compulsive about cleaning and disinfecting.
Many people are also enjoying the freedom of staying at home, especially if you are a natural introvert, or if you have social anxiety or been bullied at school or workplace. So, “hikikomori” or social withdrawal became a new norm during the lockdown. And then, interestingly, when the government announce that you can now return to office or school/college, many people who have gotten accustomed to the “new normal” of working/learning from home now have increased anxieties and fearfulness of returning to the workplace or school again.
No doubt, we all want to restore our losses – and we have lost our freedom to travel, freedom to play and socialize, and for some, freedom to resume their businesses/work and education. We have also lost our sense of security about the world and the future. But these are actually false sense of security. It is an illusion and delusion to think that we have full control of our own lives and future. I think this pandemic really humbles us and reminds us of both our limitations and our greatness! We are not fully in charge here (that’s our limitations) but we can always create again (that’s our greatness).
So, it would be interesting to ask ourselves, if you could restore to a pre-MCO state, what do you wish keep, and what are you ready to let go of, so that you can now create the life that you want to live from this moment onwards?
Whether we realize it or not, we are really dealing with multiple LOSSES.
For everyone, we lost our freedom, or at least the “freedom” we thought we had. We can’t move about or go places as freely as we used to. There are many rules and protocols to follow now. The fact that some of us try to defy or ignore those rules/protocols doesn’t take away the fact that those rules/protocols are taking away some of our freedom, that’s why we react to it – either by complying, avoiding or defying.
For many people, the pandemic took away our sense of security or “norm”. That’s why people are talking about “new normal” now. We are trying to rebuild some structure in our life to give ourselves some sense of consistency and predictability, which are the foundations of our sense of security in the world.
Not to mention, some people lost their regular income, their jobs, or at risk of losing them now. So they are living in fears and worries. Some families have lost loved ones due to COVID-19, whereas some are still battling their lives in hospitals all over the world. Some people are stuck in foreign countries and can’t return home to be with their families. When we hear about news like these, we can imagine and feel other people’s losses, because our lives are interconnected.
So we have to take better care of ourselves during this time of the pandemic, when we are experiencing so much losses in our daily lives.
Yes, this pandemic is a CRISIS that serves as a wake-up call for many people, with mental health issue or not.
In Chinese writing, crisis consists of 2 words: danger and opportunity. In terms of our mental health, the current pandemic or crisis presents us a dangerous time whereby some people really get worse from here. These are usually people with pre-existing condition or they were already not coping well prior to the pandemic. For example, there’s an increased of domestic violence and drunk driving cases reported. These are pre-existing conditions whereby individuals and families were already struggling to cope, and the high level of stress during and after the lockdown period can really push people over the edge!
But what’s more important is that a crisis is also a time for new opportunity! We are seeing so much creativity in how people transform their business, how people discover their hidden potentials/talents, how couples and families learn to get along with each other (when before, they might try to avoid or annoy each other). Parents learn to slow down and be more understanding of their kids, which helps to bond their relationship.
This is the kind of post-crisis GROWTH that we want to cultivate and maintain even after the pandemic.
Everyone has RESOURCES. It could be support from your loved ones, your bank account, your internal coping strength, your strong immune system or your spiritual faith.
Often, when we feel that our resources are running low, that’s when we start panicking how we are going to cope and we start worrying about the future. In other words, everyone is vulnerable during this pandemic. But, people with very little resources are the ones most vulnerable and affected by this pandemic. So we need to look out more for each other, and share resources.
When everyone shares a little of what they have, we will all have enough. Just like the story of the little boy who shared his 5 loaves and 2 fishes, and in the end, 5000 people or more got fed, and there were even leftovers!!
Some level of anxiety, worries, sadness, frustration and anger are normal emotions during times of crisis. These negative thoughts and emotions are like weather that passes and don’t leave too much damage to the person themselves or to others.
On the other hand, when these emotions become more EXTREME, that’s when they can be dangerous. For example:
= Overly distressed to the point of wanting to die.
= Overeating, oversleeping, or unable to eat and sleep.
= Violent threats or actions to harm self or others.
Another tell-tale sign is the negative triad:
1) Negative view of self;
2) Negative view of the world or others; and
3) Negative view of the future.
When a person has all three, he/she is most likely experiencing clinical depression. It is good and easy to treat depression early. If we try to suppress our negative emotions too much, they often get distorted and become something more complicated, like OCD, mania, psychosis or chronic physical conditions, including addictions.
How can someone who was mentally affected by the pandemic recover after such a traumatic experience?
Just as everyone has resources, human beings are RESILIENT. Resilience means toughness and elasticity. During good times, we cannot see resilience. But in the face of adversities, you begin to tap on different facets within yourself that you may not realize it’s there. That’s when you may discover that you are really more tough than you thought you were, and you are really more elastic or flexible than you allow yourselves to be! We all have the innate ability to bounce back, and some may even become stronger! This is the kind of post-traumatic growth or post-crisis growth that everyone of us is capable of.
There are two conditions to activating resilience: 1) Community, and 2) Hope. After a trauma or crisis like tsunami or terrorist attack, people who are surrounded by a loving community tend to cope better, than those who do not have such community support. These loving communities can be families, neighbors, friends, colleagues, religious groups, helping professionals, support groups etc. We all need other people to listen to our emotional pain and help us to feel NORMAL again. It also works the other way round – if you are the breadwinner in your family, or the only caregiver left to fend for your kids, or when you know that someone is counting on you to survive this current crisis, you are less likely to allow yourself to crumble or stay in the emotional rut for long. You know you have to pick yourself up quickly, find alternatives, so that those who are depending on you can survive as well. This is the power of love – to know that you are loved or to know that you must love in order to survive!
Next is hope. Hope comes from a sense of new meaning a person can derive from the trauma or crisis experience. Often, this has to come from delving deep into the pain (rather than evading or suppressing it), and connecting with the mystery of life and suffering. This is where spiritual beliefs and community comes in – when you have lost faith in life, you can lean on other people’s faith, until you find new meaning and new faith in life again! When you deliberately choose hope over despair, that’s when you discover how strong you really are inside, in spite of the external circumstances. That’s resilience!
For children, the faster the adults/parents can stabilize and restore some concrete structure in their lives, such as some concrete learning schedules or routine, while still reassuring them from time to time, actually enables children to adapt faster. These children also tend to have less emotional or behavioral problems in the long run. Otherwise, children may try to take over by becoming a “parentified” child (so these children are hurried to grow up quickly to shoulder parenting responsibilities of younger siblings or to support the weaker parent), or they may turn against their weaker parents and become a mini “dictator or tyrant” at home.
Some Questions You May Be Thinking About…
Check out these archives Q&A
Psychologists and Psychiatrists are mental health professionals who have been trained to help people restore or improve their mental health.
The difference is psychiatrists typically use medication as primary treatment method with some talk therapy as secondary; whereas, psychologists typically use conversations as a therapeutic tool to help people understand themselves and create positive change to their thinking and behaviors. Some psychologists also use other creative methods like play, and expressive arts like art, music, dance and drama to help people express their inner experiences.
Talking with a mental health professional is different from talking with a regular friend or family member. A professional is trained to listen to anything you say with more objectivity (compared to a friend or family member), and without judgement, so you can feel safe enough to share anything that you may not necessarily want to share with a friend or family. At the very least, just being able to ventilate the sense of losses and emotional burden that you’ve been carrying inside you for some time can be very healing for most people. Next is intention – sharing with friends/family is often a mutual process whereby you take turns to unload; whereas the professional is focused on helping you find a solution that could relieve your current distress and improve your mental health.
Show your concern, but don’t overdo it. If you are overly anxious, your anxiety will only burden your friend or family member who’s probably already dealing with a lot. Because now they have to take care of your feelings, instead of focusing on their own.
Focus on building a SAFE and TRUSTING relationship with the person that you are concern about. This is the only way the person would be willing to open up and share with you what’s bothering them, and if they need help.
Suppose if you are really concern and want to convince this person to go seek professional help, you can use your authority (eg. if you are a parent, caregiver, or a teacher) if you think the person still have some respect for you, hence they would comply. A softer and more effective way is to create safety and trust first with the person you’re concern about, so that he/she is convinced that you only have their wellbeing in mind, hence they are more likely to go with you to seek professional help. Accompany them to see the professional, at least the first time, because often seeing a professional can be quite intimidating the first time if they don’t know what to expect.
If you have a family member who is adamant about not seeing a mental health professional and if you’re really concerned that they are deteriorating, go ahead and make the appointment and go see the professional yourself first! Family members have powerful influence on each other – so even if other people are unwilling to make changes, you can be the first to change your own thinking and behaviors, so that when you are happier and healthier, other people will start wanting positive change for themselves as well!
With the help of internet nowadays, people can access many information and resources, including readings or videos about diagnosis and treatment. You can also google for places or hotlines that offer free counselling services. Most private centers that offer mental health services have nice websites that you can visit and pick your choice of professionals.
In general, if someone is experiencing high level of anxiety and distress, or manifesting symptoms such as severe insomnia, manic mood, suicidal attempts, violent behaviors, hallucination and/or delusion, I would recommend to go see a psychiatrist first. Some medications can be helpful to stabilize the person quickly, so it reduces their risk of harming themselves or others. There are psychiatrists available in all major public hospitals, and some private hospitals.
On the other hand, if the person of concern is generally stable, and willing to talk to a mental health professional, then it would be good to engage the help of a professional psychotherapist – this can be a clinical psychologist, counsellor, family therapist or other therapists who use expressive art or play as their modality. Given that this pandemic has evoked many intense reactions in people, it is important to find a therapist who can empathize and normalize your experiences, rather than reinforce the sense of pathology or “disorder” that you are already feeling inside yourself. Most therapists in Malaysia are in private practice or private hospitals, usually with nice websites that you can easily access. Some are in public hospitals, usually with a long waiting list.
If you require financial aid, do ask the private center or the therapist if they offer sliding scale rate (usually according to household income), or a reduced rate for the B40 group.
It’s important to keep in mind that post-traumatic stress is really a NORMAL reaction to an abnormal situation. The pandemic has hit everyone in the world, quite unexpectedly and at a rapid rate. No one has enough time to process or prepare for it before the nationwide and global lockdown. And if you have been infected or your family members were infected, you probably have just gone through a physical and emotional battle. Recovering from the physical infection is just one level of healing; many who have been infected or their family members were stigmatized and lost their privacy through social media. It can be very painful to reconnect socially if you have been targeted or ostracized by your own community for being associated with COVID-19. This happens every day, globally. So if you were feeling traumatized, you are probably NORMAL.
There is also something called secondary traumatic stress, which is a common occupational hazard among the frontliners – this could be healthcare professionals, case workers or therapists who have been working long hours treating or witnessing and listening to people who have been traumatized by COVID-19. Many healthcare professionals have to separate with their own families and some may have even lost their fellow colleagues who were infected. The sense of trauma and grief may not hit so quickly during the acute survival phase, but as the crisis gradually eases, more physical and emotional symptoms may emerge, which are signs that it’s time to seek support and healing for yourselves.
Just as how we would deal with any traumatic experiences in our lives, we must first grieve. This means we will have to allow ourselves to feel bitter, sad, angry and fearful for as long as we need. Feelings come up so that they can be released. If we do not allow them to surface, then they would keep harassing us by becoming louder and louder, making us suicidal even, until and unless we pay attention to them.
It might be very scary to do this grief work by yourself. Look for a friend or mentor with good listening skills, or hire a professional psychotherapist who can help you process your grief and trauma in a deeper way, so you can begin to heal and experience post-traumatic growth.
Actually, change is the only constant or reality in life. If we were to keep looking backward to how things were before, we can never progress in life, which is constantly moving forward, whether we like it or not. Technology is changing. The way people do business or connect socially is also changing. Before the pandemic, certain people are considered hygiene freak or OCD, but now with the pandemic, most of us are more or less OCD! If you have young children or elderly people at home, and if you’re concerned about infecting them, you would be hypersensitive or obsessive-compulsive about cleaning and disinfecting.
Many people are also enjoying the freedom of staying at home, especially if you are a natural introvert, or if you have social anxiety or been bullied at school or workplace. So, “hikikomori” or social withdrawal became a new norm during the lockdown. And then, interestingly, when the government announce that you can now return to office or school/college, many people who have gotten accustomed to the “new normal” of working/learning from home now have increased anxieties and fearfulness of returning to the workplace or school again.
No doubt, we all want to restore our losses – and we have lost our freedom to travel, freedom to play and socialize, and for some, freedom to resume their businesses/work and education. We have also lost our sense of security about the world and the future. But these are actually false sense of security. It is an illusion and delusion to think that we have full control of our own lives and future. I think this pandemic really humbles us and reminds us of both our limitations and our greatness! We are not fully in charge here (that’s our limitations) but we can always create again (that’s our greatness).
So, it would be interesting to ask ourselves, if you could restore to a pre-MCO state, what do you wish keep, and what are you ready to let go of, so that you can now create the life that you want to live from this moment onwards?
Whether we realize it or not, we are really dealing with multiple LOSSES.
For everyone, we lost our freedom, or at least the “freedom” we thought we had. We can’t move about or go places as freely as we used to. There are many rules and protocols to follow now. The fact that some of us try to defy or ignore those rules/protocols doesn’t take away the fact that those rules/protocols are taking away some of our freedom, that’s why we react to it – either by complying, avoiding or defying.
For many people, the pandemic took away our sense of security or “norm”. That’s why people are talking about “new normal” now. We are trying to rebuild some structure in our life to give ourselves some sense of consistency and predictability, which are the foundations of our sense of security in the world.
Not to mention, some people lost their regular income, their jobs, or at risk of losing them now. So they are living in fears and worries. Some families have lost loved ones due to COVID-19, whereas some are still battling their lives in hospitals all over the world. Some people are stuck in foreign countries and can’t return home to be with their families. When we hear about news like these, we can imagine and feel other people’s losses, because our lives are interconnected.
So we have to take better care of ourselves during this time of the pandemic, when we are experiencing so much losses in our daily lives.
Yes, this pandemic is a CRISIS that serves as a wake-up call for many people, with mental health issue or not.
In Chinese writing, crisis consists of 2 words: danger and opportunity. In terms of our mental health, the current pandemic or crisis presents us a dangerous time whereby some people really get worse from here. These are usually people with pre-existing condition or they were already not coping well prior to the pandemic. For example, there’s an increased of domestic violence and drunk driving cases reported. These are pre-existing conditions whereby individuals and families were already struggling to cope, and the high level of stress during and after the lockdown period can really push people over the edge!
But what’s more important is that a crisis is also a time for new opportunity! We are seeing so much creativity in how people transform their business, how people discover their hidden potentials/talents, how couples and families learn to get along with each other (when before, they might try to avoid or annoy each other). Parents learn to slow down and be more understanding of their kids, which helps to bond their relationship.
This is the kind of post-crisis GROWTH that we want to cultivate and maintain even after the pandemic.
Everyone has RESOURCES. It could be support from your loved ones, your bank account, your internal coping strength, your strong immune system or your spiritual faith.
Often, when we feel that our resources are running low, that’s when we start panicking how we are going to cope and we start worrying about the future. In other words, everyone is vulnerable during this pandemic. But, people with very little resources are the ones most vulnerable and affected by this pandemic. So we need to look out more for each other, and share resources.
When everyone shares a little of what they have, we will all have enough. Just like the story of the little boy who shared his 5 loaves and 2 fishes, and in the end, 5000 people or more got fed, and there were even leftovers!!
Some level of anxiety, worries, sadness, frustration and anger are normal emotions during times of crisis. These negative thoughts and emotions are like weather that passes and don’t leave too much damage to the person themselves or to others.
On the other hand, when these emotions become more EXTREME, that’s when they can be dangerous. For example:
= Overly distressed to the point of wanting to die.
= Overeating, oversleeping, or unable to eat and sleep.
= Violent threats or actions to harm self or others.
Another tell-tale sign is the negative triad:
1) Negative view of self;
2) Negative view of the world or others; and
3) Negative view of the future.
When a person has all three, he/she is most likely experiencing clinical depression. It is good and easy to treat depression early. If we try to suppress our negative emotions too much, they often get distorted and become something more complicated, like OCD, mania, psychosis or chronic physical conditions, including addictions.
How can someone who was mentally affected by the pandemic recover after such a traumatic experience?
Just as everyone has resources, human beings are RESILIENT. Resilience means toughness and elasticity. During good times, we cannot see resilience. But in the face of adversities, you begin to tap on different facets within yourself that you may not realize it’s there. That’s when you may discover that you are really more tough than you thought you were, and you are really more elastic or flexible than you allow yourselves to be! We all have the innate ability to bounce back, and some may even become stronger! This is the kind of post-traumatic growth or post-crisis growth that everyone of us is capable of.
There are two conditions to activating resilience: 1) Community, and 2) Hope. After a trauma or crisis like tsunami or terrorist attack, people who are surrounded by a loving community tend to cope better, than those who do not have such community support. These loving communities can be families, neighbors, friends, colleagues, religious groups, helping professionals, support groups etc. We all need other people to listen to our emotional pain and help us to feel NORMAL again. It also works the other way round – if you are the breadwinner in your family, or the only caregiver left to fend for your kids, or when you know that someone is counting on you to survive this current crisis, you are less likely to allow yourself to crumble or stay in the emotional rut for long. You know you have to pick yourself up quickly, find alternatives, so that those who are depending on you can survive as well. This is the power of love – to know that you are loved or to know that you must love in order to survive!
Next is hope. Hope comes from a sense of new meaning a person can derive from the trauma or crisis experience. Often, this has to come from delving deep into the pain (rather than evading or suppressing it), and connecting with the mystery of life and suffering. This is where spiritual beliefs and community comes in – when you have lost faith in life, you can lean on other people’s faith, until you find new meaning and new faith in life again! When you deliberately choose hope over despair, that’s when you discover how strong you really are inside, in spite of the external circumstances. That’s resilience!
For children, the faster the adults/parents can stabilize and restore some concrete structure in their lives, such as some concrete learning schedules or routine, while still reassuring them from time to time, actually enables children to adapt faster. These children also tend to have less emotional or behavioral problems in the long run. Otherwise, children may try to take over by becoming a “parentified” child (so these children are hurried to grow up quickly to shoulder parenting responsibilities of younger siblings or to support the weaker parent), or they may turn against their weaker parents and become a mini “dictator or tyrant” at home.