Category Archives: Depression

Support Group is running now!

Yes, since my post written in 2017, I’ve finally managed to organise the first meet-up for Support Group for Anxiety and related problems. It went really well and we were all very pleased to meet each other and made this happened together, despite our levels of anxiety! We will continue to meet monthly and welcome new members.

Meet-ups for Depression and other problems will follow soon…

If you’re interested, please fill in the google form here:

https://goo.gl/forms/PaFNW2LBfOkOOeUv1

 

A few criteria to fulfill:

  • You’ve been assessed or diagnosed with the problem you specified by a mental health professional (be it a psychiatrist or psychologist or GP or…).
  • You’re attending and participating in this willingly, not being forced by others.
  • You are able to arrange your own transport and pay for your expenses.
  • You are able to pay a small fees for administrative/materials purpose.
  • You demonstrate the ability to treat others non-judgmentally and with respect, and maintain confidentiality.
  • In between our monthly meet-ups, we stay connected in Whatsapp group, however, you will only be able to join the group after first showing up in the meet-up.

 

To read more about it, please check out my previous post:

Support Groups in KL/Klang

Suicide Survivor Support Group

Due to my attempts of organising support groups in Klang Valley (more details here), I have encountered people who are searching for support groups for all sort of things.

I just happened to come across this from Befrienders. Please go get in touch with Kenny at 03-7957 1306 or admin@befrienders.org.my if you or someone you know might be interested to attend.

suicidesurvivorbefrienders

Suicide with a Hostile Intent

In the past, whenever we talk about suicidal clients, it’s normally due to depression, they feel hopeless about the future and see themselves as a burden to the family and society, and see that ending their lives as the only solution to their problems.

But things changed. Today I’m not writing about suicide bombing or attacks, but suicide with a hostile intent, on a personal level.

So recently I’m seeing more and more young people who are suicidal, who have self-harm issues, or who have attempted suicide. Or, there are also some who have done any self-harm, but they are always telling others that they don’t want to live no more.

It’s not just me. When I was teaching suicide risk assessment in Beijing, many of the students (who are teachers/psychotherapists/counsellors themselves) express the same concerns. They are seeing more and more students and young people like that. They don’t quite seem to be depressed, but they are expressing suicidal thoughts, seem to be as a mean to obtain something, usually from their parents.

It’s difficult. Because you can’t really provoke these youngsters, by telling them that “stop seeking attention! You don’t really want to die! You say it to manipulate your parents” etc. Some of them are willing to “sacrifice” their lives, to make you regret and feel guilty all your lives, just because you don’t give them what they want. Sometimes I feel they don’t appreciate and love lives as much as the previous generations (Why?!).

It’s difficult. Because any expression of suicidal ideation is important and worth our attention, we can’t simply make assumptions and then ignore it. (But do you realise, it’s also because of this, we are reinforcing their behaviour… So they get what they want, they can continue to threaten or blackmail us etc.)

We can help them as much as we can, by being more emphatic and having more compassion. But I’m just wondering, what happens to our society, parenting and education systems, why are more and more entitled children growing up, who are fairly self-centered and do not care much about how others feel?

 

N.B. I don’t mean to discount the importance of helping anyone with suicidal ideation. Here I’m only talking about a small group of people who use suicide to blackmail or manipulate around, but there are definitely plenty of people out there who are really suicidal and in need of attention and help.

Please give yourself a second chance. Malaysia suicide hotlines:

The Befrienders
03-7956 8144/ 03-7956 8145
www.befrienders.org.my

Life Line Association Malaysia
03-4265 7995
http://lifeline.org.my/cn/

Agape Counselling Center Malaysia
03-7785 5955 / 03-7781 0800
http://www.agape.org.my

Euthanasia

This is the first time I came across this word. Euthanasia.

It’s also called “mercy killing”, or “painless death.” This is the definition from google “the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma.”

I searched about it after hearing a patient telling me about “legalised suicide” in some countries. She isn’t depressed, but she was for quite a period of time. When she was thinking about ending her life and making plans about it, she came across this idea – that it’s legal in some countries and even some with the assistance of a physician. (You may read more about it on google, especially the Belgium’s “Euthanasia Act”).

She asked me, “isn’t that nice? So it wouldn’t be so painful. And less trial and error. Maybe it’s just a pill and it’s done”

I’m aware of quite a number of patients of high risk suicidal, yet they are still around because they are scared to do it or scared of pain. I’m thanking god that they are scared of pain and hence they are still around, and hence I still get to help them.

I asked her, “Joey, do you still want to end your life now?”

“No, but back then yes. I didn’t do it because I was scared, but it would be good if it’s legal and I can die painlessly” (N.B. even if it’s legal it’s under certain kind-of-strict conditions, it’s definitely not that simple)

“So now you are ok to live on?” “Yes”

“That’s the thing.” I explained to her, “Joey back then wanted to die. That was Joey with depression wanted to commit suicide. But does Joey (without depression) want to die?”

“Ehmm I guess no” (She’s no longer depressed now)

Actually that’s all I want to say today. You feel like there’s no purpose to live on, you want to die, you might even feel like a burden to your family, or it’s such a suffer living… But it’s you with depression (or other mental/physical problems) who are thinking so. It’s not you. It’s like when you’re enraged (very, very angry) you shout that you want a break up or a divorce, but you don’t mean it at all. You regret it later on. So when your emotion is not like the usual you, you can’t make the decision to take away your own life, it’s not (the original) you, yes it might feel so real, but no, you don’t mean it. So don’t do this. Please seek help. It can be treated, and you can be like many of my patients, who are grateful that they didn’t/couldn’t make that move.

 

Please give yourself a second chance. Malaysia suicide hotlines:

The Befrienders
03-7956 8144/ 03-7956 8145
www.befrienders.org.my

Life Line Association Malaysia
03-4265 7995
http://lifeline.org.my/cn/

Agape Counselling Center Malaysia
03-7785 5955 / 03-7781 0800
http://www.agape.org.my

Related read (in Chinese): 识别自杀的预警信号

Problem-Focused & Emotion-Focused Copings

She didn’t think that she would need any professional mental help. That’s why she only came after quite a few months her colleague introducing our clinic to her. She realised that she is talking to herself, cursing, mumbling, and in this persistent low yet agitated mood.

It’s not difficult to understand why she’s in such state. She has a job herself and has four children, the second child is epileptic and can’t tolerate western medication, so she suffers from recurrent and unprovoked seizures. She lives with the husband and his family, including the mother in law, who doesn’t get along with her and is always criticising her. The husband’s brother works for the husband, and has recently moved in to their house with the wife and two dogs. She wasn’t happy that nobody sought her opinion regarding this. What’s worse is the brother in law and wife who never take proper care of the dogs’ hygiene. They live there for free, and never help out in any house chores. Sometimes they even use her car to take the dogs out, leaving the car seats with fur without cleaning. The mother in law would get in the way if she tried to say anything to the brother in law.

How about the husband? She’s been married to the husband for over a decade. The husband doesn’t care about all this. He usually comes home late, and is often drunk. She said he has been found to have mistress many times, some lasted for few months, some years. So this has left her in such paranoid state, is consistently suspicious that husband has another mistress yet again, and is always trying to track and check everything. So she lives in this house with her children, with almost no support and help, and with people who seem to always make life difficult for her.

What do you think? …? …?

My first reaction was fairly direct, “Why is she still there?” Yes she did mention that when outsiders look at her, most would think that she seems to lead such a happy and complete life. Is she?

Has she recognised what her problems are? Is she able to solve these problems effectively? Perhaps she can solve some of these, how about the remaining issues? Can she cope with them? Can she see the way out at all?

I do not think medication is going to do her much good, if any. I’d say this is why everyone should learn problem-focused coping strategies and emotion-focused strategies. Have you heard the famous inspirational by Reinhold Niebuhr,

Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

For me, it is telling us to solve the problems that are within our control (effective problem solving!), and for those stressors that we can do nothing about, we accept it (building psychological resilience, mindfulness, thought defusion, acceptance of negative emotions etc). And of course, what comes before, is the insight, the wisdom to identify the problems in your life and know to which category they belong to!

Psychosis to Depression?

It all started in December last year. She presented some elementary hallucination, poor sleep at night, poor concentration and drowsiness in the day. She wasn’t hearing voices, but some knocking sounds (similar to when one is knocking the doors).

So she sought psychiatric help, was put on antipsychotic and stimulant (Ritalin, normally prescribed for ADD, ADHD or narcolepsy). Her symptoms soon got much worse, seeing ghosts(?)., talking irrationally and was then brought to general hospital, where she was put on more antipsychotic drugs.

Few weeks later, her family took her to see another private psychiatrist doctor after she was discharged. The consultant diagnosed her with bipolar disorder, based on the fact that she was once an outgoing and independent person, and prescribed her with Lithium.

Throughout the few months under the care of the psychiatrists, she took and tried many medication including antipsychotic pills, she gained over 20 kgs. She gets really depressed about her weight. For when before the first episode end of last year, she bought some slimming pills online, which acted as appetite suppressant. That was when she was 20 kilograms lighter than what she is now. She wouldn’t even want to look at herself in the mirror, when she thinks about her weight, she thinks life is meaningless. She doesn’t know how she has got here and how to find the old self. She has been unable to work for 10 months now.

It all started mild. She has no family history of mental illness. The team can’t help suspecting those slimming pills that she took, which could affect and alter her brain and nervous system. Of course we wouldn’t know whether there is a cause effect relationship for definite here (and we would never know), but it is important that you know what pills and medicine you are taking, those that you buy online, and those that you are prescribed by professional doctors. I am not saying that everyone should question his/her doctors and the diagnosis and prescription, but when in doubt or think that something is not right, seek a second opinion. Also, do not believe everything that’s said on the internet, but sometimes online resources might provide us with some basic and guidance.