Doc Talk

When life gives you lemons, make lemonade

ST ILLUSTRATION: ADAM LEE

Mental resilience helps one to accept what's beyond our control, and work around it

"Please, doctor, can you counsel my mother? She keeps worrying about my brother and his children and this is making her depressed again," said my patient, Aaron.

Both Aaron (not his real name) and his mother were my patients.

Aaron was in his early 20s when he experienced his first few episodes of bipolar disorder.

The manic episodes (high mood states) that he experienced necessitated the use of electro-convulsive therapy to settle him.

Fortunately, the ensuing years saw him accepting and understanding his illness, thereby learning to manage the stress that had previously tipped him into relapse. In other words, he learnt to be mentally resilient.

Being resilient includes being aware of one's strengths and weaknesses, and knowing the resources (family, trusted friends, religious advisers and professionals) to tap when needed.

Adopting a positive outlook on life is crucial, for our thoughts determine our feelings and actions.

Being resilient is to be able to roll with the punches, to accept situations that one cannot change, and to work around these situations.

Aaron began by not dwelling on his problems, looking for solutions or alternatives instead. He assessed his own capabilities and, after a short stint in a well-paying financial job, made the decision to step down to a lesser-paying but less stressful job that was still in the financial industry.

He sought the support of his wife whenever he was stressed, and often continued the discussions in my consultation room.

When his children came along, he adopted the same approach in handling them: being positive in his outlook, allowing the children to find their way without stressing them and himself along the way.

He built a supportive family network, maintained good physical health, practised healthy ways of relaxing and learnt from his past experiences.

His mother suffered the same disorder.

Despite this family history, Aaron was able to avert further relapses.

With his new-found resilience and compliance with medication, he remains well in remission today.

His mother benefited from his advice to adopt a positive approach to life and its trials and tribulations.

She used to relapse into depressive or manic episodes when she was stressed over her "never-do-well" older son and his unfortunate children.

She was finally convinced that her worries would not change her older son's behaviour. Instead, it would worsen her own illness.

She is now mentally well, with minimal medication, despite having to grapple with a whole host of physical illnesses at the age of 75.

Aaron's story shows clearly that mental resilience can positively influence the outcome of mental disorders. In my 35 years of experience as a psychiatrist, I have seen this happen in the lives of many patients, such as a young man who I treated for depression more than two decades ago.

With a strong family background of depression, he likewise fell into depression in his 20s, when he simultaneously faced a relationship break-up and job mismatch.

At the peak of his stress, he attempted suicide. With timely treatment, he was saved and eventually went on to train for a new career. He also moved on from the broken relationship.

Two decades later, he is established in a stable, well-paying job and felt ready to adopt a child with his new partner.

When I assessed him in relation to his fitness to adopt, I noted that he had not suffered any relapse since our last contact after his treatment, which lasted a few years. His change had come about because of his positive attitude to life. He changed what he could and adapted to what he could not. In short, he became more resilient.

Eventually, I gave approval for him to be an adoptive parent.

People without mental disorders will benefit from developing their mental resilience.

Parents would do well to teach resilience to their children from young. Instead of mollycoddling our children, we should strengthen their bodies and minds.

We can provide balanced nutrition and opportunities for physical exercise, encourage their sense of belonging in the family and community, and teach them survival skills or coping strategies.

These could include helping them identify potential dangers, or handle bullies in school.

Being resilient includes being aware of one's strengths and weaknesses, and knowing the resources (family, trusted friends, religious advisers and professionals) to tap when needed.

Adopting a positive outlook on life is crucial, for our thoughts determine our feelings and actions.

In my interactions with patients with addictive disorders, an oft-quoted reason for their relapse into addictive drug or alcohol use is "stress".

When resilience is weak in the face of stress, the tendency is to cave in to instant gratification without due consideration of adverse consequences.

•Professor Wong is an emeritus consultant at the Institute of Mental Health. She was chairman of its medical board from 2002 to 2008.

A version of this article appeared in the print edition of The Straits Times on January 05, 2016, with the headline 'When life gives you lemons, make lemonade'. Print Edition | Subscribe