Living with mental illness

People with mental disorders share their experiences to raise awareness of the health problem

Mental health advocacy is seeing a new push, as people with mental illness are calling for greater awareness of it.

For Ms Zhong Peirong, 25, this began last year, when she started having panic attacks and bouts of crying accompanied by feelings of helplessness, which she could not account for.

She felt unable to cope at work and resigned from her job as a learning support educator for children with slight learning disabilities. She says her boyfriend of more than a year left her, unable to deal with her condition.

She was diagnosed as having mild bipolar disorder, which is characterised by mood swings.

Her first reaction was "self stigma", she says.

A flurry of questions raced through her mind.

"How was I going to work? Will the next person I get into a relationship with accept me as I am?

"Am I going to be like my mum?"

She is the caregiver for her mother, who suffers from schizophrenia. She sometimes thought her mother was scolding her, when the 55-year-old housewife was instead scolding the voices in her head, the product of her condition.

Her mother's illness meant that Ms Zhong had a "chaotic" childhood, which fuelled a desire in her to help children from complicated family backgrounds like hers.

Today, she is about a month into her new job as a preschool teacher at a childcare centre.

The dosage of her medication has been halved since her diagnosis late last year and she is using her online baking business, Bakery Wellness, to advocate for mental health.

She says she opens up conversations about mental health, for example, by handing out postcards to customers. The cards ask if the recipient would like a listening ear. She also passes out information relating to misconceptions about mental illness.

Having received support from people such as her father, who is divorced from her mum, she "hopes to return this hope to other people".

She is one of several people with mental health issues participating in In My Shoes, an art exhibition held yesterday and today at the 5th floor of *SCAPEmedia Hub at 2 Orchard Link.

The event, a collaboration between Nanyang Technological University student artists and the mental health community, is organised by Uninhibited Space, a social enterprise focusing on community arts.

The Singapore Mental Health Study, conducted in 2010, found that one in 10 people in Singapore suffer from a mental disorder.

"Persons recovering from mental health conditions, or their caregivers, make good and credible mental-health advocates, given their experiences with the condition. They can also act as a bridge to persuade those who are in denial to seek professional help," says Ms Lee Yi Ping, team leader and senior youth support worker at Community Health Assessment Team (Chat).

The In My Shoes exhibition is endorsed by Chat, a national outreach and mental health check programme under the Institute of Mental Health.

Ms Lee adds, however, that mental health advocacy can be "draining", especially if advocates are swamped with requests to share their experiences.

"Advocates also need to attend to their own needs first through regular self-care," she says.

"It is important for the public to understand that mental illness can be treated. In addition, we can choose to support the reintegration of persons-in-recovery into the community, across family, work and other social settings because many persons with mental illness can function as contributing members of society if their illness is managed well."

• In My Shoes is on at *SCAPEmedia Hub, 2 Orchard Link, 05-02, today from 11am to 8pm.

Hearing voices that say 'die, die, die'

At the age of 10, Mr Chia Xun An was diagnosed with depression.

His parents took him to a child psychiatrist after he started to bang his head against a wall in distress. He had also been unable to sleep and was having nightmares.

The diagnosis of major depressive disorder caused him to miss a lot of school. The condition, characterised by a persistent low mood, meant that there were days when Mr Chia, now 24, "literally could not get out of bed".

It took him five or six hours to force himself to sit up, walk away from the bed and get dressed.

He was put on anti-depressants as he underwent psychotherapy, but suffered three relapses in Primary 5 and Secondary 2 and 5. His 59-year-old father, who works in construction, took five years off work to care for him, the eldest of three sons. His mother is a sales executive in her early 60s.

When Mr Chia got into Ngee Ann Polytechnic for a diploma course in hotel and leisure facilities management, he was determined to catch up with his peers.

But during his final semester, he exhibited new symptoms. He heard voices saying "die, die, die" and saw scribbles and lines around him. He tried to raise his health concerns, but received unkind remarks, with schoolmates saying that the project they were jointly working on was "more important".

He had a psychotic episode, where his mind blanked out. He remembered talking, but not what he talked about. His friends said he had dragged a chair to the middle of the classroom and made a 30-minute speech.

Although he is hazy about what he said, he did remember a specific feeling. It was: "Whatever I'm experiencing, I don't want other people to go through it."

Diagnosed with borderline personality disorder, a condition marked by unstable moods and behaviour, he deferred school for half a year, during which he started drawing the black scribbles only he could see. This culminated in a book about depression, The Black Box, which he wrote, illustrated and self-published last year.

Since then, he has been advocating mental health awareness by giving talks at venues such as schools and churches. Last year, he took a specialist diploma course in interior and landscape design at BCA (Building and Construction Authority) Academy. He now plans to take a degree course there.

He wants people with mental health concerns "to know that you can seek help without any fear, without reprisal and, despite whatever mental health condition you have, you are able to work and contribute to society".

5 suicide attempts in 23 years

After attempting suicide last year, Ms Shafiqah Nurul Afiqah Ramani was warded in hospital for two months. It was her fifth attempt in her 23 years.

She was diagnosed with major depressive disorder at the age of 17, a condition often associated with suicidal thoughts or behaviour.

She had been having thoughts of killing herself since the age of nine. At 11, she started cutting herself, which she found "calmed" her down, a practice she stopped only three years later.

At 17, she met her boyfriend, Mr Sayid Hafiz Sayid Zin, 28, when they were both studying at Nanyang Polytechnic and confided in him. He e-mailed a school counsellor who intervened, leading to her diagnosis.

She says her parents were shocked to learn about her depression as she had "put up a cheerful front 24 hours a day".

"It got quite taxing," says Ms Shafiqah, the eldest of four children. Her father, 50, is a senior technician and her mother, 49, is a housewife.

When she was hospitalised last year, she was also diagnosed with borderline personality disorder, which explained the extreme mood swings. Psychotherapy, which involves addressing mental health problems by talking to a psychiatrist, psychologist or other mental health provider, is one of the treatments available.

Patients like her are required to do "homework" between sessions, recording moods and emotions throughout the day. The log helps her psychotherapist to assess her conditions.

The problem was, the sessions were as infrequent as three months apart for Ms Shafiqah, who was being treated at a government hospital. She found it "stressful" to stick to the routine of keeping a daily log.

Luckily, she got some support and motivation from a WhatsApp group of young people with mental illness, where they shared their experiences.

She later came up with the idea of using apps to make psychotherapy easier. The apps can be used by both psychotherapists and their clients. Clients get prompts and guided questions to perform tasks assigned by their psychotherapists. Psychologists can remotely monitor and communicate with their clients between sessions.

With about $23,000 of seed funding from the Singapore Centre For Social Enterprise, she co-founded PsychKick, an IT solutions company, last July with Mr Hafiz, a former Web developer.

The couple, who have been dating for 51/2 years, hope to launch two apps, which will be tested by psychotherapists and people with mental health issues, in October, when World Mental Health Day is commemorated.

Ms Shafiqah, who takes nine tablets a day to medicate her condition, says her mental health advocacy, in the form of talks at schools and corporate pitches for their apps, gives her "more motivation to fight for others with mental illness".

Mr Hafiz says his reason for taking on the challenge of setting up their company was more personal. "I'm doing it for her," he says.

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A version of this article appeared in the print edition of The Sunday Times on July 31, 2016, with the headline Living with mental illness. Subscribe