Caring for sufferers

As discussed in the Learn section, there are numerous types of mental illnesses –  depression, anxiety, mania, psychosis and addiction –  each have different symptoms. In this section, we take the perspective of a caregiver and elaborate on how to identify the signs of specific mental health conditions and what kind of support to offer in each case. Also, we discuss the measures that can be taken if a sufferer’s life is at risk.

If you need more information on mental health services, please visit our professional help section for types of services and the seek help section for a list of service providers in different cities.

Depression

It can be difficult when someone you know or live with experiences depression. There are signs that you can look out for which may enable you to help them. Feeling sad or upset from time to time is normal, and can even be beneficial. However, if these feelings are prolonged over a period of four to six months or more, or impair one’s ability to function in everyday life, this can be a sign of depression.

Depression can develop slowly. Someone who is depressed doesn’t always realise or acknowledge that they’re not feeling or behaving as they usually do. Often it is a partner, family member or carer who first realises that help is needed.

Signs:

There are lots of possible symptoms of depression. If you think that the following signs are adversely affecting someone’s life, it may be time to seek help. You may notice that someone:

  • Has lost interest in doing things that bring them joy or contentment
  • Feels down or hopeless
  • Has slower speech and movements or is more fidgety and restless than usual
  • Feels tired or doesn’t have much energy
  • Is overeating or has lost their appetite
  • Is sleeping more than usual or isn’t able to sleep
  • Has trouble concentrating on everyday things, such as watching the television or reading the paper
  • Is negligent of their daily tasks and responsibilities

9) Is easily angered and more irritable than usual

How can you help?

If you believe that someone you know suffers from depression, there are specific ways for you to help:

  • Let them know you care and be ready to listen compassionately.
  • Accept them as they are, without blaming them and advising them to change.
  • Gently encourage them to help themselves– for example, by doing some exercise or staying active, eating well and doing things they enjoy.
  • Get information about professional help available in your area. For this, see our seek help
  • Stay in touch with them by meeting, messaging, texting or phoning them. People who are depressed can become isolated and may find it difficult to leave their home.
  • Do not forget to take care of yourself while being a caregiver.

Anxiety

Nearly everyone experiences nervousness, a sense of worry or panic at times, but for some of us these feelings become a part of day-to-day life and end up affecting our daily functioning. Anxiety becomes an issue if it is different from everyday worry in that it is more intense and persistent, continuously interfering with a person’s ability to attend to or complete daily tasks. If you have a family member or a friend who experiences anxiety, it may be hard for you to understand their intense or disproportionate response to stressors.

Signs:

So what should you be looking out for? You may notice that someone:

  • Appears more tense, nervous and restless than before
  • Feels irritable and angry more easily
  • Complains of physical symptoms like headaches, palpitations and weakness
  • Has episodes of panic, causing them to make rash decisions without thinking through the consequences
  • Has problems with sleeping
  • Has difficulty concentrating on their work
  • Becomes increasingly paranoid
  • Starts doing something repetitively like washing their hands or showering
  • Can’t stop thinking about a stressful event, real or imagined

How you can help?

If you recognize any of these signs, this is how you can help:

  • Try talking to them about how they feel and tell them that you have noticed a change in their behaviour and feelings
  • Be a compassionate listener
  • Help them in finding information about anxiety
  • Encourage them to try to get enough sleep, exercise and to eat well
  • Encourage them to use self-help strategies
  • If the distress levels are prolonged or intensified, encourage them to seek professional help
  • Accompany the person to a mental health professional
  • Look after yourself while supporting them

Mania

Mania or manic episodes are difficult to understand as very few of us experience them directly. If you have a family member or friend who experiences mania, you may see them experiencing elevated moods and high levels of energy, leading to an increase in physical and mental activity. Some sufferers may be excessively happy, whilst others may be irritable and easily angered.

Signs:

Here are the signs you should look out for:

  • Grandiose ideas: Those going through a manic episode may feel special, have high levels of self-esteem and think they possess special powers
  • Rapid speech
  • Excessive amounts of energy and hyperactivity
  • Racing thoughts and an excess of ideas
  • Needing little sleep, or a change in usual sleep pattern
  • Easily distracted – starting many activities and leaving them unfinished
  • Increased appetite
  • Reckless behaviour such as spending beyond their means or putting themselves in dangerous situations

How you can help?

If you detect these signs above, here are some things you can do to help:

  • Be there for the person and build a relationship of compassion and trust
  • Encourage them to look after themselves (exercise regularly, eat well)
  • Support them to think through the consequences of their choices and avoid high risk, harm or danger
  • Encourage them to seek professional help
  • Encourage them to use their energy and behaviour positively (outlets such as art and writing can help)
  • If you feel they may harm themselves or others, seek emergency measures

Psychosis

Psychosis describes a state when someone has lost touch with reality. When a person suffers from psychosis, she or he may experience unusual thoughts. These may appear suddenly, or develop gradually over time.

Signs:

If you have a family member or relative who experiences psychosis, they may display one or more of the following symptoms:

  • Unusual beliefs called delusions; these unshakeable beliefs are obviously untrue to others, but may not be to the person themselves. For example, when a person is ill, they may think that there is a conspiracy to harm them.
  • Inability to think in a logical or ordered manner; such thought disorders are a common marker for psychosis. It may be difficult to understand what they are saying; their ideas may seem jumbled, but a thought disorder is more than being muddled or confused due to stress or exhaustion.
  • Unusual experiences called hallucinations happen when they can see, hear, smell or feel something that isn’t really there. The most common hallucination which people experience is hearing voices. During psychotic episodes, hallucinations appear real to the person having them. This can be very frightening and can make them believe that they are being watched or spoken to by unseen voices.
  • Social withdrawal is another common sign of psychosis, as they may not want to meet people because of their paranoia or have difficulty communicating with people.
  • Rapid changes in mood, as some people may feel strange and cut off from the world. It may feel to the person that everything is moving in slow motion. As a result, they may experience less emotions or show a narrower range of emotions to the people around them.

The earlier psychosis is recognized, the better the chances are of receiving effective treatment. Timely treatment speeds recovery and reduces long-term harm.

How you can help?

It can be very distressing to support someone suffering from psychosis. Here are some strategies that might ease your experience:

  • Be supportive and explain that while you may not always like or agree with their behaviour, you still care for them as a person.
  • Understand that the person might be talking and acting differently due their psychotic symptoms.
  • Don’t take it personally if they say hurtful things while unwell.
  • When someone is in the midst of an acute episode, they may seem more child-like and need a comforting environment and support in making decisions.
  • Don’t engage in long discussions or disagreements about their fixed ideas or beliefs. Instead, listen with interest to demonstrate empathy and develop an understanding to discuss this with them further when they are well. It is important to generally maintain a calm environment, as conflict can contribute to the stress experienced by everyone. Remember, they may not know what they are saying and they may have lost touch with reality.
  • Take care of yourself. You should acknowledge and express your feelings. It may help if you get information about the illness and how to cope with it.

Addiction

There are many different types of addiction. People can be addicted to legal  (alcohol, tobacco, and prescription medication) or illegal (cannabis, heroin and cocaine) substances.

Signs:

As a carer, you may notice that the person is:

  • More concerned with getting their substance than engaging with other things
  • Angry if confronted about their substance use
  • Secretive and evasive
  • More often intoxicated, or under the influence of a substance
  • Tired, irritable and looking less well
  • Less interested in everyday things
  • Unable to say ‘no’ and has a strong desire for the substance
  • Using more and more of the substance to get the same effect
  • Possibly involved in criminal activity or reckless behaviour
  • Anxious, depressed or shows symptoms of other mental health problems

How you can help?

As a carer, you may be concerned and may not know how to help or fear getting into an argument with the sufferer. Here are some ways that you could help:

  • Forming a positive relationship with all those involved in helping to control or stop the substance use.
  • Avoid blame, judgment and criticism of the sufferer as this may drive them away.
  • Trying to find out why they are abusing the substance rather than forcing them to stop.
  • Encourage the person to get professional help.
  • Stay informed about treatment options and recovery support that are available so that you may be able to facilitate a referral if and when help is solicited.
  • Take care of yourself; share your worries with people you can trust, and make sure you find time for yourself.

Life at Risk

While everyone suffering from mental illness experiences periods of distress, for some these periods are more severe than for others. In its severest form, the behaviour resulting from mental illnesses can become dangerous, as those suffering may view harming themselves as the only immediate way out of their problem.

Identifying the severity of a person’s distress is extremely important. If the distress is extremely severe, the sufferer may be:

  • Talking about death from time to time
  • Mentioning plans to harm themselves or commit suicide
  • Having marks on parts of their body as a result of self-harm
  • Becoming socially withdrawn or isolated suddenly
  • Showing absence of self-care and a severe loss of functionality

If we feel that someone’s life may be at risk or irreversible damage is about to occur, through either suicide or self-harm, it is crucial that we do not wait but directly engage in the following measures:

  • Build a rapport with the sufferer and showing that you are there for them. Inform the person closest to them who can observe the threat of self harm, and intervene if required.
  • Gently inquire about how the sufferer is doing and assess the risk of the likelihood of harm. For instance, if the sufferer mentions cutting, check and remove any blades or sharp objects within their reach, if possible.
  • If the sufferer mentions any plans of self-harm or suicide, show curiosity and care, rather than demand explanations or reasons.
  • If the sufferer has any past psychiatric history, try to find out more about it, i.e. whether they are on any medications (which they may have missed), have any mental health professionals they visit or have any previous history of self-harm or suicide attempts.
  • Offer compassionately listening to the sufferer.
  • If the sufferer is very close to engaging in self harm, take them to the emergency department of a hospital with inpatient psychiatric facilities.

If the aforementioned steps are taken in a timely manner, they may help in saving the sufferer’s life.