The question from my friend Zoe (not her real name) came out of the blue while we were in the middle of a lecture on mental health as nursing students.

Leaning over, she asked me: “What if I’m experiencing these symptoms?”

“What do you mean?” I replied.

“I don’t know, I just don’t feel too good and I don’t know what to do.”

Zoe had a depressive episode when she was younger. I recalled that she once shared about how overwhelmed and hopeless she felt back then.

I was worried that these negative thoughts were back to haunt her again, so we spent the next half of the lecture searching for resources and helplines.

We wanted to get help anonymously because Zoe was afraid that her condition would jeopardise her chances of getting a hospital sponsorship, or even her career as a nurse.

I was unsure if I had the capacity to support her. At my suggestion, she approached one of our professors, who referred her to a counsellor at the National University of Singapore where both of us are pursuing a nursing degree.

Days later, before Zoe’s appointment with the counsellor, I received this message from her: “The urge to go up a building is super strong. I’m scared.”

I let out an expletive, dropped everything I was doing and asked Zoe where she was and who she was with. I paced up and down in my room, thinking of what I should do. I opened the lecture slides titled “Nursing Management of Clients with Suicidal Intent”, fervently praying that I could find a way to manage the situation.

When Zoe stopped replying, my thoughts went wild — what if I were to lose her? I knew for sure that I would hold myself culpable for her departure and eventually spiral into depression.

I had promised Zoe that I would keep her condition a secret but I knew I was ill equipped in supporting her, even though I attended an emotional skills workshop and was taking modules on psychology and mental health.

I eventually called up a mutual friend and explained the situation to him. We did not want to take the chance and lose a friend but we did not know what to do as well.

Fortunately, Zoe ended the hour-long frenzy when she replied us a while later, stating that her neighbour had sent her home.

Zoe visited the hospital’s emergency psychiatric unit the next day, after she informed her counsellor of what had happened. She was diagnosed with depression and anxiety and was given Fluoxetine.

We learnt psychopharmacology in school. I knew that Fluoxetine is a Selective Serotonin Reuptake Inhibitor, an antidepressant which has a paradoxical side effect of worsening depressive symptoms and increasing suicidal thoughts for the first two weeks of using the drug.

I was deeply concerned and kept my phone and notifications on all the time, in fear that Zoe would attempt to do something silly.

I frequently checked in with her and she would tell me how the background noises seemed to have amplified to unbearable levels, how her mouth felt so dry and parched and how terrible her trembles were. The side effects eased up later in the week.

Zoe is now coping well with her condition. While she is still on antidepressants, she is undergoing dose tapering.

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We are glad that we played a role in her recovery and we are looking forward to seeing her wean off medications in early 2020.

Zoe’s experience made me realise how we all need people to cheer us on, no matter what the circumstances are.

I struggled with what I could say to make Zoe feel better and frequently wondered if my approaches in caring for her were even helpful.

Gradually, I realised that individuals with mental health disorders often need us to simply listen to them and validate their feelings.

The truth is, many people with mental health conditions have already attempted a myriad of solutions to rid themselves of their ruminating thoughts, but to no avail.

Support from one or two people goes a long way in letting them know that someone cares.

It is human nature that we try to rationalise the feelings of those facing mental health issues. We may even dismiss their feelings because we do not understand them. It is also common to compare them to ourselves or others.

Yet, these actions invalidate their struggles and reinforce the perception that we are unable to understand them, resulting in isolation.

I learnt that it is crucial to acknowledge their feelings and thoughts, and not pass comments which make them feel trivialised.

When supporting our loved ones who are living with mental health conditions, we should continue to treat them as who they are and not let their mental illnesses engulf their identities. 

We must also be aware of our personal limitations. Helping our friends facing mental health issues can be emotionally and physically draining and we must know when we need to seek help too.  

Life in fast-paced Singapore can be stressful and mental illnesses are becoming a crucial health challenge in our society.

While we build emotional resilience and indulge in self-care, let us also learn to support those who are living with mental health conditions. 

In the recent blockbuster movie, Joker, Arthur wrote in his journal: “The worst part about having a mental illness is people expect you to behave as if you don’t.”

Perhaps, it is time to reach out to those in pain, acknowledge their feelings and learn to act appropriately.

Sometimes, a simple “How are you?” may go a long way. Let’s make our stressful society a kinder and more inclusive one. 

ABOUT THE AUTHOR:

Lua Ser Ning is a second-year nursing student at the Yong Loo Lin School of Medicine, National University of Singapore.