Mt Elvira comes out of the closet to share the lessons he has learned in his long battle against depression with the hope that his insights will help others going through the same ordeal.
If you are reading this and are approaching the age of 40, chances are you could end up as part of the 10 per cent of Malaysians to suffer from some form of mental illness come 2020.
The most commonly diagnosed mental illnesses in Malaysia are anxiety, depression and stress disorders.
The World Health Organisation (WHO) predicts that depression (a mental illness) will be the second form of health problem affecting those aged 50 and above after heart disease by 2020.
Depression is a common illness worldwide, with an estimated 350m people affected. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition.
It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. At its worst, depression can lead to suicide. Suicide results in an estimated one million deaths every year.
Even as a developing nation today, the rate of suicide cases in Malaysia is alarming, with 60 people commit suicide every month in the country, according to the National Suicide Registry Malaysia.
I am writing this to do my part to add to the discourse on mental illness in the public sphere. Why? As a long time mental illness patient, I hope to use my narrative to help create a greater public awareness of this disability.
I do not use the term mental illness lightly; for years, I refused to acknowledge that my recurrent depressive episodes were indeed a manifestation of mental illness. As this involves people near and dear to me – and my narrative will affect their privacy – I will not use real names. But the incidents are real as far as I can recall.
My intention is to alert people reading this to bear in mind that sometimes a difficult colleague or friend may be struggling with a disorder he/she is not at liberty to disclose or perhaps has not even personally acknowledged.
I was a teacher. When I was first diagnosed with depression way back in 1988, I was unfortunate to consult a psychiatrist who was not empathetic. Dr C was [and still is] in private practice but his manner of dealing with a depressed patient [me] put me off.
Perhaps it is unfair to blame him altogether; perhaps I really was not prepared to accept that I needed to go on long-term medication (anti-depressants). But this is my take of that consultation and I never went back to him – he came across as too mercenary!
Lesson 1: Keep physically active
Thus began more than 11 years of battle with recurrent episodes of depression. I was lucky to have close friends who were there to lend a helping hand when I was down and out.
In the initial two years, I was particularly lucky to have a friend, Y, who came to my house to teach me yoga, to make sure I was physically active when I was down with a depressive episode. Later he took me on his motorbike to a local park for walks when I was depressed.
So, this is the first lesson I would like to share – keep physically active. You will not feel like it; get a friend or a relative to literally drag you off your feet. You will not feel better immediately or recover overnight but for some time after the exercise, the sense of gloom and doom will not be that overwhelming.
Lesson 2: Have good friends
Colleagues who were good friends knew of my depression and at times, helped me cover classes when I could not drag myself to enter a class – and mind you, these were classes I had taught before.
In those early years, as I had refused to acknowledge I had mental illness, I was reluctant to let other colleagues and the school administration know of my problem because of the social stigma then – as it is now.
Another friend, V, would serve me a cup of coffee or tea and listen to me as I spoke of my sense of worthlessness when I was down and out. You cannot have good friends overnight; so it is important that you make sure you have fostered good friendships over the years.
So, the second lesson I would like to share is that having good friends and just talking things through can help.
Yes, I also made use of The Befriender’s telephone helpline as well, but to be honest, it did not gel with me. This is not to belittle the services of volunteer groups such as The Befrienders – they serve an important need if one is down and out and has no one to turn to.
Lesson 3: Some have imbalance of chemicals
Some may wonder how I survived those episodes of depression over the years. I met a good GP, Dr N, when I had another episode some time after I had finished Dr C’s anti-depressants. He was empathetic and he, probably of the old school, did not feel I needed long-term antidepressants.
So, over those years, when I was down with depression, I would go to Dr N for a prescription of anti-depressants (amitriptyline – it was usually the worst part then – plus two days’ medical leave to hide myself at home).
I blame him not for not referring me to specialist treatment earlier – for mental illness is not something one can take a test and confirm the required treatment protocol, unlike say diabetes.
But in 1999 when I went back to him during a particularly prolonged episode that I couldn’t shake off, he suggested it best I see a psychiatrist, Dr O. The rest, as the saying goes, is history. I accepted then I needed long-term antidepressants.
But, truth be told, Dr O told me I am a very delinquent patient but as she pointed out she can’t put a gun to my head and force me to take the antidepressants everytime. I had several relapses while under her care , when each time against her professional advice, I insisted on reducing (no, not stopping!) my dosage of antidepressants.
So, the third lesson is that there are those of us out there who suffer from some imbalance of chemicals in our brain (Dr O said mine should be serotonin). Like it or not, accept it or not, we need the antidepressants to keep us from falling into another episode of depression.
Lesson 4: Family support vital
The fourth lesson and most important in my experience is family support.
I believe my children did not understand the behavior of their father during those years when they were growing up. But I remember one episode: when I was suicidal, my young son grabbed me by my leg and implored me not to; he said he loved me when I said I wanted to commit suicide.
My wife had to double up as both parents when I could hardly function during my episodes of depression. She said it was not easy but after a time, she just struggled on, knowing I would come out of that episode!
I have a very supportive brother who gave me much support, moral and financial. When I was referred to Dr O, a private psychiatrist – the consultancy charges and the newer antidepressants were a big burden on my monthly budget.
Why did I not go to a government psychiatrist? I believe those who have been to government hospitals for treatment before will understand why I did not.
This narrative has, by its very nature, been superficial. I have painted my story with broad strokes but I feel the essence of my battle with depression has been discussed.
Mt Elvira is the pseudonym of a resident of Penang.