Carers fatigue - Who cares for the carers?

As the carers care for the mentally ill, who then care for the carers who themselves have become mentally ill?

Mr Jared Goh shares his story in the papers this morning. He gave up his job at a multinational company to take care of his sister, who was diagnosed to have anxiety, panic disorder and agoraphobia - a condition of being anxious in unfamiliar environments. He is also taking care of his mother, who has health issues. 

His sister was warded at IMH in 2013 and was put on medication. She stopped taking the pills and became suicidal. 

Jared said: “I was feeling anxious, not knowing what else may happen next. I was feeling lost, not too sure how I could help especially when I thought I could have some time for myself, and then I got activated to attend to her.”

Jared admitted: “There were thoughts of “Why me?” and “Who else?” I didn’t sleep well, and because my work was also demanding, I almost broke down.””

Jared’s case follows after the recent case of Tan Tian Chye, who hit his mentally-ill daughter with a pole and strangled her to death in 2018. He was sentenced two weeks ago to two years for culpable homicide. 

Mr Tan was diagnosed to have major depression. The burden and strain of taking care of his daughter drove his wife and him to contemplate suicide. 

I recall an author once struggled with depression too and this is what she said about it: “Depression is the most unpleasant thing I have ever experienced...It is the absence of being able to envisage that you will ever be cheerful again. The absence of hope.” (JK Rowling). 

That is the reality of depression, not that you have to struggle with it, or you have to be medicated for it, but to struggle with and be medicated for it without end. There is just no light at the end of the tunnel, and the darkness is getting darker, even the walls are closing in. 

We can live with many paradoxes in our society, you name it...faith and doubt, hope and uncertainty, joy and sorrow, and rich and poor. But the paradox of our developed world is more insidious than that. It is the paradox of the objective and the subjective. 

There is no doubt that we are getting objectively better, with longer life span, increased income and wealth, much better healthcare, more education for all, and our technology has been growing by leaps and bounds. 

We therefore have the power to solve many of our problems, yet, the one problem we have completely left behind is ourselves, our mental health, our subjective well-being. Alas, the objective appearance of progress has not resolved our subjective condition of regress. Happiness in technology is no happiness in humanity.

In any event, the insidious list goes on and on. Climate change is an indictment of our nature, our insatiable appetite. The invisible hand of the market drives us to the edge of our own destruction. 

How about inequality? Little hope can be reaped from there, as the top fifty in this world has more in material possession and wealth than the combined total of the bottom half. Can we then turn the tide around? Or is this a major system error? 

And as we herald better days with technology, globalisation and progress in human rights, we also see greater division caused by them, whereby the hypocrisy of the status quo (or the establishment) is unravelled. That is why many are turning to the far right, to patriotism, to national populism, and to religion, because no one watches over the watchmen. 

My point is about a society of hope. The one Rowling cried out for. Without vision, without hope, the nation or society perishes. But hope can die stillborn too when we pay lip service to it. 

And hope can disappoint deeply when it is exploited as a means to the ends of just a handful in society, leaving the rest to languish in their own broken devices - lucky are those who survive. For some, death is the ultimate escape. 

Returning to Jared Goh, I believe his issue, his struggles with caregiving, is, a cry for hope. His “why me?” and “who else?” largely epitomise the dearth of hope. 

As I write this post, I am mindful of the many who are suffering with no end in sight. Mental illness is often a social disease where it is not so much the good intention that fails us, but the institutions, culture and system that have betrayed us. 

Kindness is definitely not dead. It is flourishing in many hearts. But kindness alone is battling social distortion, social inequality, social deprivation and social predation, and that collectively pushes us back, even though we strive to move forward together. A delusional treadmill of progress?

Can we then make it as a society that fight for hope back? Can we view progress not as accumulation just for self, but one of cooperation and sharing for all, especially for those who need it most? Can we turn the pyramid upside down, allowing not just a change of hearts, but a change of lifestyle, a change of values and a change of priorities? 

Believe it or not, I believe we can. I am intentionally evoking hope no less. And in any event, many are doing it, giving selflessly, even anonymously. 

But ultimately, we need a change of perspective and system. We need a change for good, not just with policies, but with conviction and consistency. That is, a change from a society that is struggling for hope, every shred of it, to one that gives hope and a helping hand, almost instinctively.