17. How to help a sufferer

If you are not a sufferer, but want to know how to help someone who’s suffering from some form of mental disorder, this chapter is for you.

If you know someone who has committed suicide, this chapter is also for you. Please pay attention to the last section.

There are many ways that a sufferer can be helped. Samaritans of Singapore has a good summary of information. I will try to provide more details.

1. Do not give advice.

This is possibly the hardest lesson to learn for most people who are trying to help mental health sufferers. How can you stand by and not help? You can – by not giving advice, especially unsolicited advice. Mental health sufferers are struggling to cope with the reality of what they are facing. Believe me when I say that they probably have either already tried what you are about to suggest, or have failed in what you are about to suggest. Your suggestion or advice, especially when unsolicited, will either add to their guilt unnecessarily, by reminding them of their failed attempts, or is not useful at all. Examples include “Try to relax more,” (If a sufferer could relax, they won’t be suffering.) and “Learn to trust God more.” (This may actually be true for certain sufferers, but not all, and may spin a sufferer deeper into depression due to guilt for not what they feel is not trusting God.)

2. Do not judge.

No one chooses to be depressed, or fall ill. If you understand that depression is an illness, do not judge the sufferer if you seek to help. Don’t judge their attempts at suicide as taking the easy way out. Don’t judge their lack of compassion on themselves. Don’t minimise what they feel, or struggle with. If you are an employer, don’t assume that they are trying to get out of work. Don’t assume that depression is simply being weak, or a matter of mind practices that will improve the situation. The more you assume these things, the more the sufferer will feel judged, and it can go badly from there.

3. Do not project yourself.

Unless you are a fellow sufferer, or have gone through similar experiences in the past, don’t project your experiences onto a sufferer if you truly wish to help them. The sufferer’s experience is not your experience. Projecting your experience – even as a fellow sufferer – and expecting the sufferer to follow your exact steps to improve themselves is an unfair burden as every case is different and may need a different treatment.

Similarly, if you are not a medical health care professional, do not project your idea of how treatment should be like on a sufferer. Allow the mental health professionals to do their job.

4. Do not make undue or unfair promises.

Don’t promise a sufferer that it will be ok. Don’t promise a sufferer you won’t seek help on their behalf if they have severe suicidal tendencies. Don’t make promises you can’t keep, just to keep a sufferer happy. Be as realistic as you can, to help them to prepare for recovery, but as gently as possible.

5. Don’t demand to know the story.

Depressives and people with mood disorders can find it difficult to expend energy to talk. When breathing and walking are already difficult tasks that require concentration and energy, talking is no longer on the critical list. To really seek to help a sufferer, instead of asking why they are suffering from depression, simply be there, and if you want to know the story, either wait for them to be ready to tell you on their own, or wait till they are better before asking.

6. Do be present.

Most times, sufferers need someone to just be there with them. No one can understand their pain as fully as themselves, and quietly spending time with them may be enough for a sufferer to know that they are not alone, and pull them back from the brink of suicidal tendencies. At the same time, your presence is precious – and when you do have specific advice to give, your history of being there for a sufferer will give your words a lot more credence as the sufferer will know that you really do care for them.

7. Do listen.

As above, sufferers can find it difficult to talk to you. When they finally do open up, it is because they trust you enough to speak to you. Listen without judging, and listen with a focus to hear them. Solutions may not be what they are looking for. Rephrase what you have heard to let them know that you are simply listening, and try to empathise. If you are not able to fully understand, that’s ok too – they may just need to let their feelings out. Don’t minimise what they feel either – they may be fearful, angry, or sad, and dismissing their emotions will not help them feel better.

8. Do ask the right questions.

Especially where suicidal tendencies are concerned, helpful questions include the following:

  • Do you have constant thoughts of suicide?
  • Do you have a plan on how to commit suicide? Can you describe it to some level of detail?
  • Do you have a timeline by which you wish to commit suicide?

If the answer to the above questions is a yes, you may need to seek help on behalf of the person, or monitor the sufferer closely.

If suicidal tendencies are not an issue, at the least, the right questions will be helpful. If a sufferer is sharing something with you, ask them how they feel about critical events, or about certain people that they mention. Allowing them to share their feelings that they are not aware of, may help to unlock the pain that is hiding inside them, and help to release some of the suffering.

9. Do be aware of, or find out about avenues for help.

For suicidal cases, call the Samaritans of Singapore at 1800-221 4444. Alternatively, IMH has a 24 hour helpline at 6389 2222. Both numbers are manned by trained counsellors, 24 by 7. You can get important advice from these helplines. In case of severe emergencies only, such as really imminent danger to someone’s life, consider calling the police at 999. Please note that this should be only in a case of imminent crisis.

10. Do give specific advice, at very specific moments.

When you are sure that someone can benefit from very specific advice, after listening to them, and when you judge that a person is able to absorb what you have to say, your expertise may be very helpful. Examples include breathing exercises if someone is breathing very hard, avenues for help such as the phone numbers above, or if you are really sure that what you are advising may be something that the sufferer has not considered, based on what you have heard. Sensitivity and tact are very important at this point.

11. Seek help yourself.

If you are a caregiver, who has extended periods of having to care for someone with a mental disorder such as depression, ensure that you are cared for. Practise good self care, and seek help from counsellors if you feel the need, especially if you are in contact with the therapist or doctor that the sufferer is seeing. You can have them refer you to the help you will need.

12. The sufferer’s life is not your responsibility.

This point is especially important if you have witnessed, or know someone who has committed suicide.

A sufferer’s life is not your responsibility.

Depression and other such mood disorders makes sufferers think differently than they normally do. No matter how they are helped, or surrounded by love, because of the condition, there remains a chance that they see nothing but the pain and death surrounding them. Thus when they take that final step, no one on this world can stop them.

Mental illnesses are difficult to treat because they are not visible from the outside. No one can fully explain, understand or predict how the brain works. Thus if a sufferer is determined to end their lives, it is not your responsibility that they have done so.

As long as you have tried your best for them, that is the limit that you can do. If you suffer because you keep wondering whether you could have done more, please seek help. You do not need to suffer this alone either. Don’t blame yourself.

In my case, for example, if I hadn’t been admitted to IMH, my wife could never have known or been able to stop me.

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