​I met Gwen (not her real name) when she visited the polyclinic almost every other month for the past one year, for body aches and headaches.

She has seen many doctors and was even referred to specialists. However, her body aches and headaches persisted.

Gwen is in her mid-50s, single and the sole caregiver to her elderly mother - a cancer survivor who has dementia.

During our first counselling session, Gwen presented herself as a person with extroverted personality traits - happy, cheerful, positive and bubbly. After we built up rapport over a few sessions, her mask came off and I discovered that behind her hearty laughter was worthlessness, shame, helplessness, loneliness and emotional pain.

Peeling away the layers of her anguish, Gwen shared in a mix of Mandarin and Hokkien about the challenges of being the sole caregiver to her mother, who requires close supervision in most of her activities of daily living.

Gwen would feel anxious during bedtime as she is constantly worried that she would be too deep in sleep to respond to her mother’s sudden call for help. Gwen’s sleep is often interrupted as she would wake up to check on her mother a few times throughout the night.

Gwen’s five siblings are married and live elsewhere. Being the only single among her siblings, she has taken on the duty of caring for their mother.

She has made multiple attempts to ask her siblings to share the caregiving responsibility.

However, they would cite work and family commitments as reasons for not being able to help.

Besides feeling disappointed with her siblings, Gwen confessed that she felt angry, helpless and bitter. She also felt resentful, especially when her mother repeatedly asked for her favourite son, who hardly visits.

Going deeper into her emotional pain, she shared that she is constantly burdened by her financial situation after leaving her job in 2020 to be a full-time caregiver. As her siblings do not chip in financially, Gwen has to tap her savings and government caregiver support schemes to survive. She agonises over how she would be able to provide for herself when she becomes old.

Gwen has tried looking for a part-time job that allows her to continue to care for her mother, but was unable to get one due to skills mismatch and the current economic climate. Although financial assistance schemes are available, she said she felt shameful in having to ask for financial help. She even described herself as “a failure” for needing to ask for help in meeting basic needs.

After failing to get a job despite a year’s search, Gwen started to believe that she has become less useful to her mother and society. She has occasional thoughts that the world would be better off without her, but the thought of leaving her mother to her unsupportive siblings pushes her to carry on living.

Gwen said she used to meet up with friends on weekends to chat over a meal. When she was employed, she enjoyed the companionship of her colleagues and the exchanging of tabloid gossip during lunch breaks. With her current caregiving responsibility, she has limited time for herself and friends. She admitted that declining invitations and cutting off social activities could keep her expenses to a minimum.

To cope with her situation, Gwen started to seek comfort from food, which serves as a treat after a day of hard work. The excessive eating eventually had a negative impact on her health, causing her to suffer from diabetes and hyperlipidemia.

Over the past few months of working with Gwen, I found that she has become more comfortable in sharing her feelings and exposing a softer side of herself. Our conversations allowed her to be vulnerable and to tune into her emotions.

By acknowledging and accepting her feelings, she was able to have a good cry while talking things through and felt more comfortable seeking help. She no longer sees seeking help as a form of weakness, but accepts that everyone would require help at different points of their lives. Gwen is currently working on keeping her chronic conditions in control and setting realistic goals in her care-giving journey.

Depression often comes with initial signs. Spotting early signs among our loved ones can prevent them from spiraling into misery.

Here are some initial signs of depression, but be mindful that having these symptoms do not represent a definite diagnosis. It is recommended to seek professional help if you or someone you know has been experiencing more than one of the following signs for more than two weeks:
• Feeling sad, lonely or hopeless
• Loss of pleasure in favourite activities or hobbies
• Difficulty falling or staying asleep, or sleeping too much
• Loss of appetite or overeating
• Low energy, fatigue or restlessness
• Loss of concentration or indecisiveness
• Feeling bad about yourself or that you are a failure
• Unexplained physical symptoms such as digestive issues or persistent headaches
• Recurrent thoughts of death, suicide with or without a specific plan

It is essential for people to understand that depression is never a sign of weakness. It is a condition that is treatable with appropriate support. Do encourage the person to seek appropriate professional help from healthcare workers like psychiatrists, psychologists, social workers and counsellors.

Other helplines available:-
• Samaritans of Singapore: 1800-221-4444
• National Care Hotline: 1800-202-6868
• IMH Mental Health Helpline: 6389-2222
• Silver Ribbon Singapore: 6385-3714
• Singapore Association for Mental Health: 1800-283-7019

Source: The Straits Times, Singapore Press Holdings Limited. Reproduced with permission.